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Fox Foundation for Parkinson\u2019s Research","doi-asserted-by":"publisher","award":["#16048"],"award-info":[{"award-number":["#16048"]}],"id":[{"id":"10.13039\/100000864","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Parkinsons Dis."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Many Parkinson\u2019s 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 (<jats:italic>n<\/jats:italic>\u2009=\u200928,385 PD patients, <jats:italic>n<\/jats:italic>\u2009=\u200911,413 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 (<jats:italic>R<\/jats:italic>\u2009=\u20090.65), lower quality of life (<jats:italic>R<\/jats:italic>\u2009=\u2009\u22120.56), lower self-compassion (<jats:italic>R<\/jats:italic>\u2009=\u2009\u22120.65), and lower dispositional mindfulness (<jats:italic>R<\/jats:italic>\u2009=\u2009\u22120.48). Furthermore, patients indicated that stress significantly worsened both motor symptoms \u2013 especially tremor \u2013 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.<\/jats:p>","DOI":"10.1038\/s41531-020-00152-9","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T11:17:06Z","timestamp":1610968626000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":77,"title":["Stress and mindfulness in Parkinson\u2019s disease \u2013 a survey in 5000 patients"],"prefix":"10.1038","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3989-2267","authenticated-orcid":false,"given":"Anouk","family":"van der Heide","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5266-1554","authenticated-orcid":false,"given":"Anne E. 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A. van der Heide reports no disclosures. A. Speckens receives funding from the Dutch Cancer Foundation and the Netherlands Organization for Scientific Research. M. Meinders reports no disclosures. L. Rosenthal receives research support from the Michael J. Fox Foundation, Parkinson\u2019s Foundation, and the National Institute of Neurological Disease and Stroke. B. Bloem receives funding from the National Parkinson Foundation, the Netherlands organization for Scientific Research, International ParkinsonFonds, and the Michael J. Fox Foundation. The Center of Expertise for Parkinson & Movement Disorders the Radboud University Medical Center was supported by a center of excellence grant of the Parkinson\u2019s Foundation. R. Helmich was supported by the Michael J. Fox Foundation (grant #16048) and by the Netherlands Organization for Scientific Research (VENI grant #91617077). R. 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