Non-motor symptoms are increasingly recognized as potential harbingers of neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease as well as their variants and mimics, and prompt diagnosis and candidate identification – ideally years before the onset of hallmark symptoms – are vital to initiate patients on disease-modifying regimens.^{Reference Villa Villegas, Farias-Moreno, Gonzalez-Ruffino and Zuniga-Ramirez1} This study presents retrospectively reviewed chart data supporting an increased risk of movement disorders such as Parkinson’s disease and multiple system atrophy with antecedent restless legs syndrome, and an increased risk of major neurocognitive disorders such as Alzheimer’s disease with antecedent depression and psychosis years before either condition is diagnosed.^{Reference Villa Villegas, Farias-Moreno, Gonzalez-Ruffino and Zuniga-Ramirez1} Interestingly, restless legs syndrome is suggested in some cases as a non-motor precursor to Parkinson’s disease, preceding Parkinson’s disease in one study by 5–10 years, like the findings in this study.^{Reference Schrag, Bohlken and Dammertz2} While these findings have been disputed, there appears to be some correlation between the two conditions.^{Reference Ferini-Strambi, Carli, Casoni and Galbiati3} Another similar study highlighted the presence of delirium prior to a neurocognitive diagnosis, with increased frequency of episodes 1 year prior strongly suggestive of dementia with Lewy bodies as opposed to Alzheimer’s disease.^{Reference Fitzgerald, Perea and Chang-Tave4} Amyotrophic lateral sclerosis (ALS) was also investigated in this study despite a smaller sample size.^{Reference Villa Villegas, Farias-Moreno, Gonzalez-Ruffino and Zuniga-Ramirez1} Other studies have also investigated ALS with pain and depression being common.^{Reference Fang, Jozsa and Al-Chalabi5} With a brief duration of nonmotor symptoms leading up to the onset of ALS, diagnosing this condition in the prodromal phase therefore remains challenging.^{Reference Villa Villegas, Farias-Moreno, Gonzalez-Ruffino and Zuniga-Ramirez1,Reference Fang, Jozsa and Al-Chalabi5,Reference Garcia-Casanova and Vazquez-Costa6} Most studies in the sphere of nonmotor symptoms (including this one) have been limited by their retrospective nature, which limits diagnostic certainty per case, and lack of prospective long-term data looking at clinical and more sensitive and specific pathological correlations that can identify more acutely and more specifically patients who fit into a specific disease and not a category of diseases.^{Reference Villa Villegas, Farias-Moreno, Gonzalez-Ruffino and Zuniga-Ramirez1–Reference Garcia-Casanova and Vazquez-Costa6} As the authors of this study aptly suggest, further prospective and retrospective analyses are required to elucidate factors leading to an increased risk of neurodegenerative disorders, and to characterize not only the association but also the duration of non-motor symptoms prior to the onset of neurodegenerative diseases, as early detection may warrant disease-modifying potential if treated early.