Journal of Parkinson's disease最新文献

{"title":"<i>GBA1</i> Canada initiative (G-can), a pre-competitive, open science platform for <i>GBA1</i> research.","authors":"Priyabrata Halder, Lorna Chebon-Bore, Emma N Sommerville, Konstantin Senkevich, Andrew N Bayne, Isabella Pietrantonio, Mahtab Tavasoli, Jeremy M Van Raamsdonk, Martin Parent, Gary Ab Armstrong, Madeleine Sharp, Carl Laflamme, Peter S McPherson, Massimo Pandolfo, Thomas M Durcan, Nicolas Dupré, Austen J Milnerwood, Jean-François Trempe, Ronald B Postuma, Jason Karamchandani, Edward A Fon, Guy A Rouleau, Ziv Gan-Or","doi":"10.1177/1877718X261497542","DOIUrl":"https://doi.org/10.1177/1877718X261497542","url":null,"abstract":"<p><p>GBA1 Canada (G-Can) is a pre-competitive, open-science platform serving as a central hub for basic, translational, and clinical research on <i>GBA1</i>, which encodes the lysosomal enzyme acid beta-glucocerebrosidase (GCase), a key component of the glycosphingolipid metabolism pathway. G-Can unites basic scientists, clinicians, and industry partners in Canada and internationally to minimize duplication of effort and maximize research impact. G-Can has established a comprehensive and growing suite of biological, clinical, and analytical resources for the <i>GBA1</i> research community. Through the C-BIG Repository and partner infrastructures, these resources are made broadly accessible to academic and industry investigators under non-exclusive agreements, in accordance with G-Can's open-science mandate. G-Can's primary objectives are to deepen understanding of GCase biology and its genetic modifiers, validate disease-relevant biomarkers, and establish trial-ready cohorts exceeding 5000 genotyped participants. Therapeutic programs under development include gene therapy, RNA-based approaches, and combination strategies, with a Phase 0/1 clinical trial targeted within five years. By integrating open-science infrastructure with coordinated therapeutic development, G-Can aims to accelerate the translation of discovery into clinical application for patients with <i>GBA1</i>-associated neurodegeneration.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X261497542"},"PeriodicalIF":5.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An acoustic-only multivariable diagnostic model for Parkinson's disease using bowel sound acoustic signatures.","authors":"Sicheng Chen, Man Zhang, Surui Fang, Qi Yang, Chuyi Chen, Zhixuan Lei, Yuxia Zhu, Fen Deng, Lijuan Mo, Xi Liu, Changhong Tan, Lifen Chen","doi":"10.1177/1877718X261499238","DOIUrl":"10.1177/1877718X261499238","url":null,"abstract":"<p><p>BackgroundEarly detection of Parkinson's disease (PD) remains challenging due to the lack of reliable prodromal biomarkers. Non-invasive markers of gastrointestinal dysfunction are lacking.ObjectivesTo characterize bowel sound acoustic phenotypes in PD and evaluate their potential as non-invasive diagnostic markers by developing an acoustic-based predictive model.MethodsStandardized 5-min bowel sound recordings were collected from 120 PD patients and 100 controls. Thirteen acoustic features were extracted. LASSO (least absolute shrinkage and selection operator) selected predictors for logistic regression models, internally validated with 1000 bootstrap resamples. The acoustic-only model was evaluated without refitting within the development cohort in 48 patients with Hoehn-Yahr stages 1-2 and 100 controls.ResultsPD patients exhibited fragmented, low-energy bowel sound patterns compared with controls. Acoustic features did not differ significantly by constipation status, while two duration measures differed by Hoehn-Yahr stage. A full-feature model incorporating acoustic and biochemical markers achieved an area under the curve (AUC) of 0.8659. The acoustic-only model containing six predictors, three of which were statistically significant, yielded an AUC of 0.7999 (95% confidence interval [CI], 0.737-0.852). Optimism-corrected AUCs were 0.839 and 0.784, respectively. In the early-stage subgroup, the AUC was 0.728 (95% CI, 0.644-0.806), with 68.75% sensitivity and 66.00% specificity at the fixed probability threshold of 0.50.ConclusionsPD patients exhibit distinct bowel sound acoustic phenotypes. Acoustic features provided discrimination between PD patients and controls, including in early-stage disease. This non-invasive profiling approach offers a promising functional biomarker candidate for multimodal PD assessment.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X261499238"},"PeriodicalIF":5.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Charting the future: A multi-setting medical chart study of advance care planning in Parkinson's disease and atypical Parkinsonism.","authors":"Herma Lennaerts-Kats, Bauke W Dijkstra, Anke Elbers, Bastiaan R Bloem, Marieke C Groot, Jenny T van der Steen, Marjan J Meinders","doi":"10.1177/1877718X261495736","DOIUrl":"10.1177/1877718X261495736","url":null,"abstract":"<p><p>BackgroundAdvance Care Planning (ACP) enables people with progressive diseases to document and communicate future treatment preferences. For Parkinson's disease (PD) and atypical parkinsonism (AP), ACP is particularly important because of disease complexity, symptom burden, the progressive nature of the disease, and cognitive decline, yet its implementation across care settings remains unclear.MethodsWe conducted a medical chart review of 189 deceased patients with PD or AP who died in nursing homes (n = 91), hospitals (n = 58), or at home (n = 40) in the Netherlands. For patients who died at home, data were obtained from their general practice records. Data on treatment preferences, care discussions and palliative care goals were extracted at one year and six weeks before death.ResultsDocumentation of treatment preferences increased towards death but differed markedly between settings. Nursing homes recorded resuscitation and ICU limitations early and comprehensively, whereas hospitals made major updates only in the final weeks of life. In general practices, ACP documentation was limited. Nursing homes and hospitals more frequently addressed disease-specific scenarios, palliative sedation and end-of-life issues, while general practices more often reported preferred place of death and euthanasia. Palliative care goals in nursing homes covered all domains, while in hospitals and general practices they mainly related to physical aspects.ConclusionACP remains inconsistently documented and frequently delayed until the final weeks of life, when crises or cognitive decline may hinder meaningful participation. Earlier, iterative ACP-supported by clinician training, PD-specific guidance, and system-level measures such as ACP prompts in electronic medical records-could foster a more proactive and person-centered palliative approach aligned with patient values throughout the disease trajectory.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X261495736"},"PeriodicalIF":5.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meaningful digital mobility outcomes for people with Parkinson's disease: Insights grounded in diverse lived experience.","authors":"Jack Lumsdon, Ríona Mc Ardle, Megan Hanrahan, Alison Keogh, Cameron Wilson, Tova Gur Arieh, Alastair J Noyce, Essa Bhadra, Johanna Graeber, Lova Hulst, Moran Gilat, Heiko Gassner, Jürgen Winkler, Walter Maetzler, Anat Mirelman, Alison J Yarnall, Lynn Rochester, Katie Brittain","doi":"10.1177/1877718X261494917","DOIUrl":"10.1177/1877718X261494917","url":null,"abstract":"<p><p>BackgroundDigital mobility outcomes (DMOs) have been cited as potential clinical endpoints for trials in Parkinson's disease (PD). Current evidence from the Mobilise-D consortium suggests that selected DMOs are technically valid, with emerging research on their clinical validity. However, regulatory qualification of DMOs requires additional evidence of their meaningfulness to people with PD.ObjectiveTo identify meaningful DMOs by understanding how mobility symptoms impact aspects of health that matter to people with PD.MethodsPurposive sampling recruited a diverse sample of people with PD to participate in semi-structured interviews. Content analysis identified frequent and bothersome mobility symptoms and their impacts on meaningful aspects of health. Twelve experts mapped meaningful symptoms to relevant DMOs through a nominal group consensus.ResultsSeventy-two people with PD participated, inclusive of under-served groups: ethnic minorities (14%) or LGBTQIA + backgrounds (14%), in older age (3%) or with young-onset PD (13%), living rurally (31%) or in a deprived area (19%). Shuffling gait, bradykinesia and balance issues were the most frequent symptoms, and the most bothersome and impactful on meaningful aspects of health (i.e., activities of daily living, life-space mobility, emotional wellbeing) among participants who experienced them. Less frequent, but still highly bothersome and impactful symptoms included freezing of gait, fatigue and weakness. Expert consensus suggested that walking speed, stride length and turn duration were the most relevant DMOs to reflect these meaningful symptoms.ConclusionFindings offer an inclusive, meaningful framework for digital assessment of mobility in PD, grounded in lived experience and consistent with regulatory guidance.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X261494917"},"PeriodicalIF":5.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dopaminergic state modulates shame and contextual emotional responses in Parkinson's disease.","authors":"Sabina Catalano Chiuvé, Damien Benis, Charline Rime, Marie E Maradan-Gachet, Jevita Potheegadoo, Fosco Bernasconi, Olaf Blanke, Paul Krack, Vanessa Fleury","doi":"10.1177/1877718X261491589","DOIUrl":"https://doi.org/10.1177/1877718X261491589","url":null,"abstract":"<p><p>BackgroundShame is frequent in Parkinson's disease (PD) and negatively affects quality of life, yet its dopaminergic modulation remains unclear.MethodsWe investigated the effect of dopaminergic replacement therapy (DRT) on shame in 41 fluctuating PD patients using an experimental tailored shame induction task. At visit 1, participants were presented with 60 short written scenarios (neutral, non-PD-related shame, PD-related shame). A tailored selection of 12 scenarios (4 per category) was generated in three steps: (1) initial rating of all 60 scenarios on a shame/embarrassment visual analogue scale (VAS); (2) selection of the highest-rated scenarios for shame conditions and lowest-rated scenarios for neutral condition to account for individual emotional relevance; and (3) emotional rating of these scenarios on 10 VAS (fear, sadness, disgust, joy, self- and other-directed anger, shame, embarrassment, guilt, stress) to ensure specificity of shame/embarrassment responses. At visits 2 and 3, patients rated the 12 scenarios once ON- and once OFF-DRT (randomized crossover design) using the same 10 VAS.ResultsIn OFF-DRT state, shame ratings were lower than in ON-DRT for non-PD-related shame scenarios (Zratio = -2.53, p = 0.02), with a similar trend for PD-related shame scenarios (Zratio = -2.02, p = 0.06). Conversely, patients reported higher embarrassment (Zratio = 4.53, p < 0.001), stress (Zratio = 3.49, p < 0.001), and self-directed anger (Zratio = 3.99, p < 0.001) when evaluating scenarios rated as neutral in the ON-DRT state.ConclusionsIn OFF-DRT state, emotional responses showed altered contextual calibration, with reduced shame in shame-eliciting contexts and increased negative emotions in neutral situations. These findings suggest that dopaminergic state may modulate intensity and appraisal processes of emotions.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X261491589"},"PeriodicalIF":5.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technology to remotely capture key elements of swallowing and speech: State of the science in Parkinson's disease.","authors":"Jessica E Huber, Kevin Renz Ambrocio, Georgia A Malandraki","doi":"10.1177/1877718X261470565","DOIUrl":"10.1177/1877718X261470565","url":null,"abstract":"<p><p>Swallowing and speech impairments are common in Parkinson's disease (PD) and can significantly affect health and quality of life. Traditional methods for assessing and managing these functions rely on in-person visits and large, expensive equipment, which are inaccessible to many patients. Recent advances in health technologies offer opportunities for remote monitoring and assessment, enabling early detection, personalized intervention, and longitudinal tracking of swallowing and speech deficits in PD. This review synthesizes evidence on current and emerging technologies designed to remotely capture key elements of swallowing and speech in patients with PD. We present studies that develop and use wearable uni- and multi-modal sensor-based approaches, biofeedback devices, acoustic analysis through smartphones, and haptic cueing aimed at improving aspects of swallowing and speech. Additionally, we examine the integration of artificial intelligence for automated signal processing and predictive modeling, emphasizing validation studies and clinical feasibility. Challenges related to usability, data quality, adherence, data security, and standardization are discussed alongside opportunities for telehealth-driven care models. By identifying technological innovations and evidence gaps, this review provides a roadmap for future research and clinical implementation of remote swallowing and speech assessment in PD. These advancements have the potential to transform care, reduce healthcare burden, and improve patient outcomes through scalable, non-invasive, and patient-centered solutions for the management of dysphagia and dysarthria in PD.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X261470565"},"PeriodicalIF":5.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations for therapeutic targets for clinical trials in biomarker-characterized prodromal Parkinson's disease populations.","authors":"R B Schneider, G Skibinski, B Fiske, C M Kopil, K Merchant, T Simuni","doi":"10.1177/1877718X261493297","DOIUrl":"10.1177/1877718X261493297","url":null,"abstract":"<p><p>Parkinson's disease (PD) is a growing public health problem and biologically targeted therapeutics (BTTs) that slow disease progression are urgently needed. However, the development of effective BTTs is challenging as PD is a clinically defined syndrome with pathobiological heterogeneity and the pathobiological process begins many years before the onset of clinically detectable motor symptoms. Testing BTTs in a biomarker-defined population at an earlier stage in the disease course, before a clinical PD diagnosis, may be the key to achieving this objective. The recent emergence of biological definitions of neuronal α-synuclein disease (NSD) and research frameworks for staging disease represent the first step towards testing BTTs in biomarker-defined prodromal populations. While biomarker-defined populations are essential for implementing precision therapeutic approaches, selecting and prioritizing BTTs for testing in early-stage populations is also critical, and requires consideration of biological relevance, safety, and operational feasibility. Here, in preparation for such studies, we review the landscape of publicly available PD BTTs organized by mechanistic pathways and targets, and summarize scientific, safety, and operational considerations relevant to early-stage, biomarker-defined trials targeting NSD participants prior to PD clinical diagnosis. Recognizing that there are shared biological mechanisms across neurodegenerative disorders, we complement this review of the PD therapeutic target landscape with a review of publicly available Alzheimer's dementia and amyotrophic lateral sclerosis BTTs and provide a comprehensive list of agents for reference.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X261493297"},"PeriodicalIF":5.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring what matters: Evaluating quality of life instruments through the eyes of people with Parkinson's disease.","authors":"Samantha Dorrance, Richa Patel, Glenn T Stebbins, Jamie L Adams, Allison Allen, Tara Hastings, Soania Mathur, Onanong Phokaewvarangkul, Gary Rafaloff, Rajasumi Rajalingam, Anette Schrag, Christine Sun, Jennifer Mammen, Connie Marras","doi":"10.1177/1877718X261480905","DOIUrl":"10.1177/1877718X261480905","url":null,"abstract":"<p><p>BackgroundMany instruments are used to assess quality of life in people living with Parkinson's disease. However, there is limited understanding of what people living with Parkinson's consider relevant and important when measuring quality of life.AimTo explore what people living with Parkinson's consider relevant and important in the assessment of quality of life.MethodsSemi-structured interviews were conducted with 31 people living with Parkinson's disease. Participants completed eight instruments, which were used to guide discussion and reflection on what helps and what hinders measuring quality of life in a way that is meaningful to them.ResultsParticipants highlighted a number of features they consider important in the assessment of quality of life. These include being able to select from a wide range of response options, addressing the personal, emotional, and practical impacts of issues, using clear, specific language, and including a balance of questions that address both positive and negative aspects of the Parkinson's experience.ConclusionsThere is a need for instruments that reflect the complex and varied ways Parkinson's disease affects individuals. While existing questionnaires incorporate some features that support meaningful assessment, participants also identified features that may hinder the extent to which quality of life is adequately captured and that warrant further refinement. Incorporating feedback from people with lived experience may help inform future evaluation and refinement of quality of life measures in research and care.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X261480905"},"PeriodicalIF":5.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiling peripheral immune cells in Parkinson's disease: A scoping review.","authors":"Sherilyn Junelle Recinto, Janna E Jernigan Posey, Nadejda Lefter, Zagorka Vitic, Morten Øgelund Overgaard, Lin Liu, Andrew Jm Howden, Klaus Eyer, Marina Romero-Ramos, Malú Gámez Tansey, Jo Anne Stratton","doi":"10.1177/1877718X261479505","DOIUrl":"10.1177/1877718X261479505","url":null,"abstract":"<p><p>Parkinson's disease (PD) is increasingly recognized as a multi-system disorder with immune dysregulation extending beyond the central nervous system. Although numerous studies have examined peripheral immune alterations in people with PD, findings remain heterogeneous and difficult to reconcile. To clarify the current landscape, we conducted a comprehensive scoping review of human studies profiling peripheral blood immune cells in PD. Following PRISMA-ScR guidelines, we systematically screened the literature and curated studies reporting <i>in vivo</i> and <i>ex vivo</i> immune characterizations from PD patients. Eligible studies based on pre-defined criteria were assessed for patient demographics and clinical variables, experimental and analytical approaches, and reported immune outcomes. Our synthesis reveals a steady expansion and diversification of peripheral immune cell research in PD especially over the last decade. Deep immunophenotyping identifies convergent signatures across <i>in vivo</i> studies of both innate and adaptive compartments, including expanded pro-inflammatory T-cell subsets, altered monocyte subset distributions, increased cytotoxic natural killer cells and neutrophil-to-lymphocyte ratio, and dysregulated pathways related to immune activation, chemotaxis, mitochondrial function, and autophagy-lysosomal processes. Stimulation-based <i>ex vivo</i> assays further demonstrate recurrent T-cell hyper-responsiveness in PD, whereas myeloid cell responses are more variable and context dependent. Critically, this review highlights substantial variability and under-reporting in study design, which impeded our ability to make strong conclusions relating to many aspects of PD peripheral immunity.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X261479505"},"PeriodicalIF":5.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grid to glide: A simple visual cue that alleviates upper-limb freezing.","authors":"Ota Gál, Martin Srp, Petr Dušek, Martina Hoskovcová, Evžen Růžička","doi":"10.1177/1877718X261480898","DOIUrl":"10.1177/1877718X261480898","url":null,"abstract":"<p><p>Freezing of the upper limb (FoUL) is a poorly explored manifestation of Parkinson's disease. This report describes a case of a 54-year-old woman with FoUL predominantly affecting handwriting. Writing on grid paper with small squares (0.5 × 0.5 cm) markedly reduced FoUL frequency. A subsequent daily home-based writing and calligraphic training program led to sustained improvements in handwriting legibility, drawing ability, and transfer to writing on blank paper without the grid, without any change in medication. The immediate response to grid paper suggests that simple visual cueing-possibly by promoting block-letter writing and reducing motor planning complexity-could represent a practical strategy for writing-related FoUL, meriting further systematic investigation.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X261480898"},"PeriodicalIF":5.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}