Beyond motor improvement: The potential role of Mindfulness across the Deep Brain Stimulation pathway in Parkinson’s Disease
Giada Coluccio, Francesco Cavallieri, Valentina Fioravanti, Giacomo Argenziano, Giacomo Portaro, Luca Codeluppi, Ottavia Iotti, Claudio Fusella, Amani Abdulameer Naser Al Rikabi, Giuseppe Biagini, Alberto Feletti, Fiorina Bartiromo, Corrado Iaccarino, Sara Montepietra, Francesca Sireci
Deep Brain Stimulation November 3, 2026 DOI: 10.1016/j.jdbs.2026.11.001 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Narrative review Peer reviewed |
|---|---|
| Interventions | Mindfulness-based stress reduction Mindfulness-based cognitive therapy Acceptance and commitment therapy |
| Topics | Meditation |
| Key findings | Argues that although DBS provides substantial and durable relief of levodopa-responsive motor symptoms and complications in advanced Parkinson's disease, motor improvement does not invariably translate into satisfactory psychological, social, and quality-of-life outcomes. The authors propose that mindfulness is unlikely to enhance the neurostimulatory effect itself but may target modifiable mediators such as stress reactivity, attentional control, symptom appraisal, expectation rigidity, experiential avoidance, and dyadic adjustment, and they outline a phase-specific framework for DBS care. |
Abstract
Deep brain stimulation (DBS) provides substantial and durable relief of levodopa-responsive motor symptoms and motor complications in people with advanced Parkinson's disease (PD), yet motor improvement does not invariably translate into satisfactory psychological, social, and quality-of-life outcomes. Anxiety, depression, apathy, cognitive vulnerability, unrealistic expectations, altered illness roles, and concerns about identity or authenticity may persist or emerge during the DBS pathway. Mindfulness-based interventions (MBIs), including mindfulness-based stress reduction and mindfulness-based cognitive therapy, have been investigated as adjunctive treatments in PD, whereas acceptance and commitment therapy (ACT) provides a related framework focused on psychological flexibility and values-guided action. This narrative review integrates the literature on MBIs in PD with evidence concerning cognition, expectations, placebo/nocebo responses, psychosocial adjustment, and identity after DBS. Small trials and meta-analyses suggest that MBIs are feasible and may improve anxiety, depressive symptoms, mindfulness skills, and some aspects of quality of life, while evidence for motor, cognitive, apathy, sleep, and caregiver outcomes remains inconsistent or preliminary. Direct trials of mindfulness in patients with PD undergoing DBS are essentially lacking. We propose that mindfulness is unlikely to enhance the neurostimulatory effect itself but may target modifiable mediators between motor capacity and lived outcome: stress reactivity, attentional control, symptom appraisal, expectation rigidity, experiential avoidance, and dyadic adjustment. A phase-specific framework is outlined for preoperative preparation, early postoperative programming, and long-term adaptation. Dedicated co-designed feasibility studies and adequately controlled trials are required before mindfulness can be recommended as a routine component of DBS care.
Comparable studies
Other narrative reviews on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical populations | 2003 | Review | |
| Mindfulness: Theoretical Foundations and Evidence for its Salutary Effects | 2007 | Review | |
| Mindfulness Interventions | 2016 | Review | |
| Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation | 2017 | Review | |
| Mindfulness and acceptance: expanding the cognitive-behavioral tradition | 2005 | Review |
Citations in the library
Cites 9
- A qualitative analysis of mindfulness‐based cognitive therapy (MBCT) in Parkinson's disease Psychology and Psychotherapy Theory Research and Practice October 20, 2009
- Mindfulness-based stress reduction in Parkinson’s disease: a systematic review BMC Neurology May 15, 2017
- Mindfulness or meditation therapy for Parkinson's disease: A systematic review and meta-analysis of randomized controlled trials. European Journal of Neurology August 1, 2023
- The Effects of Mindfulness-Based Interventions in People with Parkinson's Disease: A Systematic Review and Meta-Analysis. Clinical Gerontologist 2025
- Study protocol for the MIND-PD study: a randomized controlled trial to investigate clinical and biological effects of mindfulness-based cognitive therapy in people with Parkinson's disease. BMC Neurology June 25, 2024
and 4 more in the library