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Fluid markers of synapse degeneration in synucleinopathies

  • Neurology and Preclinical Neurological Studies - Review Article
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Abstract

The abnormal accumulation of α-synuclein in the brain is a common feature of Parkinson’s disease (PD), PD dementia (PDD), dementia with Lewy bodies (DLB) and multiple system atrophy (MSA), and synucleinopathies that present with overlapping but distinct clinical symptoms that include motor and cognitive deficits. Synapse degeneration is the crucial neuropathological event in these synucleinopathies and the neuropathological correlate of connectome dysfunction. The cognitive and motor deficits resulting from the connectome dysfunction are currently measured by scalar systems that are limited in their sensitivity and largely subjective. Ideally, a marker of synapse degeneration would correlate with measures of cognitive or motor impairment, and could therefore be used as a more objective, surrogate biomarker of the core clinical features of these diseases. Furthermore, an objective surrogate biomarker that can detect and monitor the progression of synapse degeneration would improve patient management and clinical trial design, and could provide a measure of therapeutic response. Here, we review the published findings relating to candidate biomarkers of synapse degeneration in PD, PDD, DLB, and MSA patient-derived biofluids and discuss the findings in the context of the mechanisms associated with α-synuclein-mediated synapse degeneration. Understanding these mechanisms is essential not only for discovery of biomarkers, but also to improve our understanding of the earliest changes in disease pathogenesis of synucleinopathies.

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Funding

This work was funded by the Fondos de Investigaciones Sanitarias (PI18/00327 to OB) from the “Fondo Europeo de Desarrollo Regional (FEDER)”, Unión Europea, “Una manera de hacer Europa” and the “Instituto de Salud Carlos III, Ministerio de Economia y Competitividad, Gobierno de España” (ISCIII) and also by the Agència de Gestió d'Ajuts Universitaris i de Recerca (AGAUR), Spain & Regional Development Funds, EU Knowledge Industry Valorisation Grants-AGAUR-PRODUCTE (2019 PROD 00088 to OB).

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Correspondence to Olivia Belbin.

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Dr Belbin is inventor of a patent application (EP18382175) pending approval entitled “Markers of synaptopathy in neurodegenerative disease”.

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Cervantes González, A., Belbin, O. Fluid markers of synapse degeneration in synucleinopathies. J Neural Transm 129, 187–206 (2022). https://doi.org/10.1007/s00702-022-02467-8

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  • DOI: https://doi.org/10.1007/s00702-022-02467-8

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