Efeitos da terapia com luz no humor e nas alterações do ritmo vigília/ sono em paciente com acidente vascular cerebral isquêmico

Abstract

Ischemic stroke (IS) is a multifactorial disease due to an obstruction of the cerebral arterial flow causing ischemia, death of neurons and acute neurological deficit. It is currently an important cause of morbidity and mortality. Motor, mood, sleep-wake, and cognitive changes are common and potentially serious in IS. In other clinical conditions, studies have shown that light therapy is a promising treatment that reduces changes in wake-sleep rhythm, anxiety and depression. The aim of this study was to analyze the effects of light therapy on motor function, mood, wake-sleep rhythm and fatigue in ISpatients. METHODS: This is a prospective, randomized, placebo-controlled study of stroke patients. Patients of both genders aged> 50 years who had presented at least one episode of IS for at least 3 months and with severity between mild and moderately severe (National Institute of Health Stroke Scale-NIHSS < 20). Patients with a history of associated severe comorbidities were excluded. Light therapy (10,000 lux) or placebo (450 lux) was used for 30 min between 17 and 18 h for two weeks. Outcome measures were: Modified Rankin-MR and Modified Barthel Index-MBI, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), mood (Hamilton Anxiety and Depression Scale-HADS) and Fatigue Severity Scale (FSS). Results: Forty patients of both genders (52.7% male) aged 52-74 years (64.0 ± 5.9) were evaluated at baseline and two weeks after therapy. High blood pressure (63.9%), diabetes (61.1%) and cardiovascular disease (N = 7; 19.4%) were recorded. After light therapy, it was observed improvement in daytime sleepiness (ANOVA, Repeated Measures, p = 0.002adjusted for age, severity of stroke, and degree of anxiety (p = 0.005). Conclusion: In patients with IS, light therapy is an affordable non-pharmacological treatment that positively impacts the wake-sleep rhythm of patients reducing excessive daytime sleepiness and anxiety symptoms.