CSF Biomarkers in Parkinsonian Conditions: An Update
We think that several hypothesis-driven biomarkers are going to be investigated at the same time using multiplex platforms. The proteomics field is likely to expand and gain in analytical sensitivity, resulting in the identification of more candidate markers, some of which may be unexpected and give new clues on disease mechanisms. There needs to be large, prospective and longitudinal cohorts with serial CSF examinations and pathological confirmation in as many patients as possible. A very important issue to be resolved is the standardisation of protocols and improvement in quality controls in CSF analysis. Finally, like in AD, it will likely be important to combine several CSF markers with other modalities, like imaging.
Accurate diagnosis of parkinsonian conditions should occur as early as possible, before too much irreversible neuronal damage has accumulated. This is essential, especially with the emergence of potential disease-modifying drugs, which must be used to target the correct underlying pathology. There is promising progress in the development of an α-Syn imaging agent, using radio ligands that bind to α-Syn fibrils. This should enable the assessment of the distribution of brain α-Syn during life.
Future Developments for the CSF Field in Parkinsonism
We think that several hypothesis-driven biomarkers are going to be investigated at the same time using multiplex platforms. The proteomics field is likely to expand and gain in analytical sensitivity, resulting in the identification of more candidate markers, some of which may be unexpected and give new clues on disease mechanisms. There needs to be large, prospective and longitudinal cohorts with serial CSF examinations and pathological confirmation in as many patients as possible. A very important issue to be resolved is the standardisation of protocols and improvement in quality controls in CSF analysis. Finally, like in AD, it will likely be important to combine several CSF markers with other modalities, like imaging.
Accurate diagnosis of parkinsonian conditions should occur as early as possible, before too much irreversible neuronal damage has accumulated. This is essential, especially with the emergence of potential disease-modifying drugs, which must be used to target the correct underlying pathology. There is promising progress in the development of an α-Syn imaging agent, using radio ligands that bind to α-Syn fibrils. This should enable the assessment of the distribution of brain α-Syn during life.
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