Parkinson's Disease Research

Maastricht University has a long history of research into Parkinson’s disease, with a special focus on the diagnosis and treatment of neuropsychiatric symptoms and the further development of deep brain stimulation. There are longstanding international collaborations and a continuous output of scientific publications, which can be found here:

This line of research has generated a number of ‘products’, among which the frequently used Parkinson Anxiety Scale (PAS) and a Cognitive Behavioural Module (CBT) for the treatment of anxiety in patients with Parkinson’s disease. We would like to share these products with clinicians and researchers worldwide for the benefit of treatment of patients and the advancement of care for Parkinson’s disease.

The Parkinson Anxiety Scale (PAS)

History of the Parkinson Anxiety Scale

The Parkinson Anxiety Scale was especially developed for use in Parkinson patients, since it is unsensitive to the severity of motor symptoms and comorbid depressive symptoms (1). It is also the only anxiety rating scale that includes avoidance behaviour in its ratings.

The scale was developed with a grant of the Michael J Fox Foundation by an international consortium, in collaboration with patients, after a systematic review commissioned by the Movement Disorder Society (MDS) showed that the construct validity of existing anxiety rating scales was insufficient in patients with Parkinson’s disease (2). In its original languages, the PAS was validated both according to the classical test theory as well as according to the item-response theory (1,3). Subsequently other validation studies confirmed its validity (4-6). The scale has since been translated in many languages.

Cognitive Behavioural Therapy (CBT) for Anxiety

In patients with Parkinson’s disease anxiety is a common and often debilitating syndrome. Cognitive behavioural therapy (CBT) is the mainstay of non-pharmacological treatment of anxiety syndromes, but available modules are not specifically tailored to treat anxiety in Parkinson patients.

Anxiety in Parkinson patients may present different than in other patients, and is often characterized by social anxiety, anxiety in specific situations, e.g. during certain activities of daily living, fear of falling, anxiety related to on/off fluctuations. In addition, anxiety may in turn negatively influence motor symptoms.

Sponsored by a grant from the Michael J Fox Foundation, the Universities of Maastricht (the Netherlands) and Lille (France) have developed and validated a CBT treatment module specifically addressing anxiety in patients with Parkinson’s disease(1). The module is effective in reducing overall anxiety, with specific improvement of situational anxiety and avoidance behavior(2).  These improvements are accompanied by specific alterations in cerebral connectivity(3).