. 2024 Sep 27;10(1):178.

doi: 10.1038/s41531-024-00789-w.

Neuronal alpha-Synuclein Disease integrated staging system performance in PPMI, PASADENA, and SPARK baseline cohorts

Tien Dam¹, Gennaro Pagano², Michael C Brumm³, Caroline Gochanour³, Kathleen L Poston⁴, Daniel Weintraub⁵, Lana M Chahine⁶, Christopher Coffey³, Caroline M Tanner⁷, Catherine M Kopil⁸, Yuge Xiao⁸, Sohini Chowdhury⁸, Luis Concha-Marambio⁹, Peter DiBiaso^{10

11}, Tatiana Foroud¹², Mark Frasier⁸, Danna Jennings¹³, Karl Kieburtz¹⁴, Kalpana Merchant¹⁵, Brit Mollenhauer¹⁶, Thomas J Montine¹⁷, Kelly Nudelman¹², John Seibyl¹⁸, Todd Sherer⁸, Andrew Singleton¹⁹, Diane Stephenson²⁰, Matthew Stern²¹, Claudio Soto^{9

22}, Eduardo Tolosa²³, Andrew Siderowf²¹, Billy Dunn⁸, Tanya Simuni²⁴, Kenneth Marek¹⁸; Parkinson’s Progression Markers Initiative

Collaborators, Affiliations

Collaborators

Parkinson’s Progression Markers Initiative:
Caroline Tanner, Douglas Galasko, Lana Chahine, Kathleen Poston, Roseanne Dobkin, Dan Weintraub, Ethan Brown, Roy Alcalay, Aleksandar Videnovic, Duygu Tosun-Turgut, Werner Poewe, Susan Bressman, Jan Hammer, Raymond James, Ekemini Riley, Leslie Shaw, David Standaert, Sneha Mantri, Nabila Dahodwala, Michael Schwarzschild, Connie Marras, Hubert Fernandez, Ira Shoulson, Helen Rowbotham, Paola Casalin, Claudia Trenkwalder, Jamie Eberling, Katie Kopil, Alyssa O'Grady, Maggie McGuire Kuhl, Leslie Kirsch, Tawny Willson, Emily Flagg, Bridget McMahon, Craig Stanley, Kim Fabrizio, Dixie Ecklund, Trevis Huff, Laura Heathers, Christopher Hobbick, Gena Antonopoulos, Chelsea Caspell-Garcia, Michael Brumm, Arthur Toga, Karen Crawford, Jan Hamer, Doug Galasko, Thomas Montine, Carlie Tanner, Roseann Dobkin, Monica Korell, Charles Adler, Amy Amara, Paolo Barone, Bastiaan Bloem, Susan Bressman, Kathrin Brockmann, Norbert Brüggemann, Kelvin Chou, Alberto Espay, Stewart Factor, Michelle Fullard, Robert Hauser, Penelope Hogarth, Shu-Ching Hu, Michele Hu, Stuart Isaacson, Christine Klein, Rejko Krueger, Mark Lew, Zoltan Mari, Maria Jose Martí, Nikolaus McFarland, Tiago Mestre, Emile Moukheiber, Alastair Noyce, Wolfgang Oertel, Njideka Okubadejo, Sarah O'Shea, Rajesh Pahwa, Nicola Pavese, Ron Postuma, Giulietta Riboldi, Lauren Ruffrage, Javier Ruiz Martinez, David Russell, Marie H Saint-Hilaire, Neil Santos, Wesley Schlett, Ruth Schneider, Holly Shill, David Shprecher, Leonidas Stefanis, Yen Tai, Arjun Tarakad, Susan Ainscough, Courtney Blair, Erica Botting, Isabella Chung, Kelly Clark, Ioana Croitoru, Kelly DeLano, Iris Egner, Fahrial Esha, May Eshel, Frank Ferrari, Victoria Kate Foster, Alicia Garrido, Madita Grümmer, Bethzaida Herrera, Ella Hilt, Chloe Huntzinger, Farah Kausar, Christos Koros, Yara Krasowski, Dustin Le, Ying Liu, Taina M Marques, Helen Mejia Santana, Sherri Mosovsky, Jennifer Mule, Philip Ng, Lauren O'Brien, Abiola Ogunleye, Oluwadamilola Ojo, Obi Onyinanya, Lisbeth Pennente, Romina Perrotti, Michael Pileggi, Ashwini Ramachandran, Deborah Raymond, Jamil Razzaque, Shawna Reddie, Kori Ribb, Kyle Rizer, Janelle Rodriguez, Stephanie Roman, Clarissa Sanchez, Cristina Simonet, Anisha Singh, Elisabeth Sittig, Barbara Sommerfeld, Angela Stovall, Bobbie Stubbeman, Alejandra Valenzuela, Catherine Wandell, Diana Willeke, Karen Williams, Dilinuer Wubuli

Affiliations

¹ Biogen, Boston, MA, USA.
² F. Hoffmann-La Roche Ltd., Basel, Switzerland.
³ Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA.
⁴ Department of Neurology, Stanford University School of Medicine, Palo Alto, CA, USA.
⁵ University of Pennsylvania and the Parkinson's Disease and Mental Illness Research, Education and Clinical Centers (PADRECC and MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA.
⁶ Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA.
⁷ Department of Neurology, Movement Disorders and Neuromodulation Center, Weill Institute for Neuroscience, University of California, San Francisco, CA, USA.
⁸ The Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA.
⁹ Amprion Inc., San Diego, CA, USA.
¹⁰ Patient Council, The Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA.
¹¹ Clinical Solutions and Strategic Partnerships, WCG Clinical, Princeton, NJ, USA.
¹² Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN, USA.
¹³ Denali Therapeutics Inc., South San Francisco, CA, USA.
¹⁴ Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA.
¹⁵ Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
¹⁶ Department of Neurology, University Medical Center Göttingen and Paracelsus-Elena-Klinik, Kassel, Germany.
¹⁷ Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
¹⁸ Institute for Neurodegenerative Disorders, New Haven, CT, USA.
¹⁹ National Institute on Aging, National Institutes of Health, Bethesda, MD, USA.
²⁰ Critical Path for Parkinson's, Critical Path Institute, Tucson, AZ, USA.
²¹ Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
²² Department of Neurology, Mitchell Center for Alzheimer's Disease and Related Brain Disorders, University of Texas McGovern Medical School at Houston, Houston, TX, USA.
²³ Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
²⁴ Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. tsimuni@nm.org.

PMID: 39333167
PMCID: PMC11567150
DOI: 10.1038/s41531-024-00789-w

Neuronal alpha-Synuclein Disease integrated staging system performance in PPMI, PASADENA, and SPARK baseline cohorts

Tien Dam et al. NPJ Parkinsons Dis. 2024.

. 2024 Sep 27;10(1):178.

doi: 10.1038/s41531-024-00789-w.

Authors

Collaborators

Parkinson’s Progression Markers Initiative:
Caroline Tanner, Douglas Galasko, Lana Chahine, Kathleen Poston, Roseanne Dobkin, Dan Weintraub, Ethan Brown, Roy Alcalay, Aleksandar Videnovic, Duygu Tosun-Turgut, Werner Poewe, Susan Bressman, Jan Hammer, Raymond James, Ekemini Riley, Leslie Shaw, David Standaert, Sneha Mantri, Nabila Dahodwala, Michael Schwarzschild, Connie Marras, Hubert Fernandez, Ira Shoulson, Helen Rowbotham, Paola Casalin, Claudia Trenkwalder, Jamie Eberling, Katie Kopil, Alyssa O'Grady, Maggie McGuire Kuhl, Leslie Kirsch, Tawny Willson, Emily Flagg, Bridget McMahon, Craig Stanley, Kim Fabrizio, Dixie Ecklund, Trevis Huff, Laura Heathers, Christopher Hobbick, Gena Antonopoulos, Chelsea Caspell-Garcia, Michael Brumm, Arthur Toga, Karen Crawford, Jan Hamer, Doug Galasko, Thomas Montine, Carlie Tanner, Roseann Dobkin, Monica Korell, Charles Adler, Amy Amara, Paolo Barone, Bastiaan Bloem, Susan Bressman, Kathrin Brockmann, Norbert Brüggemann, Kelvin Chou, Alberto Espay, Stewart Factor, Michelle Fullard, Robert Hauser, Penelope Hogarth, Shu-Ching Hu, Michele Hu, Stuart Isaacson, Christine Klein, Rejko Krueger, Mark Lew, Zoltan Mari, Maria Jose Martí, Nikolaus McFarland, Tiago Mestre, Emile Moukheiber, Alastair Noyce, Wolfgang Oertel, Njideka Okubadejo, Sarah O'Shea, Rajesh Pahwa, Nicola Pavese, Ron Postuma, Giulietta Riboldi, Lauren Ruffrage, Javier Ruiz Martinez, David Russell, Marie H Saint-Hilaire, Neil Santos, Wesley Schlett, Ruth Schneider, Holly Shill, David Shprecher, Leonidas Stefanis, Yen Tai, Arjun Tarakad, Susan Ainscough, Courtney Blair, Erica Botting, Isabella Chung, Kelly Clark, Ioana Croitoru, Kelly DeLano, Iris Egner, Fahrial Esha, May Eshel, Frank Ferrari, Victoria Kate Foster, Alicia Garrido, Madita Grümmer, Bethzaida Herrera, Ella Hilt, Chloe Huntzinger, Farah Kausar, Christos Koros, Yara Krasowski, Dustin Le, Ying Liu, Taina M Marques, Helen Mejia Santana, Sherri Mosovsky, Jennifer Mule, Philip Ng, Lauren O'Brien, Abiola Ogunleye, Oluwadamilola Ojo, Obi Onyinanya, Lisbeth Pennente, Romina Perrotti, Michael Pileggi, Ashwini Ramachandran, Deborah Raymond, Jamil Razzaque, Shawna Reddie, Kori Ribb, Kyle Rizer, Janelle Rodriguez, Stephanie Roman, Clarissa Sanchez, Cristina Simonet, Anisha Singh, Elisabeth Sittig, Barbara Sommerfeld, Angela Stovall, Bobbie Stubbeman, Alejandra Valenzuela, Catherine Wandell, Diana Willeke, Karen Williams, Dilinuer Wubuli

Affiliations

¹ Biogen, Boston, MA, USA.
² F. Hoffmann-La Roche Ltd., Basel, Switzerland.
³ Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA.
⁴ Department of Neurology, Stanford University School of Medicine, Palo Alto, CA, USA.
⁵ University of Pennsylvania and the Parkinson's Disease and Mental Illness Research, Education and Clinical Centers (PADRECC and MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA.
⁶ Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA.
⁷ Department of Neurology, Movement Disorders and Neuromodulation Center, Weill Institute for Neuroscience, University of California, San Francisco, CA, USA.
⁸ The Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA.
⁹ Amprion Inc., San Diego, CA, USA.
¹⁰ Patient Council, The Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA.
¹¹ Clinical Solutions and Strategic Partnerships, WCG Clinical, Princeton, NJ, USA.
¹² Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN, USA.
¹³ Denali Therapeutics Inc., South San Francisco, CA, USA.
¹⁴ Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA.
¹⁵ Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
¹⁶ Department of Neurology, University Medical Center Göttingen and Paracelsus-Elena-Klinik, Kassel, Germany.
¹⁷ Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
¹⁸ Institute for Neurodegenerative Disorders, New Haven, CT, USA.
¹⁹ National Institute on Aging, National Institutes of Health, Bethesda, MD, USA.
²⁰ Critical Path for Parkinson's, Critical Path Institute, Tucson, AZ, USA.
²¹ Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
²² Department of Neurology, Mitchell Center for Alzheimer's Disease and Related Brain Disorders, University of Texas McGovern Medical School at Houston, Houston, TX, USA.
²³ Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
²⁴ Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. tsimuni@nm.org.

PMID: 39333167
PMCID: PMC11567150
DOI: 10.1038/s41531-024-00789-w

Abstract

The Neuronal alpha-Synuclein Disease (NSD) biological definition and Integrated Staging System (NSD-ISS) provide a research framework to identify individuals with Lewy body pathology and stage them based on underlying biology and increasing degree of functional impairment. Utilizing data from the PPMI, PASADENA, and SPARK studies, we developed and applied biologic and clinical data-informed definitions for the NSD-ISS across the disease continuum. Individuals enrolled as Parkinson's disease, Prodromal, or Healthy Controls were defined and staged based on biological, clinical, and functional anchors at baseline. Across the three studies 1741 participants had SAA data and of these 1030 (59%) were S+ consistent with NSD. Among sporadic PD, 683/736 (93%) were NSD, and the distribution for Stages 2B, 3, and 4 was 25%, 63%, and 9%, respectively. Median (95% CI) time to developing a clinically meaningful outcome was 8.3 (6.2, 10.1), 5.9 (4.1, 6.0), and 2.4 (1.0, 4.0) years for baseline stage 2B, 3, and 4, respectively. We propose pilot biologic and clinical anchors for NSD-ISS. Our results highlight the baseline heterogeneity of individuals currently defined as early PD. Baseline stage predicts time to progression to clinically meaningful milestones. Further research on validation of the anchors in longitudinal cohorts is necessary.

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Conflict of interest statement

T.D. declares former employment for and employee stock options in Biogen. G.P. declares employment for F. Hoffmann-La Roche Ltd. and stock ownership for F. Hoffmann-La Roche Ltd., Atea, Novartis and Eli Lilly. M.B. declares travel grants from The Michael J. Fox Foundation. C.G. declares employment for The Michael J. Fox Foundation. KP declares consultancies for Curasen; was on a scientific advisory board for Curasen and Amprion; honoraria from invited scientific presentations to universities and professional societies not exceeding $5000 per year from California Congress of Clinical Neurology, California Neurological Society, and Johns Hopkins University; and patents or patent applications numbers 17/314,979 and 63/377,293. K.P. also declares grants to her institution (Stanford University School of Medicine) from NIH/NINDS NS115114, NS062684, NS075097, NIH/NIA U19 AG065156, P30 AG066515, The Michael J. Fox Foundation, Lewy Body Dementia Association, Alzheimer’s Drug Discovery Foundation, Sue Berghoff LBD Research Fellowship and the Knight Initiative for Brain Resilience. DW declares salary support from The Michael J. Fox Foundation for serving on an Executive Steering Committee for the PPMI and consultancies for Roche Pharma. D.W. declares membership on the npj P.D. Editorial Board. L.C. declares grants to her institution from Biogen (clinical trial funding), MJFF, UPMC Competitive Medical Research Fund, National Institutes of Health, and University of Pittsburgh; grant and travel support from MJFF; royalties from Wolters Kluwel (for authorship); and in-kind donation by Advanced Brain Monitoring of equipment for research study to her institution. CC declares grants from The Michael J. Fox Foundation and NIH/NINDS. CT declares consultancies for CNS Ratings, Australian Parkinson’s Mission, Biogen, Evidera, Cadent (data safety monitoring board), Adamas (steering committee), Biogen (via the Parkinson Study Group steering committee), Kyowa Kirin (advisory board), Lundbeck (advisory board), Jazz/Cavion (steering committee), Acorda (advisory board), Bial (DMC) and Genentech. CT also declares grant support to her institution from The Michael J. Fox Foundation, National Institute of Health, Gateway LLC, Department of Defense, Roche Genentech, Biogen, Parkinson Foundation and Marcus Program in Precision Medicine. C.T. declares membership on the npj PD Editorial Board. C.K. declares employment for The Michael J. Fox Foundation. Y.X. declares employment for and travel grants from The Michael J. Fox Foundation. SC declares employment for and travel grants from The Michael J. Fox Foundation. LC-M declares employment for and employee stock options in Amprion, grants 16712 and 21233 from The Michael J. Fox Foundation to his institution; grant U44NS111672 from NIH to his institution; and patents or patent application numbers US 20210277076A1, US 20210311077A1, US 20190353669A1 and US 20210223268A1. P.D. has no declarations. TF declares travel grants and grant payments to her institution (Indiana University) from The Michael J. Fox Foundation. M.F. declares employment for The Michael J. Fox Foundation and an unpaid advisory role at Vaxxinity. D.J. declares employment for and employee stock options from Denali Therapeutics. KK declares support to his institution (University of Rochester Medical Center) from The Michael J. Fox Foundation. KMe declares consultancies for The Michael J. Fox Foundation, AcuRx, Caraway, Cerebral Therapeutics, NRG Therapeutics (scientific advisory board), Nitrase Therapeutics (scientific advisory board), Nurabio, Retromer Therapeutics (director on the board, part-time chief scientific officer), Schrodinger, Sinopia Biosciences (scientific advisory board), and Vanqua Biosciences (scientific advisory board); stock ownership for Cognition Therapeutics, Eli Lilly (retiree stock holder), Envisagenics, Nitrase Therapeutics, Sinopia Biosciences and Retromer Therapeutics; honoraria for the University of Utah; patents or patent applications for Retromer Therapeutics (planned patent); research grant from The Michael J. Fox Foundation and travel grants from the University of Utah. BM declares consultancies from Roche and Biogen; grants from The Michael J. Fox Foundation, A.S.A.P. and D.F.G.; honoraria for Abbvie and Bial; leadership role for The Michael J. Fox Foundation and travel grants for Abbvie. T.M. declares support to his institution (Stanford University School of Medicine) from The Michael J. Fox Foundation. K.N. declares grant to her institution from The Michael J. Fox Foundation. JS declares consultancies from Invicro, Biogen, and Abbvie; and stock ownership from RealmIDX, MNI Holdings, and LikeMinds as well as grants from The Michael J. Fox Foundation. TSh declares employment for The Michael J. Fox Foundation. ASin declares employment for The National Institutes of Health who received grants from The Michael J. Fox Foundation and A.S.A.P. A.S.i.n. declares Diagnostic for Stroke royalties (unrelated to current work); honoraria from Movement Disorders Society and Nature Publishing Group; travel grants from Chan Zuckerberg Initiative, The Michael J. Fox Foundation and Weill Cornell. ASin’s spouse is an employee of GeneDx. ASin declares being an associate editor for the npj PD Editorial Board. DS has no declarations. MS declared consultancies for Mediflix, Inc., Health and Wellness Partners; honoraria from Atria Foundation, International Parkinson and Movement Disorder Society, Neurocrine, Luye Pharma, and Acorda. MS serves on advisory board at Neuroderm, Alexza, Alexion, and Biogen. CS declares employment for Amprion; stock ownership for Amprion; honoraria (will receive royalties for the sale of seed amplification assay [SAA]) from Amprion; and patents or patent applications, awarded and amplified in conjunction with Amprion for the SAA assay. ET has no declarations. ASid declares consultancies for SPARC Therapeutics, Capsida Therapeutics, and Parkinson Study Group; honoraria from Bial; grants from The Michael J. Fox Foundation (member of PPMI Steering Committee); and participation on board at Wave Life Sciences, Inhibikase, Prevail, Huntington Study Group and Massachusetts General Hospital. BD declarations are T.B.D. TSi declares consultancies for AcureX, Adamas, AskBio, Amneal, Blue Rock Therapeutics, Critical Path for Parkinson’s Consortium, Denali, The Michael J. Fox Foundation, Neuroderm, Roche, Sanofi, Sinopia, Takeda, and Vanqua Bio; on advisory boards for AcureX, Adamas, AskBio, Biohaven, Denali, GAIN, Neuron23 and Roche; on scientific advisory boards for Koneksa, Neuroderm, Sanofi and U.C.B.; and received research funding from Amneal, Biogen, Roche, Neuroderm, Sanofi, Prevail and UCB and an investigator for NINDS, MJFF, Parkinson’s Foundation. KMa declares support to his institution (Institute for Neurodegenerative Disorders) from The Michael J. Fox Foundation. K.M.a., also declares consultancies for Invicro, The Michael J. Fox Foundation, Roche, Calico, Coave, Neuron23, Orbimed, Biohaven, Anofi, Koneksa, Merck, Lilly, Inhibikase, Neuramedy, IRLabs and Prothena and participates on DSMB at Biohaven.

Figures

**Fig. 1. Participant Flowchart.**
¹Not evaluable = CSF samples not available for alpha-synuclein aggregation testing ²Evaluable = CSF samples analyzed for alpha-synuclein aggregation and results available ³NSD = Individuals with positive alpha-synuclein aggregation tests (S + ) ⁴Not stageable = Missing DaT-SPECT or clinical data and unable to assess stages ⁵Not NSD = Individuals with negative alpha-synuclein aggregation tests (S-) NSD Neuronal Synuclein Disease.

**Fig. 2. Time to reaching any progression milestone by stage at baseline among PPMI sporadic PD cohort.**
Interval-censored survival curves of progression-free survival stratified by stage at baseline among PPMI sporadic PD participants. Progression was defined as reaching any clinically meaningful milestone across any of six clinical domains (walking and balance, motor complications, cognition, autonomic dysfunction, functional dependence, activities of daily living). Median (95% CI) progression-free survival equaled 8.3 (6.2, 10.1) years, 5.9 (4.1, 6.0) years, and 2.4 (1.0, 4.0) years among participants with a baseline stage of 2B, 3, and 4, respectively. A generalized log-rank test indicated a significant difference across the survival curves (P < 0.0001).

See this image and copyright information in PMC

Update of

Neuronal alpha-Synuclein Disease Integrated Staging System performance in PPMI, PASADENA, and SPARK baseline cohorts.
Dam T, Pagano G, Brumm MC, Gochanour C, Poston KL, Weintraub D, Chahine LM, Coffey C, Tanner CM, Kopil CM, Xiao Y, Chowdhury S, Concha-Marambio L, DiBiaso P, Foroud T, Frasier M, Jennings D, Kieburtz K, Merchant K, Mollenhauer B, Montine TJ, Nudelman K, Seibyl J, Sherer T, Singleton A, Stephenson D, Stern M, Soto C, Tolosa E, Siderowf A, Dunn B, Simuni T, Marek K; Parkinson’s Progression Markers Initiative. Dam T, et al. medRxiv [Preprint]. 2024 Sep 10:2024.02.14.24302818. doi: 10.1101/2024.02.14.24302818. medRxiv. 2024. Update in: NPJ Parkinsons Dis. 2024 Sep 27;10(1):178. doi: 10.1038/s41531-024-00789-w. PMID: 39314957 Free PMC article. Updated. Preprint.

References

1. Simuni, T. et al. A biological definition of neuronal alpha-synuclein disease: towards an integrated staging system for research. Lancet Neurol.23, 178–190 (2024). - PubMed
1. Siderowf, A. et al. Assessment of heterogeneity among participants in the Parkinson’s progression markers Initiative cohort using alpha-synuclein seed amplification: a cross-sectional study. Lancet Neurol.22, 407–417 (2023). - PMC - PubMed
1. Postuma, R. B. et al. MDS clinical diagnostic criteria for Parkinson’s disease. Mov. Disord.30, 1591–1601 (2015). - PubMed
1. McKeith, I. G. et al. Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB Consortium. Neurology89, 88–100 (2017). - PMC - PubMed
1. Marek, K. et al. The Parkinson’s Progression Markers Initiative (PPMI) - establishing a PD biomarker cohort. Ann. Clin. Transl. Neurol.5, 1460–1477 (2018). - PMC - PubMed

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Neuronal alpha-Synuclein Disease integrated staging system performance in PPMI, PASADENA, and SPARK baseline cohorts

Collaborators

Affiliations

Neuronal alpha-Synuclein Disease integrated staging system performance in PPMI, PASADENA, and SPARK baseline cohorts

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

Update of

References

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