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Article History

Received: 21 September 2025

Accepted: 9 April 2026

First Online: 19 May 2026

Competing interests

: I.M.-V., G.G.K. and A.E.L. share a pending patent for diagnostic assays for movement disorders (18/537,455). G.G.K. has a shared patent for the 5G4 synuclein antibody. Outside the submitted work, I.M.-V. receives funding from the Michael J. Fox Foundation for Parkinson Research and consultancy fees from Ferrer. D.A.O. receives research funding from the Michael J. Fox Foundation for Parkinson Research. N.G.D.R. is a recipient of the Brain and Behavior Research Foundation Young Investigator Award and Ontario Graduate Scholarship. M.S. has received fellowship funding from the Dystonia Medical Research Foundation of Canada and is supported by grants from the Swiss National Science Foundation, Parkinson Schweiz and the Gottfried und Julia Bangerter-Rhyner Foundation. He has also received financial support from Boston Scientific, Medtronic, Zambon and Bial. S.H.F. receives research Funding from the Michael J. Fox Foundation for Parkinson Research, the NIH (Dystonia Coalition), Parkinson Canada and the Weston Foundation; honoraria from the International Parkinson and Movement Disorder Society; consultancy/speaker fees from Abbvie, Lundbeck and Sunovion; and Royalties from Oxford University Press. B.M. has received honoraria for consultancy or educational presentations from GE Healthcare, Bial, Roche, Biogen, AbbVie, Desitin and Amprion. B.M. is a member of the executive steering committee of the Parkinson Progression Marker Initiative of the Michael J. Fox Foundation for Parkinson’s Research and has received research funding from Aligning Science Across Parkinson’s disease (Aligning Sciences Across Parkinson’s, Collaborative Research Network). M.C.T. receives funding from the NIH, the Weston Brain Foundation, the Tanenbaum Institute for Research in Science of Sport, the Canadian Institutes of Health Research and in-kind funding from Roche; she has served as an advisor to Eisai, Lilly and Novo Nordisk, and she conducts clinical trials for Biogen, Anavex, Janssen, Novo Nordisk, Bristol Myers Squibb, Aribio, Green Valley, UCB and Passage Bio. G.G.K. reports personal fees from Parexel, Mitsubishi-Tanabe, Ferrer and Treventis, and other funding from the MSA Coalition, the Michael J. Fox Foundation, Parkinson Canada, the NIH, the Canada Foundation for Innovation and the Ontario Research Fund; in addition, G.G.K. received royalties from Wiley, Univ. of Cambridge, Taylor & Francis and Elsevier. A.E.L. has served as an advisor for AbbVie, Amylyx, Aprinoia, Biogen, BioAdvance, Biohaven, BioVie, BlueRock, Bristol Myers Squibb, Denali, EG427, Ferrer, Janssen, Lilly, Northera, Pharma 2B, Sun Pharma, UCB and Ventyx Bio; received honoraria from Sun Pharma and AbbVie; received grants from Brain Canada, the Canadian Institutes of Health Research, the Michael J. Fox Foundation, the Parkinson Foundation, Parkinson Canada and the Weston Foundation. A.E.L. is serving as an expert witness in litigation related to paraquat and PD, and has received publishing royalties from Elsevier, Saunders, Wiley-Blackwell, Johns Hopkins Press and Cambridge Univ. Press. M.E., S.K.W., S.S., S.-M.F., D.G.D.L., J.T., C.A., J.L., P.B., J.S. and N.P.V. declare no competing interests.