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68/100

✓ Peer-reviewed alzhub usefulness score 68 out of 100. Getting a diagnosis

Topic: Brain proteins, microglia and lab models

The clinical diagnosis of synucleinopathies, including Parkinson's disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA), is challenging, especially at an early disease stage, due to the heterogeneous and often non-specific clinical manifestations. The discovery of reliable specific markers for synucleinopathies would consequently be of great aid to the diagnosis and management of these disorders. Real-Time Quaking-Induced Conversion (RT-QuIC) is an ultrasensitive technique that has been previously used to detect self-templating amyloidogenic proteins in the cerebrospinal fluid (CSF) and other biospecimens in prion disease and synucleinopathies. Using a wild-type recombinant α-synuclein as a substrate, we applied RT-QuIC to a large cohort of 439 CSF samples from clinically well-characterized, or post-mortem verified patients with parkinsonism or dementia. Of significance, we also studied patients with isolated REM sleep behavior disorder (iRBD) (n = 18) and pure autonomic failure (PAF) (n = 28), representing clinical syndromes that are often caused by a synucleinopathy, and may precede the appearance of parkinsonism or cognitive decline. The results show that our RT-QuIC assay can accurately detect α-synuclein seeding activity across the spectrum of Lewy Body (LB)-related disorders (LBD), including DLB, PD, iRBD, and PAF, with an overall sensitivity of 95.3%. In contrast, all but two patients with MSA showed no α-synuclein seeding activity in the applied experimental setting. The analysis of the fluorescence response reflecting the amount of α-synuclein seeds revealed no significant differences between the clinical syndromes associated with LB pathology. Finally, the assay demonstrated 98% specificity in a neuropathological cohort of 101 cases lacking LB pathology. In conclusion, α-synuclein RT-QuIC provides an accurate marker of synucleinopathies linked to LB pathology and may have a pivotal role in the early discrimination and management of affected patients. The finding of no α-synuclein seeding activity in MSA seems to support the current view that MSA and LBD are associated with different conformational strains of α-synuclein.

Key findings

The results show that our RT-QuIC assay can accurately detect α-synuclein seeding activity across the spectrum of Lewy Body (LB)-related disorders (LBD), including DLB, PD, iRBD, and PAF, with an overall sensitivity of 95.3%.
The analysis of the fluorescence response reflecting the amount of α-synuclein seeds revealed no significant differences between the clinical syndromes associated with LB pathology.
Finally, the assay demonstrated 98% specificity in a neuropathological cohort of 101 cases lacking LB pathology.
In conclusion, α-synuclein RT-QuIC provides an accurate marker of synucleinopathies linked to LB pathology and may have a pivotal role in the early discrimination and management of affected patients.
The finding of no α-synuclein seeding activity in MSA seems to support the current view that MSA and LBD are associated with different conformational strains of α-synuclein.

Why it matters

In 439 spinal-fluid samples from people with parkinsonism or dementia, an RT-QuIC test detected misfolded α-synuclein in 95.3% of Lewy body disorders (dementia with Lewy bodies, Parkinson's disease, and the possible early-stage syndromes iRBD and pure autonomic failure). It was negative in 98% of 101 autopsy-confirmed cases without Lewy body pathology. Nearly all multiple system atrophy samples tested negative, so the test points to Lewy body disease specifically. It is not a test for Alzheimer's disease or a treatment.

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Study details

Participants18
Effect size95.3%
Evidence strengthModerate

How this study scored 68/100

Published in a leading specialty journal. Scored zero for study design and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (Acta neuropathologica)
Journal's citation record	3 / 4	Acta Neuropathologica: journal h-index 287 (OpenAlex, 2026-10-29)
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	2 / 5	2020 — within 10 year(s) of the newest study here
Sample size	1 / 4	18 participants
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	6 / 7	Cited 456 times (OpenAlex, 2026-10-10)
Citations per year	5 / 5	57.0 citations a year over 8 year(s) since 2020
Impact for its field and year	5 / 6	Cited 20.6× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	3 / 6	Cited by 25 other studies in this library
Still being cited	4 / 4	Cited 234 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	3 / 4	Last-listed author Piero Parchi: h-index 84 (OpenAlex, whole career)
Institution's track record	3 / 3	National Institutes of Health: institution h-index 2,723 (OpenAlex)
Multi-centre collaboration	2 / 3	OpenAlex lists 5 institution(s) in 2 countries
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 32342188)
Free to read	2 / 2	Free to read
Total	68 / 100	—

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Read the original

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

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APA 7th

Rossi, M., Candelise, N., Baiardi, S., Capellari, S., Giannini, G., Orrù, C. D., et al. (2020). Ultrasensitive RT-QuIC assay with high sensitivity and specificity for Lewy body-associated synucleinopathies. Acta neuropathologica. https://doi.org/10.1007/s00401-020-02160-8

Vancouver

Rossi M, Candelise N, Baiardi S, Capellari S, Giannini G, Orrù CD, et al. Ultrasensitive RT-QuIC assay with high sensitivity and specificity for Lewy body-associated synucleinopathies. Acta neuropathologica. 2020. doi:10.1007/s00401-020-02160-8. PMID: 32342188.

BibTeX

@article{rossi2020-32342188,
  author  = {Rossi, M. and Candelise, N. and Baiardi, S. and Capellari, S. and Giannini, G. and Orrù, C. D. and Antelmi, E. and Mammana, A. and others},
  title   = {{Ultrasensitive RT-QuIC assay with high sensitivity and specificity for Lewy body-associated synucleinopathies}},
  journal = {Acta neuropathologica},
  year    = {2020},
  doi     = {10.1007/s00401-020-02160-8},
  pmid    = {32342188},
  url     = {https://doi.org/10.1007/s00401-020-02160-8}
}

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