Use of CSF alpha-synuclein in the differential diagnosis between Alzheimer's disease and other neurodegenerative disorders

作者：Wang, Zheng Yu; Han, Zhen Min; Liu, Qi Fei; Tang, Wei; Ye, Kui; Yao, Yu You^*

来源：International Psychogeriatrics, 2015, 27(9): 1429-1438.

DOI：10.1017/S1041610215000447

• Alzheimer's disease
• dementia with Lewy bodies
• Parkinson disease
• multiple system atrophy
• alpha-synuclein
• meta-analysis

Background: The etiology and pathogenesis of neurodegenerative disorders has yet to be elucidated, so their differential diagnosis is a challenge. This is especially true in differentiating Alzheimer's disease (AD), dementia with Lewy bodies (DLB), Parkinson disease (PD), and multiple system atrophy (MSA).
Methods: A total of 11 eligible articles were identified by search of electronic databases including PubMed, Springer Link, Elsevier, and the Cochrane Library, up to June 2014. In meta-analyses, standardized mean differences (SMD), with 95% confidence intervals (CI), comparing cerebrospinal fluid (CSF) measures of alpha-synuclein between the above conditions were calculated using random-effects models.
Results: CSF alpha-synuclein concentrations were significantly higher in AD compared to DLB [SMD: 0.32, 95% CI: (0.02, 0.62), z = 2.07, P = 0.038]; PD [SMD: 0.87, 95% CI: (0.15, 1.58), z = 2.38, P = 0.017]; or MSA [SMD: 1.14, 95% CI: (0.15, 2.14), z = 2.25, P = 0.025]. However, no significant difference was found between patients with AD and neurological cognitively normal controls [SMD: 0.02, 95% CI: (-0.21, 0.24), z = 0.13, P = 0.894].
Conclusions: Results of these meta-analysis suggest that quantification of CSF alpha-synuclein could help distinguish AD from other neurodegenerative disorders such as DLB, PD, or MSA.

• 出版日期2015-9
• 单位安徽医科大学