Use of CSF α-synuclein in the differential diagnosis between Alzheimer's disease and other neurodegenerative disorders

Int Psychogeriatr. 2015 Sep;27(9):1429-38. doi: 10.1017/S1041610215000447. Epub 2015 Apr 8.

Abstract

Background: The etiology and pathogenesis of neurodegenerative disorders has yet to be elucidated, so their differential diagnosis is a challenge. This is especially true in differentiating Alzheimer's disease (AD), dementia with Lewy bodies (DLB), Parkinson disease (PD), and multiple system atrophy (MSA).

Methods: A total of 11 eligible articles were identified by search of electronic databases including PubMed, Springer Link, Elsevier, and the Cochrane Library, up to June 2014. In meta-analyses, standardized mean differences (SMD), with 95% confidence intervals (CI), comparing cerebrospinal fluid (CSF) measures of α-synuclein between the above conditions were calculated using random-effects models.

Results: CSF α-synuclein concentrations were significantly higher in AD compared to DLB [SMD: 0.32, 95% CI: (0.02, 0.62), z = 2.07, P = 0.038]; PD [SMD: 0.87, 95% CI: (0.15, 1.58), z = 2.38, P = 0.017]; or MSA [SMD: 1.14, 95% CI: (0.15, 2.14), z = 2.25, P = 0.025]. However, no significant difference was found between patients with AD and neurological cognitively normal controls [SMD: 0.02, 95% CI: (-0.21, 0.24), z = 0.13, P = 0.894].

Conclusions: Results of these meta-analysis suggest that quantification of CSF α-synuclein could help distinguish AD from other neurodegenerative disorders such as DLB, PD, or MSA.

Keywords: Alzheimer’s disease; Parkinson disease; dementia with Lewy bodies; meta-analysis; multiple system atrophy; α-synuclein.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alzheimer Disease / cerebrospinal fluid*
  • Alzheimer Disease / diagnosis
  • Diagnosis, Differential
  • Humans
  • Lewy Body Disease / cerebrospinal fluid*
  • Lewy Body Disease / diagnosis
  • Multiple System Atrophy / cerebrospinal fluid*
  • Multiple System Atrophy / diagnosis
  • Parkinson Disease / cerebrospinal fluid*
  • Parkinson Disease / diagnosis
  • alpha-Synuclein / cerebrospinal fluid*

Substances

  • alpha-Synuclein