Article from 2017 but very interesting. " Much more than a movement disorder PD is now recognized to affect just about every system in the body, causing dermatologic, urologic, musculoskeletal, gastrointestinal and psychiatric symptoms. Early signs and symptoms of PD — including hyposmia, impaired color vision, constipation, genitourinary dysfunction, depression, anxiety, restless leg syndrome and REM sleep behavior disorder — reflect the progression of synucleinopathy and can manifest decades before motor symptoms appear. REM sleep behavior disorder appears to be a marker for a specific subtype of PD with a high prevalence of cognitive disturbance and is a strong risk factor for developing dementia. Insights like these are especially important for identifying people more likely to develop PD for recruitment for clinical trials of preventive therapies." " Environmental factors are critical Only 5 to 10 percent of PD cases can be attributed to genetic mutations. The overwhelming majority are believed to be due to a combination of genetic susceptibility and environmental insult. Head trauma — particularly with loss of consciousness — especially increases risk, as does exposure to the pesticides paraquat and rotenone. Other factors have been found to reduce risk (smoking, coffee, high uric acid levels, calcium channel antagonists), offering an important focus for research. Isradipine, a calcium channel blocker, and inosine, a uric acid elevator, are currently undergoing large-scale clinical trials as neuroprotective therapies." " Biomarkers for diagnosis, progression on the horizon The lack of a definitive test for PD hampers clinical care and research progress. Efforts are underway in a number of avenues to remedy this. " https://consultqd.clevelandclinic.org/evolution-understanding-parkinsons-3-minute-update-neurologists/?utm_campaign=qd tweets&utm_medium=social&utm_source=twitter&utm_content=170422 evolution parkinsons&cvosrc=social network.twitter.qd tweets&cvo_creative=170422 evolution parkinsons I had no idea that there was no biomarker for PD. eta: when anyone says 'well there is no test for ME' we can say 'well there isn't for Parkinsons either but no-one questions the validity of PD as a 'genuine disease''.