BOSTON—Stress may be a modifiable risk factor for Parkinson’s disease progression, according to
research presented at the 69th Annual Meeting of the
American Academy of Neurology. In a study of more
than 4,000 patients, a stress proxy score predicted mortality and was associated with worsening mobility. The
findings suggest that stress reduction may be an effective
intervention in Parkinson’s disease, said Amie Hiller,
MD, Assistant Professor of Neurology at the Oregon
Health and Science University in Portland.
“Potentially, stress reduction is something we could
think about to slow Parkinson’s disease progression,”
said Dr. Hiller. “Our goal is to not only treat symp-
toms of Parkinson’s disease, but to slow progression of
Research suggests that stressful life events may
increase the risk of Parkinson’s disease. In addition,
animal studies indicate that stress damages dopa-
mine cells, resulting in more severe parkinsonian
symptoms. In humans, acute stress can worsen mo-
tor symptoms, including bradykinesia, freezing,
To examine the relationship between psychological
stress and Parkinson’s disease progression, Dr. Hiller
and colleagues analyzed data from the National Parkinson’s Foundation Quality Improvement Initiative.
All 4,155 participants in the study were able to walk
unassisted at baseline.
For each patient, investigators calculated a stress
proxy score derived from the 39-item Parkinson’s Disease Questionnaire (PDQ- 39) and the Multidimensional
Caregiver Strain Index. They also calculated a mobility
proxy score derived from the PDQ- 39 and the Instrumented Timed Up and Go, and an overall health score
derived from the PDQ- 39, falls score, hospital admissions, and cognitive score.
Researchers also calculated patients’ levels of excess
stress (ie, emotional stress above typical stress resulting
from disease severity and overall health).
The stress proxy score predicted mortality, but the
excess stress score did not. High baseline stress proxy
scores and high levels of excess stress predicted worsening mobility.
“We need better data, as these were not data that we
collected specifically to look at stress,” Dr. Hiller said.
In addition, researchers need to conduct intervention
studies to see if stress reduction benefits patients with
Parkinson’s disease, she said. NR
Can Stress Accelerate
Progression of Parkinson’s Disease?
A high baseline stress proxy score predicts worsening mobility on follow-up.
Investigators derived a stress
proxy score from the 39-item
Parkinson’s Disease Questionnaire
and the Multidimensional Caregiver