Every year, thousands of neurologists, researchers and other Parkinson’s disease (PD) experts gather at the International Congress of Parkinson’s Disease and Movement Disorders to share new ideas and breakthroughs aimed at transforming life for people with Parkinson’s. This year the conference took place October 5 in Honolulu, HI.  

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1. Returning Secondary Health Findings in the PD GENEration Study 

PD GENEration: Powered by the Parkinson’s Foundation is a global research study providing genetic testing and counseling at no cost to people with Parkinson’s. Since 2019, the study has expanded to nearly 70 sites in the U.S. and internationally, enrolling more than 27,000 participants. PD GENEration also recently expanded its testing platform to provide secondary health findings to participants.  

Using whole genome sequencing that looks at a person’s entire DNA, PD GENEration can now disclose 21 genes linked to either PD or parkinsonism and 10 non-PD related genes. 

Key Takeaways 

• As of February 2025, 96% of study participants with whole genome sequencing consented to receive secondary health findings. 

• Gene-specific counseling materials were created to share this additional genetic health information with participants. A system was also established to review genes of secondary health findings as new research emerges. 

• Future studies will help researchers better understand how people feel after receiving these results. 

Learn more & enroll in PD GENEration. 

2. Engagement of PD GENEration Participants: Insights into Genetic Counseling Recall and Clinical Trial Interest 

Previously, data for PD GENEration was only collected from participants at enrollment — this limited long-term insights. The Parkinson’s Foundation followed up with participants to better understand their PD GENEration experience and whether their views on joining the clinical research trial changed over time. 

Key Takeaways 

• While most respondents remembered their PD GENEration experience and many were interested in learning more about future clinical trials, nearly 30% either did not recall receiving genetic counseling or receiving their genetic test report. 

• People who had a negative test result or a longer enrollment period were slightly more likely to misremember their PD GENEration experience. Men were also slightly more likely to misremember than women. 

• The results emphasize the importance of developing methods for ongoing engagement and information sharing. 

Discover how to join a research study. 

3. Distribution of Genomic Ancestries and Genetic Variation Among Individuals Enrolled in the PD GENEration Study 

Analyzing genetic ancestry is important in large Parkinson’s genetic studies to accurately measure PD risk in different populations. This study looked at the genetic backgrounds of people in the PD GENEration study and how often certain genetic results were found.  

As of August 2025, next-generation genetic sequencing — which allows for comprehensive analysis of genetic variations — was completed for 22,189 people with Parkinson’s. Of those tested, about 12% were found to have a genetic change linked to the disease. Most of those tested have European genetic ancestry, and more than 9% are of Ashkenazi Jewish genetic ancestry.  

Key Takeaways 

• There were differences between what participants reported as their race, ethnicity and ancestry and what the genetic test results showed. 

• The study also showed that the likelihood of having specific Parkinson’s-related genes varies depending on a person’s genetic ancestry.   

• The high number of people with European ancestry in PD GENEration is driving efforts to recruit participants from diverse ancestries to better understand how genes affect disease risk. 

Explore current findings from PD GENEration. 

4. The Role of Research and Genetics Educational Events in Parkinson’s Research: Overcoming Barriers in the Hispanic/Latino Community 

Diversity in Parkinson’s research is key to understanding the disease and discovering new treatments. Hispanic and Latino members of the Parkinson’s community remain underrepresented in genetics research due to barriers such as language differences, lack of information and unequal access to healthcare.  

A 2024 strategic collaboration between the Parkinson’s Foundation and the Latin American Research Consortium on the Genetics of Parkinson’s Disease (LARGE-PD) expanded PD GENEration genetic testing and counseling across Latin America to increase Hispanic and Latino participation in genetic research. 

Educational outreach events in Mexico City, Mexico and Cali, Colombia staffed by local doctor and nurse volunteers combined on-site participant recruitment with information on research, genetics and broader community topics. These events included tailored Spanish-language materials. 

Key Takeaways 

• Sustained, community-driven efforts are key to addressing participation gaps among medically underrepresented communities.  

• Research and genetics educational events, along with culturally adapted recruitment strategies, can reduce barriers, raise awareness and boost Hispanic and Latino participation in Parkinson’s genetic research. 

• The share of Hispanic and Latino PD GENEration participants rose sharply in September 2024, reaching a peak of more than 35%, reflecting recruitment efforts.  

Learn more about our commitment to making research more inclusive. 

5. Online Learning Preferences of Healthcare Providers Caring for People with Parkinson’s  

Many health professionals are required to continue their education to stay current with evolving knowledge and research. This learning can often be done online. However, information on how healthcare professionals caring for people with Parkinson’s prefer to learn online is limited. This study aimed to identify continuing education learning preferences and barriers to course participation and completion across nearly 5,000 healthcare professionals caring for people with PD.  

Key Takeaways 

• Participants preferred live and recorded webinars as well as interactive and hands-on learning experiences that are directly relevant to their healthcare roles.  

• This study showed time and financial constraints can be barriers to continuing education. Course workload and media playback speed can also be factors that can affect completion rates.  

• The Parkinson’s Foundation will use these results to inform the development of future online continuing education for healthcare professionals. 

Explore our Learning Lab courses, designed for healthcare professionals.   

6. Parkinson’s Exercise Guidelines: From Outdated to Updated 

Exercise and movement can improve many Parkinson's symptoms. The Parkinson’s Foundation, in collaboration with the American College of Sports Medicine, created Parkinson’s exercise recommendations in 2021 to help people with PD receive safe and effective exercise. Clinical guidelines are typically reviewed and updated every three to five years to ensure they reflect the latest, high-quality, evidence-based care. The Parkinson’s Foundation conducted research to identify any gaps in literature and used its findings to revise professional-facing exercise recommendation guidelines. A panel of international subject matter experts and people with Parkinson’s reviewed the revisions. Their feedback, along with information collected during a public comment period, was used to further improve the guidelines. 

Key Takeaways 

• The panel agreed recommendations should highlight the importance of exercise safety, a referral to a physical therapist and exercise modifications based on the ability of the person with Parkinson’s, their medication status and their stage of PD. 

• The guidelines were updated to reflect input from the panel, the public and the latest evidence and best practices. 

• The Parkinson’s Foundation turned the guidelines into a practical, user-friendly guide for exercise professionals who work with people with Parkinson’s. 

Read and download our Parkinson's Exercise Recommendations fact sheet. 

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Find more about the Foundation’s commitment to research at Parkinson.org/Research. 

Parkinson’s disease (PD) can be difficult to diagnose by clinicians, especially in early stages of the disease. This means that some people with PD may get diagnoses only late in the disease when the symptoms are more obvious. Others may never get a formal diagnosis at all. 

Jacob Simmering, PhD, recipient of a Parkinson’s Foundation Stanley Fahn Junior Faculty Award, is digging through healthcare data to find clues that could lead to earlier and more accurate diagnoses of PD. Using statistical analysis, he hopes to identify diagnostic patterns that commonly precede PD and that could be used as future medical signposts, guiding doctors toward earlier detection of the disease. 

“This award is crucial to my career development as a researcher in Parkinson’s disease,” said Dr. Simmering. “Parkinson’s disease is a common neurodegenerative disease without any disease-modifying, neuroprotective therapies. One issue with degenerative diseases is that the damage is irreversible. By the time clinical symptoms become apparent, the disease is often very advanced in terms of neuronal death. Earlier intervention may allow for treatments that preserve neurons — slowing, if not preventing, progression.” 

From his lab at the University of Iowa, a Parkinson’s Foundation Center of Excellence, Dr. Simmering is utilizing health insurance databases to collect healthcare data on nearly 250,000 deidentified people recently diagnosed with PD. From this information, he hopes to identify a “diagnostic window” for PD—a stretch of time with repeated doctor’s visits for PD-like symptoms signaling the presence of the disease. 

Dr. Simmering will then use this diagnostic window as a frame, looking at people with recent diagnoses and figuring out what prevented physicians from diagnosing PD sooner. His hypothesis is that the three biggest factors that play into delayed diagnoses are: 

• Unique symptom patterns of PD 

• Living in more rural areas 

• Not being seen by a neurologist 

Sorting through this data will provide evidence for other repeated symptoms that could clue doctors into a PD diagnosis earlier. While tremor and involuntary movements are most commonly used to lead to a PD diagnosis, other symptoms like urinary problems and anxiety could be just as valuable. Altogether, Dr. Simmering will use this detailed analysis to generate a forward-looking “risk score” to identify people who are most at risk of developing PD.  

“These results will allow us to screen for people who have symptoms and characteristics similar to people who will go on to be diagnosed with Parkinson's disease, potentially allowing for earlier detection of disease,” said Dr. Simmering.  

Earlier detection means providing symptom relief sooner to those with the disease, improving their quality of life with early treatment. 

Meet more Parkinson’s researchers! Explore our My PD Stories featuring PD researchers. 

Medication plays a key role in managing Parkinson’s disease (PD), but it’s only one part of a broader care plan.  

The following article is based on a Parkinson’s Foundation  Expert Briefing  exploring how medications fit into integrated, holistic Parkinson’s care, hosted by Danny Bega, MD, MSCI, associate professor of neurology, medical director and director of the Parkinson's Disease & Movement Disorders Center neurology residency program at Northwestern University Feinberg School of Medicine, a Parkinson's Foundation Center of Excellence. Dr. Bega is also the director of the Huntington's and Wilson’s diseases programs at Northwestern. 

Understanding the Dopamine-Parkinson’s Connection 

Parkinson’s is a progressive disorder linked to declining levels of dopamine, a brain chemical that influences movement, memory and many other vital body processes. Other brain chemicals, including norepinephrine and serotonin, can also be impacted in Parkinson's disease and influence symptoms.  

As Parkinson’s advances, the number of brain cells making dopamine continues to decrease, and remaining cells struggle to store and release it. This leads to slowness of movement, tremor, rigidity and other motor symptoms. It can also cause various non-motor symptoms, such as constipation, loss of smell and thinking changes. 

Managing Parkinson’s 

Parkinson’s is a complex disease. There is no standard treatment. However, medications — along with exercise, comprehensive care, a nutritious diet and mindfulness practices — can manage Parkinson’s symptoms and help you live well.  

Establishing a regular exercise routine soon after diagnosis may help slow disease progression and can improve movement, strength, balance and mood. It can also help you sleep better. Staying social and engaged can reduce feelings of loneliness.  

Your care team is equally important. Look for healthcare professionals with expertise in Parkinson’s, including a neurologist, speech-language pathologist, physical and occupational therapist, social worker and other healthcare professionals, to help manage your PD symptoms. Be sure to attend regular checkups. 

The Role of Medication 

Most Parkinson’s medications work to improve symptoms by either increasing dopamine in the brain or acting like dopamine. Levodopa is the most effective drug for managing Parkinson’s symptoms. During the course of Parkinson’s, most people will take levodopa at some point.  

Anxiety and depression can also be common in Parkinson’s and can impact well-being even more than motor symptoms. Treating these symptoms using a combination of medication, such as an SSRI, SNRI or mirtazapine — a tricyclic antidepressant drug — along with therapy, stress management and staying active, can significantly decrease disability.  

People newly diagnosed with Parkinson’s often wonder when to begin prescription medication. Studies show there is no benefit in holding off. Most doctors agree you should start medication when symptoms begin to bother you.  

Because no two people experience PD in exactly the same way, treatments vary from person to person, as does the rate of progression. However, knowing the typical stages of Parkinson’s can help you anticipate changes: 

• In the first five years following diagnosis, you may find symptoms don’t significantly impact your daily life. Your doctor might recommend a clinical trial. Participation in Parkinson’s research can potentially give you early access to new treatments, improve care and lay the foundation for a cure.  

• Within one to 10 years, as symptoms begin to interfere with activities, most people with Parkinson’s can expect a long-lasting, steady response to medication.  

• Between five and 20 years after diagnosis, it becomes increasingly harder for the brain to store dopamine. Your body’s response to levodopa can become shorter and less efficient. This can lead to motor fluctuations — "on" periods, when medication works well, and "off" periods, when medication wears off and symptoms return. It is important to work closely with your doctor to adjust your treatment and find what works best for you. 

• After 10 or more years of living with Parkinson’s, a person can experience more significant issues. Some people can develop significant memory and thinking problems. Trouble with balance, falls and freezing, a temporary inability to move, can also become an issue. Your doctor can discuss medication adjustments or drug therapies or provide a referral to the right healthcare professional for your needs, which might include a neuropsychologist, psychiatrist, or a speech or occupational therapist. 

Types of Medications Used in Parkinson’s 

It can be common for people with Parkinson’s to take a variety of medications, at different doses and different times of day, to manage symptoms. This can include: 

Dopamine agonists: Early on, drugs that stimulate dopamine in the brain, such as pramipexole, ropinirole and rotigotine, can usually treat Parkinson’s movement symptoms. Dopamine agonists pose less risk for dyskinesia — involuntary erratic movements that usually begin after a few years of levodopa treatment.  

Side effects can include nausea, dizziness, sleepiness, confusion and impulse control disorders, such as uncontrolled shopping, gambling, eating and sexual urges. Studies show 28% of people with Parkinson’s stop taking dopamine agonists due to side effects, while 40% need to add another medication within two years. 

Levodopa: Levodopa, the most effective drug for Parkinson’s movement symptoms, replaces dopamine in the brain. It is usually given in combination with the drug carbidopa to reduce nausea, a common side effect. Taking levodopa with meals can also reduce nausea, but protein may interfere with the drug’s effectiveness. About 2% of people taking levodopa stop due to side effects, while 15% need to add another medication within two years.  

Dyskinesia, also linked to levodopa, can often be managed by a dose adjustment or through direct treatment, using a medication called amantadine. It works by blocking NMDA, a chemical that causes extra movement. Immediate-release amantadine is also sometimes used alone for Parkinson’s movement symptoms. There is an increased risk of confusion and hallucinations with amantadine use in people over 75. It can also be associated with leg swelling, skin changes and other side effects.  

Anticholinergics: The medications trihexyphenidyl and benztropine are sometimes used to improve tremor or dystonia — painful, sustained cramping . They work by blocking acetylcholine, a brain chemical tied to movement. However, their use should be avoided in people 70 and older due to the risk of confusion and hallucinations. Anticholinergics can also be associated with blurred vision, dry mouth, constipation and urinary retention. 

Medications your doctor might consider to improve the effects of levodopa include: 

MAO-B inhibitors: Monoamine oxidase-B inhibitors rasagiline, selegiline and safinamide make more dopamine available to the brain. These medications can be used alone or in combination with levodopa to extend effectiveness. MAO-B inhibitors are generally well tolerated, but 70% of people taking them alone for Parkinson’s will need to add another medication within two years. 

COMT inhibitors: Medications such as entacapone and opicapone increase available levodopa in the brain by blocking the catechol-O-methyl transferase enzyme.  

A2A receptor antagonist: Istradefylline, an adenosine A2A antagonist, blocks adenosine at A2A receptors in the brain to reduce levodopa “off “time. 

Inhaled levodopa is often used with levodopa, as needed, for sudden “off” time. Injectable apomorphine can also be used on demand, for “off” time relief. Both medications can increase the risk of dyskinesia. 

It is important to work with your doctor to find the right balance for you. Your doctor might increase or decrease your levodopa based on your symptoms. For example, tremor, stiffness or mobility issues might benefit from an increase in levodopa. However, hallucinations, confusion and low blood pressure might improve with a decrease in levodopa. 

There are also strategies and medications to manage drooling, runny nose, sleep issues, gut issues, thinking changes and other Parkinson’s challenges. 

What if levodopa doesn’t seem to be working? 

If you are taking levodopa but aren’t seeing benefits, talk to your doctor. Here are some questions to ask: 

• Is the symptom troubling you one that doesn’t respond well to levodopa? Could it be related to another health issue?  
• Would you benefit from a referral to a rehabilitation therapist or another health professional? 
• Could something be interfering with how your body is absorbing medication? Some people experience less benefit when taking levodopa with a high-protein meal. 
• Do you have a condition that mimics Parkinson’s? 

It is also important to discuss whether your dose needs to be adjusted. For example, the effects of Sinemet, a form of levodopa, only last a short time — after 90 minutes half of it is gone. Your doctor might adjust the timing and dose of levodopa, use a longer-acting formulation or recommend taking your medications 30 minutes before or 60 minutes after eating a meal. 

Advanced Therapies 

If it becomes difficult to control motor fluctuations by adjusting oral medications, there are other options to improve medication absorption and reduce “off” time:  

• Duopa therapy delivers carbidopa-levodopa gel directly to your intestine through a surgically placed tube.  

• Foscarbidopa and foslevodopa (Vyalev) therapy uses a pump to steadily deliver a form of levodopa under the skin through a small tube called a cannula. A needle is used to place the cannula. 

• Continuous apomorphine therapy (Onapgo) uses a pump to deliver continuous apomorphine through a fine needle placed under the skin.  

These medications require lifestyle adjustments, training to use and a commitment to good skin care to reduce the risk of irritation and infections. 

Options Beyond Medication 

More advanced Parkinson’s symptoms can sometimes benefit from other treatment strategies, such as deep brain stimulation (DBS) — which involves surgically implanting an electrical pulse generator connected to electrodes placed in the brain to address Parkindeep-brainson’s movement symptoms and some non-movement symptoms.  

DBS might be considered for someone who:  

• lives with classic Parkinson’s disease  

• has symptoms that respond to levodopa  

• experiences frequent motor fluctuations and tremor, despite consistent medication dosing 

• has bothersome dyskinesia 

Following DBS, many people can reduce their medications and still experience a reduction of their PD symptoms. The reduction in dose of medication can lead to decreased dyskinesia. 

Focused ultrasound, a non-invasive therapy, does not require a surgical incision. During the procedure, high-frequency sound waves are aimed at a specific area of the brain connected to tremor to relieve Parkinson’s tremor. Unlike DBS therapy, which is adjustable and reversible, focused ultrasound changes are permanent. 

If you have questions about PD treatment options, contact our Helpline at 1-800-4PD-INFO (473-4636) or Helpline@Parkinson.org. 

Learn More 

Explore our resources about medications to treat symptoms of Parkinson’s:  

• Download our book Medications: A Treatment Guide to Parkinson’s Disease 

• Watch Understanding Deep Brain Stimulation (DBS) 

• Read The Latest in Parkinson’s Medications: Taking a Personalized Approach