α-Synuclein Seed Amplifications Assay in a Cohort With Cognitive Impairment

作者：Diana Esteller, Agnès Pérez‐Millan, Jordi Sarto, Roger Puey, N. Guillén Soley, Adrià Tort‐Merino, Neus Falgàs, Sergi Borrego‐Écija, Gerard Piñol‐Ripoll, Miquel Massons, G. Esteban Fernández, Raquel Ruiz‐García, Laura Naranjo, Josep Maria Augé Fradera, Anna Antonell, Raquel Sánchez‐Valle, Albert Lladó, Mircea Balasa · 发表于：Neurology · 年份：2025 · DOI：10.1212/wnl.0000000000214040 · 被引用次数：7 · 研究领域：Parkinson's Disease Mechanisms and Treatments、Dementia and Cognitive Impairment Research、Alzheimer's disease research and treatments

BACKGROUND AND OBJECTIVES: α-Synuclein seed amplification assays (αSAAs) can improve the diagnosis of synucleinopathies and detect α-synuclein (αSyn) copathology in vivo in clinical practice. We aimed to evaluate the diagnostic performance of αSAA for detecting αSyn in CSF for diagnosing dementia with Lewy bodies (DLB) in a clinical cohort of cognitively impaired individuals. We explored how the coexistence of Alzheimer disease (AD) and αSyn pathology influences biomarker levels and clinical profiles. This study contributes to the understanding of αSAA diagnostic performance for DLB and for detecting αSyn copathology in AD in a real-world memory clinic cohort, using both clinical and biomarker-based classifications. METHODS: This was a retrospective, single-center, cross-sectional observational cohort study of cognitively impaired individuals who attended a tertiary memory clinic in Spain between 2009 and 2024. Participants had neurodegenerative and non-neurodegenerative cognitive decline. αSAA was performed on CSF samples collected at first evaluation. The diagnostic performance of the assay for DLB and associations between AD/αSyn copathology, clinical features, and fluid biomarkers (phosphorylated-tau217 [p-tau217], glial fibrillary acidic protein, neurofilament light chain [NfL]) were analyzed in AD and DLB participants. Diagnostic performance of the test was assessed using standard contingency tables and interactions between biomarkers and clinical features with age, sex...