Parkinson's Disease vs Alzheimer's Disease: α-synuclein (CSF)


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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 Parkinson’s disease is below control levels (Eusebi et al., 2017; Gao et al., 2015; Sako et al., 2014; Zhou et al., 2015). In contrast, CSF α-synuclein is slightly elevated in people with Alzheimer’s disease compared with control subjects. Consistent with these findings, meta-analysis of 13 eligiible studies showed lower levels of α-synuclein in the CSF of Parkinson's patients than Alzheimer's patients (effect size = 0.758, p <0.0001).

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How to interpret a forest plot: Each individual effect size (ES) is a ratio of the mean biomarker level in one condition over the mean level in another condition. An ES equal to 1 means that the two conditions had identical mean values. An ES > 1 indicates higher levels in the first condition, whereas an ES < 1 indicates lower levels in the first condition. The overall ES, indicated by a black diamond, is a weighted average of the individual effect sizes. The weight of each data point was determined by the inverse of the variance and is reflected in the size of each square. The width of the overall ES diamond is determined by the 95 percent confidence interval. Data out of range of the scale, including ES and confidence intervals, are indicated by an arrowhead at the edge of the plot, when applicable. 

Version 3.0, July 2021.