{
  "abstract": "Background & Objectives: As recently recommended by neuropathologists, we assessed the diagnostic accuracy of cerebrospinal fluid (CSF) alpha-synuclein (-syn) seed amplification assay (SAA) in an autopsy cohort with systemic assessment of Lewy pathology. Methods: CSF was obtained antemortem and stored at -80 . -syn SAA and systemic Lewy pathology assessment were conducted as previously reported. Kinetic parameters, including maximum fluorescence (Fmax) and time to reach 50% of Fmax (T50), were also evaluated. Results: CSF samples were available from 30 patients (8 with symptomatic Lewy body disease [LBD], 2 with multiple system atrophy [MSA], 3 with Alzheimer's disease [AD], and 17 disease controls). Despite different clinical stages, all patients with LBD had diffuse neocortical or limbic-stage pathology at autopsy, with widespread peripheral Lewy bodies, including in the esophagus, heart, and sympathetic ganglia. Lewy pathology was not observed in disease controls. SAA was positive in all 8 with LBD, low positive in one patient with AD, and negative in all others. Fmax was significantly higher in LBD compared with cases without -syn pathology (9091{+/-}2083 vs. 1659{+/-}113 relative fluorescence units). The low-positive case had a lower positivity rate (25% vs. 75-100%), lower Fmax, and longer T50 than LBD cases. Conclusions: In this pilot study, CSF -syn SAA demonstrated high specificity (95%) and high sensitivity (100%) for detecting LBD; however, all LBD cases had widespread pathology, including peripheral involvement. Larger studies are needed to understand the association between CSF -syn SAA and Lewy pathology in the body.",
  "abstract_shown": true,
  "affiliations": [
    "Tokyo Metropolitan Institute for Geriatrics and Gerontology"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "M. Kurihara"
    },
    {
      "name": "K. Satoh"
    },
    {
      "name": "T. Matsubara"
    },
    {
      "name": "M. I. Shimamura"
    },
    {
      "name": "A. Arakawa"
    },
    {
      "name": "M. Hara"
    },
    {
      "name": "K. Kanemaru"
    },
    {
      "name": "A. Iwata"
    },
    {
      "name": "S. Murayama"
    },
    {
      "name": "Y. Saito"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9jjjaf5yn9vmz.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.11.02.26367119",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367119v1.full",
  "id": "9jjjaf5yn9vmz",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367119v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "neurology"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367119v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-02",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/9jjjaf5yn9vmz.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T00:21:05Z",
      "native_id": "10.64898/2026.11.02.26367119",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367119v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:neurology",
      "subfield": "neurology"
    }
  ],
  "title": "Validation of CSF αSyn-SAA in an autopsy cohort with whole-body assessment of Lewy pathology",
  "title_text": "Validation of CSF αSyn-SAA in an autopsy cohort with whole-body assessment of Lewy pathology",
  "type": "preprint",
  "updated_at": "2026-11-05T00:20:37Z",
  "url": "https://research.draconitic.com/paper/9jjjaf5yn9vmz",
  "venue": "medRxiv",
  "versions": []
}