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Updated: May 23, 2026
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Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease
Published on: July 24, 2019
Premotor Parkinson's disease: concepts and definitions
Andrew Siderowf1, Anthony E Lang
1Parkinson's Disease and Mov Disord. Center, Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Andrew.siderowf@uphs.upenn.edu
Summary
Early detection of Parkinson's disease (PD) is possible using premotor markers. Combining olfactory testing with imaging can improve screening efficiency and reduce costs for identifying PD before motor symptoms appear.
Area of Science:
- Neurology
- Biomarkers
- Diagnostic Technologies
Background:
- Parkinson's disease (PD) exhibits a prodromal phase with nonmotor symptoms and physiological changes.
- Identifying premotor markers could enable early PD screening before motor deficits manifest.
Purpose of the Study:
- To explore the potential of predictive testing for Parkinson's disease.
- To define the scope of use for identifying PD in its preclinical stages.
Main Methods:
- Utilizing dopamine transporter imaging for accurate premotor PD identification.
- Combining imaging with prescreening tests like olfactory testing to enhance efficiency and reduce costs.
- Evaluating high-risk populations, including those with rapid eye movement behavior disorder or LRRK2 mutations.
Main Results:
- Dopamine transporter imaging offers high accuracy but is costly for screening.
- A two-step screening process (imaging + olfactory testing) can reduce costs while maintaining diagnostic accuracy.
- Targeting high-risk groups can enrich samples for PD cases.
Conclusions:
- Preclinical PD detection's utility depends on the availability of effective, disease-modifying therapies.
- Large-scale screening implementation awaits safe and effective treatments targeting PD pathogenesis.
- Future research aims to identify biomarkers for earlier detection, preceding substantia nigra compacta involvement, enabling earlier therapeutic intervention.
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