MindTrails-Movement: reducing anxiety in movement disorders

Overview

Anxiety is common and burdensome for people with Huntington's disease (HD) and Parkinson's disease (PD). Cognitive bias modification for interpretation bias (CBM-I) — a technique that helps people reinterpret ambiguous situations in less threatening ways — may help, but it has not previously been tested in these populations. The team trialed a web version of their CBM-I intervention (MindTrails) and found that a tailored, movement-disorders-specific version is needed.

MindTrails-Movement adapts the intervention for HD and PD using a human-centered design (HCD) process, then tests it in a pilot randomized controlled trial.

Specific aims

• Aim 1 — Stakeholder perspectives (inspiration). Qualitative interviews (N=24) with HD patients, PD patients, caregivers, and clinicians to understand movement-disorders-specific considerations for a digital CBM-I intervention.
• Aim 2 — Develop the app (ideation). Build MindTrails-Movement by incorporating Aim 1 feedback through an iterative process: a design team, prototype development, acceptability assessment, and revision.
• Aim 3 — Preliminary efficacy. A pilot RCT (N=136) in anxious HD and PD patients, hypothesizing improved threat interpretation bias and self-reported anxiety versus a waitlist control.

Methodology

The pilot RCT collects data every two weeks across the six-week intervention, plus a four-week follow-up, to assess both short-term and sustained effects. Groups are stratified by diagnosis (HD vs PD), and analysis of these and other subgroup differences will inform a planned follow-up R01.

What the Digital Trails team is doing

• Tailored app development — building the movement-disorders-specific MindTrails-Movement app.
• Clinical-trial infrastructure — providing the infrastructure and engineering support to roll the app out within the RCT.

Outcomes & current status

App development ran from October 2023 through August 2025, with RCT recruitment beginning August 2025 and data collection scheduled to complete in September 2026.