What does this research mean for the field?

In Parkinson's disease, patients with freezing of gait exhibit similar trait anxiety and threat responses as nonfreezers, and while anxiety and cognitive load independently increase freezing of gait, their combined effect does not produce a synergistic increase. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To investigate whether state anxiety, cognitive load, or their combination distinctly alters freezing of gait in Parkinson's disease, and whether patients who freeze exhibit abnormal threat responsiveness.

September 14, 2026European Journal of NeuroscienceOpen Access

Anxiety and cognitive load each associate with higher freezing ratios but plateau when combined.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Parkinson's disease with and without freezing of gait (n=66). Intervention: Anxiety (threat of shock or freezing) and cognitive load (dual task) vs. Healthy controls and nonfreezers; baseline conditions. Primary outcome: Freezing ratio, derived from wearable sensors.

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Why the study?

It is unclear whether anxiety, cognitive load, or their combination modulates freezing of gait differently in Parkinson's disease and whether freezers have stronger threat responsiveness than nonfreezers.

Do anxiety and cognitive load modulate freezing of gait differently in people with Parkinson's disease?

Population

28 freezers, 19 nonfreezers, and 19 healthy age-matched controls

Comparison

Threat of shock vs threat of freezing and single vs dual task conditions

Design

Cross-sectional freezing-provoking protocol study

Key result

Anxiety and cognitive load each tended to increase the freezing ratio across all groups, but their combined effect seemed to plateau with no surplus effects.

Authors

DZDemi Zoetewei MGMoran Gilat NDNicholas D’Cruz

Discussion

Member takes

Overview

Whether anxiety or cognitive load differentially modulates freezing of gait remains unclear; leaves open stronger threat responsiveness in freezers.

Key Points

To investigate whether state anxiety, cognitive load, or their combination distinctly alters freezing of gait in Parkinson's disease, and whether patients who freeze exhibit abnormal threat responsiveness.
Assessed 28 Parkinson's disease patients with freezing of gait, 19 nonfreezing patients, and 19 age-matched healthy controls during a standardized freezing-provoking protocol.
Manipulated state anxiety through threats of shock or freezing, while imposing cognitive load using a dual-task paradigm.
Quantified the primary outcome of freezing ratio via wearable sensor data and recorded subjective and physiological stress markers.
Patients with freezing demonstrated poorer baseline cognition and greater motor impairment than nonfreezing patients, yet showed comparable trait anxiety and threat responses to both control groups.
Anxiety and cognitive load independently tended to increase the freezing ratio across cohorts, but their concurrent application produced no surplus or additive effect.
Threat of shock provoked a greater increase in freezing ratio than threat of freezing, despite threat of freezing eliciting stronger physiological stress responses.

Study Design

Type

Cross-Sectional (n=66)

Structured PICO

Do anxiety and cognitive load modulate freezing of gait differently in people with Parkinson's disease?

Population

66 participants, comprising 28 Parkinson's disease patients with freezing of gait, 19 without freezing of gait, and 19 healthy age-matched controls.

Exposure

Freezing-provoking protocol with state anxiety (threat of shock or threat of freezing) and cognitive load (dual task)

Comparator

Different conditions compared to each other (threat of shock vs threat of freezing, single vs dual task)

Outcome

Freezing ratio, derived from wearable sensorssurrogate

Anxiety and cognitive load independently tend to increase freezing of gait in Parkinson's disease, but their combination does not have an additive effect.

Limitations

The explanation for why the threat of freezing had a smaller effect than the threat of shock remains speculative.

Cite This Study

Zoetewei et al. (2026) conducted a cross-sectional in Parkinson's disease with and without freezing of gait (n=66). Anxiety (threat of shock or freezing) and cognitive load (dual task) vs. Healthy controls and nonfreezers; baseline conditions was evaluated on Freezing ratio, derived from wearable sensors. Anxiety and cognitive load each tended to increase the freezing ratio across all groups, but their combined effect seemed to plateau with no surplus effects.

synapsesocial.com/papers/6aa7afef79e9260bc85aacab https://doi.org/10.1111/ejn.70678

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September 14, 2026European Journal of NeuroscienceOpen Access

Anxiety and cognitive load each associate with higher freezing ratios but plateau when combined.

View Full Paper

Ask AI

Bookmark

Why the study?

Do anxiety and cognitive load modulate freezing of gait differently in people with Parkinson's disease?

Population

28 freezers, 19 nonfreezers, and 19 healthy age-matched controls

Comparison

Threat of shock vs threat of freezing and single vs dual task conditions

Design

Cross-sectional freezing-provoking protocol study

Key result

Anxiety and cognitive load each tended to increase the freezing ratio across all groups, but their combined effect seemed to plateau with no surplus effects.

Authors

DZDemi Zoetewei MGMoran Gilat NDNicholas D’Cruz

Discussion

Member takes

Overview

Whether anxiety or cognitive load differentially modulates freezing of gait remains unclear; leaves open stronger threat responsiveness in freezers.

Key Points

To investigate whether state anxiety, cognitive load, or their combination distinctly alters freezing of gait in Parkinson's disease, and whether patients who freeze exhibit abnormal threat responsiveness.
Assessed 28 Parkinson's disease patients with freezing of gait, 19 nonfreezing patients, and 19 age-matched healthy controls during a standardized freezing-provoking protocol.
Manipulated state anxiety through threats of shock or freezing, while imposing cognitive load using a dual-task paradigm.
Quantified the primary outcome of freezing ratio via wearable sensor data and recorded subjective and physiological stress markers.
Patients with freezing demonstrated poorer baseline cognition and greater motor impairment than nonfreezing patients, yet showed comparable trait anxiety and threat responses to both control groups.
Anxiety and cognitive load independently tended to increase the freezing ratio across cohorts, but their concurrent application produced no surplus or additive effect.
Threat of shock provoked a greater increase in freezing ratio than threat of freezing, despite threat of freezing eliciting stronger physiological stress responses.

Study Design

Type

Cross-Sectional (n=66)

Structured PICO

Do anxiety and cognitive load modulate freezing of gait differently in people with Parkinson's disease?

Population

66 participants, comprising 28 Parkinson's disease patients with freezing of gait, 19 without freezing of gait, and 19 healthy age-matched controls.

Exposure

Freezing-provoking protocol with state anxiety (threat of shock or threat of freezing) and cognitive load (dual task)

Comparator

Different conditions compared to each other (threat of shock vs threat of freezing, single vs dual task)

Outcome

Freezing ratio, derived from wearable sensorssurrogate

Anxiety and cognitive load independently tend to increase freezing of gait in Parkinson's disease, but their combination does not have an additive effect.

Limitations

The explanation for why the threat of freezing had a smaller effect than the threat of shock remains speculative.

Cite This Study

synapsesocial.com/papers/6aa7afef79e9260bc85aacab https://doi.org/10.1111/ejn.70678

View Full Paper

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