Peer-Reviewed Publication
NPJ Parkinsons Dis2026July 14, 2026Journal Article
Slow-SPEED: protocol for three randomised trials of remotely delivered exercise to prevent Parkinson's disease.
Thomas H Oosterhof1, Eleanor Mitchell2, Alberto Ascherio3, Stella Aslibekyan4, Viktoria Azoidou2, Kara Beasley5, Yoav Ben-Shlomo6, Eline Bunnik7, Camille Carroll8, Lana Chahine9, Daniel Corcos10, Jules M Janssen Daalen1, Karin D van Dijk11,12, Bauke W Dijkstra1, Lisanne Dommershuijsen1, Ray Dorsey13,14, Luc J W Evers1, Rick C Helmich1, Martin Johansson1,15, Lucy Norcliffe-Kaufmann4, Jessi Keavney16, Christine Klein17, Matthew J Kmiecik4, Thomas Kustermann18, Eric A Macklin19, Kenneth Marek20, Sanne K Meles21, Sebastiaan Overeem22, Carl M Philpott23,24, Angelique Pijpers22, Ronald B Postuma25, Helen M Rowbotham4, Sabine Schootemeijer26, Michael A Schwarzschild27, Tanya Simuni28, Michael Sommerauer29, Ambra Stefani30, Kenan Steidel1,31, Marcel Verbeek1, Rick van der Vliet32, Nienke M de Vries33, Bart van de Warrenburg1, Richard K Wyse34, Bastiaan R Bloem1, Ruth B Schneider13, Alastair J Noyce2, Sirwan K L Darweesh35
1Center of Expertise for Parkinson and Movement Disorders, Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
2Center for Preventive Neurology Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
3Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
423andMe Research Institute, Palo Alto, CA, USA.
5Davis Phinney Foundation, Louisville, CO, USA.
6Population Health Sciences, Bristol Medical School, Bristol, UK.
7Department of Public Health, Medical Ethics, Philosophy and History of Medicine Programme, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
8Translational and Clinical Research Institute, Newcastle University National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University, Newcastle upon Tyne, UK.
9Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA.
10Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA.
11Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands.
12Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam, The Netherlands.
13Department of Neurology and Center for Health and Technology, University of Rochester, Rochester, NY, USA.
14Center for the Brain & Environment, Atria Research and Global Health Institute, New York, NY, USA.
15Institut du Cerveau - Paris Brain Institute, Movement Investigations and Therapeutics Team (MOV'IT), Center for NeuroImaging Research (CENIR), Sorbonne University, Pitié-Salpêtrière Hospital, Paris, France.
16Parkinson's Foundation, Parkinson's Advocates in Research Program, Pendergrass, GA, USA.
17Institute of Neurogenetics, University of Luebeck and University Hospital Schleswig-Holstein, Luebeck, Germany.
18Roche Pharma Research and Early Development, Roche Innovation Center, F. Hoffmann-La Roche Ltd, Basel, Switzerland.
19Massachusetts General Hospital Biostatistics, Massachusetts General Hospital and Department of Neurology, Harvard Medical School, Boston, USA.
20Institute for Neurodegenerative Disorders, New Haven, CT, USA.
21Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
22Sleep Medicine Center Kempenhaeghe, Heeze, The Netherlands.
23Norfolk Smell & Taste Clinic, James Paget University Hospital, Gorleston, Norfolk, UK.
24Rhinology & Olfactology Research Group, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK.
25The Neuro, Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.
26Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands.
27Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
28Northwestern University Feinberg School of Medicine, Department of Neurology, Chicago, IL, USA.
29Center of Neurology, Department of Parkinson's, Sleep and Movement Disorders, University Hospital Bonn, Bonn, Germany & German Center for Neurodegenerative Diseases, Bonn, Germany.
30Center for Sleep Medicine, Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.
31Department of Neurology, Philipps University Marburg, Marburg, Germany.
32Department of Neuroscience and Neurology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
33Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
34Cure Parkinson's, London, UK.
35Center of Expertise for Parkinson and Movement Disorders, Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands. sirwan.darweesh@radboudumc.nl.
Abstract
We describe the design of the first non-pharmacological Parkinson's disease prevention trials worldwide: the randomised 'Slow-SPEED' trials. Three trials examine the feasibility and preliminary efficacy of a gamified, remotely administered exercise intervention vs. active control over 18-36 months in complementary prodromal subgroups: iRBD(n = 110; Netherlands), hyposmia(n = 110; United Kingdom) o…
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