Alpha‐synuclein RT‐QuIC in the CSF of uncertain cases of parkinsonism

Abstract

A reliable biomarker is needed for accurate and early differentiation between Parkinson's disease (PD) and the various forms of atypical parkinsonism (AP). We used a novel real‐time quaking‐induced conversion (RT‐QuIC) assay to detect alpha‐synuclein (α‐syn) aggregates in cerebrospinal fluid (CSF) of 118 patients with parkinsonism of uncertain clinical etiology and 52 controls. Diagnostic accuracy to distinguish α‐synucleinopathies from non‐α‐synucleinopathies and controls was 84% (sensitivity 75%, specificity 94% (AUC 0.84, 95% CI 0.78‐0.91, p<0.0001), PPV 93%). CSF α‐syn RT‐QuIC could be a useful diagnostic tool to help clinicians differentiate α‐synucleinopathies from other forms of parkinsonism when the clinical picture is uncertain.

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