Prodromal Parkinson's Disease Identification and Risk Factors

Prodromal Parkinson’s disease represents the interval preceding the emergence of classical motor signs, during which a spectrum of non-motor manifestations and measurable biomarkers signal the onset of neurodegeneration. This phase may extend for a decade or more, offering a critical window for early detection and intervention. Key prodromal features include hyposmia, constipation, rapid eye movement sleep behaviour disorder, mood alterations and autonomic dysfunction. Emerging evidence links these clinical signs to underlying pathology in brainstem nuclei and peripheral tissues. Advances in neuroimaging—particularly dopamine transporter single-photon emission computed tomography and metaiodobenzylguanidine scintigraphy—have enabled in vivo visualisation of nigrostriatal dysfunction. Parallel developments in genetics and population-based risk algorithms incorporate family history, polygenic risk scores and environmental exposures such as pesticide contact or head trauma. By integrating clinical, imaging and molecular data, researchers aim to stratify individuals by risk, refine diagnostic criteria and guide neuroprotective trials. The global burden of Parkinson’s disease underscores the imperative to translate prodromal research into screening strategies, lifestyle modifications and precision-medicine approaches that may delay or prevent overt disease.

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Prodromal Parkinson's Disease Identification and Risk Factors publication trend

The graph below shows the total number of articles in prodromal parkinson's disease identification and risk factors across all publications each year (not limited to Nature Index journals).

Technical terms

Prodromal Parkinson’s disease: The pre-motor phase characterised by non-motor symptoms and biomarkers indicating early neurodegeneration.

Hyposmia: A diminished sense of smell, often one of the earliest non-motor features in Parkinson’s disease.

Rapid eye movement sleep behaviour disorder (RBD): A parasomnia marked by enactment of dreams, reflecting brainstem dysfunction linked to synucleinopathy.

DaT-SPECT: Dopamine transporter single-photon emission computed tomography, an imaging technique to assess presynaptic dopaminergic function.

Polygenic risk score (PRS): A quantitative estimate of genetic susceptibility derived from multiple common variants associated with disease risk.

References

1. Widening the Spectrum of Risk Factors, Comorbidities, and Prodromal Features of Parkinson Disease. JAMA Neurology (2023).
2. Clinico-imaging features of subjects at risk of Lewy body disease in NaT-PROBE baseline analysis. npj Parkinson's Disease (2023).
3. Screening and Targeting Risk Factors for Prodromal Synucleinopathy: Taking Steps toward a Prescriptive Multi-modal Framework. Aging and Disease (2024).
4. Update of the MDS research criteria for prodromal Parkinson's disease. Movement Disorders (2019).
5. Meta‐analysis of early nonmotor features and risk factors for Parkinson disease. Annals of Neurology (2012).
6. The prediagnostic phase of Parkinson's disease. Journal of Neurology Neurosurgery & Psychiatry (2016).
7. Parkinson’s disease determinants, prediction and gene–environment interactions in the UK Biobank. Journal of Neurology Neurosurgery & Psychiatry (2020).
8. Clinical and Imaging Markers of Prodromal Parkinson's Disease. Frontiers in Neurology (2020).