In the fall of 2018, the pianist Nicolas Hodges noticed his body shaking. He brought it up at a routine doctor’s appointment in Tübingen, Germany, where he lives. The doctor said it was probably stress, but recommended that he make an appointment with a neurologist.

Hodges didn’t make that appointment right away. But then, in January 2019, the shaking caused him to play a wrong note during a performance.

“It became instantly clear that I had to find out what was going on,” he said.

Dr. Klaus Schreiber, a neurologist and a classical music lover, observed Hodges performing a few minor physical tasks — walking across a room, undressing and dressing — before he sent him for a series of tests that confirmed Hodges had Parkinson’s disease.

Dr. Schreiber estimated that Hodges had been performing with Parkinson’s for three years.

Hodges, 53, is a leading interpreter of contemporary classical music. As a soloist and chamber musician, he has premiered and recorded works by many important composers of this century, and the last. Recently, his symptoms have forced him to reduce and prioritize his performing commitments.

The worst symptoms, which rarely occur, can leave him feeling, he said, as if he “just couldn’t play the piano.” But the diagnosis has also strengthened his dedication to his artistry and the contemporary repertoire.

Physical limits have forced Hodges to make “aesthetic decisions,” he said, to select what music to commission and to perform with greater rigor. The diagnosis has “made me try to focus even more on what multiple contradictory things are most important to me.”

Hodges has formidable technique and an ability to make the form of even highly complex pieces clearly audible. His tone color on the piano can shift from vinegary to supple in seconds. He is strikingly adaptable to the widely divergent visions of various contemporary composers. In John Adams’s “China Gates” (1977), Hodges has combined rhythmic propulsion with tiptoe delicacy. In Brian Ferneyhough’s opera “Shadowtime” (2004), he tackled a prismatically virtuosic solo while asking enigmatic questions out loud, like “What is the cube root of a counterfactual?” In Simon Steen-Andersen’s Piano Concerto (2014), he faced off against a video projection of himself at a smashed grand piano.

In 2020, Hodges recorded “A Bag of Bagatelles,” which wove together works by Beethoven and Harrison Birtwistle, a close collaborator. The juxtaposition illuminates the complexity, unpredictability and orchestral scale that animate the music of two composers centuries apart. Looking back, Hodges realized that he had recorded the album with untreated Parkinson’s disease.

HODGES WAS BORN in London in 1970. His father was a studio manager at the BBC who later worked in computing, and his mother was a professional opera singer. Hodges began playing the piano at age 6 and composing at 9. Among his early pieces was the first scene of an opera based on the Perseus myth.

Hodges attended elementary school at Christ Church Cathedral School in Oxford, where he took lessons on the viola, the oboe, the harpsichord and the organ, in addition to the piano. He sang in the Christ Church Cathedral Choir, performing works like Benjamin Britten’s “War Requiem” at the Royal Festival Hall under Simon Rattle.

“We were woken up earlier than the rest of the school to practice,” Hodges said. The students who didn’t play music “got half an hour more sleep than I did the whole of my childhood.”

For secondary school, Hodges went to Winchester College, in Hampshire, where Benjamin Morison, a pianist and composer who is now a professor of philosophy at Princeton University, introduced Hodges to contemporary music by playing an LP of music by Birtwistle and Gyorgy Kurtag. Hodges and Morison performed an arrangement of Stravinsky’s “The Rite of Spring” for two pianos and Pierre Boulez’s restless “Structures II” for their teachers and fellow students at Winchester, to bemused reactions.

“I remember him being very precise — and encouraging me to be precise — and extremely musical,” Morison said of Hodges in a phone interview. “He was able to make the music speak as music.”

In 1986, Hodges took a seminar with the composer Morton Feldman at the Dartington Summer School, where Feldman impressed upon him the seriousness of the experimental avant-garde. Hodges also played in a band that covered songs by the Sex Pistols and the Sisters of Mercy.

It was a heady and influential time. “I was improvising; I was listening to weird, dark, funky music, and playing Debussy,” Hodges said.

For several years, he considered pursuing composition, to the dismay of his more traditionally minded mother. At age 23, he decided to refocus on the piano. “I just was having more fun as a pianist,” he said. “Composing is too much hard work.”

As part of that decision, Hodges began studying with the pianist Sulamita Aronovsky, who had defected to Britain from the Soviet Union. A car crash shortly after the move had ended her career as a performer. “She used to say to me, whenever I would come to her lesson and complain, ‘Mr. Hodges, you have to accept everyone has these problems,’” he recalled. “‘It’s the people who get past these problems who have careers.’”

Hodges has since performed as a soloist with orchestras including the New York Philharmonic, the Boston Symphony Orchestra and the London Philharmonic Orchestra — usually in contemporary repertoire and often with pieces written for him. He is a professor of piano at the State University of Music and Performing Arts in Stuttgart, Germany, and almost constantly premieres new work solo and in chamber music formations.

“All these composers that we had idolized when we were teenagers, he has subsequently commissioned pieces from,” said Morison, who remains close with Hodges. “It’s an extraordinary thrill to witness that.”

WHEN HODGES RECEIVED his diagnosis, the news came with conflicting emotions. The first, Hodges recalled, was a certain cockiness. “I’m going to be a medical miracle,” he thought to himself. “I’m going to carry on whatever happens.”

When that phase passed, Hodges felt relief. He had a clear diagnosis, and the dopamine treatments prescribed by Dr. Schreiber helped. “The medication makes it possible for me to sometimes feel and play like I don’t have it,” Hodges said. “When you’re suffering from something like that and you’re untreated, you feel like you’re getting old before your time, you feel like your children have worn you out — and my poor children were blamed for that.”

Hodges has had to make painful decisions while prioritizing performing commitments. Since 2012, he has played in Trio Accanto, an ensemble consisting of Hodges, the German percussionist Christian Dierstein and the Swiss saxophonist Marcus Weiss. The group has toured Europe’s major new-music festivals and recorded six albums of contemporary music together.

When Dierstein and Weiss learned of Hodges’s diagnosis, they were shaken. “We’re scared, and we are as concerned and sad as we were when we first found out,” Dierstein said in a video interview. “But it was always clear to us that we want to continue playing with Nic and that we’ll take the illness into account.”

After a period of reflection during the coronavirus pandemic, Hodges decided to withdraw from Trio Accanto. He found the logistics involved in traveling to concerts and dealing with the complex instrumental setups required by many pieces too taxing. The 2024-25 season will be Hodges’s last with the group.

Playing with Trio Accanto “was ideal chamber music for me,” Hodges said. But, he added, “Parkinson’s makes it necessary for my life to be simple.”

Hodges has also learned to structure the doses of his medication — including a dopamine inhaler, a receptor agonist patch and extended-release pills — in a way that supports his concert roster. This often requires stark sacrifices: He essentially schedules the worst of his symptoms.

In February, Hodges performed Rebecca Saunders’s “to an utterance” for piano and orchestra, a work composed for him, at the Elbphilharmonie in Hamburg. A final rehearsal the afternoon of the performance meant he had to take dopamine once at 4 p.m., and again at 8 p.m.

“There might be moments when I feel like I’ve taken a bit too much,” Hodges said earlier that day, “but in the situation of playing, that’s way better than having taken too little.”

In an email, Saunders said that Hodges still plays with intensity. “His recent performance of the piano concerto ‘to an utterance’ was brilliant, and I found it deeply expressive,” she wrote. She is planning to write him an ambitious new piece she described as “a big, long solo based on the concerto.”

Seven other composers are currently at work on new piano concertos for Hodges. This spring, he recorded Betsy Jolas’s complete solo piano works and premiered a new piece by Christian Wolff, “Scraping Up Sand in the Bottom of the Sea.” Hodges also plans to record an album with works by Debussy and contemporary composers, similar to his double portrait of Beethoven and Birtwistle.

On rare occasions, Hodges has felt he was treated differently because of his illness. One composer recently “looked straight at my hands as if they would be twisted or bleeding,” he said. But many more of his collaborators have been supportive, helping him adapt without condescension or pity.

Hodges says that his goal, now, is to adjust his career “to ensure that I have the best chance to slow the progress of the disease and thus keep playing with any qualities I might have had before Parkinson’s more or less intact.”

He knows that might not last forever. “If I should stop playing, then I hope that my friends tell me I should stop playing,” Hodges said. “But, at the moment, it’s working.”