DepressionNCT02390076
Behavioral Study of Effects of Low-Level Light Therapy on Mood and Reaction Time
A study testing Left Low Level Light Therapy, Attention bias modification and Right Low Level Light Therapy in people with Depression, run by Seth Disner.
Trial summary
The goal of this project is to use low-level light therapy (LLLT) to enhance neural metabolism in the prefrontal cortex of humans, and measure the effects of LLLT on attentional bias change following a single session of attention bias modification (ABM). Read more about this study
- Who is it for?
- Ages 18 to 35 years
- Conditions the study is for
- Depression
- What is being tested?
- Left Low Level Light Therapy, Attention bias modification and Right Low Level Light Therapy
- Type of treatment
- Medical device
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 51 participants
- Where
- No sites listed yet
- Study dates
- Jan 2013to Jan 2015
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 35 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- 18 to 35 years old,
- English as first language,
- baseline CES-D score > 16.
Who cannot join
- active neurological condition (such as epilepsy or stroke).
About this study
Official title: Influence of Low-Level Light Therapy on Attention Bias Modification and Mood Change in Dysphoric Individuals
The goal of this project is to use low-level light therapy (LLLT) to enhance neural metabolism in the prefrontal cortex of humans, and measure the effects of LLLT on attentional bias change following a single session of attention bias modification (ABM). LLLT is non-invasive, therapeutically beneficial, and promotes a wide range of biological effects including enhancement of energy production, gene expression and prevention of cell death. Previous research has indicated that human participants show a beneficial psychological effect, including improved mood and greater sustained attention, following a single treatment of LLLT to the forehead. ABM is a computer-based cognitive task designed to decrease the mood-congruent negative attentional bias frequently observed in depressed and dysphoric individuals. Previous ABM studies have led to decrease in clinical symptoms relative to a control condition. This study will explore whether the effects of LLLT on mood and attention could improve the potency of ABM, leading to greater attention change and greater improvement of mood relative to sham LLLT.
Read the detailed description
Low-level light therapy constitutes a novel intervention shown to regulate neuronal function in cell cultures, animal models, and clinical conditions. The Gonzalez-Lima lab has previously shown that low-level light therapy can increase mitochondrial cytochrome oxidase activity, which can provide neuroprotection against toxicity and can improve the aerobic capacity of other tissue such as skeletal muscle. This suggests that the oxidative metabolism of tissue exposed to LLLT is enhanced. LLLT treatments also appear to have in vivo transcranial neurochemical effects that involve metabolic-enhancing and antioxidant systems; it is a non-invasive technique that has been used in humans to stimulate the brain as an antidepressant treatment, to alleviate muscle fatigue and enhance recovery, and to increase sustained attention during cognitive tasks. These LLLT treatments have thus been proven to be not just safe but actually beneficial in humans. Collectively, these data imply that LLLT could be used as an inexpensive, noninvasive approach to boost blood flow and energy consumption in the brain and other tissues, as well as provide neuroprotection against neurological conditions which may be related to mitochondrial dysfunction. This research could ultimately lead to the development of non-invasive, non-pharmacologic, therapeutic, cytoprotective and performance-enhancing interventions in both healthy humans and in those in need of rehabilitation efforts under conditions where neuromuscular function and movement are compromised, as well as treating neurobiological disorders in which metabolic dysfunction plays an underlying causal role, such as depression and post-traumatic stress disorder.
The therapeutic use of red to near-infrared light wavelengths is based on the principle that certain molecules in living systems absorb photons and trigger signaling pathways in response to light. In biologic tissues, absorption and scattering of light (which would render it ineffective as a treatment) are maximal at wavelengths below 600 nanometers, and water absorbs light at wavelengths greater than 1150 nanometers. Thus, there is a "wavelength window" for biologic stimulation that covers the red to near-infrared light spectrum (between 600 and 1150 nm).
Early results suggest that LLLT may have significant promise in the treatment of clinical disorders. Prior work found that a single LLLT treatment to the forehead resulted in an increased cerebral blood flow and significant beneficial effect in patients with major depression and anxiety. Previous research conducted in the Gonzalez-Lima lab showed that healthy human subjects receiving LLLT showed significantly higher positive affect at two week follow-up sessions relative to subjects in the "placebo-light" condition. Importantly, no adverse side effects were found in subjects for either study, either immediately after the initial treatment, or at two or four weeks post-treatment. The investigators plan to follow the LLLT treatment protocol from these two studies, immediately prior to running subjects through the ABM procedure.
ABM is a technique designed to modify attentional bias, a cognitive factor that has been theorized to underlie the onset and maintenance of Major Depressive Disorder. ABM is built on the framework of the standard dot-probe task, wherein two valenced stimuli are presented side-by-side, and then followed by a target probe behind one of the stimuli. The difference in response time between probes directly behind a stimuli relative to probes on the opposite side of the stimuli can be used to operationalize attentional bias for that particular valence of stimuli. ABM uses a conditioning approach to shift this bias by staggering the frequency of probe distribution in favor of one specific valence. Eventually, participants are expected to preferentially process the favored valence of stimuli, leading to a shifting of attentional bias.
This placebo-controlled study will measure whether LLLT influences the efficacy of ABM on measures of biased attention and dysphoria. Participants will be randomized to receive either active or placebo LLLT, and will then undergo an ABM procedure designed to decrease attention towards negative environmental stimuli (measured using a variant of the dot-probe task). The combination of LLLT and ABM will take place over two sessions (two days apart), and will be followed by one and two week follow-up periods to assess mood change. The investigators hypothesize that participants who receive the active LLLT will show greater change in attentional bias following ABM and greater decrease in dysphoric symptoms during follow-up compared to the placebo group.
- Conditions
- Depression
- Being tested
- Left Low Level Light Therapy, Attention bias modification, Right Low Level Light Therapy, Sham Low Level Light Therapy
- Medical subject headings
- Depression
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Left Low Level Light TherapyDevice
Also called Transcranial laser stimulation
Administration of left LLLT consists of applying light of a specific wavelength (1064 nanometers) using a laser diode, the CG-5000 high density laser (Cell Gen Therapeutics, LLC). Left LLLT will target the left forehead. The diameter parameters of stimulation are the same that showed psychologically beneficial effects in Schiffer et al. (2009). At the power level described, the energy emitted by the CG-5000 at this setting is one quarter of the skin MPE (0.250 W/cm2), exposure to it is not deemed harmful to tissue, and it causes no detectable physical damage and negligible heat.
Attention bias modificationOther
Also called Cognitive bias modification
The task will consist of a modified dot-probe paradigm. A pair of stimuli depicting a negative word and a neutral word will be presented, randomly located to the right and left side of the computer screen. The words will be presented for 1000 ms. The words will then disappear and a dot-probe will appear in the center of the screen location of one of the words (i.e., O or Q). This probe will appear on the screen until the participant presses one of two response buttons to indicate the identity of the probe. The presentation of the probe will be staggered to maximize attention for the neutral stimulus. Latency and accuracy of the button press responses are recorded by the computer.
Right Low Level Light TherapyDevice
Also called Transcranial laser stimulation
Administration of right LLLT consists of applying light of a specific wavelength (1064 nanometers) using a laser diode, the CG-5000 high density laser (Cell Gen Therapeutics, LLC). Right LLLT will target the right forehead. The diameter parameters of stimulation are the same that showed psychologically beneficial effects in Schiffer et al. (2009). At the power level described, the energy emitted by the CG-5000 at this setting is one quarter of the skin MPE (0.250 W/cm2), exposure to it is not deemed harmful to tissue, and it causes no detectable physical damage and negligible heat.
Sham Low Level Light TherapyDevice
Also called Transcranial laser stimulation
Administration of sham LLLT is designed to resemble active LLLT from the participant's perspective, but uses a dosage markedly below the minimal necessary threshold to elicit a response.
| Study group | Role | What they receive |
|---|---|---|
| Left active LLLT | Active comparator | Active LLLT targeting the left forehead Attention Bias Modification Left low level light therapy Receives: Device: Left Low Level Light Therapy; Other: Attention bias modification |
| Right active LLLT | Active comparator | Active LLLT targeting the right forehead Attention Bias Modification Right low level light therapy Receives: Other: Attention bias modification; Device: Right Low Level Light Therapy |
| Sham LLLT | Sham comparator | Sham LLLT targeting the right forehead Attention Bias Modification Sham low level light therapy Receives: Other: Attention bias modification; Device: Sham Low Level Light Therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Presence and Severity of Depressive Symptoms Assessed by Center for Epidemiologic Studies - Depression Scale (CES-D)
The CES-D (Radloff, 1977) is a 20-item, self-report scale designed to assess the presence and severity of depressive symptoms over the past week. The total range is 0-80, with higher scores reflecting more severe depression symptoms. Outcome measure data table reflects clinical symptoms at 2 week follow-up.
Measured: At baseline, session 1, session 2, 1 week follow-up, and 2 week follow-up.
Secondary outcomes (1)
Biased Attention for Emotional Stimuli Measured by the Dot Probe Task
This task measures biased attention for emotional stimuli. In this task, two stimuli are presented at the same time. The investigators plan to present two words concurrently; one emotionally valenced word (positive or negative) and one neutral word. Two words appear on the screen for 1000 ms; the location of the emotional and neutral word varies randomly. Following the offset of the words, a subsequent target (i.e., O or Q) appears; the location of the target is randomized with the constraint that it must appear an equal number of times behind the emotional and neutral words. Each iteration of the dot probe task will include 96 trials, and will last approximately 7 minutes. Behavioral reaction times are recorded via a button push on the response box. Change in negative bias is calculated as mean bias value from the dot probe task at the end of session 2 minus the mean bias value calculated at the beginning of session 1.
Measured: Measure was administered at the beginning of session 1 and end of session 2.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Mar 2015 (estimated)
- Study startJan 2013
- Primary completionJan 2015
- Study completionJan 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for DepressionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 51 participants (actual)
Sponsor and investigators
- Lead sponsor
- Seth Disner
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Seth Disner, University of Texas at Austin
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02390076
- Sponsor's protocol ID
- IMHR-0001
- Status last verified
- Apr 2019
- First submitted
- 10 Mar 2015
- Last updated
- 8 May 2019
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 8 May 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Influence of Low-Level Light Therapy on Attention Bias Modification and Mood Change in Dysphoric Individuals
- ClinicalTrials.gov ID
- NCT02390076
- Acronym / sponsor ID
- IMHR-0001
- Conditions
- Depression
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 51 participants (actual)
- Lead sponsor
- Seth DisnerUniversity, hospital or other
- Study start
- Jan 2013
- Primary completion
- Jan 2015 (actual)
- Study completion
- Jan 2015 (actual)
- First posted
- 17 Mar 2015 (estimated)
- Results
- Posted 8 May 2019
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this project is to use low-level light therapy (LLLT) to enhance neural metabolism in the prefrontal cortex of humans, and measure the effects of LLLT on attentional bias change following a single session of attention bias modification (ABM). LLLT is non-invasive, therapeutically beneficial, and promotes a wide range of biological effects including enhancement of energy production, gene expression and prevention of cell death. Previous research has indicated that human participants show a beneficial psychological effect, including improved mood and greater sustained attention, following a single treatment of LLLT to the forehead. ABM is a computer-based cognitive task designed to decrease the mood-congruent negative attentional bias frequently observed in depressed and dysphoric individuals. Previous ABM studies have led to decrease in clinical symptoms relative to a control condition. This study will explore whether the effects of LLLT on mood and attention could improve the potency of ABM, leading to greater attention change and greater improvement of mood relative to sham LLLT.
Detailed description
Low-level light therapy constitutes a novel intervention shown to regulate neuronal function in cell cultures, animal models, and clinical conditions. The Gonzalez-Lima lab has previously shown that low-level light therapy can increase mitochondrial cytochrome oxidase activity, which can provide neuroprotection against toxicity and can improve the aerobic capacity of other tissue such as skeletal muscle. This suggests that the oxidative metabolism of tissue exposed to LLLT is enhanced. LLLT treatments also appear to have in vivo transcranial neurochemical effects that involve metabolic-enhancing and antioxidant systems; it is a non-invasive technique that has been used in humans to stimulate the brain as an antidepressant treatment, to alleviate muscle fatigue and enhance recovery, and to increase sustained attention during cognitive tasks. These LLLT treatments have thus been proven to be not just safe but actually beneficial in humans. Collectively, these data imply that LLLT could be used as an inexpensive, noninvasive approach to boost blood flow and energy consumption in the brain and other tissues, as well as provide neuroprotection against neurological conditions which may be related to mitochondrial dysfunction. This research could ultimately lead to the development of non-invasive, non-pharmacologic, therapeutic, cytoprotective and performance-enhancing interventions in both healthy humans and in those in need of rehabilitation efforts under conditions where neuromuscular function and movement are compromised, as well as treating neurobiological disorders in which metabolic dysfunction plays an underlying causal role, such as depression and post-traumatic stress disorder.
The therapeutic use of red to near-infrared light wavelengths is based on the principle that certain molecules in living systems absorb photons and trigger signaling pathways in response to light. In biologic tissues, absorption and scattering of light (which would render it ineffective as a treatment) are maximal at wavelengths below 600 nanometers, and water absorbs light at wavelengths greater than 1150 nanometers. Thus, there is a "wavelength window" for biologic stimulation that covers the red to near-infrared light spectrum (between 600 and 1150 nm).
Early results suggest that LLLT may have significant promise in the treatment of clinical disorders. Prior work found that a single LLLT treatment to the forehead resulted in an increased cerebral blood flow and significant beneficial effect in patients with major depression and anxiety. Previous research conducted in the Gonzalez-Lima lab showed that healthy human subjects receiving LLLT showed significantly higher positive affect at two week follow-up sessions relative to subjects in the "placebo-light" condition. Importantly, no adverse side effects were found in subjects for either study, either immediately after the initial treatment, or at two or four weeks post-treatment. The investigators plan to follow the LLLT treatment protocol from these two studies, immediately prior to running subjects through the ABM procedure.
ABM is a technique designed to modify attentional bias, a cognitive factor that has been theorized to underlie the onset and maintenance of Major Depressive Disorder. ABM is built on the framework of the standard dot-probe task, wherein two valenced stimuli are presented side-by-side, and then followed by a target probe behind one of the stimuli. The difference in response time between probes directly behind a stimuli relative to probes on the opposite side of the stimuli can be used to operationalize attentional bias for that particular valence of stimuli. ABM uses a conditioning approach to shift this bias by staggering the frequency of probe distribution in favor of one specific valence. Eventually, participants are expected to preferentially process the favored valence of stimuli, leading to a shifting of attentional bias.
This placebo-controlled study will measure whether LLLT influences the efficacy of ABM on measures of biased attention and dysphoria. Participants will be randomized to receive either active or placebo LLLT, and will then undergo an ABM procedure designed to decrease attention towards negative environmental stimuli (measured using a variant of the dot-probe task). The combination of LLLT and ABM will take place over two sessions (two days apart), and will be followed by one and two week follow-up periods to assess mood change. The investigators hypothesize that participants who receive the active LLLT will show greater change in attentional bias following ABM and greater decrease in dysphoric symptoms during follow-up compared to the placebo group.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Left active LLLT | Active comparator | Device: Left Low Level Light Therapy, Other: Attention bias modificationActive LLLT targeting the left forehead Attention Bias Modification Left low level light therapy |
| Right active LLLT | Active comparator | Other: Attention bias modification, Device: Right Low Level Light TherapyActive LLLT targeting the right forehead Attention Bias Modification Right low level light therapy |
| Sham LLLT | Sham comparator | Other: Attention bias modification, Device: Sham Low Level Light TherapySham LLLT targeting the right forehead Attention Bias Modification Sham low level light therapy |
Who may qualify
- Ages
- 18 to 35 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- 18 to 35 years old,
- English as first language,
- baseline CES-D score > 16.
Key exclusion criteria (1 listed)
- active neurological condition (such as epilepsy or stroke).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Left Low Level Light TherapyAlso: Transcranial laser stimulationAdministration of left LLLT consists of applying light of a specific wavelength (1064 nanometers) using a laser diode, the CG-5000 high density laser (Cell Gen Therapeutics, LLC). Left LLLT will target the left forehead. The diameter parameters of stimulation are the same that showed psychologically beneficial effects in Schiffer et al. (2009). At the power level described, the energy emitted by the CG-5000 at this setting is one quarter of the skin MPE (0.250 W/cm2), exposure to it is not deemed harmful to tissue, and it causes no detectable physical damage and negligible heat. | Device | Left active LLLT |
| Attention bias modificationAlso: Cognitive bias modificationThe task will consist of a modified dot-probe paradigm. A pair of stimuli depicting a negative word and a neutral word will be presented, randomly located to the right and left side of the computer screen. The words will be presented for 1000 ms. The words will then disappear and a dot-probe will appear in the center of the screen location of one of the words (i.e., O or Q). This probe will appear on the screen until the participant presses one of two response buttons to indicate the identity of the probe. The presentation of the probe will be staggered to maximize attention for the neutral stimulus. Latency and accuracy of the button press responses are recorded by the computer. | Other | Left active LLLT, Right active LLLT, Sham LLLT |
| Right Low Level Light TherapyAlso: Transcranial laser stimulationAdministration of right LLLT consists of applying light of a specific wavelength (1064 nanometers) using a laser diode, the CG-5000 high density laser (Cell Gen Therapeutics, LLC). Right LLLT will target the right forehead. The diameter parameters of stimulation are the same that showed psychologically beneficial effects in Schiffer et al. (2009). At the power level described, the energy emitted by the CG-5000 at this setting is one quarter of the skin MPE (0.250 W/cm2), exposure to it is not deemed harmful to tissue, and it causes no detectable physical damage and negligible heat. | Device | Right active LLLT |
| Sham Low Level Light TherapyAlso: Transcranial laser stimulationAdministration of sham LLLT is designed to resemble active LLLT from the participant's perspective, but uses a dosage markedly below the minimal necessary threshold to elicit a response. | Device | Sham LLLT |
Primary outcome
Presence and Severity of Depressive Symptoms Assessed by Center for Epidemiologic Studies - Depression Scale (CES-D)
Time frame: At baseline, session 1, session 2, 1 week follow-up, and 2 week follow-up.
The CES-D (Radloff, 1977) is a 20-item, self-report scale designed to assess the presence and severity of depressive symptoms over the past week. The total range is 0-80, with higher scores reflecting more severe depression symptoms. Outcome measure data table reflects clinical symptoms at 2 week follow-up.
1 secondary outcome
Biased Attention for Emotional Stimuli Measured by the Dot Probe Task
Time frame: Measure was administered at the beginning of session 1 and end of session 2.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 May 2019.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
A study testing Left Low Level Light Therapy, Attention bias modification and Right Low Level Light Therapy in people with Depression, run by Seth Disner.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 May 2019. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 8 May 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Presence and Severity of Depressive Symptoms Assessed by Center for Epidemiologic Studies - Depression Scale (CES-D) (time frame: At baseline, session 1, session 2, 1 week follow-up, and 2 week follow-up.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 May 2019.