beyond vision: physiologic effects of visible light · beyond vision: physiologic effects of...
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Beyond Vision: Physiologic effects of visible light
Shadab A. Rahman Ph.D., M.P.H.
Instructor in Medicine - Harvard Medical SchoolDivision of Sleep Medicine
Associate Neuroscientist - Brigham and Women’s HospitalDivision of Sleep and Circadian Disorders
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Acknowledgements
Brigham and Women’s HospitalMelissa St. Hilaire, PhDErin Flynn-Evans, PhD MPHSteven Lockley, PhDElizabeth Klerman, MD PhDCharles Czeisler, MD PHDDaniel Aeschbach, PhDThomas Jefferson UniversityGeorge Brainard, PhDJohn Hanifin, PhDUniversity of TorontoRobert Casper, MDTheodore Brown, PhDColin Shapiro, MBBCh, FRCPC, PhDShai Marcu, MD
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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
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Non-visual effects of light
Cajochen et al., Behav Brain Res, 2000
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Non-visual effects of light
Cajochen et al., Behav Brain Res, 2000 Campbell & Dawson Physiol Behav, 1990
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Classification of non-visual effects of light
Direct effect Pacemaker mediated phase-shift effect
0
20
40
60
80
100
Before After
Change in the levels Change in the timing
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Direct effect
Czeisler et al., N Eng J Med, 1995
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Gronfier et al., Am J Physiol, 2004
~20 h ~23 h
Pacemaker mediated (phase-shift) effect
Bright Light at Night
NIGHT 1 NIGHT 2 NIGHT 3
~20 h
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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
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Lighting characteristics that modulate non-visual effects of light
HISTORY
DURATION
WAVELENGTH
TIMINGPATTERN
INTENSITY
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Intensity and duration response
Rahman et al., JCI Insight, 2017Zeitzer et al., J. Physiol. 2000
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Spectral response
Lockley et al., SLEEP, 2006Brainard et al., J Neurosci, 2001
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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
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Gronfier et al., Am. J. Physiol. Endocrinol. Metab. 2004
Exposure pattern
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Photic history
Chang et al., J. Physiol. 2011
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Responses differ based on the time of day
Rüger et al., Am J Physiol Regul Integr Comp Physiol. 2006
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Responses differ based on the time of day
Rahman et al., SLEEP 2014
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Direct effect is not a proxy measure of pacemaker mediated phase shift effect
Rahman et al., J Physiol 2018
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Are we ready to apply what we know?
050
100150200250300350400450500
DARK <480 nm Filtered Unfiltered
Mel
aton
in A
UC
(pg/
ml*h
)
High Intensity (1000 lux)
Rahman et al., Am J Physiol Endocrinol Metab 2011 Gooley et al., Sci Transl Med 2010Rahman et al., Physiol & Behav 2017
Low Intensity (50 Lux)
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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
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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
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Thank you