{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:01:23Z","timestamp":1791907283066,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The pathophysiology of idiopathic normal pressure hydrocephalus (iNPH) and its association with neurodegenerative disorders is poorly understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim was to determine the prevalence of \u03b1\u2010synuclein pathology in iNPH and its associations with clinical characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used \u03b1\u2010synuclein seed amplification assay (synSAA) to retrospectively analyze cerebrospinal fluid (CSF) from a large single\u2010center iNPH cohort (n\u2009=\u2009144). Clinical assessments comprised Unified Parkinson's Disease Rating Scale part III, Mini\u2010Mental State Examination, levodopa\u2010challenge test, and olfactory identification test. Degenerative biomarkers (total\u2010tau, phospho\u2010tau, \u03b2\u2010amyloid 1\u201342, and \u03b2\u2010amyloid 1\u201340) were measured in CSF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 30.1% of iNPH patients were synSAA+, and presented significantly more upper limb (UL) rigidity, hallucinations, and worse olfactory performance than synSAA\u2212 cases. Anosmia was higher in synSAA+ patients (64.0%) than synSAA\u2212 patients (15.3%). Clinical assessments and other biomarkers did not significantly vary with synSAA status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Underlying \u03b1\u2010synuclein pathology is common in iNPH and presents with UL rigidity and olfactory dysfunction, suggesting a distinct synSAA+ phenotype in iNPH. \u00a9 2025 The Author(s). <jats:italic>Movement Disorders<\/jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.30184","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T04:24:06Z","timestamp":1744172646000},"page":"1206-1213","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Anosmia and Upper Limb Rigidity\u2014A Potential Phenotype of Idiopathic Normal Pressure Hydrocephalus with <scp>Cerebrospinal Fluid<\/scp> \u03b1\u2010Synuclein Seeds"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5713-2141","authenticated-orcid":false,"given":"Sandrina","family":"Weber","sequence":"first","affiliation":[{"name":"Department of Neurology University Medical Center Goettingen  Goettingen Germany"},{"name":"Paracelsus\u2010Elena\u2010Klinik  Kassel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly M.","family":"Farris","sequence":"additional","affiliation":[{"name":"R&amp;D Unit Amprion  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihua","family":"Ma","sequence":"additional","affiliation":[{"name":"R&amp;D Unit Amprion  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Dakna","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Goettingen  Goettingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maritta","family":"Starke","sequence":"additional","affiliation":[{"name":"Paracelsus\u2010Elena\u2010Klinik  Kassel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6316-6804","authenticated-orcid":false,"given":"Sebastian","family":"Schade","sequence":"additional","affiliation":[{"name":"Paracelsus\u2010Elena\u2010Klinik  Kassel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7752-2443","authenticated-orcid":false,"given":"Michael","family":"Bartl","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Goettingen  Goettingen Germany"},{"name":"Institute for Neuroimmunology and Multiple Sclerosis Research, University Medical Center Goettingen  Goettingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Trenkwalder","sequence":"additional","affiliation":[{"name":"Paracelsus\u2010Elena\u2010Klinik  Kassel Germany"},{"name":"Department of Neurosurgery University Medical Center Goettingen  Goettingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9454-8389","authenticated-orcid":false,"given":"Luis","family":"Concha\u2010Marambio","sequence":"additional","affiliation":[{"name":"R&amp;D Unit Amprion  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8437-3645","authenticated-orcid":false,"given":"Brit","family":"Mollenhauer","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Goettingen  Goettingen Germany"},{"name":"Paracelsus\u2010Elena\u2010Klinik  Kassel 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