Misfolded -Synuclein in Cerebrospinal Fluid of Contact Sport Athletes

Background: Misfolded alpha-synuclein in Parkinson's disease (PD) and dementia with Lewy bodies (DLB) can be detected using the real-time quaking-induced conversion (RT-QuIC) technique in cerebrospinal fluid (CSF).Objectives: The objectives are (1) to examine misfolded CSF alpha-synuclein incidence, and (2) to compare clinical presentation, sports history, brain volumes, and RT-QuIC alpha-synuclein positivity in former athletes.Methods: Thirty former athletes with magnetic resonance imaging, neuropsychological testing, and CSF analyzed for phosphorylated tau 181 (p-tau), total tau (t-tau), amyloid-beta 42 (A beta 42), and neurofilament light chain (NfL). CSF alpha-synuclein was detected using RT-QuIC.Results: Six (20%) former athletes were alpha-synuclein positive. alpha-Synuclein positive athletes were similar to alpha-synuclein negative athletes on demographics, sports history, clinical features, CSF p-tau, t-tau, A beta 42, and NfL; however, had lower grey matter volumes in the right inferior orbitofrontal, right anterior insula and right olfactory cortices.Conclusions: alpha-Synuclein RT-QuIC analysis of CSF may be useful as a prodromal biofluid marker of PD and DLB.(c) 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.