BioClock: Bright Light Therapy for Depressive Disorders

NCT05958940 | Recruiting

• 1 other identifier: NL83497.058.23
• Study Type: interventional
• Target: 231
• Locations: 1 country
• Sites: 2

Brief Summary

Bright Light Therapy (BLT) is a proven treatment for depression in seasonal and non-seasonal depressive disorders, as well as bipolar disorder. To make BLT more effective and practical in clinical settings and tailor it to individual needs, it is necessary to optimize the treatment approach, understand how the treatment works, and identify patient characteristics that predict response. This clinical trial has three main goals:

• Optimize the administration of BLT for patients with depressive episodes.
• Gain a deeper understanding of the treatment mechanisms.
• Determine which patients benefit the most from the treatment. The specific objectives are as follows:
• Investigate whether additional treatments and interventions related to lifestyle and the biological clock can enhance the effects of BLT.
• Examine how BLT influences the body's internal clock and sleep quality, and how these factors contribute to the outcomes.
• Identify patient characteristics and behaviours that can predict treatment outcomes.
• Develop a brain model to better understand the impact of BLT on the brain. In this study, patients will receive BLT with a light intensity of 10,000 lux for 30 minutes each morning over 5 consecutive days. The treatment duration will range from one to three weeks, depending on the improvement of depressive symptoms. Participants will be randomly assigned to one of three groups:
• Home - Patients will receive BLT at home, following the standard guidelines for light therapy in the Netherlands.
• LightCafé, fixed time: Patients will receive BLT in a café-like setting called the LightCafé, where the focus is not only on symptom improvement but also lifestyle enhancements and fostering social connections. The treatment time will be the same every day.
• LightCafé, varying time: Patients will also receive BLT at the LightCafé, with treatment timing varying each day. Additionally, this group will wear glasses in the evening that filter blue light. The study includes a baseline phase of up to two weeks, a treatment phase of up to three weeks, and a three-month follow-up phase. Patients will wear a motion watch to assess sleep-wake behaviour and physical activity during the day. Additionally, they will wear a broach that measures their personal light exposure throughout the day. Eight one-minute questionnaires per day will be sent to the participants' smartphones to assess vitality, sleep, and mood during the treatment. Predictors of treatment response, such as clinical characteristics, sleep measures, circadian parameters, and light-related behaviours, will be evaluated at baseline. In a small group of patients, salivary melatonin curves will be assessed before and after treatment. MRI scans will provide insights into functional and structural brain changes following light therapy treatment.

Conditions

Depression, Unipolar; Depression, Bipolar

Keywords

Depression; Bright Light Therapy; Chronotherapy; Circadian Rhythm; Sleep; Life Style; Ecological Momentary Assessment; Actigraphy; Dim light melatonin onset; Response predictors

Outcome Measures

Primary Outcomes (1)

• Clinical Improvement

  Difference between pre- and post-treatment assessment of the Montgomery Asberg Depression Rating Scale \[MADRS\]

  2-5 weeks

Secondary Outcomes (17)

• Subjective change in depressive symptom severity

  from baseline until follow-up, approximately 4 months

• Remission rates, self assessed and clinician rated

  2-5 weeks for clinician rated. Up until 4 months after start treatment for self-assessed

• Response Rates, self assessed and clinician rated

  2-5 weeks for clinician rated, Up until 4 months after start treatment for self-assessed

• Time to remission

  one, two or three weeks

• Circadian phase

  2-5 weeks

Other Outcomes (5)

• Personal daily light exposure

  2-5 weeks

• Treatment expectations

  baseline

• Light Induced Melatonin suppression

  Baseline

Study Arms (3)

Light@Home

ACTIVE COMPARATOR

Standard Care - BLT in the home environment

Procedure: Bright Light Therapy

LightCafé

EXPERIMENTAL

BLT will be administered in a specialized cafe, under the supervision of clinical staff, promoting lifestyle changes and social interaction.

Procedure: Bright Light Therapy

LightCafé+

EXPERIMENTAL

Treatment will be identical to the second arm but now complemented with the use of blue-light blocking glasses in the evening and the adoption of personalized BLT timing based on sleep-wake patterns

Procedure: Bright Light Therapy; Device: Blue Light Blocking Glasses

Interventions

Bright Light Therapy PROCEDURE

In this study, Bright Light Therapy (BLT) will be administered according to Dutch depression guidelines, using Innolux LED light lamp (3800K, 10,000 lux). BLT will be given for one work week (Mon-Fri), 7:30-10:30 AM, 30 mins/session. Patients can have breakfast, read, or use devices. Treatment effectiveness will be evaluated using Self-Rated Quick Inventory of Depressive Symptoms (QIDS-SR). If remission is achieved (QIDS-SR \< 6), no additional treatment is given. If response is insufficient (QIDS-SR ≥ 6), 5 more sessions will be added in the following week, with maximum two extensions (1-3 weeks total).

Light@Home; LightCafé; LightCafé+

Blue Light Blocking Glasses DEVICE

Plastic, orange-coloured glasses that primarily block blue light. To be worn in the evening.

LightCafé+

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age between 18 and 65.
• Diagnosis of unipolar or bipolar depression (seasonal or non-seasonal) as assessed with the Mini-International Neuropsychiatric Interview (M.I.N.I.)
• A current depressive episode (a score of 6 or higher on the Quick Inventory of depressive symptomatology Self Report (QIDS-SR)
• Sufficient knowledge of Dutch or English language to fill in questionnaires
• Provided Informed consent

You may not qualify if:

• A current (hypo)manic or mixed episode (as assessed with the M.I.N.I.)
• Current psychotic episode (as assessed with the M.I.N.I.)
• Prominent active suicidality (score 10 or higher on the M.I.N.I. module)
• Antidepressant therapy (medication, psychotherapy or BLT, or other forms of specific treatments for depression) that started less than 2 months prior to study entry
• participants with bipolar disorder should be in mood-stabilizing treatment for at least 1 month in a recommended dosage,
• Use of melatonin or agomelatine in the last month
• Current use of antibiotics
• Current use of light sensitivity increasing medication
• Travelled across more than 1 time zone during past month or during the treatment
• Travelled to sunny holiday locations/winter sports during past month
• pre-existing eye and skin disorders (retinitis pigmentosa, porphyria, chronic actinic dermatitis and sun-induced urticaria)
• Systemic disorders with potential retinal involvement (rheumatoid arthritis and systemic lupus erythematosus)
• Suffering from colour blindness (assessed by Ishihara colour plates)
• Participated in night shift work in the last three months
• (Retinal) blindness, severe cataract and glaucoma

Sponsors & Collaborators

• Universiteit Leiden: lead
• Eindhoven University of Technology: collaborator
• Geestelijke Gezondheidszorg Eindhoven (GGzE): collaborator
• Chrono@Work B.V.: collaborator

Study Sites (2)

GGzE - Mental Health Institute of Eindhoven and the Kempen

Eindhoven, 5626 ND, Netherlands

RECRUITING

Leids Universitair Behandel- en Expertise Centrum

Leiden, 5626 ND, Netherlands

RECRUITING

Related Publications (1)

• Visser E, Rus-Oswald OG, van der Does AJW, Gordijn MCM, Marcelis MC, de Kort YAW, Oomen PP, Schlangen LJM, Seetsen T, Simons CJP, Antypa N. BioClock-optimizing Bright Light Therapy for adults with depression: a study protocol for a multicenter randomized clinical trial on treatment strategies, response predictors, and chronobiological and neurobiological mechanisms. Trials. 2025 Oct 14;26(1):411. doi: 10.1186/s13063-025-08984-7.

  PMID: 41088238 DERIVED

MeSH Terms

Conditions

Depressive Disorder; Bipolar Disorder; Depression

Interventions

Ultraviolet Therapy

Condition Hierarchy (Ancestors)

Mood Disorders; Mental Disorders; Bipolar and Related Disorders; Behavioral Symptoms; Behavior

Intervention Hierarchy (Ancestors)

Phototherapy; Therapeutics

Study Officials

• Niki Antypa, PhD

  Leiden University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Niki Antypa, PhD

CONTACT

+31 71 527 6677; nantypa@fsw.leidenuniv.nl

Luc Schlangen, PhD

CONTACT

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: July 7, 2023
• First Posted: July 25, 2023
• Study Start: February 8, 2024
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: January 9, 2025

Record last verified: 2025-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: Data will be available after publication of the analyses
• Access Criteria: Access may be granted to researchers who intend to conduct secondary analyses or meta-analyses using individual participant data. Additionally, researchers with a valid scientific research question or hypothesis that aligns with the objectives of the original study may be considered for IPD access.

Locations

NL (2)