Shining a Light on Multiple Sclerosis-Related Fatigue

When the days are short and daylight is scant in the winter months, using special lamps that create artificial sunlight can help alleviate the symptoms of seasonal affective disorder — commonly referred to as the winter blues.

But could light therapy serve a grander purpose and help treat the debilitating symptoms associated with neurological diseases?

Farrah Photo MGH_clinical trials website
Farrah J. Mateen, MD, PhD

Farrah J. Mateen, MD, PhD, Associate Director of the MGH Multiple Sclerosis Clinic at Massachusetts General Hospital and Associate Professor of Harvard Medical School, is investigating the impact of light therapy on multiple sclerosis (MS), a degenerative condition of the central nervous system with no known cure.

In MS, damage to the protective sheath that covers nerve fibers causes communication problems between the brain, spinal cord and the rest of the body.

The disease is primarily diagnosed in women in their 20s to 40s, and is a leading cause of non-traumatic disability in young adults. Celebrities including Jamie Lynn-Sigler, Ann Romney and Jack Osbourne have all publicly discussed their personal struggles with MS.

Signs and symptoms vary widely and usually come and go in a relapsing and remitting pattern. The most commonly reported symptom is fatigue — more than a quarter of people living with MS report fatigue as their most disabling symptom.

MS-related fatigue is unique in that it can strike even after a restful night’s sleep, it can come on suddenly and severely, and it often occurs on a daily basis.

Given the substantial impact fatigue has on MS patients’ everyday life, Dr. Mateen has focused her efforts to determine whether light therapy could be a potential treatment option for the symptom.

She hypothesizes that light therapy could improve fatigue by stimulating receptors in the frontal lobes of the brain, where fatigue is thought to be localized. It could also help set the circadian rhythm and aid with sleep.

“Light therapy has already had positive results in other diseases, such as Parkinson’s, where fatigue is a key symptom,” explains Mateen. She’s optimistic that, given the similarities between the two diseases, light therapy could also improve quality of life for patients with MS.

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Light therapy box

Her current study, funded by grants from the National MS Society and the Department of Neurology’s Spark Grant (with co-principal investigator, Aleksander Videnovic, MD, MSc, a Mass General-based sleep and neurodegenerative diseases expert), provides participants with a lightbox that can be placed on a desk or a table.

Participants sit in front of either a dim red light or white light for an hour in the morning and an hour in the evening each day for four weeks and are asked to record their fatigue levels daily using a 10-point scale. Light therapy boxes can be used at home or work and participants can eat, watch TV, etc. during use.

Mateen and her team aim to enroll 50 participants, a number Mateen thinks they can easily meet.

“We have a backlog of people waiting to be in the study”, says Mateen. “An advantage of studying MS is the high number of dedicated patients who want to be part of research.

Currently there’s really no good treatment for fatigue in MS. Of the few available medications, some are potentially habit-forming stimulants, which MS patients should be cautious of because it could interfere with other medications they’re already taking.”

Children with MS also have few medical options for treating their fatigue, and most trials for new treatments are deemed too risky to test on kids. Mateen’s future research interests are to also address MS-related fatigue in children, given how disabling the symptom can be for this population.

“Light therapy trials would provide an opportunity for kids to actually be part of a study that could help them, and help other kids. In my mind, it makes just as much sense to test light therapy on kids — if we see positive results, it could be a viable a treatment option for both kids and adults.”

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