ABSTRACT NUMBER: ESOC2026A1287 EFFICACY AND SAFETY OF SUNLIGHT THERAPY IN STROKE PATIENTS –A RANDOMIZED CONTROLLED TRIAL

Abstract Background and aims Stroke rehabilitation is prolonged and resource-intensive, and accessible low-cost adjunctive therapies are limited. We evaluated whether adjunct natural sunlight exposure, compared with standard care alone, is safe and improves Stroke-Specific Quality of Life (SS-QoL) in patients with stroke Methods This prospective, randomized, open-label, blinded-endpoint (PROBE) trial was conducted at a tertiary neuroscience centre in New Delhi (Nov 2023–Apr 2025). Adults aged 18–80 years with recent moderate stroke (NIHSS 5–15 or intracerebral haemorrhage volume <30 mL) within 4 weeks were randomized 1:1 to adjunct sunlight therapy plus standard care or standard care alone. The intervention comprised 30 minutes of outdoor sunlight exposure on alternate days for 15 days (target ~10,000–25,000 lux). Outcome assessors were blinded. The primary efficacy outcome was change in SS-QoL from baseline to second follow-up (~2 months). The primary safety outcome was treatment-related adverse events. Analyses followed intention-to-treat principles. Results Of 212 screened patients, 40 were randomized (20 per group). Baseline characteristics were comparable, although SS-QoL was lower in the sunlight group. SS-QoL improved more with adjunct sunlight therapy than standard care (median change +60.5 vs +26.0; between-group median difference −34.0, 95% CI −51.0 to −11.0; p=0.012), supported by mean change analysis (p=0.013). Improvement was also observed at first follow-up. No treatment-related adverse events occurred. Two deaths (one per group) were unrelated to the intervention. Conclusions Adjunct natural sunlight therapy was safe and associated with improved SS-QoL after stroke. Larger multicentre trials are warranted to confirm efficacy Conflict of interest Shivam Mirg: nothing to disclose