In Vivo Detection of Underlying Synucleinopathies: Are We There Yet?

Synucleinopathies (SOPs) affect >2 million people in the United States and include clinical syndromes of Parkinson disease (PD), multiple system atrophy (MSA), dementia with Lewy bodies (DLB), and pure autonomic failure (PAF), all characterized by deposition of α-synuclein aggregations within the CNS and peripheral nervous system.1 To date, diagnosis is made clinically and confirmed only at autopsy. In addition, even among experts, there is only modest diagnostic accuracy early in these diseases, particularly in atypical and complex cases.2 For example, in patients clinically diagnosed with MSA, only 60% at autopsy were confirmed to have MSA, and 18% were found to have the nonsynucleinopathy progressive supranuclear palsy (PSP).3

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