Review Article

An Integrated Review of Psychological Stress in Parkinson’s Disease: Biological Mechanisms and Symptom and Health Outcomes

Table 4

Symptom and health outcomes of psychological stress that may modify the illness trajectory in human subjects with PD.

Study author & dateStudy purpose & sampleMethod(s) of psychological stress inductionMeasures of biological mechanisms, symptom, and health outcomesMajor study findings

Giza et al., 2012 [62]Purpose: to examine the effects of psychological stress on biological mechanisms of autonomic dysfunction, specifically SSR parameters
Sample: male and female subjects with PD and controls
()
Arithmetic calculations using the WAIS-R arithmetic subscaleBiological mechanisms: 4-channel Nihon Kohen Neuropack S/MFrB 5504K used to record SSR in accordance with International Federation of Clinical Neurophysiology GuidelinesBiological mechanisms: no significant differences in SSR parameters were demonstrated between subjects or controls before or after the induction of psychological stress.

Rahman et al., 2008 [63]Purpose: to examine factors that influence symptom outcomes of FoG in subjects with PD
Sample: male and female subjects with PD
Not applicableSymptom outcomes: factors influencing walking/freezing questionnaire (tool not specified)Symptom outcomes: stress was identified as a trigger of FoG by 53.1% of subjects.

Macht et al., 2007 [64]Purpose: to examine the effects of psychological stress on symptom outcomes, specifically goal directed movements and hedonic responsiveness
Sample: male and female subjects with PD and controls
()
Arithmetic calculations while listening to loud music (protocol not specified)Symptom outcomes: Eshkol and Wachman coding system for reach-to-grasp movements, duration of forward and backward movements, and emotional state questionnaire (tool not specified)Symptom outcomes: stress was associated with significant deteriorations in mood and reduced hedonistic responsiveness in subjects with PD.
Stress did not result in significant differences in each-to-grasp movements between subjects and controls.

Macht et al., 2005 [65]Purpose: to examine patterns of psychological problems in subjects with PD to include symptom frequencies and health outcomes
Sample: male and female subjects with PD
Not applicableSymptoms outcomes: Inventory of Psychosocial Stress in PD
Health outcomes: Inventory of Psychosocial Stress in PD and benefits of social support questionnaire (tool not specified)
Symptom outcomes: Symptom increases with even small amounts of stress were reported by approximately two-thirds of subjects. Higher stress levels were associated with greater frequencies
in depressive moods, sleep disturbances, anxiety, sexual problems, and communication difficulties.
Health outcomes: higher stress was associated with greater difficulties coping with PD, worsening social relationships, less enjoyment of life, and the need for more psychological support.

PD, Parkinson’s disease; FoG, freezing of gait; WAIS-R, Wechsler Adult Intelligence Scale-Revised; SSR, sympathetic skin responses.