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Longitudinal analyses of cerebrospinal fluid α‐Synuclein in prodromal and early Parkinson's disease
Journal article   Open access   Peer reviewed

Longitudinal analyses of cerebrospinal fluid α‐Synuclein in prodromal and early Parkinson's disease

Brit Mollenhauer, Chelsea J Caspell‐Garcia, Christopher S Coffey, Peggy Taylor, Andy Singleton, Leslie M Shaw, John Q Trojanowski, Mark Frasier, Tanya Simuni, Alex Iranzo, …
Movement disorders, Vol.34(9), pp.1354-1364
09/2019
DOI: 10.1002/mds.27806
PMCID: PMC7098385
PMID: 31361367
url
https://doi.org/10.1002/mds.27806View
Published (Version of record) Open Access

Abstract

Background Aggregation of α‐synuclein is central to the pathophysiology of PD. Biomarkers related to α‐synuclein may be informative for PD diagnosis/progression. Objectives To analyze α‐synuclein in CSF in drug‐naïve PD, healthy controls, and prodromal PD in the Parkinson's Progression Markers Initiative. Methods Over up to 36‐month follow‐up, CSF total α‐synuclein and its association with MDS‐UPDRS motor scores, cognitive assessments, and dopamine transporter imaging were assessed. Results The inception cohort included PD (n = 376; age [mean {standard deviation} years]: 61.7 [9.62]), healthy controls (n = 173; age, 60.9 [11.3]), hyposmics (n = 16; age, 68.3 [6.15]), and idiopathic rapid eye movement sleep behavior disorder (n = 32; age, 69.3 [4.83]). Baseline CSF α‐synuclein was lower in manifest and prodromal PD versus healthy controls. Longitudinal α‐synuclein decreased significantly in PD at 24 and 36 months, did not change in prodromal PD over 12 months, and trended toward an increase in healthy controls. The decrease in PD was not shown when CSF samples with high hemoglobin concentration were removed from the analysis. CSF α‐synuclein changes did not correlate with longitudinal MDS‐UPDRS motor scores or dopamine transporter scan. Conclusions CSF α‐synuclein decreases early in the disease, preceding motor PD. CSF α‐synuclein does not correlate with progression and therefore does not reflect ongoing dopaminergic neurodegeneration. Decreased CSF α‐synuclein may be an indirect index of changes in the balance between α‐synuclein secretion, solubility, or aggregation in the brain, reflecting its overall turnover. Additional biomarkers more directly related to α‐synuclein pathophysiology and disease progression and other markers to be identified by, for example, proteomics and metabolomics are needed. © 2019 International Parkinson and Movement Disorder Society
cohort studies outcome research Parkinson's disease/parkinsonism

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