Objective: To assess clinician and researcher views on the integration of biomarkers and biological subtyping in PD trials and perceived barriers to recruitment and completion.

Background: Investigator perspectives on barriers to address the biological heterogeneity in disease-modifying clinical trials of Parkinson’s disease (PD) remain poorly characterized.

Method: A survey developed by CureNow:PD in collaboration with the Pan-American Section of the Movement Disorders Society was distributed electronically to investigators involved in PD research and clinical care.

Results: Ninety-eight respondents completed the survey (86.7% clinicians). Most considered biological subtyping very important or essential for disease-modifying therapies (85.7%), yet only 29.6% reported routinely incorporating biomarkers into trial design. Major barriers included lack of validated biomarkers (53.1%) and limited access to biomarker data (51.0%). Investigators also reported substantial recruitment challenges related to patient awareness, logistical constraints, and limited recruitment resources.

Conclusion: Investigators strongly support precision-medicine approaches in PD but identify significant scientific and operational barriers to implementation.

Fig 1 Precision Medicine Model for Clinical Trials

Table 1 Survey Questions

Table 2 Survey Results Part A

Table 2 Survey Results Part B

Table 2 Survey Results Part C

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