Recent cohort studies published in npj Parkinson’s Disease reveal key alterations in cutaneous nerve fibers in Parkinson’s disease (PD) and atypical parkinsonism. Using immunohistochemical staining and quantitative sensory testing, researchers led by Andréasson et al. identified pathological changes in peripheral nerve fiber density and morphology, accessible via skin biopsies. Complementing this, research on perivascular fluid diffusivity highlights a promising biomarker for early PD progression prediction. These findings may enhance early diagnosis and personalized intervention strategies for neurodegenerative disorders.