Diagnosing multiple system atrophy: current clinical guidance and emerging molecular biomarkers.

Diagnosing multiple system atrophy: current clinical guidance and emerging molecular biomarkers.
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DOI:
10.3389/fneur.2023.1210220
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发表时间:
2023
影响因子:
3.4
通讯作者:
Kondru, Naveen
Kondru, Naveen
中科院分区:
医学3区
文献类型:
--
作者:
Goolla, Meghana;Cheshire, William P.;Ross, Owen A.;Kondru, Naveen

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多系统萎缩是一种罕见的进行性神经退行性疾病,其特征是运动和自主神经功能障碍。由于MSA与其他神经退行性疾病(如帕金森病和非典型帕金森病)的临床相似性,因此其准确和早期诊断具有挑战性。目前,MSA的诊断基于患者症状、对左旋多巴治疗缺乏反应、神经影像学研究和排除其他疾病的临床标准。然而,这些方法在灵敏度和特异性方面存在局限性。分子生物标志物研究的最新进展,如α-突触核蛋白蛋白扩增试验(RT-QuIC)和脑脊液和血液中的其他生物标志物,已显示出改善MSA诊断的前景。此外,这些生物标志物还可以作为开发疾病修饰疗法和监测治疗反应的靶点。在这篇综述中,我们提供了MSA的临床综合征的概述,并讨论了目前的诊断标准,目前的诊断方法的局限性,以及新兴的分子生物标志物,为提高准确性和早期检测MSA提供了希望。
Multiple system atrophy (MSA) is a rare and progressive neurodegenerative disorder characterized by motor and autonomic dysfunction. Accurate and early diagnosis of MSA is challenging due to its clinical similarity with other neurodegenerative disorders, such as Parkinson’s disease and atypical parkinsonian disorders. Currently, MSA diagnosis is based on clinical criteria drawing from the patient’s symptoms, lack of response to levodopa therapy, neuroimaging studies, and exclusion of other diseases. However, these methods have limitations in sensitivity and specificity. Recent advances in molecular biomarker research, such as α-synuclein protein amplification assays (RT-QuIC) and other biomarkers in cerebrospinal fluid and blood, have shown promise in improving the diagnosis of MSA. Additionally, these biomarkers could also serve as targets for developing disease-modifying therapies and monitoring treatment response. In this review, we provide an overview of the clinical syndrome of MSA and discuss the current diagnostic criteria, limitations of current diagnostic methods, and emerging molecular biomarkers that offer hope for improving the accuracy and early detection of MSA.
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