A longitudinal study of total and phosphorylated α-synuclein with other biomarkers in cerebrospinal fluid of Alzheimer's disease and mild cognitive impairment

Hua Wang, Tessandra Stewart, Jon B. Toledo, Carmen Ginghina, Lu Tang, Anzari Atik, Patrick Aro, Leslie M. Shaw, John Q. Trojanowski, Douglas R. Galasko, Steven Edland, Poul H. Jensen, Min Shi, Jing Zhang

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Alzheimer's disease (AD) features a dynamic sequence of amyloid deposition, neurodegeneration, and cognitive impairment. A significant fraction of AD brains also displays Lewy body pathology, suggesting that addition of classically Parkinson's disease-related proteins to the AD biomarker panel may be of value. To determine whether addition of cerebrospinal fluid (CSF) total α-synuclein and its form phosphorylated at S129 (pS129) to the AD biomarker panel [Amyloid-β1-42 (Aβ42), tau, and phosphorylated tau (p-tau181)] improves its performance, we examined CSF samples collected longitudinally up to 7 years as part of the Alzheimer's Disease Neuroimaging Initiative. From 87 AD, 177 mild cognitive impairment (MCI), and 104 age-matched healthy controls, 792 baseline and longitudinal CSF samples were tested for total α-synuclein, pS129, Aβ42, tau, and p-tau181. pS129, but not total α-synuclein, was weakly associated with diagnosis at baseline when t-tau/Aβ42 was included in the statistical model (β = 0.0026, p = 0.041, 95% CI [(0.0001)-(0.005)]). CSF α-synuclein predicted Alzheimer's Disease Assessment Scale-Cognitive (β = -0.59, p = 0.0015, 95% CI [(-0.96)-(-0.23)]), memory (β = 0.4, p = 0.00025, 95% CI [(0.16)-(0.59)]), and executive (0.62,<0.0001, 95% CI [(0.31)-(0.93)]) function composite scores, and progression from MCI to AD (β = 0.019, p = 0.0011, 95% CI [(0.002)-(0.20)]). pS129 was associated with executive function (β = -2.55, p = 0.0085, 95% CI [(-4.45)-(-0.66)]). Lower values in the mismatch between α-synuclein and p-tau181 predicted faster cognitive decline (β = 0.64, p = 0.0012, 95% CI [(0.48)-(0.84)]). Longitudinal biomarker changes did not differ between groups, and may not reflect AD progression. The α-synuclein-p-tau181-Mismatch could better predict longitudinal cognitive changes than classical AD markers alone, and its pathological correlates should be investigated further.

Original languageEnglish (US)
Pages (from-to)1541-1553
Number of pages13
JournalJournal of Alzheimer's Disease
Volume61
Issue number4
DOIs
StatePublished - 2018

Keywords

  • Alzheimer's disease
  • Biomarkers
  • Cerebrospinal fluid
  • Mild cognitive impairment
  • PS129-α-synuclein
  • α-synuclein

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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