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.
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References
Schrag, A. et al. Prediagnostic presentations of Parkinson’s disease in primary care: a case-control study. Lancet Neurol. 14, 57–64 (2015).
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).
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).
Fairfoul, G. et al. Alpha-synuclein RT-QuIC in the CSF of patients with alpha-synucleinopathies. Ann. Clin. Transl Neurol. 3, 812–818 (2016).
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).
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).
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).
Wang, Z. et al. Skin α-synuclein aggregation seeding activity as a novel biomarker for parkinson disease. JAMA Neurol. 78, 30–40 (2021).
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).
Shahnawaz, M. et al. Discriminating α-synuclein strains in Parkinson’s disease and multiple system atrophy. Nature 578, 273–277 (2020).
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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.
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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
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DOI: https://doi.org/10.1038/s41582-021-00489-6