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Original Article
- Distinct and Combined Cognitive Profiles Associated With Depression and Anxiety in Patients With Early Parkinson’s Disease
- Hak-Loh Lee, Seong-Min Choi, Soo Hyun Cho, Byeong C. Kim
- J Mov Disord. 2026;19(3):313-321. Published online June 12, 2026
- DOI: https://doi.org/10.14802/jmd.26076
- 864 View
- 44 Download
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Abstract
PDF - Objective
Cognitive impairment is a major nonmotor manifestation of Parkinson’s disease (PD), and mood disorders, including depression and anxiety, are being increasingly recognized as potentially modifiable contributors to cognitive decline. However, studies simultaneously evaluating the individual and combined effects of depression and anxiety on specific cognitive domains in PD remain limited.
Methods
One hundred forty-nine patients with early- to mid-stage PD were stratified by depression (Beck Depression Inventory≥14) and anxiety (Beck Anxiety Inventory≥8) status. Cognitive performance was evaluated using the Seoul Neuropsychological Screening Battery. Group differences were analyzed using analyses of covariance, adjusting for education, Hoehn and Yahr stage, and Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale motor scores, followed by Bonferroni correction for multiple testing.
Results
After adjustment for covariates, depression was associated with impaired verbal recognition memory (p=0.009), although this association did not survive Bonferroni correction. Conversely, anxiety-related deficits in immediate visual recall (p= 0.006) and inhibitory executive control (p=0.016) remained robustly significant even after rigorous correction. Patients with comorbid depression and anxiety exhibited the most pervasive cognitive impairment, including statistically significant deficits in both visual memory and frontal executive function (all adjusted p<0.05).
Conclusion
Depression and anxiety exert distinct yet additive detrimental effects on cognition in patients with early PD. While anxiety and comorbid symptoms show robust associations with visuospatial and executive deficits, the impact of isolated depression appears less statistically stable under conservative thresholds. These findings underscore the importance of early neuropsychiatric screening and targeted intervention, which may be associated with the maintenance of cognitive health in patients with PD.
Brief communication
- The Effects of Biofeedback Therapy on Anxiety and Depression in Parkinson’s Disease: A Pilot Study
- Justus Chun-Yu Chen, Tzu-Yun Tseng, Jong-Ling Fuh, Yu-Hsiang Cheng, Dai-Wei Lin, Han-Lin Chiang
- J Mov Disord. 2025;18(4):360-364. Published online July 14, 2025
- DOI: https://doi.org/10.14802/jmd.25097
- 4,189 View
- 43 Download
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Abstract
PDF
Supplementary Material - Objective
This pilot study aimed to evaluate the feasibility and potential effects of biofeedback therapy (BT) on anxiety and depression among patients with Parkinson’s disease (PD).
Methods
A randomized waitlist-controlled trial was conducted involving 19 patients with PD and comorbid anxiety and/or depression. Anxiety and depression were assessed at baseline, posttreatment, and 1-month follow-up.
Results
All 19 patients completed the study. Compared with those of the control group, significant improvements in the Hamilton Depression Rating Scale and the anxiety subscale (but not the depression subscale) of the Hospital Anxiety and Depression Scale were observed immediately after BT. In the pooled analysis, the anxiolytic effect persisted at the 1-month follow-up, with greater improvements observed in those with more severe baseline anxiety.
Conclusion
These preliminary findings suggest that BT may help reduce anxiety symptoms among PD patients. Future studies with larger, more severely affected cohorts are needed to confirm these findings.
Original Article
- Parkinson Anxiety Scale: A Validation Study for the Brazilian Population
- Renilson Moraes-Ferreira, Wilson Mateus Gomes da Costa Alves, Maysa Alves Rodrigues Brandao-Rangel, Odilon Abrahin, Clebson Pantoja Pimentel, Evitom Correa-Sousa, Rodolfo Paula Vieira, Erik Artur Cortinhas-Alves
- J Mov Disord. 2020;13(3):199-204. Published online July 28, 2020
- DOI: https://doi.org/10.14802/jmd.20031
- 11,295 View
- 181 Download
- 6 Web of Science
- 7 Crossref
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Abstract
PDF
- Objective
The Parkinson Anxiety Scale (PAS) was developed to measure the severity of anxiety symptoms in patients with Parkinson’s disease (PD), and it has not yet been adapted and validated in Portuguese. Thus, this study evaluated the reliability and validity of a translated and adapted version of the PAS for the Brazilian population of PD patients.
Methods
The Parkinson Anxiety Scale – Brazilian Version (PAS-BV) was completed by 55 patients with PD. The reliability (test-retest reliability, interrater reliability and internal consistency) and construct validity of the PAS-BV were assessed by comparing it with the Beck Anxiety Inventory (BAI), the Parkinson’s Disease Fatigue Scale (PFS) and the Unified Parkinson Disease Rating Scale (UPDRS) part III.
Results
Patients with PD had an average age of 64.51 ± 9.20 years and had PD for an average of 6.98 ± 5.02 years. The reliability of the PAS-BV was 0.83, and the intraclass correlation coefficient (ICC) (retest-test) was 0.88. The scale presented good convergent validity with the BAI (rs = 0.82, p < 0.05). It also presented good divergent validity with the PFS (rs = 0.24, p > 0.05) and the UPDRS part II (rs = -0.10, p > 0.05), part III (rs = -0.21, p > 0.05), and part IV (rs = 0.03, p > 0.05), as indicated by the absence of significant correlations. However, there was a significant correlation between the PAS-BV and part I of the UPDRS (rs = 0.67, p < 0.05).
Conclusion
The PAS-BV presents substantial reliability and validity for patients with PD without dementia. -
Citations
Citations to this article as recorded by
- Validation of the Patient-Rated Version of the Parkinson Anxiety Scale in Iranian People with Parkinson’s Disease
Maryam Mehdizadeh, Negin Eissazade, Seyed-Mohammad Fereshtehnejad, Mohsen Shati, Seyede Salehe Mortazavi, Sayed Amir Hasan Habibi, Masoumeh Bayat, Farzaneh Fendereski, Reihaneh Akbari, Parvaneh Taghavi Azar Sharabiani, Ghorban Taghizadeh
Clinical Gerontologist.2026; 49(3): 596. CrossRef - Clinical Outcome Assessments in Parkinson's Disease: A Scoping Review of Current Rating Scales and Future Needs
Evita Papathoma, Panagiota Tsitsi, Nirosen Vijiaratnam, Camila Aquino, Stephen R. Duma, Norbert Kovacs, Kigocha Lameck Okeng'o, Aparna Wagle Shukla, Roongroj Bhidayasiri, Tiago A. Mestre, Alvaro Sanchez Ferro, Alberto J. Espay, Michelle H.S. Tosin, Matej
Movement Disorders Clinical Practice.2026; 13(5): 1124. CrossRef - Online dance versus online therapeutic exercise on quality of life - a study protocol for a randomized controlled trial investigating social telerehabilitation efficacy in Parkinson disease
Camila Pinto, Rafaela Simon Myra, Francisca Pereira, Aline Nogueira Haas, Caroline Reppold, Guido Orgs, Aline S Pagnussat
European Journal of Physiotherapy.2025; 27(2): 81. CrossRef - Assessment of reliability and validity of the Persian version of the Parkinson’s Anxiety Scale (P-PAS)
Alireza Alikhani, Mehri Salari, Masoud Etemadifar
Applied Neuropsychology: Adult.2025; : 1. CrossRef - Tailoring anxiety assessment for Parkinson's disease: The Chinese Parkinson anxiety scale with cultural and situational anxiety considerations
Shu-Fai Poon, Chun-Hsiang Tan, Wei-Pin Hong, Kao Chin Chen, Rwei-Ling Yu
Social Science & Medicine.2025; 381: 118284. CrossRef - Validation of the English version of the Parkinson Anxiety Scale in two Canadian Parkinson’s disease samples
Joyce S.T. Lam, Kira N. Tosefsky, Xuyan Tang, Dylan Meng, Petra Uzelman, Fabricio Pio, Nicholas J. Ainsworth, Fidel Vila-Rodriguez, Andrew K. Howard, Silke Appel-Cresswell
Clinical Parkinsonism & Related Disorders.2025; 13: 100387. CrossRef - Should patients with Parkinson’s disease only visit a neurologist’s office? - a narrative review of neuropsychiatric disorders among people with Parkinson’s disease
Julita Szarpak, Paulina Drożak, Michał Piwoński, Hubert Wróblewski, Justyna Morylowska-Topolska
Current Problems of Psychiatry.2022; 23(4): 220. CrossRef
- Validation of the Patient-Rated Version of the Parkinson Anxiety Scale in Iranian People with Parkinson’s Disease
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