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However, there is limited consensus regarding the diagnostic and differential diagnostic performance of \u03b1\u2010syn SAAs on biofluids and peripheral tissues.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive research was performed in PubMed, Web of Science, Embase and Cochrane Library. Meta\u2010analysis was performed using a random\u2010effects model. A network meta\u2010analysis based on an ANOVA model was conducted to compare the relative accuracy of \u03b1\u2010syn SAAs with different specimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The pooled sensitivity and specificity of \u03b1\u2010syn SAAs in distinguishing PD from healthy controls or non\u2010neurodegenerative neurological controls were 0.91 (95% confidence interval [CI] 0.89\u20100.92) and 0.95 (95% CI 0.94\u20100.96) for cerebrospinal fluid (CSF); 0.91 (95% CI 0.86\u20130.94) and 0.92 (95% CI 0.87\u20100.95) for skin; 0.80 (95% CI 0.66\u20100.89) and 0.87 (95% CI 0.69\u20100.96) for submandibular gland; 0.44 (95% CI 0.30\u20130.59) and 0.92 (95% CI 0.79\u20130.98) for gastrointestinal tract; 0.79 (95% CI 0.70\u20130.86) and 0.88 (95% CI 0.77\u20130.95) for saliva; and 0.51 (95% CI 0.39\u20100.62) and 0.91 (95% CI 0.84\u20100.96) for olfactory mucosa (OM). The pooled sensitivity and specificity were 0.91 (95% CI 0.89\u20130.93) and 0.50 (95% CI 0.44\u20130.55) for CSF, 0.92 (95% CI 0.83\u20130.97) and 0.22 (95% CI 0.06\u20130.48) for skin, and 0.55 (95% CI 0.42\u20130.68) and 0.50 (95% CI 0.35\u20130.65) for OM in distinguishing PD from multiple system atrophy. The pooled sensitivity and specificity were 0.92 (95% CI 0.89\u20130.94) and 0.84 (95% CI 0.73\u20130.91) for CSF, 0.92 (95% CI 0.83\u20130.97) and 0.88 (95% CI 0.64\u20130.99) for skin and 0.63 (95% CI 0.52\u20100.73) and 0.86 (95% CI 0.64\u20100.97) for OM in distinguishing PD from progressive supranuclear palsy. The pooled sensitivity and specificity were 0.94 (95% CI 0.90\u20130.97) and 0.95 (95% CI 0.77\u20131.00) for CSF and 0.94 (95% CI 0.84\u20130.99) and 0.86 (95% CI 0.42\u20131.00) for skin in distinguishing PD from corticobasal degeneration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>\u03b1\u2010Synuclein SAAs of CSF, skin, saliva, submandibular gland, gastrointestinal tract and OM are promising diagnostic assays for PD, with CSF and skin \u03b1\u2010syn SAAs demonstrating higher diagnostic performance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16041","type":"journal-article","created":{"date-parts":[[2023,8,13]],"date-time":"2023-08-13T03:40:17Z","timestamp":1691898017000},"page":"3949-3967","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Comparison of biospecimens for \u03b1\u2010synuclein seed amplification assays in Parkinson's disease: A systematic review and network 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