{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"bioRxiv"}],"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T03:59:14Z","timestamp":1781323154933,"version":"3.54.1"},"posted":{"date-parts":[[2024,5,8]]},"group-title":"Neuroscience","reference-count":66,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2024,5,8]]},"abstract":"<jats:title>\n                  <jats:bold>Abstract<\/jats:bold>\n                <\/jats:title>\n                <jats:p>\n                  Spread and aggregation of misfolded \u03b1-synuclein (aSyn) within the brain is the pathologic hallmark of Lewy body diseases (LBD), including Parkinson\u2019s disease (PD) and dementia with Lewy bodies (DLB). While evidence exists for multiple aSyn protein conformations, often termed \u201cstrains\u201d for their distinct biological properties, it is unclear whether PD and DLB result from aSyn strain differences, and biomarkers that differentiate PD and DLB are lacking. Moreover, while pathological forms of aSyn have been detected outside the brain (\n                  <jats:italic>e.g.,<\/jats:italic>\n                  in skin, gut, blood), the functional significance of these peripheral aSyn species is unclear. Here, we developed assays using monoclonal antibodies selective for two different aSyn species generated\n                  <jats:italic>in vitro<\/jats:italic>\n                  \u2013 termed Strain A and Strain B \u2013 and used them to evaluate human brain tissue, cerebrospinal fluid (CSF), and plasma, through immunohistochemistry, enzyme-linked immunoassay, and immunoblotting. Surprisingly, we found that plasma aSyn species detected by these antibodies differentiated individuals with PD vs. DLB in a discovery cohort (UPenn, n=235, AUC 0.83) and a multi-site replication cohort (Parkinson\u2019s Disease Biomarker Program, or PDBP, n=200, AUC 0.72). aSyn plasma species detected by the Strain A antibody also predicted rate of cognitive decline in PD. We found no evidence for aSyn strains in CSF, and ability to template aSyn fibrillization differed for species isolated from plasma vs. brain, and in PD vs. DLB. Taken together, our findings suggest that aSyn conformational differences may impact clinical presentation and cortical spread of pathological aSyn. Moreover, the enrichment of these aSyn strains in plasma implicates a non-central nervous system source.\n                <\/jats:p>","DOI":"10.1101\/2024.05.07.593056","type":"posted-content","created":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T21:55:27Z","timestamp":1715205327000},"source":"Crossref","is-referenced-by-count":2,"title":["\u03b1-Synuclein Conformations in Plasma Distinguish Parkinson\u2019s Disease from Dementia with Lewy Bodies"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4428-1820","authenticated-orcid":false,"given":"George T.","family":"Kannarkat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Zack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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