How Early Environmental Detection Could Refine Parkinson Disease Risk Models: Rodolfo Savica, MD, PhD

WATCH TIME: 4 minutes

“We have to be very careful not to claim that everything comes from one source. What we need is a much deeper understanding of genes and environment acting together to create disease.”

Parkinson disease (PD) is increasingly recognized as a condition influenced by both genetic susceptibility and environmental exposures, with growing evidence suggesting that risk accumulates over decades before clinical diagnosis. While several genetic variants have been linked to disease risk and phenotype, many cases likely reflect a more complex interaction between genes and environmental factors. One of the major challenges in this space is that by the time patients present with motor symptoms, the relevant exposures may have occurred years earlier, limiting the ability to identify causal relationships in real time.

Recent epidemiologic research has renewed attention on environmental contributors to PD, including a 2025 study published in JAMA Neurology that evaluated the association between proximity to golf courses and PD risk. In this population-based case-control analysis, individuals living within 1 mile of a golf course had more than double the odds of developing PD compared with those living farther away (adjusted odds ratio, 2.26). The study also suggested that drinking water contamination, particularly in vulnerable groundwater regions and municipal well systems, may represent a potential route of exposure, highlighting the complexity of environmental risk pathways.

At the 2026 American Academy of Neurology Annual Meeting (AAN), held April 18-22, in Chicago, Illinois, Rodolfo Savica, MD, PhD, an associate professor of neurology at Mayo Clinic Rochester, presented on neuroepidemiology and environmental exposures in Parkinson disease, building on these evolving insights. His work explores how environmental risk factors, including pesticide exposure and lifestyle-related variables, intersect with genetic predisposition to influence disease onset and progression.

Following the meeting, Savica spoke with NeurologyLive® about the next steps needed to advance this line of research. In the conversation, he discusses the challenges of identifying environmental risk earlier in the disease course, the importance of gene-environment interaction studies, and the need for carefully designed, high-quality research before translating findings into clinical or public health recommendations.

Click here for more AAN 2026 coverage.

REFERENCES
1. Krzyzanowski B, Mullan AF, Dorsey ER, et al. Proximity to Golf Courses and Risk of Parkinson Disease. JAMA Network Open. 2025;8(5):e259198. doi:10.1001/jamanetworkopen.2025.9198