Divya Palanisamy, MD, is passionate about improving multigenerational health literacy, helping people better understand general brain health and conditions like Parkinson’s disease (PD) long before a diagnosis. As a Parkinson’s Foundation Wesley G. McCain Movement Disorders Fellow (in honor of Dr. Lucien Côté), she works to support people with movement disorders, both as a physician and an educator.

Dr. Palanisamy completed her fellowship at Columbia University Irving Medical Center, a Parkinson’s Foundation Center of Excellence, and is currently a movement disorders specialist at SUNY Downstate Health Sciences University.

We spoke to Dr. Palanisamy about her exciting work in the PD field, and what inspires her.

What led you to Parkinson’s research? 

I was always interested in movement. I did karate as a kid, and I grew up paying very close attention to how my body moved and how subtle adjustments could have a specific effect. I also always had a love for neuroscience and the brain, and how humans use movement and the mechanics of the brain to shape the way we move throughout the world. 

After I went to medical school, I was putting those two things together and that led me to movement disorders and Parkinson’s disease. As I progressed further in medicine, I started to see myself and other physicians more as educators rather than just people who provide clinical care. A provider can really influence the way someone navigates their own identity because of an illness, and the education piece of the job allows them to help shape the course of care beyond just medications

What spurred your interest in multigenerational health education and community building?

I did a gap year program between undergraduate and medical school called City Year, which is an AmeriCorps program. I was an assistant teacher in a fourth-grade classroom. There was a clear lack of science education — the main focus was math and English. So, I started a neuroscience club, and it really took off. Not only did the kids participate, but they were telling their friends about it. It showed me that kids naturally gravitate toward being ambassadors of health information. 

I started to think about how I could take advantage of their natural inclination to spread information by empowering them to be ambassadors of health information to communities that are challenging to reach in traditional settings. That became my hypothesis. I designed a seven-week curriculum for students in partnership with St. Luke's A.M.E. Church in Harlem, and we did programming on various brain health topics. The program was my first time exploring whether the health information we deliver to children can ripple out into their communities. In piloting this program, I learned a lot and hope to carry these lessons forward.

I also helped build a community website while I was at Columbia University that was meant to be a hub for people who may see a doctor at Columbia but were looking for additional resources. This website, called Community Movers, was meant to be a place doctors could direct people who wanted to see things like a calendar of local events and nearby spiritual information and support. The project showed me, again, how providers can connect people with resources beyond clinical recommendations, which is important for building trust.

How will receiving the Parkinson’s Foundation award impact your career?

The biggest impact is a personal one. This award honors Dr. Côté [Lucien J. Côté, MD, was one of the most respected and beloved PD doctors in the U.S.], and being at Columbia, I was able to talk to some of my mentors and senior attendings there and get a sense of who he was and what the practice of movement disorders meant to him. It was so inspiring to hear about how he prioritized education, which of course resonates a lot with me. I heard stories about how he would stay for hours, just going over one detail of a presentation, and stay not only with patients but with students as well. 

It is so reassuring and very humbling to realize that the same values, the same priorities of education, of patient empowerment have been around for a long time, and, incredibly, I am just a continuation in some small way of all the work that came before me. 

Are you working on any Parkinson’s research?

I am also an American Academy of Neurology Healthcare Equity Scholar, which is a year-long program where I workshop a community health initiative similar to the one I did, but I receive feedback and develop it further. I'm building another iteration of the community health literacy outreach initiative that I ran as a pilot. This time, it'll be in association with SUNY Downstate in Brooklyn, where I work as an attending.

How do you see your work and research improving the health and lives of people with PD and their children?

What I’ve seen often is that delivery of this kind of core brain health knowledge doesn't happen until someone gets diagnosed with Parkinson’s disease. Then you're trying to deliver not only foundational brain health information, but also a diagnosis and treatment options. I think that can get overwhelming. My hope is that by delivering core knowledge much earlier, integrating it into the community through schools, students, young people, it will have some sort of foundational improvement in the types of brain health knowledge that patients come in with overall. 

Even more directly, I hope my work will highlight that brain health conditions can be approached as a family. 

When people are diagnosed with a neurodegenerative condition like PD, education and support often focus on the adults in that community, but kids are affected too. As more young people are diagnosed with Parkinson's, their children and grandchildren also need help navigating this disease. 

There aren't as many resources directed toward children. I hope that by making kids the focus for this type of outreach, we will start to see that the family support unit for patients with Parkinson's becomes stronger — on more than a direct caregiver level. It engages and empowers the family unit to come together, no matter the ages of the family members.

What gives you the greatest hope for the Parkinson’s community?

What gives me the most hope is how excited people are to engage in discussions about Parkinson’s. People are thinking creatively about how we can support people with Parkinson's beyond medication, clinical trials or clinic interventions. 

There are drawing classes, painting classes and boxing classes for people with PD. The creativity people bring to improving quality of life with this disease gives me the most hope because creativity is not something you see a whole lot of in other parts of medicine. When we think about supporting people outside the clinic, there is so much room for creativity, discussion and partnership.

It's these types of interactions and research that make me the most excited, the most hopeful, for what's to come.

Explore more topics and resources mentioned in this article:

• Join our Children of People with Parkinson’s Community Network
• Parkinson’s and Your Children/Teenagers
• Young-Onset Parkinson’s
• Frequently Asked Questions: A Guide to Parkinson’s Disease
• Find your Parkinson’s Foundation Chapter and explore PD wellness or exercise classes near you.

Find a neurologist or movement disorders specialist at Parkinson.org/Search or call the Parkinson's Foundation Helpline at 1-800-4PD-INFO (1-800-473-4636).

After a Parkinson’s diagnosis, many people start their journey by learning about treatments to help ensure their best quality of life. But according to experts like Robert Hauser, MD, from the University of South Florida, a Parkinson’s Foundation Center of Excellence, the initial months after a diagnosis also hold a unique window of opportunity that may go unnoticed by people newly diagnosed with Parkinson’s and their care team. 

In Episode 108 of the Parkinson’s Foundation podcast Substantial Matters: Life & Science of Parkinson's, Dr. Hauser discusses the "golden year," a time prior to starting Parkinson’s medications. This window may hold a key to finding therapies that could change the course of PD. 

What is the “Golden Year”?

The "golden year" refers to the period of about 12 months after diagnosis when a person is more likely to have mild movement symptoms and may not yet need Parkinson’s medications to manage activities of daily life. 

Before starting medications to manage Parkinson’s symptoms, the brain is at its natural baseline. People who have not started medications are sometimes called treatment naïve. Being treatment naïve gives researchers a window to test disease-modifying therapies — treatments designed to slow, halt or possibly reverse Parkinson's progression. 

Timing Matters

Current Parkinson's medications manage movement symptoms such as stiffness and slowness of movement. However, they do not treat symptoms that may appear after many years, such as cognitive changes or serious balance issues. An important need in Parkinson's research is finding a way to diagnose the disease as early as possible and halt its progression before these long-term symptoms arise. 

For a clinical trial to test how a new treatment works, researchers must track changes in a person’s PD over time. Entering a trial before daily medication becomes necessary gives researchers the clearest picture of how well the new treatment works. This makes the "golden year" a unique opportunity for both researchers and people with PD.

Despite the importance of trials in the first year after a Parkinson’s diagnosis, finding eligible participants is a hurdle. It remains a challenge because of these factors: 

• Starting medication: Neurologists often start people with PD on medications right away, making treatment-free baseline observations unavailable.
• Wait times: Delays in scheduling appointments with movement disorder specialists can cause newly diagnosed people to miss early trial eligibility. 
• Awareness: Many health care professionals are unaware of clinical trials for newly diagnosed and treatment naïve people — or how important the golden year is to Parkinson’s research — and do not share trial information with people with PD.

What can we do?

To make the most of this critical time, collaboration is needed between people with Parkinson’s and their care teams:

• People with Parkinson’s and families: If you or a loved one is newly diagnosed and do not feel an immediate need for medication to manage daily activities, ask your PD doctor about clinical trial opportunities for treatment-naïve individuals.
• Healthcare providers: Doctors and care teams should discuss clinical trials with their newly diagnosed patients before prescribing PD medications. If symptoms are mild and manageable, allowing time to consider a trial can open doors to groundbreaking research. 
• Improving access: Some medical centers are working to improve systems to get newly diagnosed people into appointments quickly, so they can explore trial options before starting standard treatment. 

What’s Next

Every approved Parkinson’s treatment exists today because people chose to voluntarily participate in clinical research in the past. Raising awareness about research options helps to ensure newly diagnosed people know what's available and to decide if research participation is the right choice for them. 

Whether you are newly diagnosed or familiar with Parkinson’s, explore opportunities to get involved with PD research today. Explore current studies now.

When federal leaders developing the National Plan to End Parkinson’s met for the second time on August 24, the Parkinson’s Foundation brought a clear message from our community: accelerate the breakthroughs that can change Parkinson’s tomorrow while making sure people can access the care they need today.

Ahead of the meeting, we asked advocates what they want federal leaders to prioritize. Nearly 900 people responded, and their input helped inform both the Foundation’s recommendations to the federal government and remarks delivered by Parkinson’s Foundation President and CEO John Lehr to the Advisory Council.

What We Heard from the Parkinson’s Community

Research that can fundamentally change the course of Parkinson’s was the clearest priority. Of the 873 survey responses, 94% identified developing treatments that can slow, stop, cure or prevent Parkinson’s as a top research priority. 

Access to care was another major concern: 36% of respondents reported difficulty finding a healthcare provider with Parkinson’s expertise or getting an appointment within a reasonable amount of time. Among respondents in rural communities, that number climbed to 46%. Another 17% reported trouble getting insurance or Medicare to cover recommended Parkinson’s care. 

Six Priorities for the National Plan

The survey findings reinforce the six high-impact goals that guided the Parkinson’s Foundation recommendations to the federal government through its Request for Information on the National Plan.

In partnership with the American Parkinson Disease Association and The Michael J. Fox Foundation, we outlined six priorities for what the National Plan should achieve by 2035: 

1. Reduce the financial impact of Parkinson’s on families living with the disease. 
2. Improve health outcomes and quality of life for people with Parkinson’s. 
3. Prevent Parkinson’s, improve symptoms and slow or stop disease progression. 
4. Improve the quality of care for people with Parkinson’s covered through federally funded healthcare programs, including Medicare and Medicaid. 
5. Research the association between environmental triggers and Parkinson’s and reduce exposure to potential risks. 
6. Research and better understand the underlying factors contributing to Parkinson’s. 

Together, these priorities reflect both the long-term goal of preventing and curing Parkinson’s and the immediate need to improve care, affordability and quality of life for people living with the disease today.

Bringing Priorities to Federal Leaders

John Lehr brought these priorities directly to the Advisory Council during its August 24 meeting.

“The National Plan should provide the leadership and accountability necessary to turn these priorities into measurable progress for people with Parkinson’s and their families,” John said.

The Parkinson’s Foundation is also urging the Advisory Council to keep implementation of the National Parkinson’s Project on track, including delivering its first annual report within a year.

The work is far from over. Two more public Advisory Council meetings are planned for November 9 and December 7, giving people affected by Parkinson’s additional opportunities to weigh in as the National Plan takes shape.

After years of advocacy to create this historic federal initiative, the Parkinson’s community now has an opportunity to help determine what it delivers.

Stay involved. Join our Advocacy Network to receive updates about opportunities to make your voice heard and help us push for a National Plan that meets the needs of people with Parkinson’s and their families.

By the time most people are diagnosed with Parkinson’s disease (PD), the condition has most likely been developing quietly, undetected, for years. This early period — before the typical tremors, stiffness and slowness that lead to a diagnosis become obvious — is known as the prodromal phase. Finding ways to detect Parkinson’s during this window is a major goal of research, because earlier identification could improve outcomes through earlier treatment and better care. 

Researchers are working to find biomarkers that could detect PD early. In addition to lab tests, wearable technology may monitor daily activity and detect subtle clues of disease. These “digital gait biomarkers,” may provide a simple, accessible way to detect early signs of Parkinson’s.  

A new study published in the Journal of Neural Transmission suggests that subtle changes in how people walk in everyday life may be detectable up to nearly seven years before a Parkinson’s diagnosis — and that an ordinary wrist-worn device, similar to a fitness tracker, may be able to detect those changes. 

Study Results

Researchers at the University of New South Wales in Australia analyzed data from more than 73,000 participants in the UK Biobank, a large long-term health study. Between 2013 and 2015, each participant wore a wrist accelerometer (a motion sensor) for seven days, and was then followed for up to 10 years through their medical records. During that time, 314 people were diagnosed with Parkinson’s.

The researchers used software called Watch Walk to translate raw motion data into 17 detailed measures of walking — not just step counting, but the quality and structure of movement: walking speed, step rhythm, how long they walked continuously and how their hands and arms moved.

Researchers then compared people later diagnosed with Parkinson’s with those who were not. People who developed Parkinson's had five measures that stood out consistently years before diagnosis. They:

1. Took fewer daily steps. They took substantially fewer steps per day, and the gap grew wider as their diagnosis approached.
2. Had slower top walking speed. Their fastest walking pace was slower, suggesting a reduced ability to speed up when needed.
3. Had reduced arm movement. They spent more time walking with their arms held still — for example, hands held in front of the body — and less time with a natural arm swing. Reduced arm swing is an early sign of Parkinson’s.
4. Showed changes in step rhythm. Their step patterns were, somewhat unexpectedly, more uniform — which the researchers suggest may reflect a loss of natural flexibility in how healthy people adjust their walking.
5. Displayed differences in walking patterns. The way their walking was broken up over the day — into shorter versus longer continuous stretches — also differed from those who did not develop Parkinson’s.

Of these, changes in arm movement were detectable the earliest — up to 6.8 years before diagnosis. The drop in daily steps was especially pronounced in the years closest to diagnosis.

Why is This Study Important?

Parkinson’s affects the brain circuits that control movement, so in practice, walking — a complex, coordinated activity — would show early signs of change. Postural instability, or difficulty balancing is one of the most challenging PD movement symptoms. Importantly, the technology from wearable sensors can break down the complex aspects of walking into components that can be analyzed separately.

What makes this study notable is that these changes were measured in the real world, during participants’ normal daily lives, rather than in a clinic. Continuous, at-home monitoring can capture patterns that a brief walking test in a doctor’s office might miss. It can also help identify potential problems years before someone is aware they exist.

The researchers also emphasize that the device used was a simple wrist-worn sensor, the kind that could be built into widely available consumer wearables, like a smartwatch. That makes this approach potentially scalable to large numbers of people. 

What Does This Mean for People with Parkinson’s?

This study does not mean that a smartwatch can diagnose Parkinson’s. The walking differences the researchers identified are subtle and show patterns across large groups — not a test that could predict whether someone will develop Parkinson’s. But these findings bring us closer to a future where observational, easy-to-record changes in the way we walk could help identify Parkinson’s years before a diagnosis. 

That possibility is significant. Growing evidence suggests that Parkinson’s leaves detectable traces years before diagnosis and traditional symptoms appear. As potential disease-slowing therapies move through clinical trials, tools that can flag people in the earliest stages could become increasingly valuable — helping researchers identify candidates for prevention studies and, eventually, helping doctors intervene sooner.

Learn More

The Parkinson’s Foundation believes in empowering the Parkinson’s community through education. Learn more about PD and movement through our resources below, or by calling our free Helpline at 1-800-4PD-INFO (1-800-473-4636) for answers to your Parkinson’s questions.

• 10 Early Signs
• Trouble Moving or Walking
• Finding Balance: Steps to Move Safely and Minimize Falls with Parkinson’s