This article is part of a special edition dedicated to the memory of Tom Isaacs. He was a shining light in the Parkinson's community. Having Parkinson's himself, he grew frustrated with the slow progress of research, and set up his own charity - The Cure Parkinson's Trust. The aim of the Cure Parkinson's Trust is to slow, halt or cure Parkinson's and only fund research that has the potential to do that. Tom's vision in creating and leading the Trust has changed the landscape of Parkinson's research and we are getting closer to achieving his dream.
We are honoured to have been part of this evidence-based memorial to Tom. In this article we highlight the evidence of the stage before Parkinson's symptoms lead to a positive diagnosis - the prodromal phase. We look in particular at people with smell loss, individuals who have a particular sleep disorder (Rapid Eye Movement Sleep Behavioural Disorder) and some genetic causes of Parkinson's.
It is increasingly clear that Parkinson's is an umbrella term for different sub-types of the pathology - in a group of people with Parkinson's, very few will have exactly the same features as each other. Even tremor - what most people think is the quintessential feature of Parkinson's, is totally absent in some individuals. Therefore, it stands to reason that there are different prodromal phases too. This is work that we are currently exploring, especially with our work with people with smell loss and with this sleep disorder. We hope to find out what are the markers that separate these groups, and what might shape the kind of Parkinson's that different people get.
The article is open access, thanks to the generous support of Parkinson's UK and can be found here.
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