doi:10.1016/j.bbrc.2006.08.024
Copyright © 2006 Elsevier Inc. All rights reserved.
Decreased α-synuclein in cerebrospinal fluid of aged individuals and subjects with Parkinson’s disease
Takahiko Tokudaa, Sultan A. Salemb, David Allsopb, Toshiki Mizunoa, Masanori Nakagawaa, Mohamed M. Qureshic, Joseph J. Locasciod, e, Michael G. Schlossmacherd, e and Omar M.A. El-Agnafc,
, 
aDepartment of Neurology, Kyoto Prefectural University of Medicine, Kyoto 602-0841, Japan
bBiomedical Sciences Unit, Department of Biological Sciences, Lancaster University, Lancaster LA14YQ, UK
cDepartment of Biochemistry, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain 17666, United Arab Emirates
dDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
eCenter for Neurologic Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
Received 28 July 2006.
Available online 14 August 2006.
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Abstract
There is ample biochemical, pathological, and genetic evidence that the metabolism of α-synuclein (α-syn) plays a crucial role in the pathogenesis of Parkinson disease (PD). To examine whether quantification of α-syn in cerebrospinal fluid (CSF) is potentially informative in the diagnosis of PD, we developed a specific ELISA system and measured the concentration of α-syn in CSF from 33 patients with PD (diagnosed according to UK PD Society Brain Bank criteria) and 38 control subjects including 9 neurologically healthy individuals. We found that PD patients had significantly lower α-syn levels in their CSF than the control groups (p < 0.0001) even after adjusting for gender and age. Age was independently associated with lower α-syn levels. Logistic regression analysis showed that reduction in CSF α-syn served as a significant predictor of PD beyond age and gender alone (area under ROC curve, c = 0.882). Furthermore, we observed a close inverse correlation between α-syn levels in CSF and assigned Hoehn and Yahr score in this cohort of 71 living subjects (p < 0.0001), even after adjusting for age. These findings identify in the quantification of α-syn from CSF a potential laboratory marker to aid the clinical diagnosis of PD.
Keywords: Parkinson disease; Neurodegenerative diseases; α-Synuclein; Cerebrospinal fluid; ELISA; Biomarker; Diagnosis
Fig. 1. Standard curves of the sandwich-ELISA. Specificities and sensitivities for human α- (•), β- (■) and γ-syn (
) in the sandwich-ELISA we used.
Fig. 2. (A) Scatter plot of age versus CSF α-syn in the control patient groups, as measured by sandwich ELISA. The concentration of α-syn was significantly reduced with aging. (B) Predicted values of log CSF α-syn (ng/ml) versus age, by diagnostic group (44 percent of variance accounted for; see text for details).
Fig. 3. (A) Scatter plot of the concentrations of α-syn in CSF in the PD (•) and control (x) groups, as measured by sandwich ELISA. (B) Plot of predicted probability of being a PD patient as opposed to control subject (for selected subpopulation) versus residuals of log transformed CSF α-syn (holding age constant) based on logistic regression of probability assessment. (C) ROC curves based on logistic regression analyses for the classification of Parkinson disease patients versus control subjects based on various predictors and combination of predictors.
Fig. 4. Predicted values of log CSF α-syn (ng/ml) versus age, by Hoehn and Yahr score (52 percent of variance accounted for; see text for details).