Describes the PPMI centralized brain donation program that improves postmortem tissue collection and highlights how neuropathology can validate biomarkers and support new pathological analysis methods.

By enabling gold-standard correlation of longitudinal clinical, imaging, genetic, and biofluid biomarkers with neuropathology, this resource strengthens biomarker validation and translational readiness, indirectly supporting Parkinson's therapeutic discovery and trial development.

Brain autopsy plays a critical role advancing understanding of neurological conditions, providing unique insights that may otherwise not be captured through studies of living individuals. In addition, given our increasing reliance on biomarkers of disease biology, pathology is the gold standard to validate biomarkers showing that early evidence of disease biology is consistent with postmortem pathology. Postmortem tissue collection is challenging, and opportunities to correlate neuropathological findings with longitudinal clinical, genetic, imaging, and biomarker data are often limited. The Parkinson's Progression Markers Initiative study demonstrates how centralized brain donation leads to a higher number of successful tissue collections. Summarized findings from study cases highlight how neuropathology enhances disease characterization and how plans to implement new and innovative methods for neuropathological analysis will advance the field. ANN NEUROL 2026.