Background:The ongoing COVID-19 pandemic has many consequences for people with Parkinson’s disease (PD). Social distancing measures complicate regular care and result in lifestyle changes, which may indirectly cause psychological stress and worsening of PD symptoms. Objective:To assess whether theCOVID-19 pandemic was associated with increased psychological distress and decreased physical activity in PD, how these changes related to PD motor and non-motor symptom severity, and what frequency and burden of COVID-related stressors were. Methods:We sent an online survey to the Personalized Parkinson Project (PPP) cohort (n = 498 PD patients) in the Netherlands. In the survey, we distinguished between COVID-related stressor load, psychological distress, PD symptom severity, and physical activity. We related inter-individual differences to personality factors and clinical factors collected before the pandemic occurred. Results:358 PD patients completed the survey between April 21 and May 25, 2020 (response rate 71.9%). Patients with higher COVID-related stressor load experienced more PD symptoms, and this effect was mediated by the degree of psychological distress. 46.6% of PD patients were less physically active since the COVID-19 pandemic, and reduced physical activity correlated with worse PD symptoms. Symptoms that worsened most were rigidity, fatigue, tremor, pain and concentration. Presence of neuropsychiatric symptoms (anxiety, depression) before the pandemic, as well as cognitive dysfunction and several personality traits predicted increased psychological distress during the COVID-19 pandemic. Conclusion:Our findings show how an external stressor (the COVID-19 pandemic) leads to a worsening of PD symptoms by evoking psychological distress as well as lifestyle changes (reduced physical activity).

中文翻译：

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COVID-19大流行对帕金森氏病的心理困扰，体育活动和症状严重程度的影响。

背景：持续发生的COVID-19大流行对帕金森氏病（PD）的人造成许多后果。社会疏远措施使定期护理变得复杂，并导致生活方式的改变，这可能间接导致心理压力和PD症状加重。目的：评估COVID-19大流行是否与PD的心理困扰增加和体育活动减少有关，这些变化与PD运动和非运动症状的严重程度如何相关，以及与COVID相关的应激源的频率和负担是什么。方法：我们向荷兰的帕金森个性化项目（PPP）队列（n = 498 PD患者）发送了在线调查。在调查中，我们区分了COVID相关的应激源负荷，心理困扰，PD症状严重程度和体育锻炼。我们将个体间的差异与大流行发生之前收集的人格因素和临床因素相关。结果：358名PD患者在2020年4月21日至5月25日之间完成了调查（答复率为71.9％）。与COVID相关的应激源负荷较高的患者会出现更多的PD症状，并且这种影响由心理困扰的程度介导。自从发生COVID-19大流行以来，有46.6％的PD患者的体育活动较少，并且体育活动减少与PD症状加重有关。最严重的症状是僵硬，疲劳，震颤，疼痛和注意力不集中。大流行之前出现神经精神症状（焦虑，抑郁），以及认知功能障碍和几种人格特质预示着COVID-19大流行期间的心理困扰增加。结论：