Psychological stress and Parkinson’s disease: underlying mechanisms and focused interventions

Wednesday 3 April 2024, 10:30 am - 10:30 am
PhD student
Anouk van der Heide
Prof. dr. B.R. Bloem
Prof. dr. A.E.M. Speckens

Parkinson’s disease (PD) is the second most common neurodegenerative disorder. People with PD are particularly sensitive to the negative effects of stress. PD symptoms worsen during stress, and stress-related symptoms (depression, anxiety) are highly prevalent in PD. In my PhD thesis, I investigated which symptoms are particularly affected by stress, what helps to lower the impact of stress (non-pharmacologically and pharmacologically) and which factors protect against stress-related disorders in people with PD. In a large survey study (N=5000), we found that acute stress exacerbated the severity of a wide range of PD symptoms, especially tremor. A pharmacological functional MRI study (N=27) showed that the noradrenergic system, which is activated during stress, is a key modulator of PD resting tremor. This offers new ways of treating PD tremor, targeting the noradrenergic system either with propranolol, or non-pharmacologically with stress-reducing strategies. We also describe how stressful events triggered the onset of clinically manifest PD, in two previously healthy individuals. Regarding effects of more chronic stress, we showed that stress resilience in PD could be predicted primarily by psychiatric, social, and cognitive factors, rather than by factors related to dopamine depletion using a longitudinal survey (N=350). While it remains unclear whether stress accelerates PD progression, partly due to a lack of reliable progression markers, our findings suggest promising prospects for non-pharmacological therapies focused on stress reduction. Mindfulness might promote stress resilience and relaxation. People with PD who practice mindfulness experienced beneficial effects on all PD symptoms, most pronounced for psychiatric symptoms. Further research is needed to fully understand explain the mechanisms by which psychological stress influences the pathophysiology of PD, and to optimize stress management interventions for individuals with PD. Overall, addressing psychological stress may contribute to an improved quality of life and better treatment outcomes for individuals living with PD.