Ires Ghielen

183 English summary complex interactions between motor and anxiety symptoms in PD. An optimized Beware intervention is currently being investigated in a large multicenter RCT. Finally, in Chapter 9 , the findings of this thesis are summarized and reflected upon. I describe the reciprocal interactions between anxiety, motor, and autonomic symptoms. I link our findings to the research field on body awareness in psychosomatic disorders, discussing the commonalities in the inaccuracy of interpretation of bodily symptoms that is seen in both PD patients with wearing- off related anxiety and patients with psychosomatic disorders. Subsequently, I provide suggestions for improving this inaccuracy. Regarding the reciprocal interactions between motor and anxiety symptoms, I discuss how this interaction should be taken into account through multidisciplinary treatment, of which the BEWARE training is a first attempt in PD. This thesis helps to understand and treat anxiety symptoms in the context of motor symptoms in PD patients, aiming to improve psychological wellbeing irrespective of disease progression. Since patients experience symptom fluctuations during the day, I provide suggestions for more in-depth investigation of interactions between motor and anxiety symptoms during response fluctuations, for which we propose using high-frequent time-series data.