Editorial: Parkinson's disease: current findings and challenges in diagnosing and treating motor and non-motor symptoms

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The present Research Topic was conceived to contribute to this goal. As outlined in the original Research Topic Description, it's principal aims were to "…enhance our understading of PD by (i) advancing knowledge of neuropathological mechanisms, (ii) elucidating the interplay between motor and non-motor symptoms, (iii) improving early and differential diagnosis, and (iv) elaborating advanced therapeutical approaches."We are pleased to announce that our special issue covers a broad spectrum of topics that far extends beyond the aforementioned objectives and also incorporates aspects related to disease progression and translation of research findings into clinical practice (see Figure 1B). 2026) examined the modulating effect of striatal cholinergic interneurons (CIN) on L-Dopa induced dyskinesias (LID) in mice. Their results disclose that -in mice -LID severity and LID-associated molecular markers in CIN may be reduced after D2 ablation from cholinergic neurons. Given that the pharmacological inhibition of D2 generally is associated with debilitating motor side effects, the authors propose that the therapeutic effects of L-DOPA can best be maintained by tuning D2 receptors in CINs at the molecular level. Finally, the authors discuss how their findings could be translated to human studies.In their systematic review and meta-analysis, Wang et al. (2025) aimed to elucidate the association between orthostatic hypotension (OH) and clinical manifestations of PD. Resultsshow that older age, longer disease duration, greater motor symptom severity and poorer cognitive performance are associated with OH in PD. In contrast, no significant differences were found between people with PD (PwP) with and without OH regarding sex, depression, or anxiety.Diagnosis. The majority of studies in this special issue (n=11) address topics related to the diagnosis of PD, incorporating aspects of motor and/or non-motor symptoms and employing a broad range of methodologies, including self-report questionnaires, neuropsychological assessments, and neuroimaging techniques and digital, remote and AI-based (artificial intelligence) approaches.The study by Baizabal-Carvallo et al. (2025) investigated whether and how self-reported primary motor and non-motor complaints are associated with demographic and clinical characteristics, including cognitive status, among PwP. Findings reveal distinct patterns of selfreported complaints, with cognitive decline emerging as a significant predictor of non-motor symptoms. Although tremor was identified as the most burdensome symptom, nearly 70% of study participants listed one of the non-motor symptoms among their top three complaints. examined the cognitive, structural, and neurofunctional correlates of basic and advanced financial abilities (FA) in PwP and mild cognitive impairment (PD-MCI). Their findings revealed distinct cognitive functions and neural networks underlying basic and advanced FA. Although overall performance was high, impairments were more frequent in basic than in advanced FA tasks (18.2% vs. 12.1%, respectively). The authors suggest that this pattern reflects compensatory neural mechanisms supporting advanced FA and propose that financial decision-making in PD-MCI is mediated by adaptive reorganization of cortico-subcortical and cerebellar systems.motor symptoms. To this end, they examined the relationship between depression and anxiety scores in PwP and multiparametric MRI measures, including T1 and T2* mapping, proton density mapping, and quantitative susceptibility mapping (QSM). Findings revealed significant associations between specific quantitative MRI parameters and self-reported depression and anxiety. The authors conclude that multiparametric MRI may facilitate the early detection of non-motor symptoms in PD.Algon and Saban (2026) examined whether remote assessments of cognition and motor symptoms might be used reliably to assess cognitive-motor associations in PD. Findings reveal that home-based assessments (i.e., videoconference-based versions of the MoCA as well as online versions of the UPDRS-III and Hoehn & Yahr scales) provide comparable results to inperson settings by reflecting significant -yet small-negative correlations between cognitive and motor scores. The authors therefore conclude that remote cognitive assessments represent a reliable approach for evaluating disease severity in PwP. Depression, COVID-19, long-COVID, and Epilepsy. Overall, taVNS was associated with improvements across multiple cognitive domains, including global cognition, attention, memory, language, executive function, and social cognition. However, the authors caution that these findings should be interpreted carefully because of substantial methodological heterogeneity across the included studies.In their systematic review and meta-analysis, Ye et al. ( 2025) evaluated the effects of transcranial alternating current stimulation (tACS) on neurophysiologic motor function in PD.Their findings indicate that tACS has beneficial effects on motor functions, as reflected by improvements in motor evoked potentials and short-interval intracortical inhibition. The authors suggest that tACS is an effective treatment method for alleviating motor symptoms in PD and should therefore be integrated into PD rehabilitation. 2026) conducted a narrative review to investigate whether deep brain stimulation (DBS) -an established surgical intervention to improve PD motor symptoms-may alleviate dysphagia in PwP. Dysphagia is a common complication in PD that seriously hampers medication intake. Findings are heterogeneous and disclose that the beneficial effects of DBS on dysphagia depend on various factors, including the stimulation site (subthalamic versus pallidal DBS). Interestingly, subjective reports of swallowing improvement following DBS were more positive than objective measures of swallowing function.Trajectories. Two papers aimed at investigating disease trajectories in PD by focusing on cognitive functions. Gibbs et al. (2026) examined the longitudinal relationship between cognition and non-tremor motor symptoms in PD, using seven assessments conducted at three-month intervals.Findings reveal that though MoCA scores were not significantly correlated with severity of motor impairment, global cognition at baseline was associated with progression (but not severity) of PD motor symptoms. However, interestingly, the latter link was observed only for non-tremor motor symptoms. The authors interpret their findings as evidencing partly distinguishable neurofunctional circuits underlying non-tremor and tremor motor symptoms in PD.Peña Arauzos et al. (2025) conducted a systematic review to investigate whether cognitive deterioration may precede the diagnosis of PD. The results indicate that cognitive impairments can occur during the prodromal phase of PD, with these being most consistently observed in tests tapping executive functions, processing speed and attention. However, the authors emphasize that large-scale, long-term follow-up studies are needed to further clarify whetherand which-cognitive domains are most susceptible to be hampered in prodromal PD.Translation. Four studies address the translation of research findings into practice; three dealing with aspects of care for PwP and one examining the use of digital health applications among PwP. Overall, this special issue provides a broad and timely overview of contemporary PD research, reflecting both the diversity of current scientific approaches and the increasing integration of basic, translational, and clinical perspectives. While the collected contributions showcase important advances across multiple domains, they also identify key areas that deserve greater attention in future research. We therefore hope that this collection will not only serve as a valuable resource for researchers and clinicians but also stimulate interdisciplinary collaborations that accelerate the translation of scientific

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