Recent studies published in npj Parkinson’s Disease and others reveal advancements in understanding Parkinson’s disease pathology, including the role of cutaneous nerve fibers and brain perivascular fluid dynamics as predictive biomarkers. Additional research highlights aberrant excitation-inhibition balances shaping gray matter structure-function in Parkinson’s and drug repurposing efforts targeting cognitive decline. These findings open new avenues for early diagnosis and therapeutics development.