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Here we describe the evidence for the presence and progression of motor deficits in this pre-diagnostic phase in order to provide suggestions for the design of future observational studies for an effective, quantitatively oriented investigation. On the one hand, these future studies must detect these motor deficits in as large (potentially, population-based) cohorts as possible with high sensitivity and specificity. On the other hand, they must describe the progression of these motor deficits in the pre-diagnostic phase as accurately as possible, to support the testing of the effect of pharmacological and non-pharmacological interventions. Digital technologies and artificial intelligence can substantially accelerate this process.<\/jats:p>","DOI":"10.3233\/jpd-230350","type":"journal-article","created":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T10:46:04Z","timestamp":1708080364000},"page":"S287-S296","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Identifying Subtle Motor Deficits Before Parkinson\u2019s Disease is Diagnosed: What to Look for?"],"prefix":"10.1177","volume":"14","author":[{"given":"Walter","family":"Maetzler","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital Schleswig-Holstein and Kiel University, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anat","family":"Mirelman","sequence":"additional","affiliation":[{"name":"Laboratory for Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"},{"name":"Sagol School of Neuroscience and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Pilotto","sequence":"additional","affiliation":[{"name":"Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy"},{"name":"Laboratory of Digital Neurology and Biosensors, University of Brescia, Brescia, Italy"},{"name":"Neurology Unit, Department of Continuity of Care and Frailty, ASST Spedali Civili Brescia Hospital, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roongroj","family":"Bhidayasiri","sequence":"additional","affiliation":[{"name":"Chulalongkorn Centre of Excellence for Parkinson\u2019s Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand"},{"name":"The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,2,15]]},"reference":[{"key":"ref001","doi-asserted-by":"crossref","unstructured":"NoyceAJ, ReesRN, AcharyaAP, SchragA(2018) An early diagnosis is not the same as a timely diagnosis of Parkinson\u2019s disease. 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