Relationship of serum beta-synuclein with blood biomarkers and brain atrophy

Abstract

Background: Recent data support beta-synuclein as a blood biomarker to study synaptic degeneration in Alzheimer’s disease (AD). Methods: We provide a detailed comparison of serum beta-synuclein immunopre- cipitation – mass spectrometry (IP-MS) with the established blood markers phos- phorylated tau 181 (p-tau181) (Simoa) and neurofilament light (NfL) (Ella) in the German FTLD consortium cohort (n = 374) and its relation to brain atrophy (magnetic resonance imaging) and cognitive scores. Results: Serum beta-synuclein was increased in AD but not in frontotemporal lobar degeneration (FTLD) syndromes. Beta-synuclein correlated with atrophy in tempo- ral brain structures and was associated with cognitive impairment. Serum p-tau181 showed the most specific changes in AD but the lowest correlation with structural alterations. NfL was elevated in all diseases and correlated with frontal and temporal brain atrophy. Discussion: Serum beta-synuclein changes differ from those of NfL and p-tau181 and are strongly related to AD, most likely reflecting temporal synaptic degeneration. Beta-synuclein can complement the existing panel of blood markers, thereby providing information on synaptic alterations.