Biobehavioral Framework of Symptom and Health Outcomes of Uncertainty and Psychological Stress in Parkinson Disease

Abstract

Parkinson disease (PD) is a debilitating, progressive neurodegenerative disorder characterized by complex motor and nonmotor symptoms that fluctuate in onset, severity, level of disability, and responsiveness to treatment. The unpredictable nature of PD and the inability to halt or slow disease progression may result in uncertainty and psychological stress. Uncertainty and psychological stress have important implications for symptom and health outcomes in PD. Uncertainty and psychological stress have been shown to worsen symptoms, functional capacity, and quality of life in chronic illnesses; however, the causal mechanisms have yet to be elucidated. We propose a biobehavioral framework for examining uncertainty and psychological stress in PD. The framework considers factors that may contribute to uncertainty and neuroendocrine-immune mechanisms of uncertainty and psychological stress that may influence symptom and health outcomes in PD, for the ultimate purpose of improving symptom and disease progression, functional capacity, and quality of life.

Associations of Nonmotor Symptom Burden, Activities of Daily Living, and Fear of Falling in Parkinson Disease

“…The progressive characteristics of PD lead to significant individual and social burdens. 3 In this study, nonmotor symptom burden in patients with PD was examined, and the relationship of this burden with activities of daily living and fear of falling was revealed. It was determined that approximately two-thirds of the patients had very high levels of nonmotor symptom burden, and the most symptoms were experienced in the gastrointestinal and sensory areas.…”

“…arkinson disease (PD) is a progressive neurodegenerative disorder that develops when nerve cells in the basal ganglia become impaired or die, lead-ing to decreased levels of dopamine, a neurotransmitter in the brain, 1,2 and it is characterized by motor and nonmotor symptoms. 3 Despite recent developments in medical, surgical, and rehabilitating therapies, PD continues to be a progressive disease. 4 The incidence of PD varies between 5 and 35 new cases per 100 000 in a year, and it increases 5-to 10-fold between the sixth and ninth decades of life.…”

“…7 Bradykinesia, resting tremors, rigidity, and postural instability are among the main motor symptoms of PD. 3,8 These motor symptoms lead to posture, balance, and gait disorders. Although patients mostly present with motor symptoms, they also experience nonmotor symptoms such as pain, sleep disorders, depression, anxiety disorder, constipation, loss of smell, and sexual dysfunction.…”

Stigma and Associated Correlates of Elderly Patients With Parkinson's Disease

“…The experience of diagnosis of a neurodegenerative disease relatively early in life may be qualitatively different than diagnosis in later life, having a greater impact on self-perception and self-expectations in family, social, and occupational roles (24,25). Meanwhile, the unpredictability and inability to prevent or slow down the progression of Parkinson's disease may bring uncertainty and psychological pressure to patients (26). With the prolongation of the course of disease, the patients were forced to give up their daily work and social life, aggravating social isolation.…”

The delta‐opioid receptor and Parkinson’s disease

“…The progression and development of scientific techniques and establishment of various models have become the driving force for the discovery of the etiology, pathogenic changes, and molecular mechanism of PD . In general, the pathogenesis of PD is the joint result of environment, gene, and aging factors.…”