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Beyond Vision: Physiologic Effects of Visible Light Shadab A Beyond Vision: Physiologic effects of visible light Shadab A. Rahman Ph.D., M.P.H. Instructor in Medicine - Harvard Medical School Division of Sleep Medicine Associate Neuroscientist - Brigham and Women’s Hospital Division of Sleep and Circadian Disorders [email protected] Acknowledgements Brigham and Women’s Hospital Melissa St. Hilaire, PhD Erin Flynn-Evans, PhD MPH Steven Lockley, PhD Elizabeth Klerman, MD PhD Charles Czeisler, MD PHD Daniel Aeschbach, PhD Thomas Jefferson University George Brainard, PhD John Hanifin, PhD University of Toronto Robert Casper, MD Theodore Brown, PhD Colin Shapiro, MBBCh, FRCPC, PhD Shai Marcu, MD Outline • Characteristic non-visual physiologic responses to light exposure • Properties of light exposure that modulate non-visual responses • Nuances & application considerations • What do we know • Future directions Non-visual effects of light Cajochen et al., Behav Brain Res, 2000 Non-visual effects of light Cajochen et al., Behav Brain Res, 2000 Campbell & Dawson Physiol Behav, 1990 Classification of non-visual effects of light Direct effect Pacemaker mediated phase- shift effect Change in the levels Change in the timing 100 80 60 40 20 0 Before After Direct effect Czeisler et al., N Eng J Med, 1995 Pacemaker mediated (phase-shift) effect NIGHT 1 NIGHT 2 NIGHT 3 Bright Light at Night ~20 h ~20 h ~23 h Gronfier et al., Am J Physiol, 2004 Pathway for non-visual effects of light Czeisler et al., N Eng J Med, 1995 Vandewalle et al., Trends Cog. Sci. 2009 Vandewalle et al., Trends Cog Sci, 2009 Lighting characteristics that modulate non-visual effects of light INTENSITY DURATION HISTORY WAVELENGTH PATTERN TIMING Intensity and duration response Zeitzer et al., J. Physiol. 2000 Rahman et al., JCI Insight, 2017 Spectral response Brainard et al., J Neurosci, 2001 Lockley et al., SLEEP, 2006 Phase response Light after ~6:00 am (Temp min) causes an advance Light before ~6:00 am (Temp min) causes a delay Adapated from Rajaratnam & Arendt, 2001 Exposure pattern Gronfier et al., Am. J. Physiol. Endocrinol. Metab. 2004 Photic history Chang et al., J. Physiol. 2011 Responses differ based on the time of day Rüger et al., Am J Physiol Regul Integr Comp Physiol. 2006 Responses differ based on the time of day Rahman et al., SLEEP 2014 Direct effect is not a proxy measure of pacemaker mediated phase shift effect Rahman et al., J Physiol 2018 Are we ready to apply what we know? High Intensity (1000 lux) Low Intensity (50 Lux) 500 450 /ml*h) 400 pg 350 300 250 200 150 100 Melatonin AUC AUC Melatonin ( 50 0 DARK <480 nm Filtered Unfiltered Rahman et al., Am J Physiol Endocrinol Metab 2011 Rahman et al., Physiol & Behav 2017 Gooley et al., Sci Transl Med 2010 What do we know? • Diverse range of physiologic responses to light • Physiologic effects of light follow a dose response • Short-wavelength sensitive ipRGC (melanopsin) response dominates in long-duration, bright-light conditions • Visual photoreceptors modulate physiologic response to light • Significant inter-individual variability • COMPLEX AND DYNAMIC SYSTEM Future directions • Interactions between neural and receptor pathways • Interactions between response modulators • Lab to field applications • Evidence based claims • Definitions • Standard(s) – for application & research Thank you.
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