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Parkinson's Disease: Recent Advances in Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 20 June 2026 | Viewed by 858

Special Issue Editors


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Guest Editor
Neurology Unit, Department of Neuroscience, Azienda Ospedaliero-Universitaria S. Anna, 44124 Ferrara, Italy
Interests: Parkinson’s disease; disease-modifying therapies; artificial intelligence; microbiome; alpha-synuclein; neuroimaging

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Guest Editor
Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
Interests: parkinson disease; disease modifying therapies; artificial intelligence; microbiome; alpha-synuclein; neuroimaging

Special Issue Information

Dear Colleagues,

Current diagnostic criteria for Parkinson’s disease (PD) rely on clinical criteria, and early diagnosis remains a challenge. Researchers have made significant strides in identifying reliable biomarkers to detect the disease earlier, even before motor symptoms appear. These include measuring alpha-synuclein in various body fluids and tissues and identifying specific inflammatory markers in the blood and cerebrospinal fluid, including lysosomal enzymes, fatty acid-binding proteins, and neurofilament light chains, whose concentrations differ in different neurodegenerative diseases. Carriers of specific gene variants have an increased risk of developing PD.

Neuroimaging, utilising technologies like MRI, PET, and SPECT, has similarly advanced the diagnosis and management of these disorders.

The digital revolution has also transformed Parkinson's diagnosis. Wearable sensors and smartphone applications now allow for objective measurement to monitor disease progression and treatment response in patients' daily lives. Artificial intelligence algorithms analyse these data alongside other clinical information and might detect prodromal PD in its motor and non-motor manifestations.

Moreover, the gut–brain connection has led to investigations of the gut microbiome as both a diagnostic marker and therapeutic target. Indeed, on the treatment front, beyond dopamine replacement, novel drug targets or disease-modifying therapies are showing promise in clinical trials. Nutritional and exercise approaches have also shown effects.

The future points toward precision medicine approaches that take into account each patient's unique biological, genetic, and environmental factors to create tailored treatment regimens.

Dr. Mariachiara Sensi
Dr. Fabiana Colucci
Guest Editors

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Keywords

  • Parkinson’s disease
  • disease-modifying therapies
  • artificial intelligence
  • microbiome
  • alpha-synuclein
  • neuroimaging

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Published Papers (1 paper)

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21 pages, 2661 KB  
Systematic Review
The Effects of Repetitive Transcranial Magnetic Stimulation on Gait, Motor Function, and Balance in Parkinson’s Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Myoung-Ho Lee, Ju-Hak Kim, Je-Seung Han and Myoung-Kwon Kim
J. Clin. Med. 2026, 15(1), 166; https://doi.org/10.3390/jcm15010166 - 25 Dec 2025
Viewed by 353
Abstract
Objective: This study aimed to systematically evaluate the therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) on gait, motor function, and balance in patients with Parkinson’s disease (PD) and identify optimal stimulation parameters for clinical application. Methods: This systematic review and [...] Read more.
Objective: This study aimed to systematically evaluate the therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) on gait, motor function, and balance in patients with Parkinson’s disease (PD) and identify optimal stimulation parameters for clinical application. Methods: This systematic review and meta-analysis of randomized controlled trials (CTs) was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, EMBASE, Cochrane Central, Scopus, and Ovid-LWW were searched until December 2024 for RCTs evaluating the effects of rTMS on PD-related gait, balance, or motor outcomes. Nineteen studies (n = 547) met the inclusion criteria. Data on study characteristics, rTMS protocols (frequency, target area, pulses, session duration, number of sessions, and treatment duration), and outcome measures (freezing of gait questionnaire [FOG-Q], gait speed, Unified Parkinson’s Disease Rating Scale Part III [UPDRS-III], UPDRS total, and timed up and go [TUG] test) were extracted. Effect sizes (Hedges’ g) were pooled using inverse variance meta-analysis, heterogeneity was assessed using I2, and publication bias was assessed using funnel plots and Egger’s regression. Results: rTMS produced significant improvements in gait freezing (FOG-Q: g = −0.74; 95% confidence interval [CI] [−1.05, −0.43]; p < 0.001), gait speed (g = 0.62; 95% CI [0.29, 0.95]; p < 0.001), and motor symptoms (UPDRS-III: g = −0.42; 95% CI [−0.70, −0.15]; p = 0.003). No significant effects were observed for UPDRS total (g = 0.18; p = 0.58) or balance (TUG, g = −0.29; p = 0.06). Egger’s test indicated publication bias for gait speed (p = 0.016); however, trim-and-fill imputed zero studies. Subgroup analyses indicated that high-frequency stimulation of the supplementary motor area (SMA) for ≥20 min over 10 sessions (total duration <2 weeks or ≥2 weeks) optimally improved gait speed, whereas low-frequency stimulation targeting M1 and SMA with >1000 pulses per session for 20 min over 10 sessions within <2 weeks most effectively improved the UPDRS-III scores. Conclusions: rTMS exerts moderate and significant benefits on gait and motor performance in PD, particularly when tailored protocols involving SMA or M1 stimulation are employed. High-frequency SMA protocols improve gait speed, whereas low-frequency M1/SMA protocols optimize motor symptom relief. These findings provide evidence-based guidance for rTMS implementation in PD rehabilitation. Full article
(This article belongs to the Special Issue Parkinson's Disease: Recent Advances in Diagnosis and Treatment)
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