Evidence map›Paper›PMID 39702948›Full record

ArticleAnnals of neurology2025

Identifying Individuals in the Prodromal Phase of Parkinson's Disease: A Prospective Cohort Study.

Mario H Flores-Torres, Katherine C Hughes, Marianna Cortese, Albert Y Hung, Brian C Healy, Michael A Schwarzschild, Kjetil Bjornevik, Alberto Ascherio

Abstract read
In one paragraph

Article in Annals of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mario H Flores-TorresDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.ORCID 0000-0001-9791-3196
Katherine C HughesOptum Epidemiology, Boston, MA.
Marianna CorteseDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.ORCID 0000-0002-3665-2006
Albert Y HungDepartment of Neurology, Harvard Medical School, Boston, MA.
Brian C HealyDepartment of Neurology, Harvard Medical School, Boston, MA.
Michael A SchwarzschildDepartment of Neurology, Harvard Medical School, Boston, MA.
Kjetil BjornevikDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.ORCID 0000-0002-2892-6986
Alberto AscherioDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.

Funding

Cancer Epidemiology Cohort in Male Health ProfessionalsU01CA167552 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Lorelei Mucci, Walter C. Willett · 2017 to 2026
$17.0M
Biomarkers and Risk Factors for Prodromal Parkinson's Disease and its ProgressionR01NS126260 · NINDS · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI ALBERTO ASCHERIO · 2022 to 2026
$2.9M
NCI NIH HHS U01 CA167552NIH HHS 5R01NS126260-02NIH HHS U01 CA167552NINDS NIH HHS R01 NS126260
6 · The paper itself

Abstract

objectiveWe prospectively evaluated how well combinations of signs and symptoms can identify individuals in the prodromal phase of Parkinson's disease (PD).

methodsThe study comprised 6,108 men who underwent repeated assessments of key prodromal features and were prospectively followed for the development of PD. Two composite measures of prodromal PD were evaluated: (i) the co-occurrence of constipation, probable rapid eye movement (REM) sleep behavior disorder (pRBD), and hyposmia, and (ii) the probability of prodromal PD based on the Movement Disorders Society (MDS) research criteria. We also examined the progression and heterogeneity of the prodromal PD phase.

resultsOne hundred three individuals were newly diagnosed with PD over an average follow-up of 3.4 years. Men with constipation, pRBD, and hyposmia had a 23-fold higher risk of receiving a PD diagnosis in the subsequent 3 years, compared with men without these features (risk ratio [RR] = 23.35, 95% confidence interval [CI] = 10.62-51.33). The risk of PD was 21-fold higher in men with a probability of prodromal PD ≥ 0.8 compared with those with a probability < 0.2 (RR = 21.96, 95% CI = 11.17-43.17). Both the co-occurrence of the 3 non-motor features and an MDS-based probability ≥ 0.8 had comparable predictive values, and both were stronger predictors of PD than any of the features individually. We identified 2 prodromal PD subtypes where RBD and visual color impairment were key discriminators.

interpretationOur study demonstrates that combinations of key signs and symptoms strongly predict future clinically manifest PD. These measures may be integrated into screening strategies to identify individuals who could be targeted for enrollment into PD prevention trials. ANN NEUROL 2025;97:720-729.

Indexed as

Parkinson DiseaseProdromal SymptomsREM Sleep Behavior DisorderAgedCohort StudiesConstipationDisease ProgressionHumansMaleMiddle AgedOlfaction DisordersProspective Studies

Identifiers

PMID39702948
PMCPMC11890925

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.