Objective: To assess whether an app-based mindfulness training (MT) intervention, “Unwinding Anxiety”, can be used for Parkinson’s Disease (PD) patients with mild-moderate anxiety to reduce anxiety and to explore the effects of MT on the cognitive and motor aspects of PD.

Background: Anxiety affects ~30% of PD patients and can contribute to emotional and physical symptoms [1]. Due to medication anxiety or hesitancy, non-pharmacologic anxiety treatments are of interest [2]. Recently, online mindfulness-based programs have been shown to improve anxiety in PD patients and suggest they may improve motor scores [3].

Method: Recruitment of outpatients with PD and anxiety is ongoing with 11 participants; goal 20. Eligible participants were provided the Unwinding Anxiety app and goal to complete 30, ~10 minute modules over 6 to 8 weeks. Their GAD-7, UPDRS part III and IV, PHQ-9, MoCA, Penn State Worry Questionnaire (PSWQ), 15-item Five Facet Mindfulness Questionnaire (FFMQ-15), PDQ-39 and Attention Network Test (ANT) scores were assessed at baseline (screening for MoCA), 2, and 6 months. Mean value pairwise comparisons between timepoints were calculated to assess for significant improvements. Participants were additionally asked if the app was user friendly and subjectively helpful.

Results: This study is ongoing with preliminary data derived from 11 subjects who are enrolled at various timepoints in the study. Our preliminary data show that the PSWQ and PHQ-9 scores significantly decreased from baseline to 2-month follow up (PSWQ mean difference (md)= -10.74, p=0.03; PHQ-9 md= -3.77, p=0.02). The GAD-7, UPDRS part III, UPDRS part IV, FFMQ and PDQ-39 did not change significantly from baseline to 2 months nor did the MoCA from screening to 2 months (GAD-7 md= -2.83 p=0.13; UPDRS part III md= -2.48, p=0.99; UPDRS part IV md= 2.52, p=0.09;; FFMQ md= +0.28, p=0.55; PDQ-39 md= -12, p=0.16; MOCA md=-0.34, p=0.68).

Conclusion: Given the preliminary nature of our data, it cannot be concluded whether the mindfulness-based app “Unwinding Anxiety” is effective at reducing anxiety and improving motor symptoms, cognition scores and mindfulness levels in PD patients. We anticipate additional participant data in the coming weeks. Our preliminary data does show that participants had an overall positive experience with the app and reported increased self-awareness relating to their anxiety.

References: [1] Kassm, S. A., Naja, W., Haddad, R., & Pelissolo, A. (2021). The Relationship Between Anxiety Disorders and Parkinson’s Disease: Clinical and Therapeutic Issues. https://doi.org/10.1007/s11920-021-01229-9/Published
[2] Blundell, E. K., Grover, L. E., Stott, J., & Schrag, A. (2023). The experience of Anxiety for people with Parkinson’s disease. Npj Parkinson’s Disease, 9(1). https://doi.org/10.1038/s41531-023-00512-1
[3] Seritan, A. L., Iosif, A. M., Prakash, P., Wang, S. S., & Eisendrath, S. (2022). Online Mindfulness-Based Cognitive Therapy for People with Parkinson’s Disease and Their Caregivers: a Pilot Study. Journal of Technology in Behavioral Science, 7(3), 381–395. https://doi.org/10.1007/s41347-022-00261-7

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MDS Abstracts - https://www.mdsabstracts.org/abstract/unwinding-anxiety-feasibility-and-effectiveness-of-app-based-mindfulness-training-for-people-with-anxiety-and-parkinsons-disease-a-pilot-study/