Multiple System Atrophy vs Alzheimer's Disease: α-synuclein (CSF)
Alpha-synuclein is a pre-synaptic protein that accumulates in Lewy bodies and Lewy neurites. The literature suggests that the concentration of α-synuclein in the cerebrospinal fluid of individuals with multiple system atrophy is below control levels (Cong et al., 2020; Sako et al., 2014; Yang et al., 2018). By contrast, CSF α-synuclein is marginally elevated in people with Alzheimer’s disease compared with control subjects. Meta-analysis of five eligiible studies showed that levels of α-synuclein in the CSF of people with MSA are only about 60 percent those of people with AD (effect size = 0.594, p <0.0001).