Segmental Laser Acupuncture for Constipation and Sleep in Patients With Parkinson's Disease

Parkinson's disease (PD) is characterized not only by motor symptoms but also by commonand clinically significant non‐motor symptoms, including constipation and sleepdisturbances, which can substantially impair quality of life. The concept of the"gut‐brain axis" describes bidirectional communication among the central nervous system,autonomic nervous system, enteric nervous system, and gut microbiota. Increasing evidencefrom animal models suggests that the gut‐brain axis may play an important role in thepathophysiology and progression of PD.Given the central role of autonomic nervous system regulation in the gut‐brain axis, thisstudy will use laser acupuncture as a safe, non‐invasive form of photobiomodulation (PBM)with potential neuromodulatory effects. Based on the concept of segmentalneuromodulation, laser stimulation will be applied to the thoracolumbar paraspinalregions (T10‐L2) and sacral segments (S2‐S4, corresponding to the Baliao points) tomodulate sympathetic activity arising from T10‐L2 and pelvic parasympathetic activityarising from S2‐S4. This approach is intended to promote intestinal motility anddefecation reflexes. Meanwhile, by modulating autonomic balance and stabilizingstress‐sleep rhythms, as assessed by salivary biomarkers including salivary cortisol andsalivary alpha‐amylase (sAA), the intervention is expected to improve sleep quality inpatients with PD.This study is designed as a randomized, double‐blind, sham‐controlled clinical trial.Participants with PD who experience constipation will be recruited and undergo an 8‐weekintervention. The primary outcomes will assess changes in constipation symptoms using theBristol Stool Form Scale (BSFS) and the Constipation Scoring System (CSS; Agachan Score).Secondary outcomes will assess sleep quality using the Parkinson's Disease Sleep Scale‐2(PDSS‐2) and the REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ). Objectivesalivary biomarkers, including salivary cortisol and sAA, will also be measured toinvestigate changes in autonomic function and their associations with improvements inclinical symptoms.This study is expected to provide preliminary evidence regarding the potential role ofsegmental laser acupuncture in modulating the gut‐brain axis and improving non‐motorsymptoms in patients with PD, thereby providing a basis for future larger‐scale studiesand the development of clinical care strategies.