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Vreijling SR, Neuhaus L, Brouwer A, Penninx BWJH, Beekman ATF, Lamers F, Jansen R, Bremmer M. The role of immuno-metabolic depression features in the effects of light therapy in patients with depression and type 2 diabetes mellitus: A randomized controlled trial. J Psychosom Res 2024; 181:111671. [PMID: 38657564 DOI: 10.1016/j.jpsychores.2024.111671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/22/2024] [Accepted: 04/13/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Immuno-metabolic depression (IMD) is proposed to be a form of depression encompassing atypical, energy-related symptoms (AES), low-grade inflammation and metabolic dysregulations. Light therapy may alleviate AES by modulating inflammatory and metabolic pathways. We investigated whether light therapy improves clinical and biological IMD features and whether effects of light therapy on AES or depressive symptom severity are moderated by baseline IMD features. Associations between changes in symptoms and biomarkers were explored. METHODS In secondary analyses, clinical trial data was used from 77 individuals with depression and type 2 diabetes mellitus (T2DM) randomized to four weeks of light therapy or placebo. AES severity and depressive symptom severity were based on the Inventory of Depressive Symptomatology. Biomarkers included 73 metabolites (Nightingale) summarized in three principal components and CRP, IL-6, TNF-α, INF-γ. Linear regression analyses were performed. RESULTS Light therapy had no effect on AES severity, inflammatory markers and metabolite principle components versus placebo. None of these baseline features moderated the effects of light therapy on AES severity. Only a principle component reflecting metabolites implicated in glucose homeostasis moderated the effects of light therapy on depressive symptom severity (βinteraction = 0.65, P = 0.001, FDR = 0.003). Changes in AES were not associated with changes in biomarkers. CONCLUSION Findings do not support the efficacy of light therapy in reducing IMD features in patients with depression and T2DM. We find limited evidence that light therapy is a more beneficial depression treatment among those with more IMD features. Changes in clinical and biological IMD features did not align over four-weeks' time. TRIAL REGISTRATION The Netherlands Trial Register (NTR) NTR4942.
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Affiliation(s)
- Sarah R Vreijling
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
| | - Layla Neuhaus
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands
| | - Annelies Brouwer
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands
| | - Femke Lamers
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
| | - Rick Jansen
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands
| | - Marijke Bremmer
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands; Amsterdam Public Health, Aging & Later Life Program, Amsterdam, the Netherlands
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Elliott JE, Brewer JS, Keil AT, Ligman BR, Bryant-Ekstrand MD, McBride AA, Powers K, Sicard SJ, Twamley EW, O’Neil ME, Hildebrand AD, Nguyen T, Morasco BJ, Gill JM, Dengler BA, Lim MM. Feasibility and acceptability for LION, a fully remote, randomized clinical trial within the VA for light therapy to improve sleep in Veterans with and without TBI: An MTBI 2 sponsored protocol: LION: A remote RCT protocol within VA. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.30.24308195. [PMID: 38853958 PMCID: PMC11160858 DOI: 10.1101/2024.05.30.24308195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Sleep-wake disturbances frequently present in Veterans with mild traumatic brain injury (mTBI). These TBI-related sleep impairments confer significant burden and commonly exacerbate other functional impairments. Therapies to improve sleep following mTBI are limited and studies in Veterans are even more scarce. In our previous pilot work, morning bright light therapy (MBLT) was found to be a feasible behavioral sleep intervention in Veterans with a history of mTBI; however, this was single-arm, open-label, and non-randomized, and therefore was not intended to establish efficacy. The present study, LION (light vs ion therapy) extends this preliminary work as a fully powered, sham-controlled, participant-masked randomized controlled trial (NCT03968874), implemented as fully remote within the VA (target n=120 complete). Randomization at 2:1 allocation ratio to: 1) active: MBLT (n=80), and 2) sham: deactivated negative ion generator (n=40); each with identical engagement parameters (60-min duration; within 2-hrs of waking; daily over 28-day duration). Participant masking via deception balanced expectancy assumptions across arms. Outcome measures were assessed following a 14-day baseline (pre-intervention), following 28-days of device engagement (post-intervention), and 28-days after the post-intervention assessment (follow-up). Primary outcomes were sleep measures, including continuous wrist-based actigraphy, self-report, and daily sleep dairy entries. Secondary/exploratory outcomes included cognition, mood, quality of life, circadian rhythm via dim light melatonin onset, and biofluid-based biomarkers. Participant drop out occurred in <10% of those enrolled, incomplete/missing data was present in <15% of key outcome variables, and overall fidelity adherence to the intervention was >85%, collectively establishing feasibility and acceptability for MBLT in Veterans with mTBI.
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Affiliation(s)
- Jonathan E. Elliott
- VA Portland Health Care System, Portland, OR, USA
- Oregon Health & Science University, Department of Neurology, Portland, OR, USA
- Military Traumatic Brain Injury Initiative (MTBI), Bethesda, MD, USA
- VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
| | | | | | | | | | | | | | | | - Elizabeth W. Twamley
- VA San Diego Health Care System, Research Service; Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Maya E. O’Neil
- VA Portland Health Care System, Portland, OR, USA
- VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Oregon Health & Science University, Medical Informatics and Clinical Epidemiology, Portland, OR, USA
- Oregon Health & Science University, Department of Psychiatry, Portland, OR, USA
| | - Andrea D. Hildebrand
- Oregon Health & Science University – Portland State University, School of Public Health, Biostatistics & Design Program, Portland, OR, USA
| | - Thuan Nguyen
- Oregon Health & Science University – Portland State University, School of Public Health, Biostatistics & Design Program, Portland, OR, USA
| | - Benjamin J. Morasco
- VA Portland Health Care System, Portland, OR, USA
- VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Oregon Health & Science University, Department of Psychiatry, Portland, OR, USA
| | - Jessica M. Gill
- John’s Hopkins University, School of Nursing, Baltimore, MD, USA
| | | | - Miranda M. Lim
- VA Portland Health Care System, Portland, OR, USA
- Oregon Health & Science University, Department of Neurology, Portland, OR, USA
- Military Traumatic Brain Injury Initiative (MTBI), Bethesda, MD, USA
- VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
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3
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Chrono-Nutrition: Circadian Rhythm and Personalized Nutrition. Int J Mol Sci 2023; 24:ijms24032571. [PMID: 36768893 PMCID: PMC9916946 DOI: 10.3390/ijms24032571] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
The human circadian system has a period of approximately 24 h and studies on the consequences of "chornodisruption" have greatly expanded. Lifestyle and environmental factors of modern societies (i.e., artificial lighting, jetlag, shift work, and around-the-clock access to energy-dense food) can induce disruptions of the circadian system and thereby adversely affect individual health. Growing evidence demonstrates a complex reciprocal relationship between metabolism and the circadian system, in which perturbations in one system affect the other one. From a nutritional genomics perspective, genetic variants in clock genes can both influence metabolic health and modify the individual response to diet. Moreover, an interplay between the circadian rhythm, gut microbiome, and epigenome has been demonstrated, with the diet in turn able to modulate this complex link suggesting a remarkable plasticity of the underlying mechanisms. In this view, the study of the impact of the timing of eating by matching elements from nutritional research with chrono-biology, that is, chrono-nutrition, could have significant implications for personalized nutrition in terms of reducing the prevalence and burden of chronic diseases. This review provides an overview of the current evidence on the interactions between the circadian system and nutrition, highlighting how this link could in turn influence the epigenome and microbiome. In addition, possible nutritional strategies to manage circadian-aligned feeding are suggested.
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The Circadian Axis and Cardiometabolic Syndrome. JOURNAL OF INTERDISCIPLINARY MEDICINE 2022. [DOI: 10.2478/jim-2022-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Abstract
Circadian rhythm refers to the daily physiologically fluctuating patterns of systemic processes that occur within a circa 24-hour timeframe, independently of external factors. There is evidence that in time, external and internal cycle misalignment leads to severe health consequences, resulting in the development of cardiometabolic disturbances. Desynchronized hormonal fluctuations along with daily specific macronutrient utilization patterns are also discussed, which by consequence, are all predictors of metabolic syndrome. The aim of this paper is to provide insight on the circadian clock’s organization throughout the human body and to explain the underlying genetic background. By understanding these well-established molecular mechanisms and processes, we believe this paper will provide accuracy regarding the importance of the circadian clock’s integrity and will highlight its role in the etiopathology of cardiometabolic syndrome.
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Brouwer A, van Raalte DH, Lamers F, Rutters F, Elders PJM, Van Someren EJW, Snoek FJ, Beekman ATF, Bremmer MA. Insulin resistance as a marker for the immune-metabolic subtype of depression. J Affect Disord 2021; 295:1371-1376. [PMID: 34565592 DOI: 10.1016/j.jad.2021.08.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/14/2021] [Accepted: 08/27/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Insulin resistance (IR), a marker of metabolic dysregulation and pro-inflammatory state, moderates the antidepressant treatment effect in patients with type 2 diabetes (T2D) and is therefore a potential marker for personalized treatment. Based on data from a light therapy trial (NTR4942), we aimed to evaluate whether 1) depression symptoms differ according to the level of IR, and 2) improvement of specific depression symptoms drive the positive effects of light therapy in those with higher IR. METHODS This secondary analysis in 59 individuals with depression and T2D explored differences in depressive symptom profile (30-item Inventory of Depressive Symptomatology (IDS)) at baseline and in response to light therapy (versus placebo), between lower and higher IR individuals, using Likelihood Ratio tests and Linear-by-linear association. IR was measured using the gold standard, a hyperinsulinemic-euglycaemic clamp. RESULTS At baseline, higher IR individuals reported more symptoms of irritability (p=0.024) anhedonia (no interest in people and activities: p=0.011; absence of pleasure and enjoyment: p=0.021), fatigue (fatigue: p=0.036; physical fatigue: p=0.035) and hypersomnia (p=0.029) relative to persons with lower IR, who reported more insomnia (nightly awakening: p=0.041; early morning awakening: p=0.012). Light therapy led to an improvement across IDS symptoms in higher IR individuals, while in lower IR individuals, light therapy improved early morning awakening (p=0.005) and interest in people and activities (p=0.015), but worsened mood (feeling sad: p=0.001; feeling irritable: p=0.002; interpersonal sensitivity: p=0.014). CONCLUSIONS Results add to the hypothesis of an immune-metabolic subtype of depression, and suggest that IR might be a promising focus for precision medicine.
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Affiliation(s)
- Annelies Brouwer
- Amsterdam UMC and GGZ inGeest, Dept. of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, De Boelelaan 1117, 1081 HV, Postbus, 7075, 1007 MB, Amsterdam, the Netherlands.
| | - Daniël H van Raalte
- Amsterdam UMC, Dept. of Internal Medicine, Diabetes Center, Vrije Universiteit, Amsterdam, the Netherlands
| | - Femke Lamers
- Amsterdam UMC and GGZ inGeest, Dept. of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, De Boelelaan 1117, 1081 HV, Postbus, 7075, 1007 MB, Amsterdam, the Netherlands
| | - Femke Rutters
- Amsterdam UMC, Dept. of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Petra J M Elders
- Amsterdam UMC, Dept. of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Eus J W Van Someren
- Amsterdam UMC and GGZ inGeest, Dept. of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, De Boelelaan 1117, 1081 HV, Postbus, 7075, 1007 MB, Amsterdam, the Netherlands; Dept. of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, the Netherlands; Amsterdam UMC, Dept. of Integrative Neurophysiology, Centre for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, Vrije Universiteit, Amsterdam, the Netherlands
| | - Frank J Snoek
- Amsterdam UMC, Dept. of Medical Psychology, Amsterdam Public Health research institute, Vrije Universiteit and University of Amsterdam, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Amsterdam UMC and GGZ inGeest, Dept. of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, De Boelelaan 1117, 1081 HV, Postbus, 7075, 1007 MB, Amsterdam, the Netherlands
| | - Marijke A Bremmer
- Amsterdam UMC and GGZ inGeest, Dept. of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, De Boelelaan 1117, 1081 HV, Postbus, 7075, 1007 MB, Amsterdam, the Netherlands
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Abstract
Circadian clocks are biological timing mechanisms that generate 24-h rhythms of physiology and behavior, exemplified by cycles of sleep/wake, hormone release, and metabolism. The adaptive value of clocks is evident when internal body clocks and daily environmental cycles are mismatched, such as in the case of shift work and jet lag or even mistimed eating, all of which are associated with physiological disruption and disease. Studies with animal and human models have also unraveled an important role of functional circadian clocks in modulating cellular and organismal responses to physiological cues (ex., food intake, exercise), pathological insults (e.g. virus and parasite infections), and medical interventions (e.g. medication). With growing knowledge of the molecular and cellular mechanisms underlying circadian physiology and pathophysiology, it is becoming possible to target circadian rhythms for disease prevention and treatment. In this review, we discuss recent advances in circadian research and the potential for therapeutic applications that take patient circadian rhythms into account in treating disease.
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Affiliation(s)
- Yool Lee
- Department of Translational Medicine and Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | - Jeffrey M. Field
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Amita Sehgal
- Howard Hughes Medical Institute, Chronobiology and Sleep Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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7
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Kronfeld-Schor N, Stevenson TJ, Nickbakhsh S, Schernhammer ES, Dopico XC, Dayan T, Martinez M, Helm B. Drivers of Infectious Disease Seasonality: Potential Implications for COVID-19. J Biol Rhythms 2021; 36:35-54. [PMID: 33491541 PMCID: PMC7924107 DOI: 10.1177/0748730420987322] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Not 1 year has passed since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19). Since its emergence, great uncertainty has surrounded the potential for COVID-19 to establish as a seasonally recurrent disease. Many infectious diseases, including endemic human coronaviruses, vary across the year. They show a wide range of seasonal waveforms, timing (phase), and amplitudes, which differ depending on the geographical region. Drivers of such patterns are predominantly studied from an epidemiological perspective with a focus on weather and behavior, but complementary insights emerge from physiological studies of seasonality in animals, including humans. Thus, we take a multidisciplinary approach to integrate knowledge from usually distinct fields. First, we review epidemiological evidence of environmental and behavioral drivers of infectious disease seasonality. Subsequently, we take a chronobiological perspective and discuss within-host changes that may affect susceptibility, morbidity, and mortality from infectious diseases. Based on photoperiodic, circannual, and comparative human data, we not only identify promising future avenues but also highlight the need for further studies in animal models. Our preliminary assessment is that host immune seasonality warrants evaluation alongside weather and human behavior as factors that may contribute to COVID-19 seasonality, and that the relative importance of these drivers requires further investigation. A major challenge to predicting seasonality of infectious diseases are rapid, human-induced changes in the hitherto predictable seasonality of our planet, whose influence we review in a final outlook section. We conclude that a proactive multidisciplinary approach is warranted to predict, mitigate, and prevent seasonal infectious diseases in our complex, changing human-earth system.
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Affiliation(s)
| | - T. J. Stevenson
- Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, UK
| | - S. Nickbakhsh
- Institute of Infection, Immunity & Inflammation, MRC-University of Glasgow Centre for Virus Research, University of Glasgow, Glasgow, UK
| | - E. S. Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Channing Division of Network Medicine, Harvard Medical School, Boston, MA, USA
| | - X. C. Dopico
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - T. Dayan
- School of Zoology, The Steinhardt Museum of Natural History, Tel Aviv University, Tel Aviv, Israel
| | - M. Martinez
- School of Public Health, Columbia University, New York City, NY, USA
| | - B. Helm
- Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, UK
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, The Netherlands
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Bishehsari F, Voigt RM, Keshavarzian A. Circadian rhythms and the gut microbiota: from the metabolic syndrome to cancer. Nat Rev Endocrinol 2020; 16:731-739. [PMID: 33106657 PMCID: PMC8085809 DOI: 10.1038/s41574-020-00427-4] [Citation(s) in RCA: 135] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2020] [Indexed: 12/13/2022]
Abstract
The metabolic syndrome is prevalent in developed nations and accounts for the largest burden of non-communicable diseases worldwide. The metabolic syndrome has direct effects on health and increases the risk of developing cancer. Lifestyle factors that are known to promote the metabolic syndrome generally cause pro-inflammatory alterations in microbiota communities in the intestine. Indeed, alterations to the structure and function of intestinal microbiota are sufficient to promote the metabolic syndrome, inflammation and cancer. Among the lifestyle factors that are associated with the metabolic syndrome, disruption of the circadian system, known as circadian dysrhythmia, is increasingly common. Disruption of the circadian system can alter microbiome communities and can perturb host metabolism, energy homeostasis and inflammatory pathways, which leads to the metabolic syndrome. This Perspective discusses the role of intestinal microbiota and microbial metabolites in mediating the effects of disruption of circadian rhythms on human health.
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Affiliation(s)
- Faraz Bishehsari
- Department of Internal Medicine, Division of Gastroenterology, Rush University Medical Center, Chicago, IL, USA
| | - Robin M Voigt
- Department of Internal Medicine, Division of Gastroenterology, Rush University Medical Center, Chicago, IL, USA
| | - Ali Keshavarzian
- Department of Internal Medicine, Division of Gastroenterology, Rush University Medical Center, Chicago, IL, USA.
- Department of Physiology, Rush University Medical Center, Chicago, IL, USA.
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands.
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9
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Eveleens Maarse BC, Loh NY, Karpe F, Rosendaal FR, van Heemst D, Mook-Kanamori DO, Willems van Dijk K, Rensen PCN, Kooijman S, Christodoulides C, Noordam R. Associations between outdoor temperature and bright sunlight with metabolites in two population-based European cohorts. Nutr Metab Cardiovasc Dis 2020; 30:2252-2261. [PMID: 32912789 DOI: 10.1016/j.numecd.2020.07.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 07/19/2020] [Accepted: 07/20/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND AIMS Outdoor temperature and bright sunlight may directly and/or indirectly modulate systemic metabolism. We assessed the associations between outdoor temperature and bright sunlight duration with metabolomics. METHODS AND RESULTS Cross-sectional analyses were undertaken in non-diabetic individuals from the Oxford BioBank (OBB; N = 6368; mean age 47.0 years, males 44%) and the Netherlands Epidemiology of Obesity (NEO; N = 5916; mean age 55.6 years, males 43%) study. Data on mean outdoor bright sunlight and temperature were collected from local weather stations in the week prior to blood sampling. Fasting serum levels of 148 metabolites, including 14 lipoprotein subclasses, were measured using NMR spectroscopy. Linear regression analyses were performed to assess the associations between mean outdoor temperature and bright sunlight duration with metabolomics adjusted for age, sex, body mass index, season and either outdoor temperature or bright sunlight. A higher mean outdoor temperature was associated with increased serum concentrations of lipoprotein (sub)particles (β (SE) = 0.064 (0.018) SD per 5 °C, p = 5.03e-4) and certain amino acids such as phenylalanine (0.066 (0.016) SD, p = 6.44e-05) and leucine (0.111 (0.018) SD, p = 1.25e-09). In contrast, longer duration of bright sunlight was specifically associated with lower concentrations of very low-density lipoprotein (sub)particles (e.g., VLDL cholesterol (-0.024 (0.005) SD per 1-h bright sunlight, p = 8.06e-6)). The direction of effects was generally consistent between the OBB and NEO, although effect sizes were generally larger in the OBB. CONCLUSIONS Increased bright sunlight duration is associated with an improved metabolic profile whilst higher outdoor temperature may adversely impact cardiometabolic health.
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Affiliation(s)
- Boukje C Eveleens Maarse
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
| | - Nellie Y Loh
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, OUH Foundation Trust, Oxford, UK
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Diana van Heemst
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Dennis O Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ko Willems van Dijk
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands; Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Patrick C N Rensen
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
| | - Sander Kooijman
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands; Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Constantinos Christodoulides
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
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Beneficial effects of daytime high-intensity light exposure on daily rhythms, metabolic state and affect. Sci Rep 2020; 10:19782. [PMID: 33188227 PMCID: PMC7666121 DOI: 10.1038/s41598-020-76636-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 10/27/2020] [Indexed: 12/13/2022] Open
Abstract
While the importance of the circadian system to health and well-being is extensively studied, the role of daylight exposure in these interactions is relatively poorly understood. Here we show, using a diurnal animal model naturally exposed to daylight, that daily morning exposure to 3000 lux, full spectrum electric light has beneficial health effects. Compared with controls, sand rats (Psammomys obesus) subjected to morning light treatment demonstrate daily rhythms with high peak to trough difference in activity, blood glucose levels and per2 gene expression in the suprachiasmatic nucleus, pre-frontal cortex, kidney and liver. The treated animals were also healthier, being normoglycemic, having higher glucose tolerance, lower body and heart weight and lower anxiety- and depression-like behavior. Our results suggest that exposure to high intensity light is important for the proper function of the circadian system and well-being, and are important in face of human's low exposure to daylight and extensive use of artificial light at night.
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Scott J, Langsrud K, Vethe D, Kjørstad K, Vestergaard CL, Faaland P, Lydersen S, Vaaler A, Morken G, Torgersen T, Kallestad H. A pragmatic effectiveness randomized controlled trial of the duration of psychiatric hospitalization in a trans-diagnostic sample of patients with acute mental illness admitted to a ward with either blue-depleted evening lighting or normal lighting conditions. Trials 2019; 20:472. [PMID: 31370871 PMCID: PMC6676579 DOI: 10.1186/s13063-019-3582-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 07/16/2019] [Indexed: 12/13/2022] Open
Abstract
Background There is increasing recognition of the need to stabilize sleep-wake cycles in individuals with major mental disorders. As such, clinicians and researchers advocate the use of interventions targeted at sleep and circadian dysrhythmias as an adjunct to the standard treatments offered for acute illness episodes of a broad range of diagnoses. To determine the trans-diagnostic generalizability of chronotherapy, we explore the benefits of admitting individuals with an acute illness episode to a psychiatric inpatient unit where changes in light exposure are integrated into the therapeutic environment. Methods/design A two-arm, pragmatic effectiveness, randomized controlled treatment trial, where individuals admitted for acute inpatient psychiatric care will be allocated to a ward with blue-depleted evening light or to a ward with the same layout and facilities but lacking the new lighting technology. The trial will test whether the experimental lighting conditions offer any additional benefits beyond those associated with usual treatment in an acute psychiatric inpatient unit. The main objectives are to examine any differences between groups in the mean duration of hospitalization in days. Additional analyses will compare group differences in symptoms, functioning, medication usage, and side effects and whether length of stay is associated with stability of sleep-wake cycles and circadian rhythms. Ancillary investigations should determine any benefits according to diagnostic subgroups and potential drawbacks such as any adverse effects on the well-being of professionals working across both wards. Discussion This unit offers a unique opportunity to explore how exposure to different lighting conditions may modify sleep-wake cycles and how any changes in sleep-wake cycle may impact on the clinical and functional outcomes of individuals experiencing an acute episode of a severe mental disorder that requires inpatient care. The findings could influence the future design of hospital units offering care to patients with mental or physical disorders. Trial registration ClinicalTrials.gov, ID: NCT03788993. Retrospectively registered on 28 December 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3582-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jan Scott
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Knut Langsrud
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway
| | - Daniel Vethe
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway
| | - Kaia Kjørstad
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway
| | - Cecilie L Vestergaard
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway
| | - Patrick Faaland
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway
| | - Stian Lydersen
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Arne Vaaler
- Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway
| | - Gunnar Morken
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway
| | - Terje Torgersen
- Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway
| | - Håvard Kallestad
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway. .,Division of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway. .,Department of Research and Development, St. Olavs University Hospital, PO Box 3250, Sluppen, 7006, Trondheim, Norway.
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12
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Zimmet P, Alberti KGMM, Stern N, Bilu C, El‐Osta A, Einat H, Kronfeld‐Schor N. The Circadian Syndrome: is the Metabolic Syndrome and much more! J Intern Med 2019; 286:181-191. [PMID: 31081577 PMCID: PMC6851668 DOI: 10.1111/joim.12924] [Citation(s) in RCA: 158] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The Metabolic Syndrome is a cluster of cardio-metabolic risk factors and comorbidities conveying high risk of both cardiovascular disease and type 2 diabetes. It is responsible for huge socio-economic costs with its resulting morbidity and mortality in most countries. The underlying aetiology of this clustering has been the subject of much debate. More recently, significant interest has focussed on the involvement of the circadian system, a major regulator of almost every aspect of human health and metabolism. The Circadian Syndrome has now been implicated in several chronic diseases including type 2 diabetes and cardiovascular disease. There is now increasing evidence connecting disturbances in circadian rhythm with not only the key components of the Metabolic Syndrome but also its main comorbidities including sleep disturbances, depression, steatohepatitis and cognitive dysfunction. Based on this, we now propose that circadian disruption may be an important underlying aetiological factor for the Metabolic Syndrome and we suggest that it be renamed the 'Circadian Syndrome'. With the increased recognition of the 'Circadian Syndrome', circadian medicine, through the timing of exercise, light exposure, food consumption, dispensing of medications and sleep, is likely to play a much greater role in the maintenance of both individual and population health in the future.
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Affiliation(s)
- P. Zimmet
- Department of DiabetesCentral Clinical SchoolMonash UniversityMelbourneVic.Australia
- Sagol Center for Epigenetics and MetabolismTel Aviv Medical CenterTel AvivIsrael
| | | | - N. Stern
- Sagol Center for Epigenetics and MetabolismTel Aviv Medical CenterTel AvivIsrael
| | - C. Bilu
- School of ZoologyTel Aviv UniversityTel AvivIsrael
| | - A. El‐Osta
- Department of DiabetesCentral Clinical SchoolMonash UniversityMelbourneVic.Australia
- Department of PathologyThe University of MelbourneParkvilleVic.Australia
- Hong Kong Institute of Diabetes and ObesityPrince of Wales HospitalThe Chinese University of Hong KongHong Kong SARChina
| | - H. Einat
- School of Behavioral SciencesTel Aviv‐Yaffo Academic CollegeTel AvivIsrael
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13
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Noordam R, Ramkisoensing A, Loh NY, Neville MJ, Rosendaal FR, Willems van Dijk K, van Heemst D, Karpe F, Christodoulides C, Kooijman S. Associations of Outdoor Temperature, Bright Sunlight, and Cardiometabolic Traits in Two European Population-Based Cohorts. J Clin Endocrinol Metab 2019; 104:2903-2910. [PMID: 30759251 PMCID: PMC6543772 DOI: 10.1210/jc.2018-02532] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 02/07/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT Seasonal variation in cold and light exposure may influence metabolic health. OBJECTIVE We assessed the associations of bright sunlight and outdoor temperature with measures of glucose and lipid metabolism in two populations of middle-aged European subjects. DESIGN Cross-sectional study. SETTING Two population-based European cohorts. PARTICIPANTS Middle-aged nondiabetic subjects from the Oxford Biobank (OBB; N = 4327; mean age, 41.4 years) and the Netherlands Epidemiology of Obesity (NEO) study (N = 5899; mean age, 55.6 years). INTERVENTIONS Data on outdoor bright sunlight and temperature collected from local weather stations. MAIN OUTCOME MEASURES Insulin resistance and fasting lipid levels. Multivariable regression analyses were adjusted for age, sex, percentage body fat, season, and either outdoor temperature or bright sunlight. RESULTS In the OBB cohort, increased bright sunlight exposure was associated with lower fasting insulin [-1.27% (95% CI, -2.09 to -0.47%) per extra hour of bright sunlight], lower homeostatic model assessment for insulin resistance (-1.36%; 95% CI, -2.23 to -0.50), lower homeostatic model assessment for β-cell function (-0.80%; 95% CI, -1.31 to -0.30), and lower triglyceride (-1.28%; 95% CI, -2.07 to -0.50) levels. In the NEO cohort generally unidirectional but weaker associations were observed. No associations between outdoor temperature and measures of glucose or lipid metabolism were detected following adjustment for bright sunlight. CONCLUSIONS Bright sunlight, but not outdoor temperature, might be associated with increased insulin sensitivity and lower triglyceride levels.
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Affiliation(s)
- Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, Netherlands
| | - Ashna Ramkisoensing
- Department of Molecular Cell Biology, Division of Neurophysiology, Leiden University Medical Center, Leiden, Netherlands
| | - Nellie Y Loh
- Radcliffe Department of Medicine, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, United Kingdom
| | - Matt J Neville
- Radcliffe Department of Medicine, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research, Oxford Biomedical Research Centre, Oxford, United Kingdom
- Oxford University Hospitals Foundation Trust, Oxford, United Kingdom
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Ko Willems van Dijk
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
| | - Diana van Heemst
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, Netherlands
| | - Fredrik Karpe
- Radcliffe Department of Medicine, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research, Oxford Biomedical Research Centre, Oxford, United Kingdom
- Oxford University Hospitals Foundation Trust, Oxford, United Kingdom
| | - Constantinos Christodoulides
- Radcliffe Department of Medicine, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, United Kingdom
- Oxford University Hospitals Foundation Trust, Oxford, United Kingdom
- Correspondence and Reprint Requests: Constantinos Christodoulides, MD, PhD, Radcliffe Department of Medicine, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Churchill Hospital, Headington OX3 7LE, United Kingdom. E-mail:
| | - Sander Kooijman
- Radcliffe Department of Medicine, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, United Kingdom
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
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14
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Brouwer A, van Raalte DH, Nguyen HT, Rutters F, van de Ven PM, Elders PJM, Moll AC, Van Someren EJW, Snoek FJ, Beekman ATF, Bremmer MA. Effects of Light Therapy on Mood and Insulin Sensitivity in Patients With Type 2 Diabetes and Depression: Results From a Randomized Placebo-Controlled Trial. Diabetes Care 2019; 42:529-538. [PMID: 30796110 DOI: 10.2337/dc18-1732] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 01/19/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Depression is common in patients with type 2 diabetes and adversely affects quality of life and diabetes outcomes. We assessed whether light therapy, an antidepressant, improves mood and insulin sensitivity in patients with depression and type 2 diabetes. RESEARCH DESIGN AND METHODS This randomized, double-blind, placebo-controlled trial included 83 patients with depression and type 2 diabetes. The intervention comprised 4 weeks of light therapy (10,000 lux) or placebo light therapy daily at home. Primary outcomes included depressive symptoms (Inventory of Depressive Symptomatology [IDS]) and insulin sensitivity (M-value derived from the results of a hyperinsulinemic-euglycemic clamp). Secondary outcomes were related psychological and glucometabolic measures. RESULTS Intention-to-treat analysis showed that light therapy was not superior to placebo in reducing depressive symptoms (-3.9 IDS points [95% CI -9.0 to 1.2]; P = 0.248) and had no effect on insulin sensitivity (0.15 mg/kg*min [95% CI -0.41 to 0.70]; P = 0.608). Analyses incorporating only those participants who accurately adhered to the light therapy protocol (n = 51) provided similar results, but did suggest positive effects of light therapy on depression response rates (≥50% reduction in IDS points) (26% more response; P = 0.031). Prespecified analysis showed effect moderation by baseline insulin sensitivity (P = 0.009) and use of glucose-lowering medication (P = 0.023). Light therapy did not affect depressive symptoms in participants with higher insulin sensitivity or those who use only oral glucose-lowering medication or none at all, but it did produce a relevant effect in participants with lower insulin sensitivity (-12.9 IDS points [95% CI -21.6 to -4.2]; P = 0.017) and a trend toward effectiveness in those using insulin (-12.2 IDS points [95% CI -21.3 to -3.1]; P = 0.094). Light therapy was well tolerated. CONCLUSIONS Although this trial is essentially inconclusive, secondary analyses indicate that light therapy might be a promising treatment for depression among a subgroup of highly insulin-resistant individuals with type 2 diabetes.
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Affiliation(s)
- Annelies Brouwer
- Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Daniel H van Raalte
- Amsterdam UMC, Vrije Universiteit, Department of Internal Medicine, Diabetes Center, Amsterdam, the Netherlands
| | - Hoang-Ton Nguyen
- Amsterdam UMC, Vrije Universiteit, Department of Ophthalmology, Amsterdam, the Netherlands
| | - Femke Rutters
- Amsterdam UMC, Vrije Universiteit, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Peter M van de Ven
- Amsterdam UMC, Vrije Universiteit, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Petra J M Elders
- Amsterdam UMC, Vrije Universiteit, Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Annette C Moll
- Amsterdam UMC, Vrije Universiteit, Department of Ophthalmology, Amsterdam, the Netherlands
| | - Eus J W Van Someren
- Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands.,Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, the Netherlands.,Amsterdam UMC, Vrije Universiteit, Department of Integrative Neurophysiology, Centre for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Frank J Snoek
- Amsterdam UMC, Vrije Universiteit and University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Marijke A Bremmer
- Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands
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15
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Zhou TH, Dang WM, Ma YT, Hu CQ, Wang N, Zhang GY, Wang G, Shi C, Zhang H, Guo B, Zhou SZ, Feng L, Geng SX, Tong YZ, Tang GW, He ZK, Zhen L, Yu X. Clinical efficacy, onset time and safety of bright light therapy in acute bipolar depression as an adjunctive therapy: A randomized controlled trial. J Affect Disord 2018; 227:90-96. [PMID: 29053981 DOI: 10.1016/j.jad.2017.09.038] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 07/20/2017] [Accepted: 09/23/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Bright light therapy (BLT) is an effective treatment for seasonal affective disorder and non- seasonal depression. The efficacy of BLT in treating patients with bipolar disorder is still unknown. AIMS The aim of this study is to examine the efficacy, onset time and clinical safety of BLT in treating patients with acute bipolar depression as an adjunctive therapy (trial registration at ClinicalTrials.gov: NCT02009371). METHODS This was a multi-center, single blind, randomized clinical trial. Seventy-four participants were randomized in one of two treatment conditions: BLT and control (dim red light therapy, dRLT). Sixty-three participants completed the study (33 BLT, 30 dRLT). Light therapy lasted for two weeks, one hour every morning. All participants were required to complete several scales assessments at baseline, and at the end of weeks 1 and 2. The primary outcome measures were the clinical efficacy of BLT which was assessed by the reduction rate of HAMD-17 scores, and the onset time of BLT which was assessed by the reduction rate of QIDS-SR16 scores. The secondary outcome measures were rates of switch into hypomania or mania and adverse events. RESULTS 1) Clinical efficacy: BLT showed a greater ameliorative effect on bipolar depression than the control, with response rates of 78.19% vs. 43.33% respectively (p < 0.01). 2) Onset day: Median onset day was 4.33 days in BLT group. 3) BLT-emergent hypomania: No participants experienced symptoms of hypomania. 4) Side effects: No serious adverse events were reported. CONCLUSION BLT can be considered as an effective and safe adjunctive treatment for patients with acute bipolar depression.
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Affiliation(s)
- Tian-Hang Zhou
- Peking University Sixth Hospital, Peking University Institute of Mental Health, the Key Laboratory of the Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders, Beijing, China
| | - Wei-Min Dang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, the Key Laboratory of the Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders, Beijing, China
| | - Yan-Tao Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, the Key Laboratory of the Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders, Beijing, China
| | - Chang-Qing Hu
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University & China Clinical Research Center for Mental Disorders Center of Depression, Beijing Institute for Brain Disorders, Beijing, China
| | - Ning Wang
- Beijing Huilongguan Hospital, Peking University, Beijing, China
| | - Guo-Yi Zhang
- School of physics, Peking University, Beijing, China
| | - Gang Wang
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University & China Clinical Research Center for Mental Disorders Center of Depression, Beijing Institute for Brain Disorders, Beijing, China
| | - Chuan Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, the Key Laboratory of the Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders, Beijing, China
| | - Hua Zhang
- Peking University Third Hospital, Beijing, China
| | - Bin Guo
- Beijing Huilongguan Hospital, Peking University, Beijing, China
| | - Shu-Zhe Zhou
- Peking University Sixth Hospital, Peking University Institute of Mental Health, the Key Laboratory of the Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders, Beijing, China
| | - Lei Feng
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University & China Clinical Research Center for Mental Disorders Center of Depression, Beijing Institute for Brain Disorders, Beijing, China
| | - Shu-Xia Geng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, the Key Laboratory of the Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders, Beijing, China
| | - Yu-Zhen Tong
- School of physics, Peking University, Beijing, China
| | - Guan-Wen Tang
- Beijing Huilongguan Hospital, Peking University, Beijing, China
| | - Zhong-Kai He
- School of physics, Peking University, Beijing, China
| | - Long Zhen
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University & China Clinical Research Center for Mental Disorders Center of Depression, Beijing Institute for Brain Disorders, Beijing, China
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, the Key Laboratory of the Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders, Beijing, China.
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16
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Brouwer A, Nguyen HT, Snoek FJ, van Raalte DH, Beekman ATF, Moll AC, Bremmer MA. Light therapy: is it safe for the eyes? Acta Psychiatr Scand 2017; 136:534-548. [PMID: 28891192 DOI: 10.1111/acps.12785] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/18/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Light therapy has become an increasingly popular treatment for depression and a range of other neuropsychiatric conditions. Yet, concerns have been raised about the ocular safety of light therapy. METHOD We conducted the first systematic review into the ocular safety of light therapy. A PubMed search on January 4, 2017, identified 6708 articles, of which 161 were full-text reviewed. In total, 43 articles reporting on ocular complaints and ocular examinations were included in the analyses. RESULTS Ocular complaints, including ocular discomfort and vision problems, were reported in about 0% to 45% of the participants of studies involving light therapy. Based on individual studies, no evident relationship between the occurrence of complaints and light therapy dose was found. There was no evidence for ocular damage due to light therapy, with the exception of one case report that documented the development of a maculopathy in a person treated with the photosensitizing antidepressant clomipramine. CONCLUSION Results suggest that light therapy is safe for the eyes in physically healthy, unmedicated persons. The ocular safety of light therapy in persons with preexisting ocular abnormalities or increased photosensitivity warrants further study. However, theoretical considerations do not substantiate stringent ocular safety-related contraindications for light therapy.
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Affiliation(s)
- A Brouwer
- Department of Psychiatry, Amsterdam Public Health research institute, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - H-T Nguyen
- Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands
| | - F J Snoek
- Departments of Medical Psychology, Amsterdam Public Health research institute, VU University Medical Center and Academic Medical Center, Amsterdam, The Netherlands
| | - D H van Raalte
- Diabetes Center, VU University Medical Center, Amsterdam, The Netherlands
| | - A T F Beekman
- Department of Psychiatry, Amsterdam Public Health research institute, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - A C Moll
- Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands
| | - M A Bremmer
- Department of Psychiatry, Amsterdam Public Health research institute, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands
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17
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Dimitrova TD, Reeves GM, Snitker S, Lapidus M, Sleemi AR, Balis TG, Manalai P, Tariq MM, Cabassa JA, Karim NN, Johnson MA, Langenberg P, Rohan KJ, Miller M, Stiller JW, Postolache TT. Prediction of outcome of bright light treatment in patients with seasonal affective disorder: Discarding the early response, confirming a higher atypical balance, and uncovering a higher body mass index at baseline as predictors of endpoint outcome. J Affect Disord 2017; 222:126-132. [PMID: 28692905 DOI: 10.1016/j.jad.2017.06.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 05/17/2017] [Accepted: 06/17/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND We tested the hypothesis that the early improvement in mood after the first hour of bright light treatment compared to control dim-red light would predict the outcome at six weeks of bright light treatment for depressed mood in patients with Seasonal Affective Disorder (SAD). We also analyzed the value of Body Mass Index (BMI) and atypical symptoms of depression at baseline in predicting treatment outcome. METHODS Seventy-eight adult participants were enrolled. The first treatment was controlled crossover, with randomized order, and included one hour of active bright light treatment and one hour of control dim-red light, with one-hour washout. Depression was measured on the Structured Interview Guide for the Hamilton Rating Scale for Depression-SAD version (SIGH-SAD). The predictive association of depression scores changes after the first session. BMI and atypical score balance with treatment outcomes at endpoint were assessed using multivariable linear and logistic regressions. RESULTS No significant prediction by changes in depression scores after the first session was found. However, higher atypical balance scores and BMI positively predicted treatment outcome. LIMITATIONS Absence of a control intervention for the six-weeks of treatment (only the first session in the laboratory was controlled). Exclusion of patients with comorbid substance abuse, suicidality and bipolar I disorder, and patients on antidepressant medications, reducing the generalizability of the study. CONCLUSION Prediction of outcome by early response to light treatment was not replicated, and the previously reported prediction of baseline atypical balance was confirmed. BMI, a parameter routinely calculated in primary care, was identified as a novel predictor, and calls for replication and then exploration of possible mediating mechanisms.
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Affiliation(s)
- Tzvetelina D Dimitrova
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Psychiatry Residency Training Program, St. Elizabeths Hospital, Washington, DC 20032, United States
| | - Gloria M Reeves
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Division of Child & Adolescent Psychiatry, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - Soren Snitker
- Division of Endocrinology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - Manana Lapidus
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - Aamar R Sleemi
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Psychiatry Residency Training Program, St. Elizabeths Hospital, Washington, DC 20032, United States
| | - Theodora G Balis
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - Partam Manalai
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Psychiatry Residency Training Program, St. Elizabeths Hospital, Washington, DC 20032, United States
| | - Muhammad M Tariq
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Psychiatry Residency Training Program, St. Elizabeths Hospital, Washington, DC 20032, United States
| | - Johanna A Cabassa
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - Naila N Karim
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Psychiatry Residency Training Program, St. Elizabeths Hospital, Washington, DC 20032, United States
| | - Mary A Johnson
- Department of Ophthalmology and Visual Science, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - Patricia Langenberg
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - Kelly J Rohan
- Department of Psychological Science, University of Vermont, Burlington, VT 05405-0134, United States
| | - Michael Miller
- Center for Preventive Cardiology, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - John W Stiller
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Psychiatry Residency Training Program, St. Elizabeths Hospital, Washington, DC 20032, United States; Department of Neurology, St. Elizabeths Hospital, Washington, DC 20032, United States
| | - Teodor T Postolache
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Rocky Mountain MIRECC, Denver, CO 80220, United States; VISN 5 MIRECC, Baltimore, MD 21201 United States.
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18
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Abstract
Use of artificial light resulted in relative independence from the natural light-dark (LD) cycle, allowing human subjects to shift the timing of food intake and work to convenient times. However, the increase in artificial light exposure parallels the increase in obesity prevalence. Light is the dominant Zeitgeber for the central circadian clock, which resides within the hypothalamic suprachiasmatic nucleus, and coordinates daily rhythm in feeding behaviour and metabolism. Eating during inappropriate light conditions may result in metabolic disease via changes in the biological clock. In this review, we describe the physiological role of light in the circadian timing system and explore the interaction between the circadian timing system and metabolism. Furthermore, we discuss the acute and chronic effects of artificial light exposure on food intake and energy metabolism in animals and human subjects. We propose that living in synchrony with the natural daily LD cycle promotes metabolic health and increased exposure to artificial light at inappropriate times of day has adverse effects on metabolism, feeding behaviour and body weight regulation. Reducing the negative side effects of the extensive use of artificial light in human subjects might be useful in the prevention of metabolic disease.
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