Bridging global diversity gaps in Parkinson disease research

The global burden of Parkinson disease (PD) is rapidly shifting towards low-income and middle-income countries (LMICs), which already account for 44% of all individuals with PD. Despite this trend, the populations of LMICs and other under-represented populations defined by ethnicity, sex, geography and minority groups within high-income countries remain largely excluded from PD research. The continuation of these disparities limits our knowledge of disease biology and restricts the applicability of advances in prevention, diagnosis and treatment, increasing inequity in global health. Substantial disparities persist across the PD research continuum, extending beyond resource limitations and encompassing epidemiology, environment, genetics, deep phenotyping and biomarkers, data integration and diversity-aware analytics, clinical trials and basic science. To repair structural diversity gaps that compromise validity and equity in PD research, we propose an ethically grounded, coordinated agenda that prioritizes increased funding and local capacity building in under-represented regions, the development and adoption of harmonized and context-adapted methods, sustained community engagement with cultural competence, the creation of collaborative research networks, and more inclusive editorial and regulatory policies. Moreover, because inequities in care and research commonly co-occur and are mutually reinforcing, PD research should advance alongside a worldwide commitment to minimum standards of care and access to treatment. This Perspective details diversity gaps across PD research, outlines priority actions to address them, and illustrates, through recent examples, how interventions along these axes can advance equity and representation in PD studies.