Objective: In this study, we intended to use network meta-analysis to compare the diagnostic performances of different CSF biomarkers in the diagnosis and differential diagnosis accuracy of PD.

Background: To date, there are multiple biomarkers in cerebrospinal fluid (CSF) that have the potential to be used in the diagnosis and differential diagnosis of Parkinson’s disease (PD). However, there is limited consensus regarding the diagnostic and differential diagnostic performance of different CSF biomarkers.

Method: A comprehensive research was performed on PubMed, Web of Science, Embase and Cochrane library. Pooled sensitivity, specificity, positive likelihood, negative likelihood, and summary receiver operating characteristic curves were selected to represent the diagnostic utility of individual biomarkers. The network meta-analysis based on the ANOVA model was selected to rank the diagnostic performance of the included biomarkers by calculating the relative sensitivity, specificity and diagnostic odds ratio (DOR).

Results: Meta-Analyses were performed on 50 studies, which involved α-synuclein (α-syn), α-synuclein oligomers (o-α-syn), a-syn seeding amplification assays (a-syn SAAs), Aβ1-42, DJ-1, GCase, NFL, o-α-syn/α-syn, p-Tau, p-Tau/α-syn, S100β, t-Tau, t-Tau/α-syn in distinguishing PD patients from healthy controls, multiple system atrophy (MSA), progressive supranuclear palsy (PSP) and Lewy body dementia patients. Network meta-analysis showed CSF a-syn SAAs had the best diagnostic efficacy (DOR:263.62; 95%CI: 86.30-560.95), Followed by o-α-syn/α-syn (DOR:10.3; 95%CI: 2.14-28.01) and DJ-1 (DOR:8.06; 95%CI: 1.26-22.80). a-syn SAAs had the highest relative sensitivity and specificity, while o-α-syn had the second highest relative sensitivity. O-α-syn/α-syn and t-Tau had the second highest relative specificity. α-syn SAAs and NFL had good potential for differential diagnosis of PD and MSA, and α-syn SAAs were able to discriminate PD from PSP.

Conclusion: CSF α-syn SAAs, o-α-syn/α-syn, DJ-1 and NFL are promising CSF biomarkers in the diagnosis and differential diagnosis of PD, and they are expected to become a new PD diagnostic biomarker for clinical use.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cerebrospinal-fluid-biomarkers-for-diagnosis-of-parkinsons-disease-a-systematic-review-and-network-meta-analysis/