Validation of CSF αSyn-SAA in an autopsy cohort with whole-body assessment of Lewy pathology

CSF alpha-synuclein seed amplification assay detected Lewy body disease with 100% sensitivity and 95% specificity in 30 autopsy-confirmed patients, with higher Fmax in LBD.

• Why it matters: Neuropathologists recommend systemic Lewy pathology assessment, but CSF alpha-synuclein SAA accuracy against whole-body Lewy distribution is unclear and needs validation in autopsy cohorts.
• What they did: Antemortem CSF from 30 patients underwent alpha-synuclein SAA, including kinetic readouts Fmax and T50, alongside systemic autopsy evaluation for Lewy pathology across brain and peripheral sites.
• The result: SAA was positive in all 8 LBD cases, low positive in 1 AD case, and negative in all other disease controls; LBD showed higher Fmax (9091{+/-}2083 vs. 1659{+/-}113) and the low-positive case had lower positivity and longer T50.

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