{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:32:26Z","timestamp":1792794746977,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2014,9,25]],"date-time":"2014-09-25T00:00:00Z","timestamp":1411603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Alpha\u2010synuclein plays a key role in the pathology of synucleinopathies including Parkinson's disease (PD) and multiple system atrophy (MSA). However, whether alpha\u2010synuclein level in cerebrospinal fluid (CSF) could distinguish synucleinopathies from progressive supranuclear palsy (PSP) is still a contentious issue. A comprehensive literature search yielded nine eligible studies. We expressed the between\u2010group difference of the concentration of alpha\u2010synuclein in CSF as the standardized mean difference. The proportion of variation attributable to heterogeneity was computed and expressed as I<jats:sup>2<\/jats:sup>. Nine studies involved 537 controls, 843 PD, 130 MSA, and 98 PSP patients. The overall effect of PD on alpha\u2010synuclein in CSF was significantly different from normal control or disease control (standardized mean difference = \u20130.67, <jats:italic>P<\/jats:italic> &lt; 0.00001). These studies were heterogeneous (I<jats:sup>2<\/jats:sup> = 40%). Alpha\u2010synuclein in CSF in MSA was significantly reduced relative to controls with heterogeneous studies (standardized mean difference = \u20130.75, <jats:italic>P<\/jats:italic> &lt; 0.0001; I<jats:sup>2<\/jats:sup> = 62%). In contrast, no significant difference of alpha\u2010synuclein in CSF was observed between PSP and controls with heterogeneous studies (standardized mean difference = \u20130.28, <jats:italic>P<\/jats:italic> = 0.13; I<jats:sup>2<\/jats:sup> = 53%). Alpha\u2010synuclein in CSF was significantly reduced in synucleinopathies compared with PSP (\u201cPD vs. PSP\u201d: standardized mean difference = \u20130.38, <jats:italic>P<\/jats:italic> = 0.001; \u201cMSA vs. PSP\u201d: standardized mean difference = \u20130.66, <jats:italic>P<\/jats:italic> &lt; 0.00001). The included studies were homogeneous (I<jats:sup>2<\/jats:sup> = 0%). Our study showed that alpha\u2010synuclein levels in CSF in synucleinopathies was significantly lower than in PSP. This finding provides insights into the pathophysiological difference between synucleinopathies and PSP as well as possibility of development of a tool for differential diagnosis between MSA and PSP using enzyme\u2010linked immunosorbent assay (ELISA) and similar methods. \u00a9 2014 International Parkinson and Movement Disorder Society<\/jats:p>","DOI":"10.1002\/mds.26036","type":"journal-article","created":{"date-parts":[[2014,9,25]],"date-time":"2014-09-25T11:12:14Z","timestamp":1411643534000},"page":"1599-1605","source":"Crossref","is-referenced-by-count":66,"title":["Reduced alpha\u2010synuclein in cerebrospinal fluid in synucleinopathies: Evidence from a meta\u2010analysis"],"prefix":"10.1002","volume":"29","author":[{"given":"Wataru","family":"Sako","sequence":"first","affiliation":[{"name":"Department of Clinical Neuroscience, Institute of Health Biosciences The University of Tokushima Graduate School Tokushima Japan"},{"name":"Center for Neurosciences The Feinstein Institute for Medical Research Manhasset New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagahisa","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Institute of Health Biosciences The University of Tokushima Graduate School Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuishin","family":"Izumi","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Institute of Health Biosciences The University of Tokushima Graduate School Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuji","family":"Kaji","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Institute of Health Biosciences The University of Tokushima Graduate School Tokushima 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