Objective: This is a prospective observational study to identify biomarkers in parkinsonian syndromes.

Background: Parkinson’s disease (PD) and atypical parkinsonian syndromes namely progressive supranuclear palsy (PSP), corticobasal syndrome (CBS) and multiple system atrophy (MSA) are neurodegenerative disorders that lack widely available, validated biomarkers.

Method: This is a single-center ongoing study, aiming to include N=200 patients of Greek origin. Patients fulfilling criteria of probable or clinically established PD; suggestive, possible, or probable PSP or CBS; possible, probable, or clinically confirmed MSA are included. Patients with parkinsonism <2 years not fulfilling yet criteria for PD, PSP or MSA are labeled as ‘unclassified parkinsonism’. Patients are grouped by disease duration of <2 years (early-disease group), or >2 years (late-disease group). Patients undergo clinical evaluation and clinical scales (H&Y, UPDRS I-IV, PSPRS and others) and neuroimaging studies (FDG-PET, MIBG heart imaging at baseline). Serum and plasma samples are collected at baseline for collection of PBMCs, exosome markers, proteomic and genetic analyses.

Results: 134 patients (54F, 80M) were recruited (03/2022–03/2025). Mean age: 61.9 (36-82; +/- 9.7) years, disease duration: 5.5 years. Mean UPDRS scores at baseline were: Part 1–9.5 (+/- 8), Part 2–10.8 (+/- 9.5), Part 3–34.3 (+/- 18.5), Part 4–2.3 (+/- 3.7). Mean age at onset was 57.1 (27-79; +/- 10.7), years. Early-disease group (N=49, 37%) had mean age 63.2 (46-78; +/- 8.9) years. 1 patient met the criteria for clinically established (2%), 41 for probable PD (83%). 2 patients had possible, 5 probable and 2 suggestive PSP, 3 a possible MSA and 3 had unknown diagnosis. 4 met criteria for both probable PD and PSP, 3 for probable PD and MSA and 1 for the three diagnoses.21/49 patients had unclassified parkinsonism. Late-disease group (N=86, 63%) had mean age 62.1 years. 40 met the criteria for CE PD (46%), 40 for probable PD (46%). 2 patients had probable and 1 suggestive PSP, 2 CE and 1 probable MSA. 4 (5%) met the criteria for unclassified parkinsonism. As part of the GP2, genetic analysis is ongoing.

Conclusion: Preliminary data may aid early biomarker identification in parkinsonian syndromes.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-prospective-observational-study-to-identify-biomarkers-in-parkinsonian-syndromes-proatyp/