4.6 Article

Probing the Pre-diagnostic Phase of Parkinson's Disease in Population-Based Studies

Journal

FRONTIERS IN NEUROLOGY
Volume 12, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fneur.2021.702502

Keywords

heterogeneity; pre-diagnostic Parkinson's disease; prodromal Parkinson's disease; population-based; epidemiology; prevention trials; prediction; target trial emulation

Funding

  1. Stichting ParkinsonFonds

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Parkinson's disease presents a wide range of symptoms, with increasing recognition of its heterogeneity. Population-based studies offer specific advantages in overcoming biases and broadening data collection, providing insights into the pre-diagnostic phase of the disease. Bridging study designs will be crucial in making vital advances in understanding the heterogeneity of pre-diagnostic Parkinson's disease.
Parkinson's disease covers a wide spectrum of symptoms, ranging from early non-motor symptoms to the characteristic bradykinesia, tremor and rigidity. Although differences in the symptomatology of Parkinson's disease are increasingly recognized, there is still a lack of insight into the heterogeneity of the pre-diagnostic phase of Parkinson's disease. In this perspective, we highlight three aspects regarding the role of population-based studies in providing new insights into the heterogeneity of pre-diagnostic Parkinson's disease. First we describe several specific advantages of population-based cohort studies, including the design which overcomes some common biases, the broad data collection and the high external validity. Second, we draw a parallel with the field of Alzheimer's disease to provide future directions to uncover the heterogeneity of pre-diagnostic Parkinson's disease. Finally, we anticipate on the emergence of prevention and disease-modification trials and the potential role of population-based studies herein. In the coming years, bridging gaps between study designs will be essential to make vital advances in elucidating the heterogeneity of pre-diagnostic Parkinson's disease.

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