A new seed amplification assay to diagnose multiple system atrophy

Compared with Parkinson's disease, multiple system atrophy is more aggressive, rapidly progressing, and fatal neurodegenerative condition driven by both glial and neuronal pathology.1 Differentiating between Parkinson's disease and multiple system atrophy is critical for prognosis, treatment response, and survival outcomes.2 However, owing to the overlapping early clinical presentations of α-synucleinopathies, achieving an accurate diagnosis early in the disease course remains highly challenging. [...]multiple system atrophy is often misdiagnosed.3 The potential of α-synuclein seed amplification assays (SAAs) to reliably diagnose α-synucleinopathies early in their pathogenesis is, therefore, of considerable interest. The study included data from pathology-confirmed cases, cohorts with longitudinal follow-up, and real-life cohorts from multiple centres, showing diagnostic accuracy of the SAA for clinical and pathological progression.