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Factors Associated With Response to Pilot Home-Based Light Therapy for Fatigue Following Traumatic Brain Injury and Stroke

Background: Fatigue and sleep disturbance are common and debilitating problems after brain injury. Light therapy shows promise as a potential treatment. We conducted a trial of in-home light therapy to alleviate fatigue and sleep disturbance. The aim of the current study was to identify factors mode...

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Autores principales: Connolly, Laura J., Rajaratnam, Shantha M. W., Spitz, Gershon, Lockley, Steven W., Ponsford, Jennie L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8319544/
https://www.ncbi.nlm.nih.gov/pubmed/34335435
http://dx.doi.org/10.3389/fneur.2021.651392
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author Connolly, Laura J.
Rajaratnam, Shantha M. W.
Spitz, Gershon
Lockley, Steven W.
Ponsford, Jennie L.
author_facet Connolly, Laura J.
Rajaratnam, Shantha M. W.
Spitz, Gershon
Lockley, Steven W.
Ponsford, Jennie L.
author_sort Connolly, Laura J.
collection PubMed
description Background: Fatigue and sleep disturbance are common and debilitating problems after brain injury. Light therapy shows promise as a potential treatment. We conducted a trial of in-home light therapy to alleviate fatigue and sleep disturbance. The aim of the current study was to identify factors moderating treatment response. Methods: Participants were 24 individuals with traumatic brain injury (TBI) (n = 19) or stroke (n = 5) reporting clinically significant fatigue. Outcomes included fatigue on Brief Fatigue Inventory (primary outcome), sleep disturbance on Pittsburgh Sleep Quality Index, reaction time (RT) on Psychomotor Vigilance Task and time spent in productive activity. Interactions of demographic and clinical variables with these outcomes were examined in linear mixed-model analyses. Results: Whilst there were no variables found to be significantly associated with change in our primary outcome of fatigue, some variables revealed medium or large effect sizes, including chronotype, eye color, injury severity as measured by PTA, and baseline depressive symptoms. Chronotype significantly moderated sleep quality, with evening chronotype being associated with greater improvement during treatment. Injury type significantly predicted mean RT, with stroke participants exhibiting greater post-treatment reduction than TBI. Age significantly predicted productive activity during Treatment, with younger participants showing stronger Treatment effect. Conclusion: Light therapy may have a greater impact on sleep in younger individuals and those with an evening chronotype. Older individuals may need higher treatment dose to achieve benefit. Clinical Trial Registration: www.anzctr.org.au, identifier: ACTRN12617000866303.
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spelling pubmed-83195442021-07-30 Factors Associated With Response to Pilot Home-Based Light Therapy for Fatigue Following Traumatic Brain Injury and Stroke Connolly, Laura J. Rajaratnam, Shantha M. W. Spitz, Gershon Lockley, Steven W. Ponsford, Jennie L. Front Neurol Neurology Background: Fatigue and sleep disturbance are common and debilitating problems after brain injury. Light therapy shows promise as a potential treatment. We conducted a trial of in-home light therapy to alleviate fatigue and sleep disturbance. The aim of the current study was to identify factors moderating treatment response. Methods: Participants were 24 individuals with traumatic brain injury (TBI) (n = 19) or stroke (n = 5) reporting clinically significant fatigue. Outcomes included fatigue on Brief Fatigue Inventory (primary outcome), sleep disturbance on Pittsburgh Sleep Quality Index, reaction time (RT) on Psychomotor Vigilance Task and time spent in productive activity. Interactions of demographic and clinical variables with these outcomes were examined in linear mixed-model analyses. Results: Whilst there were no variables found to be significantly associated with change in our primary outcome of fatigue, some variables revealed medium or large effect sizes, including chronotype, eye color, injury severity as measured by PTA, and baseline depressive symptoms. Chronotype significantly moderated sleep quality, with evening chronotype being associated with greater improvement during treatment. Injury type significantly predicted mean RT, with stroke participants exhibiting greater post-treatment reduction than TBI. Age significantly predicted productive activity during Treatment, with younger participants showing stronger Treatment effect. Conclusion: Light therapy may have a greater impact on sleep in younger individuals and those with an evening chronotype. Older individuals may need higher treatment dose to achieve benefit. Clinical Trial Registration: www.anzctr.org.au, identifier: ACTRN12617000866303. Frontiers Media S.A. 2021-07-15 /pmc/articles/PMC8319544/ /pubmed/34335435 http://dx.doi.org/10.3389/fneur.2021.651392 Text en Copyright © 2021 Connolly, Rajaratnam, Spitz, Lockley and Ponsford. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Connolly, Laura J.
Rajaratnam, Shantha M. W.
Spitz, Gershon
Lockley, Steven W.
Ponsford, Jennie L.
Factors Associated With Response to Pilot Home-Based Light Therapy for Fatigue Following Traumatic Brain Injury and Stroke
title Factors Associated With Response to Pilot Home-Based Light Therapy for Fatigue Following Traumatic Brain Injury and Stroke
title_full Factors Associated With Response to Pilot Home-Based Light Therapy for Fatigue Following Traumatic Brain Injury and Stroke
title_fullStr Factors Associated With Response to Pilot Home-Based Light Therapy for Fatigue Following Traumatic Brain Injury and Stroke
title_full_unstemmed Factors Associated With Response to Pilot Home-Based Light Therapy for Fatigue Following Traumatic Brain Injury and Stroke
title_short Factors Associated With Response to Pilot Home-Based Light Therapy for Fatigue Following Traumatic Brain Injury and Stroke
title_sort factors associated with response to pilot home-based light therapy for fatigue following traumatic brain injury and stroke
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8319544/
https://www.ncbi.nlm.nih.gov/pubmed/34335435
http://dx.doi.org/10.3389/fneur.2021.651392
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