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Given that many brain\u2010biased circular RNAs (circRNAs) are stable and expressed in blood cells, peripheral blood mononuclear cell (PBMC) circRNAs were profiled in 140 individuals (iPD 43, MSA 35, PSP 19, healthy controls 43) using RT\u2010qPCR across 46 a priori candidates. Group differences were analyzed using the Kruskal\u2013Wallis test with FDR correction; clinical associations were examined using Bonferroni\u2010corrected Spearman correlations with a bootstrap stability assessment; and discrimination was assessed using logistic regression with nested repeated cross\u2010validation, calibration analysis, and ROC analysis. Six circRNAs differed across groups after FDR adjustment (SLC8A1_circ_0000994, MAPK9_circ_0001566, MGA_circ_0000591, AGTPBP1_circ_0007162, SFMBT2_circ_0000211, HIPK3_circ_0000284), with median levels lowest in iPD and highest in PSP. Internally cross\u2010validated multi\u2010marker panels achieved AUCs of 0.88 for PSP versus controls, 0.78 for PSP versus iPD, and 0.67 for MSA versus iPD. Several circRNAs, including non\u2010differential ones, showed bootstrap\u2010stable associations with cognitive, mood, working\u2010memory, and praxis measures. ENCORI\u2010 and CircInteractome\u2010based analyses placed the differentially expressed circRNAs within a shared RBP interaction landscape and identified modest but significant miRNA\u2010target overlap. Findings indicate that PBMC circRNA patterns aid APS\u2010iPD differentiation and align with clinical impairment within this cohort; external validation, longitudinal assessment, and mechanistic studies are needed to establish diagnostic performance and biological relevance.<\/jats:p>\n                  <jats:p>\n                    <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                      <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/jnc70519-gra-0001-m.png\">\n                        <jats:alt-text>image<\/jats:alt-text>\n                      <\/jats:graphic>\n                    <\/jats:boxed-text>\n                  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