Digital gait biomarkers in Parkinson’s disease: susceptibility/risk, progression, response to exercise, and prognosis

Abstract This narrative review examines the utility of gait digital biomarkers in Parkinson’s disease (PD) research and clinical trials across four contexts: disease susceptibility/risk, disease progression, response to exercise, and fall prediction. The review of the literature to date suggests tha...

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Main Authors: Martina Mancini, Mitra Afshari, Quincy Almeida, Sommer Amundsen-Huffmaster, Katherine Balfany, Richard Camicioli, Cory Christiansen, Marian L. Dale, Leland E. Dibble, Gammon M. Earhart, Terry D. Ellis, Garett J. Griffith, Madeleine E. Hackney, Jammie Hopkins, Fay B. Horak, Kelvin E. Jones, Leah Ling, Joan A. O’Keefe, Kimberly Kwei, Genevieve Olivier, Ashwini K. Rao, Anjali Sivaramakrishnan, Daniel M. Corcos
Format: Article
Language:English
Published: Nature Portfolio 2025-03-01
Series:npj Parkinson's Disease
Online Access:https://doi.org/10.1038/s41531-025-00897-1
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Summary:Abstract This narrative review examines the utility of gait digital biomarkers in Parkinson’s disease (PD) research and clinical trials across four contexts: disease susceptibility/risk, disease progression, response to exercise, and fall prediction. The review of the literature to date suggests that upper body characteristics of gait (e.g., arm swing, trunk motion) may indicate susceptibility/risk of PD, while pace aspects (e.g., gait speed, stride length) are informative for tracking disease progression, exercise response, and fall likelihood. Dynamic stability aspects (e.g., trunk regularity, double-support time) worsen with disease progression but can improve with exercise. Gait variability emerges as a sensitive biomarker across all 4 contexts but with low specificity. The lack of standardized gait testing protocols and the lack of a minimum set of quantified digital gait biomarkers limit data harmonization across studies. Future studies, using a commonly agreed upon protocol, could be used to demonstrate the utility of specific gait biomarkers for clinical practice.
ISSN:2373-8057