Stress and mindfulness in Parkinson’s disease – a survey in 5000 patients

Abstract

Many Parkinson’s disease (PD) patients notice that motor symptoms worsen during stress, and experience stress-related neuropsychiatric symptoms such as anxiety and depression. Here we investigated which personal and disease characteristics are associated with perceived stress in PD, which PD symptoms are sensitive to stress, and we assessed self-reported benefits of stress-reducing strategies such as mindfulness. We sent an online survey to the Fox Insight cohort (n = 28,385 PD patients, n = 11,413 healthy controls). The survey included specific questions about the influence of stress on PD symptoms, use of stress-reducing strategies, and several validated scales measuring perceived stress, anxiety, dispositional mindfulness, rumination, and self-compassion. We received completed surveys from 5000 PD patients and 1292 controls. Patients perceived more stress than controls. Among patients, stress was correlated with increased rumination (R = 0.65), lower quality of life (R = −0.56), lower self-compassion (R = −0.65), and lower dispositional mindfulness (R = −0.48). Furthermore, patients indicated that stress significantly worsened both motor symptoms – especially tremor – and non-motor symptoms. Physical exercise was most frequently used to reduce stress (83.1%). Mindfulness was practiced by 38.7% of PD respondents, who noticed improvement in both motor and non-motor symptoms. Among non-users, 43.4% were interested in gaining mindfulness skills. We conclude that PD patients experience greater levels of stress than controls, and that stress worsens both motor and non-motor symptoms. Mindfulness may improve PD symptom severity, with the strongest effects on anxiety and depressed mood. These findings justify further controlled studies to establish the merits of mindfulness and other stress-alleviating interventions.

Impact of COVID-19 Pandemic on (Health) Care Situation of People with Parkinson’s Disease in Germany (Care4PD)

“…The response rate of 5.7% of this study was within the range of previous, comparable questionnaire studies of PD clientele [ 45 , 46 , 47 ]. Interestingly, the response rate resembled that of a recent questionnaire-based study (4.7%) using the same distribution method via the members’ journal of the German Parkinson Association but addressing a completely different topic [ 48 ].…”

Case Report: Chronic Adaptive Deep Brain Stimulation Personalizing Therapy Based on Parkinsonian State

“…A high beta band oscillation strength in the STN of patients with PD is correlated with the severity of motor symptoms, especially rigidity and bradykinesia (Kuhn et al, 2006). The strength of the beta band oscillation is influenced not only by movement (Feingold et al, 2015) or dopaminergic drugs (Weinberger et al, 2006), but also by several other factors (Urrestarazu et al, 2009;Duprez et al, 2019;Benis et al, 2020). A previous study has suggested that PD motor symptoms worsened when patients were subjected to stress (van der Heide et al, 2021), while training and relaxation programs mitigated motor symptoms of PD (Reuter et al, 2011).…”

Clinical neurophysiology of Parkinson’s disease and parkinsonism

“…PD rest tremor typically increases during cognitive tasks or motor coactivation, e.g., counting or tapping with the contralateral hand, and this can be used by clinicians to bring out the tremor in the clinic ( Dirkx et al, 2020 ). PD tremor is very sensitive to stress, and it can be reduced with stress-reducing interventions such as mindfulness ( van der Heide et al, 2021 ) and relaxation exercises ( Blakemore et al, 2019 ). Patients with PD may also manifest tremor in the cranio-cervical area, including chin, tongue, and voice tremor.…”