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Article History

Received: 13 February 2026

Accepted: 16 April 2026

First Online: 14 May 2026

Competing interests

: C.R.S. has no conflict of interest related to this work. Outside this work, C.R.S. has served as a consultant, scientific collaborator or on scientific advisory boards for Sanofi, Berg Health, Pfizer, Biogen; has received grants from NIH, U.S. Department of Defense, Michael J Fox Foundation, American Parkinson Disease Association; and research support from Dooley LLC. A.E., J.H.G., A.Y.H., C.C.U., S.K., P.T., J.S.P., M.C.C., M.T.H., C.W.G. report no relevant financial or other conflicts of interest in relation to this study. G.L. has no conflict of interest related to this work. Outside this work, G.L. has received grants from the National Natural Science Foundation of China. M.A.S. has no conflict of interest related to this work. Outside this work, M.A.S. received grants from NINDS, DoD, Michael J Fox Foundation, Parkinson’s Foundation; has served as a consultant for Accorda Therapeutics (trial steering committee), Eli Lilly & Co (data monitoring committee), Prevail Therapeutics (scientific advisory board). M.A.S. serves as Guest Editor for a npj Parkinson’s disease Collection with the title “Clinical trials on disease modification: Trial design, endpoints and regulatory issues in Parkinson’s disease”, 2026. M.A.S. was not involved in the journal’s review of, or decisions related to, this manuscript. J.C.C. has no conflict of interest related to this work. Outside this work, J.C.C. received honoraria for consulting in advisory boards for Alzprotect, Bayer, BioProjet, Ferrer, iRegene, Lilly, Novartis, Servier, UCB, and Roche, and received research grants from AXA and the ICM Foundation outside of this work. P.T. is supported by the Estonian Research Council and the Institute of Clinical Medicine of the University of Tartu. R.A.B. has no conflicts of interest related to this work; outside this work, R.A.B. has received consultancy fees from Novo Nordisk, Fujifilm Cellular Dynamics, BlueRock Therapeutics/Bayer, Aspen Neuroscience, UCB, Neurona, Rinri Therapeutics, Synacure, SNIPR Biome, and Harness Therapeutics; has received grant funding from the Medical Research Council (MRC), Wellcome Trust, NIHR, the European Union FP7 and Horizon 2020 programmes, Parkinson’s UK, Cure Parkinson’s, the John Black Charitable Foundation, Rosetrees Trust, the Evelyn Trust, the Michael J. Fox Foundation/Aligning Science Across Parkinson’s, and LifeArc; and receives royalties from Wiley and Springer Nature. C.H.W.-G. has no conflict of interest related to this work. C.H.W.-G. was supported by a RCUK/UKRI Research Innovation Fellowship awarded by the Medical Research Council (MR/R007446/1; MR/W029235/1), has received support from the Cambridge Centre for Parkinson-Plus and the NIHR Cambridge Biomedical Research Centre (NIHR203312), and received grants from Addenbrooke's Charitable Trust, the Michael J Fox Foundation, the Evelyn Trust, the Rosetrees Trust, Parkinson's UK and Cure Parkinson's. C.H.W.-G. has received honoraria from Lundbeck, Profile Pharma and GSK, and payments for consultancy/advisory work from Evidera, Modus Outcomes, Helicon Bio Ltd, Mission Therapeutics and the Michael J Fox Foundation. C.C. reports no conflict of interest and has received grant funding from Parkinson’s UK, the Scottish Chief Scientist Office, the British Medical Association Doris Hillier award, RS Macdonald Trust, the BUPA Foundation, and NHS Grampian Charities. A.D.M. reports no conflict of interest. A.D.M. has received grant funding from the National Institute of Health and Care Research, Parkinson’s UK, LifeArc, and NHS Grampian Charities. P.H. has no conflict of interest related to this work. Outside this work, P.H. C.K. has served as a medical advisor to Centogene and Biogen, received speakers’ honoraria from Bial, and royalties from Oxford University Press and Springer Nature. T.M.H. has served as a consultant for Neuron23, Boxer Capital Management LLC, The Michael J. Fox Foundation, Singleton Bioscience, Neuroscience Capital LLC and the LSP Dementia Fund and serves on the Scientific Advisory Board of AlectorMedtronic, Inc., iota Biosciences, MarvelBiome and Blue Rock Therapeutics. P.S. has no conflict of interest related to this work. Outside this work, P.S. received honoraria for consulting in advisory boards for AbbVie, Britannia, Lundbeck and Merz Pharmaceuticals, and received research grants from Michael J Fox Foundation, Lexa/Nordstjernan and Knut and Alice Wallenberg Foundation. T.G.B. has no conflict of interest related to this work and has received grant funding from the National Institute on Aging (P30 AG019610 and P30 AG072980), Arizona Alzheimer’s Disease Core Center and Research Center. In the last 12 months, T.S. has served as a consultant for AskBio, Blue Rock Therapeutics, Critical Path for Parkinson's Consortium (CPP), Denali, Blue Rock Therapeutics, Centessa, Critical Path for Parkinson's Consortium (CPP), Genentech, MJFF, Prevail/ Lilly, Roche/ Genentech, Ventus, Sinopia, Ventyx, TrueBinding and Vanqua Bio. T.S. has equity in Sinopia and has served on the ad board for Biohaven, GE, GAIN, Genentech, FDA, Neuron23, Parkinson Study Group, Prevail/Lilly and Roche/Genentech. T.S. has served as a member of the scientific advisory board of Koneksa and UCB. T.S. has received research funding from MJFF, Neuroderm, NINDS, Parkinson’s Foundation Prevail, Roche and UCB. A.M.W. has received research funding from the Parkinson's Foundation, National Institutes of Health/National Institute on Aging, and has participated in clinical trials funded by BioSensics, Roche, Ono Pharmaceuticals, Biohaven, Biogen, Ferrer, Amylyx, and received consultant payments from Genentech, Ono Pharmaceuticals, Biohaven, Novartis, and Arvinas. The remaining authors declare no competing financial or non-financial interests.