Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

PARKINSON DISEASE

Prodromal Parkinson disease — time is brain

Biomarkers that predict conversion from isolated REM sleep behaviour disorder to Parkinson disease are urgently needed. A new study finds that detection of misfolded α-synuclein in the cerebrospinal fluid is a good marker of conversion risk, but an inability to predict the timeline of progression might limit its utility.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Schrag, A. et al. Prediagnostic presentations of Parkinson’s disease in primary care: a case-control study. Lancet Neurol. 14, 57–64 (2015).

    Article  Google Scholar 

  2. Postuma, R. B. et al. Risk and predictors of dementia and parkinsonism in idiopathic REM sleep behaviour disorder: a multicentre study. Brain 142, 744–759 (2019).

    Article  Google Scholar 

  3. Iranzo, A. et al. Detection of α-synuclein in CSF by RT-QuIC in patients with isolated rapid-eye-movement sleep behaviour disorder: a longitudinal observational study. Lancet Neurol. 20, 203–212 (2021).

    Article  CAS  Google Scholar 

  4. Fairfoul, G. et al. Alpha-synuclein RT-QuIC in the CSF of patients with alpha-synucleinopathies. Ann. Clin. Transl Neurol. 3, 812–818 (2016).

    Article  CAS  Google Scholar 

  5. Shahnawaz, M. et al. Development of a biochemical diagnosis of parkinson disease by detection of α-synuclein misfolded aggregates in cerebrospinal fluid. JAMA Neurol. 74, 163–172 (2017).

    Article  Google Scholar 

  6. Candelise, N. et al. Towards an improved early diagnosis of neurodegenerative diseases: the emerging role of in vitro conversion assays for protein amyloids. Acta Neuropathol. Commun. 8, 117 (2020).

    Article  CAS  Google Scholar 

  7. Orrù, C. D. et al. A rapid α-synuclein seed assay of Parkinson’s disease CSF panel shows high diagnostic accuracy. Ann. Clin. Transl Neurol. 8, 374–384 (2021).

    Article  Google Scholar 

  8. Wang, Z. et al. Skin α-synuclein aggregation seeding activity as a novel biomarker for parkinson disease. JAMA Neurol. 78, 30–40 (2021).

    Article  Google Scholar 

  9. De Luca, C. M. G. et al. Efficient RT-QuIC seeding activity for α-synuclein in olfactory mucosa samples of patients with Parkinson’s disease and multiple system atrophy. Transl Neurodegener. 8, 24 (2019).

    Article  Google Scholar 

  10. Shahnawaz, M. et al. Discriminating α-synuclein strains in Parkinson’s disease and multiple system atrophy. Nature 578, 273–277 (2020).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Brit Mollenhauer.

Ethics declarations

Competing interests

B.M. has received honoraria for consultancy from AbbVie, Amprion, Biogen, Roche and Servier. B.M. is a member of the executive steering committee of the Parkinson Progression Marker Initiative and co-Principal Investigator of the Systemic Synuclein Sampling Study of the Michael J. Fox Foundation for Parkinson’s Research, and has received research funding from the Deutsche Forschungsgemeinschaft (DFG), EU (Horizon2020), Parkinson Fonds Deutschland, Deutsche Parkinson Vereinigung, Parkinson’s Foundation and the Michael J. Fox Foundation for Parkinson’s Research. S.W. declares no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Weber, S., Mollenhauer, B. Prodromal Parkinson disease — time is brain. Nat Rev Neurol 17, 329–330 (2021). https://doi.org/10.1038/s41582-021-00489-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41582-021-00489-6

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing