Cerebrospinal fluid alpha-synuclein as a biomarker for Parkinson's disease diagnosis: a systematic review and meta-analysis

To date, there are no definitive biomarkers for Parkinson's disease (PD) diagnosis. The detection of cerebrospinal fluid (CSF) alpha (α)-synuclein in PD patients has yielded promising but inconclusive results. To determine the performance of CSF α-synuclein as a diagnostic biomarker of PD and w...

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Published in:International journal of neuroscience 2015-09, Vol.125 (9), p.645-654
Main Authors: Gao, Liang, Tang, Hongmei, Nie, Kun, Wang, Limin, Zhao, Jiehao, Gan, Rong, Huang, Jing, Zhu, Ruiming, Feng, Shujun, Duan, Zhenpeng, Zhang, Yuhu, Wang, Lijuan
Format: Article
Language:English
Subjects:
alpha-Synuclein - cerebrospinal fluid
biomarker
Biomarkers - cerebrospinal fluid
cerebrospinal fluid
Humans
meta-analysis
Parkinson Disease - cerebrospinal fluid
Parkinson's disease
α-synuclein
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Summary:To date, there are no definitive biomarkers for Parkinson's disease (PD) diagnosis. The detection of cerebrospinal fluid (CSF) alpha (α)-synuclein in PD patients has yielded promising but inconclusive results. To determine the performance of CSF α-synuclein as a diagnostic biomarker of PD and whether CSF α-synuclein can discriminate PD from other neurodegenerative diseases, a systematic search of all relevant studies investigating reproducible CSF α-synuclein quantification methods was conducted in electronic databases. A total of 17 studies that included 3311 patients were included in this systemic review and meta-analysis. The mean CSF α-synuclein concentration was significantly lower in PD patients compared to normal/neurological controls [weighted mean difference (WMD) −0.31; 95% CI, −0.45, −0.16; p < 0.0001] and patients with Alzheimer's disease (AD) [WMD −0.15; 95% CI, −0.26, −0.04; p < 0.0001]. There was no significant difference between PD patients and dementia with Lewy bodies (DLB) patients [WMD −0.03; 95% CI, −0.16, 0.09; p = 0.58] or patients with multiple system atrophy (MSA) [WMD 0.05; 95% CI, −0.04, 0.13; p = 0.25]. Sensitivity and specificity of CSF α-synuclein in the diagnosis of PD was 0.88 (95% CI, 0.84-0.91) and 0.40 (95% CI, 0.35-0.45), respectively. The positive and negative likelihood ratios of CSF α-synuclein in the diagnosis of PD were 1.41 (95% CI, 1.24-1.60), and 0.29 (95% CI, 0.15-0.56), respectively. The corresponding summary receiver operating characteristic (SROC) curve showed an area under the curve (AUC) of 0.73. The concentration of CSF α-synuclein may be a biomarker for the diagnosis of PD. The use of α-synuclein alone however is not sufficient as a single biomarker and it must therefore be used in conjunction with other documented and reliable biomarkers.
ISSN:0020-7454
1563-5279
1543-5245
DOI:10.3109/00207454.2014.961454