Cerebrospinal fluid [alpha]-synuclein in the differential diagnosis of parkinsonian syndromes

• Published in: Future neurology Vol. 9; no. 5; p. 525
• Main Authors: Heegaard, Niels HH, Tanassi, Julia T, Bech, Sara, Salvesen, Lisette, Jensen, Peter Lüttge, Montezinho, Liliana CP, Winge, Kristian
• Format: Journal Article
• Language: English
• Published: London Future Medicine Ltd 01.09.2014
• Subjects: Cerebrospinal fluid; Composition; Diagnosis; Genetic aspects; Measurement; Nerve tissue proteins; Parkinson disease
• ISSN: 1479-6708; 1748-6971
• DOI: 10.2217/fnl.14.51

Aim: To evaluate the diagnostic value of the level of [alpha]-synuclein, DJ-1, and Alzheimer's disease markers in the cerebrospinal fluid (CSF) in patients with parkinsonian syndromes. Materials & methods: We measured [alpha]-synuclein, DJ-1 and Alzheimer's disease markers by quantitative immunoassays in 122 CSF samples from patients with Parkinson's disease (PD; n = 38), dementia with Lewy bodies (n = 20), multiple-system atrophy (n = 18), progressive supranuclear palsy (n = 28), corticobasal degeneration (n = 7), unspecified atypical parkinsonian disorders (n = 5) and healthy controls (n = 6). Results: The level of [alpha]-synuclein was significantly decreased in CSF from PD patients. For the total tau/[alpha]-synuclein ratio, we obtained an area under the curve of 0.80 of the receiver operating characteristics curve for the PD diagnosis. With a cut-off of 1.33, the tau/[alpha]-synuclein ratio had 93% diagnostic specificity at 75% sensitivity for PD. Conclusion: CSF [alpha]-synuclein measurement may be useful in the differential diagnosis of PD versus other parkinsonian syndromes. CSF [alpha]-synuclein is found at low levels in the CSF and requires specifically adjusted assays to be measured.