Evidence map›Paper›PMID 25589779›Full record

Observational studyJournal of neurology, neurosurgery, and psychiatry2015

A panel of nine cerebrospinal fluid biomarkers may identify patients with atypical parkinsonian syndromes.

N K Magdalinou, R W Paterson, J M Schott, N C Fox, C Mummery, K Blennow, K Bhatia, H R Morris, P Giunti, T T Warner and 3 more

Open access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of neurology, neurosurgery, and psychiatry, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 137 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
137citing papers in PubMed, 10 pooled it
15.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

137 citing papers in PubMed, 10 syntheses or guidelines pooled it, 249 citations in OpenAlex.

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  10. Cerebrospinal fluid levels of neurofilament light chain in multiple system atrophy relative to Parkinson's disease: a meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2017
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  19. Fluid biomarkers in atypical Parkinsonism: current state and future perspectives.Journal of neural transmission (Vienna, Austria : 1996) · 2025
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77 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 2 countries.

N K MagdalinouReta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, UK.
R W PatersonDepartment of Neurodegeneration, Dementia Research Centre, UCL Institute of Neurology, London, UK.
J M SchottDepartment of Neurodegeneration, Dementia Research Centre, UCL Institute of Neurology, London, UK.
N C FoxDepartment of Neurodegeneration, Dementia Research Centre, UCL Institute of Neurology, London, UK.
C MummeryDepartment of Neurodegeneration, Dementia Research Centre, UCL Institute of Neurology, London, UK.
K BlennowClinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
K BhatiaSobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK.
H R MorrisDepartment of Clinical Neuroscience, UCL Institute of Neurology, Royal Free Hospital, London, UK.
P GiuntiDepartment of Molecular Neuroscience, UCL Institute of Neurology, London, UK.
T T WarnerReta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, UK.
R de SilvaReta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, UK.
A J LeesReta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, UK.
H ZetterbergSobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.
University College London · GBUK Dementia Research Institute · GBSobell House · GBUniversity of Gothenburg · SE

Funding

Medical Research Council G0700943Medical Research Council MC_G1000735Wellcome Trust 089698
6 · The paper itself

Abstract

backgroundPatients presenting with parkinsonian syndromes share many clinical features, which can make diagnosis difficult. This is important as atypical parkinsonian syndromes (APSs) such as progressive supranuclear palsy (PSP), multiple system atrophy (MSA) and corticobasal syndrome (CBS) carry a poor prognosis, compared with patients with Parkinson's disease (PD). In addition, there is overlap between APS and dementia diseases, such as Alzheimer's disease (AD) and frontotemporal dementia (FTD).

objectiveTo use a panel of cerebrospinal fluid (CSF) biomarkers to differentiate patients with APS from PD and dementia.

methodsA prospective cohort of 160 patients and 30 control participants were recruited from a single specialist centre. Patients were clinically diagnosed according to current consensus criteria. CSF samples were obtained from patients with clinical diagnoses of PD (n=31), PSP (n=33), CBS (n=14), MSA (n=31), AD (n=26) and FTD (n=16). Healthy, elderly participants (n=30) were included as controls. Total τ (t-τ), phosphorylated τ (p-τ), β-amyloid 1-42 (Aβ42), neurofilament light chain (NFL), α-synuclein (α-syn), amyloid precursor protein soluble metabolites α and β (soluble amyloid precursor protein (sAPP)α, sAPPβ) and two neuroinflammatory markers (monocyte chemoattractant protein-1 and YKL-40) were measured in CSF. A reverse stepwise regression analysis and the false discovery rate procedure were used.

resultsCSF NFL (p<0.001), sAPPα (p<0.001) and a-syn (p=0.003) independently predicted diagnosis of PD versus APS. Together, these nine biomarkers could differentiate patients with PD from APS with an area under the curve of 0.95 and subtypes of APS from one another. There was good discriminatory power between parkinsonian groups, dementia disorders and healthy controls.

conclusionsA panel of nine CSF biomarkers was able to differentiate APS from patients with PD and dementia. This may have important clinical utility in improving diagnostic accuracy, allowing better prognostication and earlier access to potential disease-modifying therapies.

Indexed as

AgedBiomarkersCohort StudiesDementiaDiagnosis, DifferentialFemaleHumansLongitudinal StudiesMaleMiddle AgedMultiple System AtrophyNerve Tissue ProteinsParkinson DiseaseParkinsonian DisordersProspective StudiesSupranuclear Palsy, ProgressiveBiomarkersNerve Tissue ProteinsCORTICOBASAL DEGENERATIONCSFPARKINSON'S DISEASEPOST MORTEMSUPRANUCLEAR PALSY

Identifiers

PMID25589779
PMCPMC4564944
OpenAlexW2155180180

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.