EAN 2025 | Fluid biomarkers in atypical Parkinsonism: current state and future perspectives
Anastasia Bougea, PhD, National and Kapodistrian University of Athens, Athens, Greece, discusses the use of fluid biomarkers to diagnose atypical Parkinsonian syndromes. Dr Bougea notes that while alpha-synuclein antibodies may not be effective as diagnostic biomarkers, other spinal fluid biomarkers may provide valuable diagnostic and prognostic information. This interview took place at the 11th Congress of the European Academy of Neurology (EAN 2025) in Helsinki, Finland.
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Transcript
This paper, this review, it’s a work, I have to say, first of a beautiful group with my colleagues from the European Neurology Academy. And we are all together participating in the Movement Disorder Panel of the European Academy of Neurology. And we want to have this review because it’s the first one that summarizes and updates all the evidence based on this subject...
This paper, this review, it’s a work, I have to say, first of a beautiful group with my colleagues from the European Neurology Academy. And we are all together participating in the Movement Disorder Panel of the European Academy of Neurology. And we want to have this review because it’s the first one that summarizes and updates all the evidence based on this subject. Diagnosing atypical Parkinsonian syndrome may be challenging due to overlapping of the features of Parkinson’s disease and the lack of a pathognomonic diagnostic test makes it difficult. So fluid biomarkers can be useful tools to make it easier to identify and track different Parkinsonian atypical syndromes, like multiple system atrophy and progressive supranuclear palsy or corticobasal syndrome. So therefore, with this review, we are able to update the current state of fluid biomarker research and their potential implications in clinical practice. However, the results show that the lack of high affinity of alpha-synuclein antibodies [inaudible] may contribute to alpha-synuclein low efficacy as diagnostic biomarkers for atypical Parkinsonian syndromes. There are spinal fluid biomarkers reflecting Alzheimer pathology or axonal damage like neurofilament light chains and may add valuable diagnostic and prognostic information in the neurochemical characterization of these syndromes. However, we need more prospective and well-regarded methodological design studies on this subject. Inflammatory and microRNA markers need to be further validated before their clinical use for atypical Parkinsonian syndrome. Seeding amplification assays, despite their high sensitivity and specificity, are at this point used only for research tools and they are not reflective of the disease severity. Biomarkers’ research for early identification and prognosis of typical Parkinsonian syndromes require multicenter collaboration, rigorous validation of the guidelines, and the artificial intelligent tools are going to help us for the accurate differential diagnosis between these syndromes.
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