Could Parkinson's start in the gut?

We talk with neurologist Kathleen Poston about early signs of Parkinson's outside the brain and how they might influence treatment and detection

Apr 16 2026

Nicholas Weiler

From Our Neurons to Yours Wu Tsai Neuro Podcast

Traditionally, we think of Parkinson's as a movement disorder—defined by slowed movement, stiff muscles, and involuntary shaking.

But it turns out there are other symptoms that appear years or even decades before movement problems bring patients to the clinic: sleep disturbances, chronic constipation, and loss of smell.

For today's guest, these early symptoms represent an incredible opportunity to understand where Parkinson's begins and to identify patients much earlier in the disease.

Kathleen Poston is a neurologist and division chief for movement disorders at Stanford Medicine. She's also a member of the steering committee for the Knight Initiative for Brain Resilience at Wu Tsai Neuro, and advises the Michael J. Fox Foundation and pharmaceutical companies on Parkinson's research.

We discuss why non-motor symptoms might hold the key to early diagnosis, how new biomarkers are redefining the disease, and whether Parkinson's might actually start in the gut.

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Kathleen Poston, MD, MS — Kathleen Poston is a neurologist and division chief for movement disorders at Stanford Medicine. She's also a member of the steering committee for the Knight Initiative for Brain Resilience at Wu Tsai Neuro.

Learn More

Learn about Poston's research on her lab site
Learn about the Stanford Lewy Body Dementia Research Center of Excellence
Redefining Parkinson's Disease | Our previous conversation with Poston on From Our Neurons to Yours, in which we learned about a sea change in our understanding of Parkinson's Disease.
Neuroscientists dive into the gut (Wu Tsai Neuro, 2025) | The 12th annual Wu Tsai Neurosciences Institute Symposium explored how our brains and bodies communicate—and what that means for our health and well-being
Parkinson’s comes in many forms. New biomarkers may explain why (Knight Initiative, 2025) | Blood and cerebrospinal fluid markers tied to inflammation and metabolism sort some patients into subgroups, according to Knight Initiative researchers, a step toward predicting progression and tailoring care.
Alzheimer’s and Parkinson’s biomarkers show promise for early diagnosis (Knight Initiative, 2025) | Two studies supported by the Knight Initiative highlight groundbreaking new early biomarkers for the diagnosis and treatment of neurodegenerative disease.
A biological definition of neuronal α-synuclein disease: towards an integrated staging system for research (The Lancet - Neurology, 2024)
International Working Group Proposes New Framework for Defining Parkinson Disease Based on Biology, Not Symptoms (Neurology Live article)

Episode credits

This episode was produced by Michael Osborne at 14th Street Studios, with sound design by Mark Bell . Social media strategy is by Julia Diaz, and additional editing by Nathan Collins. Our logo is by Aimee Garza. The show is hosted by Nicholas Weiler at Stanford's Wu Tsai Neurosciences Institute and supported in part by the Knight Initiative for Brain Resilience.

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