Cohorts of Ashkenazi Jewish descent are also likely to be enriched in glucocerebrosidase mutations,49 which may also influence PD progression, particularly in regard to early motor progression50 and later cognitive decline.51 Indeed, a similar machine learning approach to that used in our study has demonstrated that diverse genetic polymorphisms can also predict longitudinal clinical outcomes.39 Moreover, other factors outside of peripheral inflammation and genetics very likely contribute to PD progression. This evidence concerns the gene GBA1 and Mental deterioration.