ArticleNPJ Parkinson's disease2026
Synucleinopathy-like clinical features and biologically defined synuclein seeding in PSP-Parkinsonism: an imperfect match.
Article in NPJ Parkinson's disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Whether synucleinopathy-like (syn-like) symptoms match biologically defined synuclein seeding in PSP-parkinsonism (PSP-P) vs. Parkinson's disease (PD) remains unexplored. We studied 80 subjects: 20 PSP-P, 20 PSP-Richardson-syndrome(PSP-RS), 20 PD, and 20 controls(CS). Procedures included specific smell-testing, structured interview by a sleep specialist, orthostatic-stress test, specific dysautonomia scale, CSF-α-synuclein seed-amplification-assay (asyn-SAA) and neurofilament-levels (NfL). Frequency of syn-like symptoms was low in CS and PSP-RS, intermediate in PSP-P, and high in PD. Premotor probable-RBD and orthostatic hypotension favoured PD, whereas probable-RBD after motor onset and higher pupillomotor dysautonomia scale scores predominated in PSP groups. NfL peaked in PSP-RS, not differing among PSP-P, PD and CS. asyn-SAA was 100% positive in PD, 100% negative in CS and PSP-RS, and positive in 24% PSP-P. Not all clinically syn-like PSP-P cases were asyn-SAA positive, and vice versa. In summary, while partly overlapping with PD (including mild neurodegeneration as per NfL), syn-like symptoms do not always match biologically defined synuclein seeding in PSP-P.
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