Parkinson's disease-Crucial advances and on-going challenges.

Abstract

Dramatic advances have been seen over the past 5 years in neurodegenerative disease medicine. In Parkinson's disease (PD), significant advances have been made in molecular biomarkers and imaging tools. These have led to improved diagnostic accuracy for clinical trial recruitment and stratification, as well as contributing fundamentally to biomarker-based disease frameworks that define PD by its biology. In combination, these advances may enable the tracking of disease progression and improved evaluation of disease-modifying therapies in the research setting. Biofluid-based biomarkers currently available in research settings have the potential to reach real-world settings as commercially viable diagnostic tests. These will provide physicians with the necessary tools required to diagnose PD early and accurately without relying solely on the presence of clinical symptoms. Moreover, with each trial that reports, greater insights are gained into those individuals likely to benefit from different therapeutic options for PD, particularly with monoclonal antibody immunotherapy strategies targeting α-synuclein, where disease-modifying signals have been reported in some trials. This review focuses on some of the groundbreaking advances and the immediate challenges faced by researchers, clinicians, and individuals with PD, as they collaborate to address the great-and ever-growing-clinical need in PD.