Researchers are finding new ways to measure how Parkinson’s disease (PD) progresses and how well promising treatments work. These discoveries could help make way for disease-modifying therapies; interventions that may slow, stop or possibly reverse brain changes in Parkinson’s. Learn more about research breakthroughs and where to exercise caution.

This article is based on an Expert Briefing hosted by movement disorders specialist and Parkinson’s Foundation National Medical Advisor, Michael S Okun, MD, director of the Norman Fixel Institute for Neurological Diseases, a Parkinson’s Foundation Center of Excellence.

Discoveries Driving Disease-Modifying Research: Biomarkers, Genetics and More

Parkinson’s is a progressive brain disease that scientists believe involves a mix of environmental and genetic factors. Researchers are beginning to uncover those complex connections and better understand the diversity of the disease as people with Parkinson’s have different genetic ties to PD, symptoms and rate of progression.

Parkinson’s can begin developing sometimes a decade or more before visible symptoms appear. This quiet evolution has historically made it difficult to test therapies early in the course of disease. Researchers were often unable to enroll people in testing for potential therapies until they had developed the movement symptoms used to diagnose Parkinson’s or learned they had a genetic link. 

Research advances are helping scientists uncover who may be at risk, measure disease biology and test therapies in more targeted ways, including:

Biomarkers: The discovery of biomarkers in PD, substances in the body that provide clues about health, is changing the field. Diagnosis still relies on neurological exams, symptom history and response to dopamine therapies, but key PD biomarker tests can support a diagnosis. Researchers are working toward defining Parkinson’s by biology rather than symptoms. Biomarkers could help diagnose PD earlier, track disease progression and show whether treatments are working.

Focusing on alpha-synuclein: Clumps of misfolded alpha-synuclein proteins are linked to brain changes in Parkinson’s. Researchers are exploring ways to reduce alpha-synuclein production, prevent it from misfolding and clumping or to stop its spread.

Genetic studies: Groundbreaking research, such as PD GENEration: Powered by the Parkinson’s Foundation, is having a tremendous impact in detecting genetic variants linked to Parkinson’s. This work is helping people access clinical trials earlier and driving the development of personalized treatments. 

Thanks to the more than 35,000 people who have already joined PD GENEration, the Parkinson’s Foundation has learned that around 13% of people have a Parkinson’s related genetic variant, a big increase from earlier research estimates of 5 to 10%. The ever-growing study is continuing to propel new discoveries.

Active clinical trials that test new therapies are targeting genetic variants identified through PD GENEration testing, such as LRRK2. Clinical studies for therapies targeting a mutated GBA gene, one of the most common genetic risk factors for Parkinson’s, are also underway. 

Stem cell therapies: Research are exploring the potential of using tissue cells that can be transformed into dopamine neurons to address dopamine loss in Parkinson’s. Stem cell studies suggest that this approach may one day help improve PD symptoms. 

Some promising stem cell studies are moving closer to Phase 3 clinical trials, often one of the last steps before a drug manufacturer seeks approval from the U.S. Food and Drug Administration.

Other research areas to watch include:

• Glucagon-like peptide-1 (GLP-1) receptor agonists. These and similar therapies, initially targeted at weight loss and type 2 diabetes, are being explored for the potential to improve Parkinson’s symptoms.
• Studies exploring the gut-brain connection in PD. Scientists have discovered that Lewy bodies (clumps of misfolded alpha-synuclein proteins linked to brain disruption in Parkinson’s) can also be found in the gastrointestinal tract of people living with PD. Dietary interventions to alter gut bacteria and change the course of Parkinson’s may be on the horizon.
• Focused ultrasound is an advanced PD treatment that may lessen motor fluctuations when medications are no longer effective. Low-intensity focused ultrasound, an emerging technique, is being explored to temporarily open the blood-brain barrier to deliver targeted PD trial treatments directly to the brain.
• Scientists are exploring whether a gene-editing tool called CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) could address PD-related genetic targets.

Exercising Caution

Though hopeful progress is happening in disease-modifying therapies and stem cell research for Parkinson’s, legitimate trials are critical. Dubious and sometimes dangerous offerings have been shut down by the FDA and regulatory agencies all over the world. 

Stem cell tourism, travel to places with little medical or scientific regulation for unverified treatments, can put people at serious health and financial risk.

⚠️Be careful with any trials or experimental treatments that make big promises, skip over risks or ask for payment. Clinical trials do not charge people to take part.  

If you are considering a trial, be sure to ask questions about study protocols and talk with your healthcare team to determine whether it feels like the right fit. These websites can help you learn more about clinical trials for Parkinson’s:

• Join A Study — a Parkinson’s Foundation webpage that lists ongoing PD research studies.
• ClinicalTrials.Gov — a public database with active and completed clinical studies in the U.S. and around the world.

Learn More

Building the foundation for a cure is at the heart of the Parkinson's Foundation mission:

• Learn more about clinical trials and Parkinson’s.
• Discover how our research is changing the course of Parkinson’s.
• Get involved: Join opportunities like the PD GENEration genetic study to advance understanding of Parkinson's and accelerate new therapies. 
• Learn how PD Trial Navigator is connecting PD GENEration participants with clinical trials relevant to them.

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