Trial Outcomes & Findings for Treatment of Post-Traumatic Brain Injury (Post-TBI) Fatigue With Light Therapy (NCT NCT01725750)

NCT ID: NCT01725750

Last Updated: 2019-08-07

Results Overview

Multidimensional Assessment of Fatigue (MAF) yields a Global Fatigue Index (GFI), assessing 5 dimensions of fatigue: distress, degree, severity, impact on ADLs and frequency of fatigue in the past week, and it yields a composite score. GFI full score from 0-50, with a higher score indicating more severe fatigue, fatigue distress, or impact on activities of daily living.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

88 participants

Primary outcome timeframe

baseline, 4 weeks, 8 weeks

Results posted on

2019-08-07

Participant Flow

From October 2015-January 2017, recruitment materials were sent to previous research and support group participants, and other local TBI centers. Information was also posted online and at consumer conferences. External sites included Centre for Neuro Skills facilities and post-acute rehab centers in Bakersfield and Los Angeles, CA, and Dallas, TX.

Participant milestones

Participant milestones
Measure
Bright White Light (BWL)
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Overall Study
STARTED
44
44
Overall Study
COMPLETED
42
34
Overall Study
NOT COMPLETED
2
10

Reasons for withdrawal

Reasons for withdrawal
Measure
Bright White Light (BWL)
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Overall Study
Adverse Event
1
0
Overall Study
Lost to Follow-up
1
1
Overall Study
Withdrawal by Subject
0
9

Baseline Characteristics

Treatment of Post-Traumatic Brain Injury (Post-TBI) Fatigue With Light Therapy

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Bright White Light (BWL)
n=44 Participants
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=44 Participants
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Total
n=88 Participants
Total of all reporting groups
Age, Continuous
48.045 years
STANDARD_DEVIATION 16.335 • n=93 Participants
45.182 years
STANDARD_DEVIATION 13.138 • n=4 Participants
46.614 years
STANDARD_DEVIATION 14.808 • n=27 Participants
Sex: Female, Male
Female
20 Participants
n=93 Participants
24 Participants
n=4 Participants
44 Participants
n=27 Participants
Sex: Female, Male
Male
24 Participants
n=93 Participants
20 Participants
n=4 Participants
44 Participants
n=27 Participants
Race/Ethnicity, Customized
Asian/Pacific Islander
2 Participants
n=93 Participants
5 Participants
n=4 Participants
7 Participants
n=27 Participants
Race/Ethnicity, Customized
Hispanic/Latino
5 Participants
n=93 Participants
8 Participants
n=4 Participants
13 Participants
n=27 Participants
Race/Ethnicity, Customized
Black or African American
6 Participants
n=93 Participants
5 Participants
n=4 Participants
11 Participants
n=27 Participants
Race/Ethnicity, Customized
White
27 Participants
n=93 Participants
23 Participants
n=4 Participants
50 Participants
n=27 Participants
Race/Ethnicity, Customized
More than one race/Other
4 Participants
n=93 Participants
3 Participants
n=4 Participants
7 Participants
n=27 Participants
Years of education completed
15.841 years
STANDARD_DEVIATION 2.533 • n=93 Participants
15.651 years
STANDARD_DEVIATION 2.654 • n=4 Participants
15.747 years
STANDARD_DEVIATION 2.580 • n=27 Participants

PRIMARY outcome

Timeframe: baseline, 4 weeks, 8 weeks

Multidimensional Assessment of Fatigue (MAF) yields a Global Fatigue Index (GFI), assessing 5 dimensions of fatigue: distress, degree, severity, impact on ADLs and frequency of fatigue in the past week, and it yields a composite score. GFI full score from 0-50, with a higher score indicating more severe fatigue, fatigue distress, or impact on activities of daily living.

Outcome measures

Outcome measures
Measure
Bright White Light (BWL)
n=44 Participants
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=44 Participants
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Multidimensional Assessment of Fatigue (MAF)
Baseline
33.332 score on a scale
Standard Deviation 9.043
30.531 score on a scale
Standard Deviation 10.633
Multidimensional Assessment of Fatigue (MAF)
4 weeks (end of treatment)
27.993 score on a scale
Standard Deviation 9.993
24.937 score on a scale
Standard Deviation 10.558
Multidimensional Assessment of Fatigue (MAF)
8 weeks (one month post treatment)
28.658 score on a scale
Standard Deviation 12.213
25.350 score on a scale
Standard Deviation 10.895

SECONDARY outcome

Timeframe: baseline, 4 weeks, 8 weeks

The Traumatic Brain Injury-Quality Of Life Fatigue (TBI-QOL) measures form part of the Promis Neuro-QOL initiative and include well-validated self-report measures that assess the health-related QOL of individuals with neurological disorders. All TBI-QOL scores have been transformed to a T metric,from 0-100, with a mean of 50 (SD = 10), with a higher score indicating more fatigue.

Outcome measures

Outcome measures
Measure
Bright White Light (BWL)
n=44 Participants
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=44 Participants
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
TBI-QOL Fatigue
Baseline
61.819 T score
Standard Deviation 6.255
58.821 T score
Standard Deviation 7.533
TBI-QOL Fatigue
4 weeks (end of treatment)
58.071 T score
Standard Deviation 7.384
55.724 T score
Standard Deviation 8.305
TBI-QOL Fatigue
8 weeks (one month post treatment)
58.226 T score
Standard Deviation 8.481
57.252 T score
Standard Deviation 9.033

SECONDARY outcome

Timeframe: baseline, 4 weeks, 8 weeks

The Neuro-QOL Depression and Sleep measures the physical, mental, and social effects experienced by adults and children living with neurological conditions. Raw scores were converted to T-Scores; from 0-100, with a T = 50 indicating average function compared to the reference population and a standard deviation of 10, with a higher score indicating worse function.

Outcome measures

Outcome measures
Measure
Bright White Light (BWL)
n=44 Participants
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=44 Participants
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Neuro-QOL Depression and Sleep
Baseline
52.893 T-score
Standard Deviation 8.033
82.942 T-score
Standard Deviation 7.570
Neuro-QOL Depression and Sleep
4 weeks (end of treatment)
53.337 T-score
Standard Deviation 8.190
52.864 T-score
Standard Deviation 7.896
Neuro-QOL Depression and Sleep
8 weeks (one month post treatment)
55.162 T-score
Standard Deviation 8.193
52.290 T-score
Standard Deviation 9.698

SECONDARY outcome

Timeframe: baseline, 4 weeks, 8 weeks

The Epworth Sleepiness Scale (ESS) will also be used, to assess daytime sleepiness; it is an 8-item measure that asks about the probability of dozing or sleeping during typical daytime activities and has been widely used in TBI research. Scores correlate well with objective measures of speed of daytime sleep onset. The test is a list of eight situations in which the participate rates tendency to become sleepy on a scale of 0, no chance of dozing, to 3, high chance of dozing for each item. Total scale from 0 to 24, with higher score indicating severe excessive daytime sleepiness.

Outcome measures

Outcome measures
Measure
Bright White Light (BWL)
n=44 Participants
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=44 Participants
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Epworth Sleepiness Scale (ESS)
baseline
9.695 score on a scale
Standard Deviation 4.869
6.970 score on a scale
Standard Deviation 4.323
Epworth Sleepiness Scale (ESS)
4 weeks (end of treatment)
8.162 score on a scale
Standard Deviation 3.927
8.312 score on a scale
Standard Deviation 3.182
Epworth Sleepiness Scale (ESS)
8 weeks (one month post treatment)
8.169 score on a scale
Standard Deviation 4.041
8.133 score on a scale
Standard Deviation 3.899

SECONDARY outcome

Timeframe: baseline, 4 weeks, 8 weeks

The Centre for Neuro Skills Vital Signs TBI Rehab Toolbox is a brief, 25-minute computerized cognition battery; it emphasizes those cognitive functions that are the most likely to respond to alerting effects of light (vigilance, attention, speed) and has multiple forms for serial assessment. The scores are reported as Standard Scores, with mean = 100 and standard deviation = 15. Higher scores are correlated with better outcomes.

Outcome measures

Outcome measures
Measure
Bright White Light (BWL)
n=44 Participants
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=44 Participants
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
CNS Vital Signs TBI Rehab Toolbox
baseline
79.59 score on a scale
Standard Deviation 26.260
82.83 score on a scale
Standard Deviation 21.805
CNS Vital Signs TBI Rehab Toolbox
4 weeks (end of treatment)
83.19 score on a scale
Standard Deviation 27.489
77.64 score on a scale
Standard Deviation 37.658
CNS Vital Signs TBI Rehab Toolbox
8 weeks (one month post treatment)
86.17 score on a scale
Standard Deviation 28.051
79.10 score on a scale
Standard Deviation 35.443

SECONDARY outcome

Timeframe: baseline, 4 weeks, 8 weeks

The Cognitive Failures Questionnaire (CFQ)100 is a 25-item self-report inventory, with items measuring difficulties in several cognitive domains (e.g., memory, perception), each item scored from 0 (never) to 4 (very often), with total scale from 0 - 100, with higher score indicating worse outcome.

Outcome measures

Outcome measures
Measure
Bright White Light (BWL)
n=44 Participants
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=44 Participants
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Cognitive Failures Questionnaire
baseline
47.823 score on a scale
Standard Deviation 16.872
42.806 score on a scale
Standard Deviation 15.175
Cognitive Failures Questionnaire
4 weeks (end of treatment)
45.261 score on a scale
Standard Deviation 17.590
46.564 score on a scale
Standard Deviation 16.646
Cognitive Failures Questionnaire
8 weeks (one month post treatment)
47.503 score on a scale
Standard Deviation 18.204
45.352 score on a scale
Standard Deviation 18.310

SECONDARY outcome

Timeframe: baseline, 4 weeks, 8 weeks

The Neuro-QOL Anxiety measure. Raw scores were converted to T-Scores; from 0-100, with a T = 50 indicating average function compared to the reference population and a standard deviation of 10, with a higher score indicating worse anxiety.

Outcome measures

Outcome measures
Measure
Bright White Light (BWL)
n=44 Participants
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=44 Participants
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Neuro-QOL Anxiety
baseline
55.725 T score
Standard Deviation 8.137
56.253 T score
Standard Deviation 7.581
Neuro-QOL Anxiety
4 weeks (end of treatment)
55.250 T score
Standard Deviation 8.929
56.661 T score
Standard Deviation 7.766
Neuro-QOL Anxiety
8 weeks (one month post treatment)
57.441 T score
Standard Deviation 8.073
55.226 T score
Standard Deviation 8.828

SECONDARY outcome

Timeframe: 4 weeks post treatment

Population: After the Actigraph data were cleaned and analyzed, there was clean, usable data for 30 in the white arm and 23 in the red arm.

Philips Actiwatch Spectrum to measure circadian rhythms; it is the size and shape of a digital wristwatch and weighs about one ounce. It is worn on an ordinary watchband and is waterproof. Data can be downloaded and analyzed using Actiware software. The Actiwatch Spectrum logs all physical movement using a piezoelectric accelerometer and detects the presence of ambient light (400-700nm), making it a useful measure of circadian cycles because it allows for accurate quantitative assessment of periods of activity, rest and sleep. Acrophase is time of the peak activity, so it is expressed in hours. The higher the number, the later in the day the peak activity occurs.

Outcome measures

Outcome measures
Measure
Bright White Light (BWL)
n=30 Participants
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=23 Participants
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Actiwatch Spectrum - Acrophase
15.68 hours
Standard Deviation 2.29
15.98 hours
Standard Deviation 1.09

SECONDARY outcome

Timeframe: 4 weeks post treatment

Population: After the Actigraph data were cleaned and analyzed, there was clean, usable data for 30 in the white arm and 23 in the red arm.

Philips Actiwatch Spectrum to measure circadian rhythms; it is the size and shape of a digital wristwatch and weighs about one ounce. It is worn on an ordinary watchband and is waterproof. Data can be downloaded and analyzed using Actiware software. The Actiwatch Spectrum logs all physical movement using a piezoelectric accelerometer and detects the presence of ambient light (400-700nm), making it a useful measure of circadian cycles because it allows for accurate quantitative assessment of periods of activity, rest and sleep. Mesor is an adjusted proportion of the difference between the minimum and half the peak, so range is 0-1. Higher means a more rhythmic pattern.

Outcome measures

Outcome measures
Measure
Bright White Light (BWL)
n=30 Participants
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=23 Participants
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Actiwatch Spectrum - Mesor
0.72 score on a scale
Standard Deviation 0.21
0.83 score on a scale
Standard Deviation 0.25

SECONDARY outcome

Timeframe: 4 weeks post treatment

Population: After the Actigraph data were cleaned and analyzed, there was clean, usable data for 30 in the white arm and in the 23 red arm.

Philips Actiwatch Spectrum to measure circadian rhythms; it is the size and shape of a digital wristwatch and weighs about one ounce. It is worn on an ordinary watchband and is waterproof. Data can be downloaded and analyzed using Actiware software. The Actiwatch Spectrum logs all physical movement using a piezoelectric accelerometer and detects the presence of ambient light (400-700nm), making it a useful measure of circadian cycles because it allows for accurate quantitative assessment of periods of activity, rest and sleep. F statistic is an F value, so the range is 0 - infinity. It compares two different models of calculating the curve. Higher means a more rhythmic pattern.

Outcome measures

Outcome measures
Measure
Bright White Light (BWL)
n=30 Participants
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=23 Participants
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Actiwatch Spectrum - F Statistic
1765.36 score on a scale
Standard Deviation 1120.32
2307.38 score on a scale
Standard Deviation 1574.54

SECONDARY outcome

Timeframe: baseline, 4 weeks, 8 weeks

Satisfaction with Life Scale, a 5-item measure of global satisfaction with life, on likert scale from 1 strongly disagree to 7 strongly agree. Total scale from 5 to 35, with higher scores indicating more satisfaction with life, and 20 representing a neutral point on the scale.

Outcome measures

Outcome measures
Measure
Bright White Light (BWL)
n=44 Participants
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=44 Participants
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Satisfaction With Life Scale
baseline
17.409 score on a scale
Standard Deviation 6.956
18.698 score on a scale
Standard Deviation 7.386
Satisfaction With Life Scale
4 weeks (end of treatment)
17.622 score on a scale
Standard Deviation 7.154
18.394 score on a scale
Standard Deviation 7.925
Satisfaction With Life Scale
8 weeks (one month post treatment)
17.441 score on a scale
Standard Deviation 6.219
19.900 score on a scale
Standard Deviation 6.707

SECONDARY outcome

Timeframe: at 4 weeks (end-of-treatment)

An adapted version of the Treatment Satisfaction Questionnaire for Medication (TSQM). This is a validated, psychometrically sound measure of general treatment satisfaction. The TSQM scores range from 0 to 100 with higher scores representing higher satisfaction.

Outcome measures

Outcome measures
Measure
Bright White Light (BWL)
n=44 Participants
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=44 Participants
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Treatment Satisfaction Questionnaire for Medication
42.455 score on a scale
Standard Deviation 29.827
47.546 score on a scale
Standard Deviation 33.112

SECONDARY outcome

Timeframe: at 4 weeks (end-of-treatment)

Population: Compared to other outcome measures, fewer CEQ records were analyzed due to participant non-compliance.

Assess treatment credibility (BWL vs. DRL) with the Credibility/Expectancy Questionnaire (CEQ), used in clinical outcome studies. The CEQ utilizes two scales during the administration (1-9, and 0-100%), and so a composite z score was derived for each factor (expectancy and credibility) by first standardizing the individual items and then summing those items for each factor. The Z-score indicates the number of standard deviations away from the mean. A Z-score of 0 is equal to the mean. A higher score indicates more belief or feeling of reduction in anxiety.

Outcome measures

Outcome measures
Measure
Bright White Light (BWL)
n=43 Participants
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=37 Participants
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Credibility/Expectancy Questionnaire
-.5539 score on a scale
Standard Deviation 2.577
.4489 score on a scale
Standard Deviation 2.74

Adverse Events

Bright White Light (BWL)

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Dim Red Light (DRL)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Bright White Light (BWL)
n=44 participants at risk
Participants will self-administer bright white light daily using a Litebook® (The Litebook Company Ltd.). The Litebook is a small (6" x 5" x 1") and lightweight (8 oz.) box.
Dim Red Light (DRL)
n=44 participants at risk
Participants will self-administer dim red light daily using a device that appears identical to Bright White Light (BWL) Litebook but that uses red LEDs emitting DRL.
Eye disorders
Blurred vision
2.3%
1/44 • 8 weeks
0.00%
0/44 • 8 weeks

Additional Information

Jacob Greisman

Icahn School of Medicine at Mount Sinai

Phone: 212-241-4886

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place