Recent Advances and Emerging Challenges in Parkinson’s Disease Management: Diagnostic Innovations, Therapies, and Complementary Approaches

As of 2019, more than 8.5 million persons worldwide were affected with Parkinson’s disease (PD), the second most prevalent neurological disorder among older adults. Despite advances in understanding disease pathology, PD remains incurable, with existing treatments predominantly being symptomatic. Recent advancements in diagnostic precision have emerged through innovative biomarkers, including neuron-derived extracellular vesicles containing α-synuclein, volatile organic compounds (VOCs) analysis, and fluid biomarkers such as serum autoantibodies and cerebrospinal fluid seed amplification assays (SAAs). Neuroimaging has also advanced, with techniques like neuromelanin-sensitive MRI and quantitative susceptibility mapping (QSM) offering enhanced visualization of brain pathology. The complexity of diagnosis is further increased by overlapping symptoms between PD, Alzheimer’s disease, and Lewy body dementia, requiring precise biomarkers and clinical supervision. Psychiatric comorbidities such as depression, psychosis, and apathy significantly influence PD prognosis, indicating aggressive disease progression. Complementary and alternative medicine (CAM) interventions, notably acupuncture, probiotics, traditional Chinese exercises (TCEs) such as Tai Chi, and adherence to the Mediterranean diet, have shown significant effectiveness in reducing both motor and non-motor symptoms, thereby improving quality of life. Future treatment approaches include investigating potential disease-modifying treatments like α-synuclein aggregation inhibitors, gene therapies, and mitochondrial enhancers; focusing on neuroinflammation and changes in the gut microbiome; and using artificial intelligence for early PD diagnosis and progression monitoring. However, significant challenges remain, particularly in ensuring the inclusion of older adults in clinical trials, optimizing geriatric-focused research, and translating promising therapies from experimental stages into clinically viable interventions. This review summarizes the current PD management, highlighting recent diagnostic, therapeutic, and complementary treatment advancements while outlining emerging opportunities and critical challenges in treating this increasingly prevalent neurodegenerative disease.