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Evaluation of cerebrospinal fluid alpha-synuclein seed amplification assay in PSP and CBS

Vaughan, D.; Fumi, R.; Theilmann Jensen, M.; Georgiades, T.; Wu, L.; Lux, D.; Obrocki, R.; Lamoureux, J.; Ansorge, O.; Allinson, K.; Warner, T. T.; Jaunmuktane, Z.; Misbahuddin, A.; Leigh, N.; Ghosh, B. C.; Bhatia, K. P.; Church, A.; Kobylecki, C.; Hu, M. T.; Rowe, J. B.; Blauwendraat, C.; Morris, H. R.; Jabbari, E.

2024-02-29 neurology
10.1101/2024.02.28.24303478 medRxiv
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BackgroundSeed amplification assay (SAA) testing has become an important biomarker in the diagnosis of alpha-synuclein related neurodegenerative disorders. ObjectivesTo assess the rate of alpha-synuclein SAA positivity in progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS), and analyse the clinical and pathological features of SAA positive and negative cases. Methods106 CSF samples from clinically diagnosed PSP (n=59), CBS (n=37) and indeterminate parkinsonism cases (n=10) were analysed using alpha-synuclein SAA. ResultsThree cases (1 PSP, 2 CBS) were Multiple System Atrophy (MSA)-type SAA positive. 5/59 (8.5%) PSP cases were Parkinsons disease (PD)-type SAA positive, and these cases were older and had a shorter disease duration compared with SAA negative cases. In contrast, 9/35 (25.7%) CBS cases were PD-type SAA positive. ConclusionsOur results suggest that PD-type seeds can be detected in PSP and CBS using a CSF alpha-synuclein SAA, and in PSP this may impact on clinical course.

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