Grant for Erwin van Wegen: Treatment of wearing-off related stress for people with Parkinson's disease

Maintaining a valuable life when you have Parkinson's disease is a challenge for many patients. The disease is accompanied by physical and mental ups and downs; fluctuations over days, weeks and years. An example of such a fluctuation is 'wearing-off', which occurs when the effect of Parkinson's medication decreases. Research shows that patients find this one of the most unpleasant symptoms, especially the stress associated with wearing-off. With stress, feelings of fear, gloom, and / or tension are present. In clinical practice we often observe a vicious cycle: during wearing off, physical complaints will worsen and cause stress and mental blockages. Because this stress subsequently aggravates the physical complaints, a circle arises that is difficult to break through. The anticipation of the wearing-off complaints also causes additional stress, which reinforces the cycle.

VUmc researchers have developed the BEWARE training in which patients learn how to deal with the fluctuations of the disease so that they and maintain a valuable life and experience less stress despite the symptoms. The BEWARE group training consists of a combination of physiotherapy and acceptance & commitment therapy (ACT). ACT is a behavioral therapy in which, for example, mindfulness exercises in which participants learn to act on what is important to them.

Based on results from a pilot study, the BEWARE training has been optimized and a detailed research plan has been drawn up to investigate this improved treatment in a multicenter Randomized Clinical Trial. Participants receive one-and-a-half-hour therapy sessions once a week for 10 weeks, in addition to doing homework, or regular care. Before and after the therapy period, functioning is assessed with standardized measures. After positive completion, the BEWARE training can immediately be applied in clinical practice. 

For more information, visit:

A study by VUmc Amsterdam, in collaboration with Zuyderland Hospital Heerlen and Zorgsprectrum and St. Anthonius, Nieuwegein

Awarded budget € 300,000

Researchers: Dr. Erwin van Wegen (PI), Prof. Odile van den Heuvel (co-PI), drs. Ires Ghielen (co-PI)

Source: Press release from the Hersenstichting in the Sneller Beter Behandelen program