NCT07299240

Remote Ischemic Conditioning for Sleep Disturbances and Other Non-motor Symptoms in Parkinson's Disease

Remote Ischemic Conditioning for Sleep Disturbances and Other Non-motor Symptoms in Parkinson's Disease: a Randomized, Single-blind, Sham-controlled Clinical Study

• Status: Not Yet Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 48 (estimated)
• Sponsor: Jiangsu Province Nanjing Brain Hospital · Academic / Other
• Sex: All
• Age: 50 Years – 70 Years
• Healthy volunteers: Not accepted

Summary

This single-center, randomized, single-blind, sham-controlled clinical trial aims to evaluate whether remote ischemic conditioning (RIC) can improve sleep disturbances and other non-motor symptoms in patients with Parkinson's disease (PD). Forty-eight PD patients with insomnia will be randomly assigned in a 1:1 ratio to receive either active RIC (cuff inflation to high pressure) or sham RIC (cuff inflation to low pressure) for 7 consecutive days, in addition to their standard antiparkinsonian medications. Subjective sleep scales, sleep diaries, validated rating scales for motor and non-motor symptoms, and overnight polysomnography will be used to assess treatment effects at baseline, after the 7-day intervention, and during short-term follow-up. The study will also explore potential mechanisms of RIC by combining EEG, functional MRI, retinal optical coherence tomography, and blood biomarkers.

Detailed description

Parkinson's disease (PD) is a common neurodegenerative disorder characterized not only by motor symptoms, but also by a wide spectrum of non-motor symptoms. Sleep disturbances, including insomnia and fragmented sleep, are highly prevalent in PD and markedly impair quality of life, yet current pharmacological therapies have limited efficacy and may cause adverse effects. Remote ischemic conditioning (RIC) is a non-invasive intervention induced by repeated brief episodes of limb ischemia and reperfusion using an inflatable cuff. Experimental and clinical studies suggest that RIC can modulate immune responses, humoral mediators, neural activity and circadian rhythms. Based on these observations, we hypothesize that RIC may improve sleep disturbances and other non-motor symptoms in PD. In this study, 48 PD patients with insomnia will be recruited from the outpatient clinics and inpatient wards of Nanjing Brain Hospital. Eligible participants will be randomized (1:1) to an active RIC group or a sham RIC group on top of stable antiparkinsonian medications. Each participant will undergo two nights of polysomnography (one adaptation night and one baseline recording), comprehensive clinical assessments, EEG, retinal optical coherence tomography (OCT) and functional MRI (fMRI) before the intervention. RIC or sham RIC will then be performed twice daily for 7 consecutive days. After completion of the 7-day intervention, polysomnography, EEG, fMRI, OCT, clinical rating scales and blood sampling will be repeated. A further clinical and neurophysiological assessment will be conducted approximately 21 days after the end of RIC to evaluate the persistence of treatment effects. The primary objective is to determine whether RIC improves subjective and objective sleep parameters in PD patients with insomnia. Secondary objectives include assessing changes in other non-motor symptoms, motor symptoms, cognition, mood, autonomic function, quality of life and exploratory imaging and blood biomarkers.

Conditions

• Parkinson Disease (PD)
• Insomnia

Interventions

Type	Name	Description
DEVICE	Remote ischemic conditioning device	An automated upper-limb cuff device is applied to one arm to induce brief episodes of limb ischemia and reperfusion. In the active RIC group, the cuff is inflated to a high pressure (approximately 200 mmHg) sufficient to occlude arterial blood flow, and then deflated repeatedly according to a pre-set program recommended by the manufacturer. RIC is performed twice daily for 7 consecutive days.
DEVICE	Sham remote ischemic conditioning	The same device and procedure are used as in the active RIC group, but the cuff is inflated only to a low pressure (approximately 60 mmHg) that does not occlude arterial blood flow. Sham RIC is performed twice daily for 7 consecutive days.

Timeline

• Start date: 2026-01-01
• Primary completion: 2026-12-31
• Completion: 2026-12-31
• First posted: 2025-12-23
• Last updated: 2025-12-30

Locations

1 site across 1 country: China