Alpha-synuclein in spinal fluid isn’t a parkinsonism biomark

Dutch researchers found that the amount of alpha-synuclein in cerebrospinal fluid (CSF) is not a tool for differentiating those who have Parkinson’s Disease from those who have an atypical parkinsonism disorder (MSA, DLB, PSP, CBD, and vascular parkinsonism). Alpha-synuclein in CSF is also not a tool for differentiating among the atypical parkinsonism disorders. The search for a biomarker continues.

Neurobiology of Aging. 2011 Jan 12. [Epub ahead of print]

CSF alpha-synuclein does not differentiate between parkinsonian disorders.

Aerts MB, Esselink RA, Abdo WF, Bloem BR, Verbeek MM.
Department of Neurology, Parkinson Center Nijmegen (ParC), and Alzheimer Centre Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, the Netherlands.

Differentiating between Parkinson’s disease (PD) and atypical Parkinsonism (AP) is clinically relevant but challenging.

A timely and correct diagnosis might result in better targeted treatment strategies, adequate patient counseling, and early recognition of disease-specific complications.

We aimed to investigate whether cerebrospinal fluid (CSF) concentrations of alpha-synuclein are of additional diagnostic value. We examined 142 consecutive patients with parkinsonism, mean disease duration 39.7 mo (Parkinson’s disease (PD), n = 58; MSA, n = 47; dementia with Lewy bodies (DLB), n = 3; VaP, n = 22; progressive supranuclear palsy (PSP), n = 10; CBD, n = 2).

Gold standard was the clinical diagnosis established after 2 years of clinical follow-up.

CSF concentrations of alpha-synuclein, blood pigments and the erythrocyte count were determined.

No differences between CSF alpha-synuclein concentrations of patients with PD with the reference values from our laboratory were observed.

We neither found significant differences between patients with PD and AP nor between AP subgroups. Adjustment for age, disease severity or presence of erythrocytes or blood pigments in CSF did not alter these results.

Our results imply that CSF alpha-synuclein is currently unsuitable as biomarker to differentiate between PD and AP.

Copyright 2011 Elsevier Inc. All rights reserved.

PubMed ID#: 21236518 (see for abstract only)