ArticleNPJ Parkinson's disease2023
Head-to-head comparison of 6 plasma biomarkers in early multiple system atrophy.
Article in NPJ Parkinson's disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Cerebrospinal fluid and blood neurofilament light chain in Parkinson's disease and atypical parkinsonian syndromes: a systematic review and Bayesian network meta-analysis.Journal of neurology · 2025Pooled it
- Plasma neurofilament light for early differentiation of multiple system atrophy from Parkinson disease.EBioMedicine · 2026Article
- Multiple system atrophy: cure and care.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- Plasma Neurofilament Light Chain as a Biomarker for Motor Progression and Disease Milestones in Multiple System Atrophy: An Updated Prospective Cohort Study.Movement disorders : official journal of the Movement Disorder Society · 2026Article
- Neurofilament light chain as a diagnostic and prognostic biomarker in atypical parkinsonisms: current evidence, new data, challenges, and future directions.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- Combining plasma biomarkers, clinical parameters, and neuroimaging features for differential diagnosis of Parkinson's disease and atypical parkinsonian syndromes: a multidimensional modeling approach.Frontiers in aging neuroscience · 2026Article
- Disease Progression in Multiple System Atrophy: The ASPIRE Multi-Modal Biomarker Study.Annals of neurology · 2026Article
- The role of neurofilament light chain and other fluid biomarkers in cerebellar ataxias.Brain communications · 2026Review
- Multiple system atrophy: advances in pathogenesis and emerging therapeutic strategies.Journal of neurology · 2025Review
- Plasma neurofilament light chain as a predictor of multiple system atrophy in idiopathic REM sleep behavior disorder.Journal of neurology · 2025Article
- Autonomic dysfunction in multiple system atrophy: from pathophysiology to clinical manifestations.Annals of medicine · 2025Review
- Predictive clinical factors for the progression from idiopathic late-onset cerebellar ataxia to multiple system atrophy cerebellar type.Journal of neurology · 2025Article
- Neurofilament Light Chain in Cerebrospinal Fluid and Blood in Multiple System Atrophy: A Systematic Review and Meta-Analysis.Brain sciences · 2025Review
- Article
- The potential of phosphorylated α-synuclein as a biomarker for the diagnosis and monitoring of multiple system atrophy.CNS neuroscience & therapeutics · 2024Review
- Comparative methods for quantifying plasma biomarkers in Alzheimer's disease: Implications for the next frontier in cerebral amyloid angiopathy diagnostics.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Review
- Associations of Alzheimer's-related plasma biomarkers with cognitive decline in Parkinson's disease.Journal of neurology · 2023Article
- Enzymatic properties and clinical associations of serum alpha-galactosidase A in Parkinson's disease.Annals of clinical and translational neurology · 2023Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
There is a dire need for reliable biomarkers to solidify an early and accurate diagnosis of multiple system atrophy (MSA). We sought to compare the ability of emerging plasma markers in distinguishing MSA from its mimics and healthy controls in early disease stages, and to evaluate their performance in detecting disease severity and brain atrophy. Plasma neurofilament light (NfL), glial fibrillary acidic protein (GFAP), phosphorylated tau181, amyloid-β (Aβ)42, and Aβ40 were measured using ultrasensitive Simoa in early-stage patients with MSA (n = 73), spinocerebellar ataxia (SCA, n = 29), Parkinson's disease (PD, n = 28), and healthy controls (n = 100). We observed that elevated NfL outperformed other biomarkers in distinguishing MSA and its subtypes (AUC = 0.9) versus controls. Intriguingly, when separating MSA from its mimics, increased GFAP (AUC = 0.717) in MSA-C and decreased Aβ40 (AUC = 0.807) in MSA-P best discriminated from SCA and PD respectively. Plasma levels were comparable between MSA-C and MSA-P and the differentiation by plasma index alone was poor. Combining plasma markers noticeably improved the discriminatory efficacy. Of note, among MSA patients, higher GFAP and NfL were correlated with the atrophy of brain regions vulnerable to MSA (e.g., cerebellum, pons, or putamen). They could also aggravate the severity of MSA, and this association was partially mediated by cerebral volumes. In contrast, no obvious associations of phosphorylated tau and Aβ with disease severity were observed. Collectively, plasma biomarkers, especially in combination, are useful to facilitate the discriminatory work-up of MSA at early stages. Moreover, NfL and GFAP may be promising biomarkers to monitor the disease severity of MSA.
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Registered trials
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.