{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:17:20Z","timestamp":1783484240076,"version":"3.55.0"},"reference-count":51,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J of Neuroscience"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Freezing of gait (FOG) is a common and disabling symptom in people with Parkinson's Disease (PD), characterized by paroxysmal episodes where there is an inability to step effectively, despite attempting to do so. Anxiety and stress exacerbate FOG, particularly in\u00a0situations where people with FOG anticipate not being in control of their movements. Some people with PD use compensatory strategies that target anxiety and stress to improve FOG. However, tailored strategies to ameliorate anxiety\u2010 and stress\u2010related FOG have never been evaluated in a systematic manner. We describe the study protocol of the TACKLING\u2010FOG trial, which aims to evaluate the effectiveness of a novel 4\u2010week Managing the Mental State intervention in reducing FOG\u2010related anxiety and stress to improve FOG. We also aim to identify the key determinants influencing the response to the intervention. This study is a randomized controlled trial (RCT) with a waitlist control group. Forty participants with PD who experience anxiety\u2010 or stress\u2010related FOG will be included. All participants receive a baseline measurement and are subsequently randomized to the intervention or control group in a 1:1 ratio. The intervention group immediately receives four weekly sessions of the Managing the Mental State intervention, whereas the control group enters a waitlist period. Afterwards, both groups are reassessed. Next, the intervention group enters a 10\u2010week follow\u2010up period, while the control group receives the intervention, is reassessed, and enters the follow\u2010up period. Both groups receive a final measurement at the end of the follow\u2010up. The primary outcome is the percentage of time frozen during a home\u2010based walking course that includes self\u2010selected FOG \u201chotspots.\u201d Secondary outcomes involve the percentage of time frozen during the same trajectory under elevated stress conditions and during a standardized FOG\u2010provoking protocol. Additionally, heart rate is collected as a physiological marker of stress and anxiety, and questionnaires are administered to assess domains that may improve in response to the intervention, including anxiety, quality of life, and self\u2010esteem. TACKLING\u2010FOG will be the first RCT to examine the use of tailor\u2010made behavioral strategies to tackle anxiety\u2010 and stress\u2010related FOG in people with PD.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/Clinicaltrials.gov\">Clinicaltrials.gov<\/jats:ext-link>\n                    NCT06302309. Registered on March 8, 2024\n                  <\/jats:p>","DOI":"10.1111\/ejn.70584","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T04:15:17Z","timestamp":1781756117000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tackling Anxiety\u2010 and Stress\u2010Related Freezing of Gait in People With Parkinson's Disease (TACKLING\u2010FOG): Study Protocol for a Randomized Controlled Trial"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2440-3492","authenticated-orcid":false,"given":"Gijs","family":"Vissers","sequence":"first","affiliation":[{"name":"Donders Institute for Brain Cognition and Behavior; Department of Rehabilitation; Center of Expertise for Parkinson &amp; Movement Disorders Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anouk","family":"Tosserams","sequence":"additional","affiliation":[{"name":"Donders Institute for Brain Cognition and Behavior; Department of Rehabilitation; Center of Expertise for Parkinson &amp; Movement Disorders Radboud University Medical Center  Nijmegen the Netherlands"},{"name":"Donders Institute for Brain Cognition and Behavior; Department of Neurology; Center of Expertise for Parkinson &amp; Movement Disorders Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annelien A.","family":"Duits","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology Radboud University Medical Centre  Nijmegen the Netherlands"},{"name":"Department of Psychiatry and Neuropsychology Maastricht University  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anouk","family":"van der Heide","sequence":"additional","affiliation":[{"name":"Donders Institute for Brain Cognition and Behavior; Department of Neurology; Center of Expertise for Parkinson &amp; Movement Disorders Radboud University Medical Center  Nijmegen the Netherlands"},{"name":"Donders Institute for Brain Cognition and Behavior; Centre for Cognitive Neuroimaging Radboud University  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastiaan R.","family":"Bloem","sequence":"additional","affiliation":[{"name":"Donders Institute for Brain Cognition and Behavior; Department of Neurology; Center of Expertise for Parkinson &amp; Movement Disorders Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick C.","family":"Helmich","sequence":"additional","affiliation":[{"name":"Donders Institute for Brain Cognition and Behavior; Department of Neurology; Center of Expertise for Parkinson &amp; Movement Disorders Radboud University Medical Center  Nijmegen the Netherlands"},{"name":"Donders Institute for Brain Cognition and Behavior; Centre for Cognitive Neuroimaging Radboud University  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William R.","family":"Young","sequence":"additional","affiliation":[{"name":"School of Sport and Health Sciences University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorik","family":"Nonnekes","sequence":"additional","affiliation":[{"name":"Donders Institute for Brain Cognition and Behavior; 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