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CSF Biomarkers for Early Diagnosis of Synucleinopathies: Focus on Idiopathic RBD

  • Sleep (M Thorpy and M Billiard, Section Editors)
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Abstract

Purpose of Review

Idiopathic REM sleep behavior disorder (iRBD) is one of the most significant prodromal manifestations of synucleinopathies. Different predictive biomarkers for iRBD conversion have been investigated, but scarce data are present in literature about the predictive role of cerebrospinal fluid (CSF) biomarkers. In this review, we focus on CSF biomarkers in patients with both iRBD and RBD associated with synucleinopathies to explore their potential predictive power.

Recent Findings

Recent studies revealed that CSF α-synuclein levels are higher in Parkinson’s disease (PD) patients with RBD compared to those without RBD, even if α-synuclein does not seem to predict conversion of iRBD into PD. In the Parkinson Progression Marker Initiative (PPMI) cohort, early PD patients with RBD show lower CSF Aβ42 levels, which predict faster cognitive decline. CSF prion protein and inflammatory biomarkers have been also investigated in RBD and synucleinopathies with controversial results.

Summary

A variety of CSF biomarkers are promising candidate for predicting iRBD conversion into synucleinopathies. Further studies are needed in iRBD patients followed for several years in order to observe the phenoconversion in synucleinopathies and to elucidate the possible role of CSF biomarkers as predictive biomarkers of conversion.

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Author notes

  1. Claudio Liguori and Federico Paolini Paoletti contributed equally to this work.

Authors and Affiliations

  1. Sleep Medicine Centre, Department of Systems Medicine, University of Rome ‘Tor Vergata’, Viale Oxford, 81 00133, Rome, Italy

    Claudio Liguori, Fabio Placidi & Roberta Ruffini

  2. Section of Neurology, Department of Medicine, University of Perugia, Perugia, Italy

    Federico Paolini Paoletti, Paolo Eusebi & Lucilla Parnetti

  3. IRCCS Fondazione Santa Lucia, Rome, Italy

    Giulia Maria Sancesario & Nicola Biagio Mercuri

  4. Neurology Unit, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy

    Nicola Biagio Mercuri

Authors
  1. Claudio Liguori
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  2. Federico Paolini Paoletti
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  3. Fabio Placidi
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  4. Roberta Ruffini
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  8. Lucilla Parnetti
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Correspondence to Claudio Liguori.

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Conflict of Interest

Paolo Eusepi, Claudio Liguori, Nicola Biagio Mercuri, Federico Paolini Paoletti, Lucilla Parnetti, Fabio Placidi, Roberta Ruffini and Giulia Maria Sancesario each declare no potential conflicts of interest.

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Liguori, C., Paoletti, F.P., Placidi, F. et al. CSF Biomarkers for Early Diagnosis of Synucleinopathies: Focus on Idiopathic RBD. Curr Neurol Neurosci Rep 19, 3 (2019). https://doi.org/10.1007/s11910-019-0918-y

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