Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
~ 327231
q~hi inven~lon ~a~ce~; 1;o app~ra~u~ and
trea~ment~ ~or pho~o~ rapy ~nd in p~ticulEIr ~o more
~onvQnient tre~ Dnt~ ~or a~ecting ~h~ n~uro~ndocrine
~y~tela, ci~cadian rhythm~ ~n~ cl~cannual ~hythms in humans~
~9~ ;
~he 2~1010glcal ~g~ec~s o2 light are incre~E~ingly
l:eing reoognlz~ playing~ ~n i~por~hnt role in ~od~rn
he2~1thc:are. Phototherap~ u~ o~ llght ~ a tr~a~en~,
h~4s beon ~uaoessfully u~od to treat ~ ~umb~r o~ disea~es
including p~ori~si~ and r:Lclcetfi~. Nore r~cently, ~ienti~ts
hav~ csov~r~aa ~t ~unli~ht ~la~8 ~ ~rlti~l role in 'c;tle
regul~ltiLon o~ cir~adian ~nd ~ireann~al ~hyth~s in hu~an~. -
Acco:~aihgly, in~rea~ea atte~t~ion i8 ~ing pai~ to ~he U~;e
of phQtotll~rap~ in CliOEea~es in~lu~no~d by dally a~d
~asonal rhyth~s. Phototh~rapy ha~ en d2monstratef~ to
: 2~ h~ve signific~mt ~ffects in thq; ~:reat~n'c~ o~ ~e~rer~l
di~e~ e~ pa~i.~u~a~ $n~ t ~o p~ hiAtr~ ncl~ding
a~Qctiv~ illn~ and chronolbiolc~gical d~;o~de~. It ha~
~1BO bO~r~ u~3ed w~ o~o ~UC~ in t~e t~ 'e~nt of
p~ych~atri~: d~;o~d~ which Xa~re ~ 5'~sa~;o~aal C o~pon~n~
2S ~or exa~ple, ~s~a~on4~ ~f~ tiv~ di~ord~r ~8~cD~
Li ~ht. h8~ ~ee3n 6~hown tg~ hal~2 ~ ns~er o~
p~y~hological off~ct~ on th~ human c~nt~l n~rvou~ ~y~cm
whio~ ~y ~e~ 8-pl~r~ 2 fro~ lt6 ~i~u~ f~:t~ ry brigh~
li~ht, i.o. ~ve abou~ ~000 luxl i~ cap~bl~ o~ ~lappr~ g
;~
` ~272~1
~ ;~
the pr~ucl~ t~on ~n~ relea~e o~ t~e pineal ho~on~ An'd ¢an
-qlet th~s ~ nternal "cloc~k", within ~ c~rta$ rl ra~, iFo~
c:irl:adlan rhythme . Ra~rRnae ~ ~ h~r~in ~ade ~o P . M .
Jacobsen e~ al. ~ 30nal ~ffective ~ order and the Use
5 of Light a~ an Antideprs2~ ntn, nlnca~o~,
~ol ~, 198~.
one c:urrently pre~ ibed treat~ent ~or
p}~oto~herapy i~3 to hæ~e patient~ ~it ~pprc~xilllat~ly three
$~et ~rom a light box ~hich typis:~lly h2~ diD~ension~ o~E
lO about a ~ by 4 ' . The~ light boxe~E; a~e q~nç~rally awkwar~l
An~ ~u~berso~ to ue~e. Fllrtlhe~o~e, the patient~ ~e
r~quired ts 8it: in one ~pot ~or approximat~ly on~ ~o ~iv~
hour~:, depending c\n their ~p~c:if i~ ~her~py . Thif~ hd~ been
Potlnd to be res~ri~t.ive aJld lin-itirlg. A~ditionally, 1:~e~
15 d~3vioe3 are diffic~llt to tranE;port due t~ thei~ ~ize ~nd
welght and gener~lly require an extern~l power souXc~.
Acaordingly, a need ~xi~ts fo~ ~ mob~le
pho~otherapy treatman~ whi:~ would no~ re~uire patiexlt
inaati~ty. In a~dition, ~ need exist~ ~o~ a
20 phototherapeutic devi~ which i~ lightwei~ht and s213~-
eontained .
~ = .
In aac:ordan¢e with the lteaahing~; of this
inventlon, an improved photother~peut~a deviae and
z5 pho~otherapy metho~ are provideæ. $he invention i~
de~igned to sti~ul~te the neuroendocrina and circadian
~y~t~m~: aircan~ual of the p~tient with a ~ery l:~righ~ light
of Rt: leaBt 200 1UX. ~ lighlt: ~IS portably ~o~ted to
port~on~ oI th~ pati13nt'~: body, pr~erably-the h~aad, and i~
30 d~xected tow~d~ the Fa~ t'~ 2~e~ he liglht preferal:~ly
u;e& a full white 1 ight fipeatrum e~n~ 18 ~Uppl ied wlt~ pow6~r
lt* el b~t~:2ry whi~h i; p~ ra~ly ~eabargeable. The
~n~ention al~o m~y t::ho~s ~o defle~t heat: g~ne~ated from the
light ~way from thkl pg~on tdearing th~ . It i~
35 en~isloned tha~ the l~ght c:an be oquipped with ~a dimmer
itch o~ rheo~tat ~a that th~ u~er ~ay r~du~ th~
lr~te~n~ity o~ ~ch~ bulbE;. In ~ddi~lon, t:he ~ev~ce ~an be
~32~2~
pp~ ~ fll~r~, ~uch as ~ 3hrolc ~ neutral
~on~lty ~ o~ ~n~ ~ho~ r~ 8~ dl to blo~k or
#orQen ~Is~gn~t~d r~ tlon, ~u~ in~ra~d OX
ultraviol~ ligh~. ~uch f~ltors e:An be ~ erpoS~ w~en
5 ~he l~np o~ the light ar~d t~e ua~r ' ~ ~yee n
Ao~or~g~y, ~ ~hotothor~p~u~ic devic~ ahd ~ethc~d
ar~ pro~f$d~a ~hi~h per~it ~inte~upted ~p~tient actlvity
durlng tr~a~ment. The d~ e u~ed ~or ~h~ t~eatment
o~ depres~on, su~:h aa~ SA~, or u~d by h~althy peop}~
lo invol~ed in ~h~ wor~c to ~rco~e ra~ ance b~ thei~
in~ernal ~locks.
~ hift work ch~llen~e~ the rlor~l blolc~
rhyth~; o~ hu~an being~. P$cple ~ho change work ~:hift~
o~en repor~ psyc:hological di~com~or~ and negati~re healtll
lS ~:on~equ~noe~. Aooident~ and h~lth rel~ted abl~:enkeq~iem ~re
oft~n hi~her among shi~t-work~r~ d~e ~o th~ str~ss ln
~hangin~ h~dulos. Tllo u~:e of the phototherapeutic d~ice
of th~ invention ~ay pro~r~ b~n~ie~l in r~ etting the
p~rson~ biolog~c~l ~lock when he or she ohans~e~ shif~.
20 Currantly, an e~tim~to~l 20-255e oi~ the ~o~)c Yor~:~ in the
UnLte~d ~ta~ ln~olv~d in ~iw~e gon~ of ~hi~t workO
Finally, th~ pho'cotherapeutic: d~vic~ o~ thi~
lr.v~nt~or~ ~ay ~ u~eful fo~ people who t~avel by pl~ ~rer
~ult~plo time ~one:a. S~wh trlltrel~r~ ~xperienc~ ~ ~alady
25 kn~wn as ~2t-l~g" which oan sl~bilitR~e tl~e ~rav~ler for
one to ~our day6 a~t~2r the 1iyhtO A~ wl~h ghift workers,
the devic~ o thiE; in~ention miyht l~e u ~d ~or a 3Aor~
r~pi~, e~eGti~ r~setting o~ the internal ~iological
clock, allowin5~ pr~VQnt~on or quic:ker ~co~r~ rom j~t
30 lay.
It i~:, therQ~oa~ an ob~e~;~ of this irnrentio~ ~o
p~ov~de ~ porSab~e, hea~-mou~ate~ phototherapeuti~ dev~c~
~or th~ treat~n~ of p~;yc:hiatr$c dioo;rder~.
It i~ a~other obi~c1: o~ thlE; ~mr-3ntion to p~Ylde
35 a ~lf-containing photo~he~zlp~u~1¢ devi~:e for d~ rer~ng
bri~h~ ligh~ tCI the U~ '6 eye'G ~or ~stl~ul~ttng the
ci~ca~lan and nouroondocrine ~y~tl!~ c~ u3~r.
~272~
-- 4 --
till ~noth~ ob~ao~ of ~i~ ln~ren'c~n ~o
~rovid~ an i~ro~e~d uathod oP phsto~he~y ~or ~r~a'Gia~lg
~oth p~yd~ r~ c: di~ord~ræ ~n~ ne~a~ he~lth oons@~uenc~s
~ oo~at~ ith ~;hift ~ork or ~0t l~g.
W~th tb~s~ and ot~r oh~ in ~ w, thi~
~nventio~l reaide~ in the nOY~ n8truoJtion~ a~bination
arrange~n~ of part~ and n~etlaods ~ubot~nt~ally a~
h~reinaflte~ d~ ri}~d and aor~ p~ ulaxly de~ino4 by the
atta~ d ~l~i~e.
~ he ~oc~pan~ g dr~ing~ illu~tr~ a c~ampl~te
e~ ment csf ~h~ v~n~i~n ~ccordins~ to the }~est Dlode ~30
f;l3~ de~ ed ~or the practic~l appli~ation of th~ prinçipl~
thereo~ ~nd ~ n whie~
~ s a p~rl~p~tiv~ u~tration o~ a
p~ erred port~le ~hototh0~ euti~ d~Ev1~e og:~ this
invontion, ~quipped w~th ~ ~lide-mountQd ba~tery pa~
dimmer f~wit~h, li9ht 60ur~e ~nCI h~æ~t d~fl~'cor;
FIC. 2 ~ r~poo~re ll~u~tra~tion o~E another
pre~rred, E~ort~bl~, pl~ototherAp@u~ e~odiment having
top-mouA~ ba~t~ry paclc ~nd ~ront-mounted light ~urae:
FI~:. 3: i~ a p~re~c~ e vi~w o~ another
photo~ t:herapeu~ic e~odlmen~ o~ thi8 inven~ion lnc~udlng a
front ~ounted li~h~ source ~nd fi~ter; a~aa
FI~:~ 4 ~ tr~n~ver~e Y~ r o~ another
photothQr2~p~u~1c embo~ nt Or thi~ in~n~ion whic~2 !
in~ des a ~ont mount~l 1 $ght sourc~ ~nd romot~ bat~ery
pai:k for providing a lighlt~r w~ight conllstruc~lotl7
~ i
3 ~ R~r~in~ nc~w to the ~igure~ and p~ ularl~ ~o
~IG, 1, th~3r~ i~ ç;hown a po~able photothera~euti¢ d~vlc:~e
~,Q h~ving a heat d~1Ot:tor ;L~. ~n~ he~d ~nouJlting deYi~e 5
~e ~ pro~rided ~ith a ligh~ ~ou~ce ~ and
batto~y pa~lc 14. It beco~e~ r~d$1y ~pp~ren'c t~t thl~
3~ d~vicQ ~LQ o~r~co~ tho p~ob1e~a~ of ~xce~siv~ ~ize a~d
brs~igl~t ~nd li~ited ~o~ ty by being llght weight, 8~1
c~ntain0d an~ h~a~ount~ deYlt~ at~ o 3b~
- ~32~2~1
-- S
~tt~d ~ith ~ rboo~t~t ~ ~or ~r~ltting ~ p~tio~t to
~d~u~t th~ lnt~n~ty o~ gh~ ~ou~co~.
An ~lt~ o~odi~on~ Lu~tr~t~d in
2 whi~h ~e~cr~ a photo~r~p~at~ ~eyis~ Q h~vinSI a
5 light ~ouroe ~ounted on ~n ~x~ sn o~ the ~ç~a~ m~3unl:ing
:~eAn~ a~lon, ~e light ~ourc,q ~ aan be mor~
App~opriately ~o~u i;ed on t~e oyo3~ oiE ~ e~. !rhqa battery
p~c:lc 2~ of thi~: e~bodi~t ~ tedl ~long lthe top
porl:ion o~ t~e head ~ounting D~ ,o
Ir~ ~IC. 3, A phototherapeu~ d~3via~ hewing
radiation shi~ld ~ i~ deE~aribe~. ~e l~ght ~æour~e ~/ 0
~his q~mbo~i~ont ~ taahed to the h~a~l ~c~nl~ing 3Dean~ ~,
spoE;ed b4tw~en ~he eyes of t~e u~r ~nd th~a light ~c)urs:e
~ i~ a fil~r desigs~e~l to blo¢lc or ~cre~an designa~d
15 r~diati~n, ~uah ae~ ~fr~red o~ ultrallriolet llght. Th~
~ilt~r 36 aould al~o b~ ~ di~hrola or n~u~ral den6ity
Pilter.
Re~4rrinq now to F~a. 4 ~ A ligh~-~$ight
ph~o~erap~utic dQvicsll 4Q i~ illu6~r~ hAving ~ re~ote
20 battor~ bac~ . ~Q light s:ourc~ ~ ls di~po6~d on ~
~our~ting E~ean~ 4~, wh~ch ~an g~nerally a~ u~e th~ ape of
~un vi30r. Tla~3 device ~0 ie o~auipped w~th a DI~D~er ~i
~hich aan corre~pond ~o a ~ist~on ~ er ~-nd~ox ~ hea~
deflootion æhi~ld. ~tn a~cordance with thl~ particular
25 e~nbodinlent, a sl:r~p 48 a~n be p;covid~ ~or ad~lstm@nt to
v~rio~ head ~iZQ$~ ;
~ h~ light E~ouro~ Z" ;~ or ~ pre~e~ y
comp~ioe~ an incande~c~nt ~a~p, pre~e~ably a quar~z ~alog~n
l~mp. The ~ntens~ty o~ th~ lll~inance pro~Uc~ y l;he$e
30 lamp~ 1?, 2~ 3~, and 42 ~hould ~ 1!15t: 20~
~lthouyh ~ore pre~er~ble ~ang~ include f~oDIl a~out 200 lUx
to a~clut 10~00 luX, ~rsm ~bout 1000 ~ o abou~ 3000 luxo,
~ro~ ~ t 15D0 lux to o~ut 27Q0 lux, and ~o~ prsr~rab~y
~rom ~bou'c 2000 lu~c 'co about 2500 l~X~r rhe latter r~nsle
35 h~ be~3n r~aoognized ~ ac¢ept~ . For ~n~tanco, s~cudle~
o~ phototherapy ~lth ~goA~ p~ticnts h~e con~lu~l~d th;~
bri~ht llg~ 500 lux) iE~ ~ignlfic:~n~l~r ~o~ ~ffeo~iv~ aE;
` ~32 123~
an An~idep~es~an~ than ~he in~en~î~y of light ordlna~lly
~ound in a ho~a or o~ (100-300 lux~. Soe
Jacob~en, ~S~a~onal Af~e~tiYe ~i~ord~r and ~he U~e of ~igh~
a~ an ~nti-Depre~ant~ EYr Vol~ 6,
1~8~.
One a~pt~le traat~n~ ~or t~e ~i~mpto~ of
Sea~onal Affe~ve ~i~ord~r c~uld b0 to ~xpos~ patle~ts ~o
~he bright ar~ ial light pr2du~ y ~hQ
pho~other~peudi~ device~ of th~ in~ention for a period o~
S to ~ hour~ per day. It i~ ~nder~tood th~ the anti-
dep~es~ant effeat~ could app~ar within ~ to 6 day~ a~ter
the commenaement of tr~atmont, and a relapse v~ten could
occur 2-4 day~ ~f~er light ~reatment i~ di~continued.
In the t~ea~ment of manic-~epre~sive patients, an
15 expo~ure to 500 lux ha~ been known t~ cau~e a 50~
~uppr~s~ion o~ melatohin levels~ bu~ produced no ef~et in
~he con~rols. A.J~ L~Wy, ~t ~1, '9~ani~-d~pre~iY~ Patientæ
~ay Be Supe~6ensitive to ~igh~ he ~ncet~ p. 3~4,
~ebru~ry 14, 198~ ha~ ~180 ~ean de~onstrat~d that when
ma~ic-~pre~nt~ were expo~ed to ~ ht lnten~ity of 15~0
lux, al~o~t ~o~plete suppressiQn ~f mela~onin æeoretion w~
no~ed, re ul~ing in level~ of approaching ~hos~ o~erved
durlng dayt~mc in two healthy ~ub~ect~. ~c~ordin~lyJ ~he
use og the de~ice~ of th$~ invention coul~ be used to
~uppre ~ hu~an mela~onin ~e~re~ion in manic-depre~nt~ and
alter the e~vironm~ntal ligh~-cy~le Which generat~ thelx
cir~adian rhy~h~,
From the for~go$n~ ha~ be~n demon~tra~ed that
this inven~ion prcwi~ port~ble, light-weighlt
3 o phototh~rapeu~ d~vice~ gor ~t~ul~ting a patlen~ ' ~
c:irc:Adian 6y~t~ and a~soc~ated ~euro~ndocrine parameter~ .
Althoug~ ~riou$ embo~iment~ hatJ~ be~n lll~s~ra~e~l, this
w;~ for the purpo~e of ~escrlbing, but no~ ll~i~ing t~e
inven~ n. Variou~ modif~r:~tions, whic~h will b~G~me
35 apparent to on~ Q~ ed in the ~rt, aro wi~chin the ~cvpe o:~
thl~ in~ention de~ribsd in ~he att2~ch~q clai~n~.
