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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
  • 3,258 View
  • 38 Download
AbstractAbstract PDFSupplementary 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.
Review Article
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Fighting Against the Clock: Circadian Disruption and Parkinson’s Disease
Yen-Chung Chen, Wei-Sheng Wang, Simon J G Lewis, Shey-Lin Wu
J Mov Disord. 2024;17(1):1-14.   Published online November 21, 2023
DOI: https://doi.org/10.14802/jmd.23216
  • 12,804 View
  • 658 Download
  • 12 Web of Science
  • 13 Crossref
AbstractAbstract PDF
Circadian disruption is being increasingly recognized as a critical factor in the development and progression of Parkinson’s disease (PD). This review aims to provide an in-depth overview of the relationship between circadian disruption and PD by exploring the molecular, cellular, and behavioral aspects of this interaction. This review will include a comprehensive understanding of how the clock gene system and transcription–translation feedback loops function and how they are diminished in PD. The article also discusses the role of clock genes in the regulation of circadian rhythms, as well as the impact of clock gene dysregulation on mitochondrial function, oxidative stress, and neuroinflammation, including the microbiota-gut-brain axis, which have all been proposed as being crucial mechanisms in the pathophysiology of PD. Finally, this review highlights potential therapeutic strategies targeting the clock gene system and circadian rhythm for the treatment of PD.

Citations

Citations to this article as recorded by  
  • Circadian alterations in isolated Rapid-Eye-Movement sleep behavior disorder: associations with clinical, glymphatic, and dopaminergic imaging markers
    Ignacio Roura, Jèssica Pardo, Cristina Martín-Barceló, Laura Pacheco-Jaime, Carla García-Vicente, Carles Falcon, Juan Antonio Madrid, Ángeles Rol, Aida Niñerola-Baizán, Andrés Perissinotti, Roser Sala-Llonch, Nuria Bargalló, Monica Serradell, Claustre Pon
    SLEEP.2026;[Epub]     CrossRef
  • Spatial transcriptomics reveals the molecular signatures of prodromal and advanced α-synucleinopathy
    Lin Lin, Nanna M. Jensen, Alberto Delaidelli, Sara A. Ferreira, Fatemeh Yarmahmoudi, Poul H. Sorensen, Marina Romero-Ramos, Poul H. Jensen, Ian R. Mackenzie, Jens R. Nyengaard, Asad Jan
    iScience.2026; 29(3): 114845.     CrossRef
  • Diabetes mellitus and glymphatic dysfunction: Roles for oxidative stress, mitochondria, circadian rhythm, artificial intelligence, and imaging
    Kenneth Maiese
    World Journal of Diabetes.2025;[Epub]     CrossRef
  • Circadian Rhythm, Clock Genes, and Stroke
    Kenneth Maiese
    Current Neurovascular Research.2025; 21(4): 343.     CrossRef
  • Exploring Fatigue in Parkinson’s Disease: A Comprehensive Literature Review
    Jamir Pitton Rissardo, Maleesha Jayasinghe, Ahmed Farid Gadelmawla, Masoumeh Rashidi, Fatemeh Rashidi, Hania Moharam, Ola D Hag Ali, Mohamed Yousif Elamin Yousif, Ibrahim Khalil, Ana Leticia Fornari Caprara, Omesh Prathiraja, Mallak Bahar
    Cureus.2025;[Epub]     CrossRef
  • Clinical and brain volumetric correlates of decreased DTI-ALPS, suggestive of local glymphatic dysfunction, in iRBD
    Ignacio Roura, Jèssica Pardo, Cristina Martín-Barceló, Carles Falcon, Javier Oltra, Anna Campabadal, Nuria Bargalló, Mònica Serradell, Gerard Mayà, Angelica Montini, Claustre Pont-Sunyer, Carles Gaig, Mariateresa Buongiorno, Carme Junqué, Alex Iranzo, Bàr
    npj Parkinson's Disease.2025;[Epub]     CrossRef
  • Circadian rhythm disruption exacerbates neurodegeneration and alters proteomic profiles in a 6-OHDA induced Parkinson's disease model
    Halil I. Koc, Enes Dogan, Hayriye E. Yelkenci, Cigdem Bayraktaroglu, Aysenur Ozpinar, Buse Balaban, Serdar Altunay, Merve Beker, Ertugrul Kilic, Mustafa C. Beker
    Experimental Neurology.2025; 392: 115356.     CrossRef
  • Anxiety and Depression: Triggers for Cognitive Loss, Alzheimer's Disease, and Neurodegeneration
    Kenneth Maiese
    Current Neurovascular Research.2025; 22(1): 1.     CrossRef
  • Multifaceted dynamics of circadian timing system influence aging and longevity
    Anita Jagota, Zeeshan Akhtar Khan, Sushree Abhidhatri Sharma, Priyanka
    Biogerontology.2025;[Epub]     CrossRef
  • “Recommendations for clinical study protocols for immune and inflammatory profiling in Parkinson’s disease”
    Laura Muñoz-Delgado, Caroline H. Williams-Gray, Gaetan Garraux, Diego Clemente, Özgür Öztop Çakmak, Julia C. Greenland, Inês Figueira, Isabel Machín-Díaz, Elenamaria Pirovano, Alessia di Flora, Clotilde Tournerie, Stamatia Papoutsopoulou, Sibel Ertan, Pab
    npj Parkinson's Disease.2025;[Epub]     CrossRef
  • Circadian Rhythm Dysfunction in Neurodegenerative Diseases: A Bidirectional Perspective and Therapeutic Potential
    Dhondup Namgyal, Chae-Seok Lim
    Nature and Science of Sleep.2025; Volume 17: 2969.     CrossRef
  • The molecular interplay between the gut microbiome and circadian rhythms: an integrated review
    Boyang Zheng, Liwei Wang, Shilin Sun, Xingxing Yuan, Qun Liang
    Frontiers in Microbiology.2025;[Epub]     CrossRef
  • SLEEP DEPRIVATION AND CIRCADIAN RHYTHM DISTURBANCES IN NEURODEGENERATIVE DISEASES: MECHANISMS, CLINICAL CONSEQUENCES, AND PREVENTIVE STRATEGIES
    Daria Godlewska, Katarzyna Kleszczewska, Agnieszka Pruska, Natalia Senatorska, Julia Rarok, Hanna Pietruszewska, Monika Banaszek, Agata Panfil, Julia Błocka, Agata Lurka
    International Journal of Innovative Technologies in Social Science.2025;[Epub]     CrossRef
Case Report
Transcranial Direct Current Stimulation Combined with Action Observation and Electromyographic Biofeedback Training in a Patient with Writer’s Cramp
Yohei Okada, Chiharu Shibamoto, Yukari Osumi, Chihiro Asano, Riho Takeuchi, Sachio Nabeshima, Shu Morioka, Koji Shomoto
J Mov Disord. 2018;11(2):82-86.   Published online May 30, 2018
DOI: https://doi.org/10.14802/jmd.18007
  • 12,092 View
  • 93 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDFSupplementary Material
We present a 47-year-old right-handed woman with a 15-year history of writer’s cramp who was provided with six sessions of cathodal transcranial direct current stimulation (tDCS) combined with observation of writing actions performed by a healthy subject and electromyographic (EMG) biofeedback training to decrease EMG activities in her right forehand muscles while writing for 30 min for 4 weeks. She showed improvement in dystonic posture and writing speed after the intervention. The writing movement and writing speed scores on a writer’s cramp rating scale decreased, along with writing time. Our findings demonstrated that cathodal tDCS combined with action observation and EMG biofeedback training might improve dystonic writing movements in a patient with writer’s cramp.

Citations

Citations to this article as recorded by  
  • Effects of non-invasive brain stimulation in dystonia: a systematic review and meta-analysis
    Jordan Morrison-Ham, Gillian M. Clark, Elizabeth G. Ellis, Andris Cerins, Juho Joutsa, Peter G. Enticott, Daniel T. Corp
    Therapeutic Advances in Neurological Disorders.2022;[Epub]     CrossRef
  • New modalities and directions for dystonia care
    Genko Oyama, Nobutaka Hattori
    Journal of Neural Transmission.2021; 128(4): 559.     CrossRef
  • The Mini-BESTest is an independent predictor of falls in Parkinson Disease
    Larissa Karlla Rodrigues Lopes, Aline Alvim Scianni, Lidiane Oliveira Lima, Raquel de Carvalho Lana, Fátima Rodrigues-De-Paula
    Brazilian Journal of Physical Therapy.2020; 24(5): 433.     CrossRef
  • Modulating Observation-Execution-Related Motor Cortex Activity by Cathodal Transcranial Direct Current Stimulation
    Fengxue Qi, Michael A. Nitsche, Volker R. Zschorlich
    Brain Sciences.2019; 9(5): 121.     CrossRef
  • Beyond the target area: an integrative view of tDCS-induced motor cortex modulation in patients and athletes
    Edgard Morya, Kátia Monte-Silva, Marom Bikson, Zeinab Esmaeilpour, Claudinei Eduardo Biazoli, Andre Fonseca, Tommaso Bocci, Faranak Farzan, Raaj Chatterjee, Jeffrey M. Hausdorff, Daniel Gomes da Silva Machado, André Russowsky Brunoni, Eva Mezger, Luciane
    Journal of NeuroEngineering and Rehabilitation.2019;[Epub]     CrossRef

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