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Proximity extension assay testing reveals novel diagnostic biomarkers of atypical parkinsonian syndromes.

Published version
Peer-reviewed

Type

Article

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Authors

Woodside, John 
Guo, Tong 
Magdalinou, Nadia K 
Chelban, Viorica 

Abstract

OBJECTIVE: The high degree of clinical overlap between atypical parkinsonian syndromes (APS) and Parkinson's disease (PD) makes diagnosis challenging. We aimed to identify novel diagnostic protein biomarkers of APS using multiplex proximity extension assay (PEA) testing. METHODS: Cerebrospinal fluid (CSF) samples from two independent cohorts, each consisting of APS and PD cases, and controls, were analysed for neurofilament light chain (NF-L) and Olink Neurology and Inflammation PEA biomarker panels. Whole-cohort comparisons of biomarker concentrations were made between APS (n=114), PD (n=37) and control (n=34) groups using logistic regression analyses that included gender, age and disease duration as covariates. RESULTS: APS versus controls analyses revealed 11 CSF markers with significantly different levels in cases and controls (p<0.002). Four of these markers also reached significance (p<0.05) in APS versus PD analyses. Disease-specific analyses revealed lower group levels of FGF-5, FGF-19 and SPOCK1 in multiple system atrophy compared with progressive supranuclear palsy and corticobasal syndrome. Receiver operating characteristic curve analyses suggested that the diagnostic accuracy of NF-L was superior to the significant PEA biomarkers in distinguishing APS, PD and controls. The biological processes regulated by the significant proteins include cell differentiation and immune cell migration. Delta and notch-like epidermal growth factor-related receptor (DNER) had the strongest effect size in APS versus controls and APS versus PD analyses. DNER is highly expressed in substantia nigra and is an activator of the NOTCH1 pathway which has been implicated in the aetiology of other neurodegenerative disorders including Alzheimer's disease. CONCLUSIONS: PEA testing has identified potential novel diagnostic biomarkers of APS.

Description

Keywords

cerebrospinal fluid, corticobasal degeneration, diagnostic test assessment, multiple system atrophy, progressive supranuclear palsy, Age Factors, Aged, Biomarkers, Case-Control Studies, Female, Humans, Immunoassay, Male, Middle Aged, Parkinson Disease, Parkinsonian Disorders, Sex Factors

Journal Title

J Neurol Neurosurg Psychiatry

Conference Name

Journal ISSN

0022-3050
1468-330X

Volume Title

90

Publisher

BMJ
Sponsorship
Wellcome Trust (103838/Z/14/Z)