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Funded Studies

Undiagnosed Parkinson’s in the Emergency Department: An Opportunity for Early Intervention

Study Rationale: Many patients diagnosed with Parkinson’s disease had signs or symptoms of the disease years before an actual diagnosis is made. An astonishingly high percentage of these patients are seen in emergency departments for falls, loss of balance or consciousness, or constipation, two to five years before diagnosis. This population of patients has not yet been recognized, nor has the opportunity for early diagnosis been realized.

Hypothesis: Based on preliminary data, we hypothesize that upwards of 75% of patients diagnosed with Parkinson’s disease presented symptoms at acute care facilities, two to five years prior to diagnosis. We think this unrecognized population of future patients represents an unrealized opportunity for early diagnosis, intervention and enrollment in clinical studies of disease modifying therapies not likely to be otherwise effective in advanced disease.

Study Design: In this pilot study, we are making a detailed review of the scant literature on the identification and management of Parkinson’s disease and formulating a conceptual framework for pragmatic, early identification opportunities in the emergency department.

Impact on Diagnosis/Treatment of Parkinson’s disease: Two major impacts of this nascent program relate to increasing the pool of patients amenable to early, minimal or non-pharmacological intervention and improving long-term outcomes. Further, early identification of disease will increase the numbers of patients eligible for therapeutic clinical trials and better long-term outcomes for individuals as well as the greater population of Parkinson’s Disease patients.

Next Steps for Development: Raising awareness of Parkinson’s disease in the emergency rooms and acute care settings is of paramount importance to identify the hundreds of thousands, if not millions, of patients who would benefit from early diagnosis.


  • Matthew R. Lewin, MD, PhD

    San Francisco, CA United States

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