{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:18:35Z","timestamp":1790360315107,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alz &amp; Dem Diag Ass &amp; Dis Mo"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>INTRODUCTION<\/jats:title><jats:p>Seed amplification assays (SAAs) demonstrate remarkable diagnostic performance in alpha\u2010synucleinopathies. However, existing protocols lack accessibility in routine laboratories, mainly due to the requirement for in\u2010house production of recombinant alpha\u2010synuclein (aSyn). This study proposes a cerebrospinal fluid (CSF) aSyn\u2010SAA protocol using solely commercial reagents to facilitate its clinical implementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Routine clinical care CSF samples from 126 patients, comprising 47 with Lewy body diseases (LBD) (41 with dementia with Lewy bodies, six with Parkinson's disease), 37 without alpha\u2010synucleinopathy, and 42 with Alzheimer's disease (AD), underwent assessment for aSyn\u2010SAA activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>CSF aSyn\u2010SAA showed a sensitivity of 72.3% and a specificity of 100% when distinguishing clinically diagnosed LBD patients from those without alpha\u2010synucleinopathy. In AD patients, 14.3% were tested positive for aSyn.<\/jats:p><\/jats:sec><jats:sec><jats:title>DISCUSSION<\/jats:title><jats:p>The commercial\u2010only CSF aSyn\u2010SAA protocol exhibited excellent specificity when applied to a real\u2010life cohort, signaling progress toward the accessibility of an aSyn biomarker in clinical settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Diagnosis of LBD through aSyn\u2010SAA lacks accessibility.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>This commercial\u2010only aSyn\u2010SAA has satisfactory performance in a real\u2010life cohort.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>A negative aSyn\u2010SAA does not completely exclude a synucleinopathy.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Some technical points must be considered when developing aSyn\u2010SAA.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>aSyn\u2010SAA must be confined to expert laboratories due to prion\u2010like risk management.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/dad2.70066","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T07:28:52Z","timestamp":1737012532000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Toward alpha\u2010synuclein seed amplification assay in clinical practice"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2619-3907","authenticated-orcid":false,"given":"Mathieu","family":"Verdurand","sequence":"first","affiliation":[{"name":"Biochemistry and Molecular Biology Department Neurodegenerative Pathologies LBMMS Hospices Civils de Lyon Lyon France"},{"name":"Lyon Memory Resources and Research Center Hospices Civils de Lyon Lyon France"},{"name":"BIORAN Team Lyon Neurosciences Research Center CNRS UMR 5292 INSERM U1028 Lyon 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