Category: Parkinsonism, Others
Objective: To evaluate the role of cerebrospinal fluid (CSF) biomarkers in the differential diagnosis of degenerative parkinsonian syndromes.
Background: The differential diagnosis of degenerative parkinsonian syndromes may be challenging in the early phases of the disease. CSF biomarkers have been studied as potentially useful in the differential diagnosis of these disorders, presenting however conflicting results.
Method: Patients with Parkinson disease (PD), multisystem atrophy (MSA), progressive supranuclear palsy (PSP) and corticobasal syndrome followed in the movement disorders unit of a tertiary centre that have been submitted to lumbar puncture in the context of an investigation protocol were included. Amyloid ß1-42 (Aß1-42), amyloid ß1-40, tau e phosphorylated tau (p-tau), and respective relevant ratios, were analysed. Patients with CSF suggestive of Alzheimer disease were excluded. Diagnosis acuity was evaluated through ROC curves.
Results: Seventy-four patients were included (42 PD, 16 PSP, 10 CBS, 6 MSA). PD patients presented lower tau levels (179.1 [150.4;207.7]) and tau/Aß1-42 ratio (0.24 [0.20;0.27]) and higher p-tau/tau ratio (0.19 [0.18;0.21]) than PSP (tau 214.4 [175.1;253.6], p=0.022; tau/Aß1-42 0.31 [0.23;0.38], p=0.044; p-tau/tau 0.15 [0.14;0.17], p=0.002) and CBS (tau 361.8 [139.8;583.8], p=0.03; tau/Aß1-42 0.58 [0.32;0.83], p<0.001; p-tau/tau 0.12 [0.04;0.20], p=0.03) patients. CBS patients presented higher tau/Aß1-42 ratio than PSP (p=0.016) and MSA (0.24 [0.13;0.37], p=0.016) patients. P-tau/tau ratio presented the best acuity in the differential diagnosis between PD and PSP (area under curve (AUC)=0.773, p=0.022). Tau/Aß1-42 ratio presented the best acuity in the differential diagnosis between PD and CBS (AUC=0.876; p=<0.001), CBS and PSP (AUC=0.787; p=0.017), and CBS and MSA (AUC=0.867; p=0.017).
Conclusion: CSF biomarkers in current practice may potentially contribute to the differential diagnosis of degenerative parkinsonian syndromes, integrating distinction models together with other biomarkers.
To cite this abstract in AMA style:
C. Bernardes, JM. Alves, I. Cunha, D. Carneiro, J. Lemos, F. Moreira, MJ. Leitão, I. Baldeiras, I. Santana, A. Morgadinho. May CSF biomarkers have a role in degenerative parkinsonian syndromes workup? [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/may-csf-biomarkers-have-a-role-in-degenerative-parkinsonian-syndromes-workup/. Accessed June 30, 2025.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/may-csf-biomarkers-have-a-role-in-degenerative-parkinsonian-syndromes-workup/