Objective: To identify changes in functional connectivity in the brain after cognitive behavioral therapy (CBT) for anxiety in patients with Parkinson’s disease (PD).
Background: CBT reduces anxiety symptoms in patients with PD.
Method: Thirty-five patients with PD and clinically significant anxiety were randomized over two groups: CBT plus clinical monitoring or clinical monitoring only (CMO). Changes in severity of anxiety symptoms were assessed with the Parkinson Anxiety Scale (PAS). Resting-state functional brain MRI was performed at baseline and after the intervention. Functional networks were extracted by an Independent Component Analysis (ICA). Functional connectivity (FC) changes between structures involved in the PD-related anxiety circuits and both within and between functional networks were compared between groups and regressed with anxiety symptoms changes.
Results: Compared to CMO, CBT reduced the FC between the right thalamus and the bilateral orbitofrontal cortices and increased the striato-frontal FC. CBT also increased the fronto-parietal FC within the central executive network (CEN) and between the CEN and the salience network. After CBT, improvement of PAS-score was associated with an increased striato-cingulate and parieto-temporal FC, and a decreased FC within the default-mode network and between the dorsal attentional network and the language network.
Conclusion: CBT in PD-patients improves anxiety symptoms by inducing functional changes reversing the imbalance between PD-related anxiety circuits and reinforcing cognitive control on emotional processing.
References: Moonen AJH et al. Cognitive Behavioral Therapy for Anxiety in Parkinsonʼs Disease: A Randomized Controlled Trial. Movement Disord. Published online 2021. doi:10.1002/mds.28533
Carey G et al. Neuroimaging of Anxiety in Parkinson’s Disease: A Systematic Review. Movement Disord. Published online 2020. doi:10.1002/mds.28404
To cite this abstract in AMA style:
G. Carey, R. Lopes, A. Moonen, A. Mulders, J. de Jong, G. Kuchcinski, L. Defebvre, M. Kuijf, K. Dujardin, A. Leentjens. Cognitive behavioral therapy for anxiety in Parkinson’s disease induces functional brain changes [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/cognitive-behavioral-therapy-for-anxiety-in-parkinsons-disease-induces-functional-brain-changes/. Accessed June 15, 2025.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-behavioral-therapy-for-anxiety-in-parkinsons-disease-induces-functional-brain-changes/