Thinking about motor fluctuations: An examination of metacognitions in Parkinson's disease

Objective: Motor fluctuations (characterised by a sudden increase in symptom intensity, referred to as an 'off-period') are common side effects after treatment of Parkinson's disease (PD) with dopaminergic medication. A proportion of these people find motor fluctuations highly distressing. This study aimed to identify metacognitions associated with cognitive and attentional responses to these experiences. Methods: Ten individuals with PD who experience motor fluctuations were interviewed for this study using an adapted metacognitive profiling schedule. Participants were asked about their metacognitions, and the cognitive processes and attentional strategies activated in response to a distressing off-period. Results: Metacognitions identified were more often related to conceptual thinking about symptoms rather than symptom focus and data suggested trends for increased depressive symptoms among individuals with stronger metacognitive beliefs. Conclusion: Metacognitions may play a role in determining or maintaining off-period distress in PD.