About this Research Topic
There are currently no effective disease-slowing interventions for Parkinson’s Disease (PD). In people with PD, accumulation of pathology starts years before the clinical diagnosis of PD can be made, which is known as the prediagnostic phase of the disease. By the time of clinical diagnosis, over 60% of dopaminergic neurons in the nigrostriatal pathway of people with PD are already depleted. The advanced stage of pathology at diagnosis likely contributes to the failure of trials that aim to slow disease progression in people with PD. Against that background, there is rapidly growing interest in unravelling the prediagnostic phase of the disease as a gateway to earlier disease-slowing interventions.
Recent studies have demonstrated a gradual emergence of signs and symptoms over time among people with prediagnostic PD, reflecting the progressive nature of underlying pathology. However, those studies largely followed a one-size-fits-all approach, which may disregard differences in prediagnostic features or in (biomarkers of) the stage of underlying pathological processes across subgroups of patients.
In particular, there is a lack of insight on differences in prediagnostic evolution of PD by key patient characteristics such as sex, age at disease manifestation (e.g., Young-Onset vs. other) and genetic predisposition (e.g., complex vs. mendelian GBA / LRRK2). Furthermore, since most previous research has been restricted to Western European or North American populations with relatively limited ethnic diversity, it remains unclear to what extent our current understanding of the natural course of prediagnostic PD is generalizable to patients from other ethnical backgrounds or geographical regions.
In this Research Topic of Frontiers of Neurology, we invite manuscripts that address these critical gaps in knowledge. We anticipate that the novel insight provided by these manuscripts will be used to inform the design of disease-slowing intervention trials across the diverse spectrum of people with prediagnostic PD.
We are welcoming submissions which focus on the following specific themes:
• Potential differences in the emergence, presence or evolution of prediagnostic signs or symptoms across subgroups of patients with PD.
• Potential differences in biomarkers of prediagnostic disease-progression across subgroups of patients with PD.
• The natural course of prediagnostic PD in underrepresented ethnic populations or geographical regions.
We are interested in original empirical research (e.g., trials, cohort studies, case-control studies), reviews, study protocol or methodology papers, or perspective papers.
Keywords: Parkinson's Disease, Prediagnostic, Subgroups, Ethnic diversity, Geographical diversity
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.