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A New Frontier in Diagnosing Parkinson’s Disease and Multiple system atrophy

Imagine being told you have Parkinson’s disease, only to find out later that you actually have a different, more aggressive condition called multiple system atrophy (MSA). This misdiagnosis happens more often than people realise because the early symptoms of Parkinson’s disease and MSA are so similar. But new research from our team may soon make this a thing of the past.

In our recent study published in Translational Neurodegeneration, our collaborative team from the University of Sydney and the University of Auckland developed a refined version of a technique called seed amplification assay. This method allows us to not only detect the protein that builds up in both Parkinson’s disease and MSA — called alpha-synuclein — but also to measure how it builds up in different patterns for each disease.

This represents a leap forward: a shift from diagnosis based on symptoms and clinical judgment to one based on the actual biology of the disease.

 

Same Protein, Different Diseases

Parkinson’s disease and MSA are both caused by the misfolding and buildup of a protein called alpha-synuclein in the brain. But despite sharing this common biological feature, the diseases affect the brain in very different ways.

In Parkinson’s disease, damage begins in a small part of the brain responsible for producing dopamine, leading to symptoms such as tremors, stiffness, and slowed movement. These changes happen gradually, and people with Parkinson’s disease often maintain a good level of independence for many years.

MSA, on the other hand, causes more widespread and rapid damage. It affects not just movement but also balance and internal functions like blood pressure control. This makes MSA harder to manage and leads to a faster decline in health. Importantly, treatments that help in Parkinson’s disease, like levodopa, are often ineffective — and sometimes even harmful — for people with MSA.

This is why accurate diagnosis matters so much.

 

Measuring the Shape of the Disease

Traditional tests can detect whether alpha-synuclein is present in the brain, but our new approach takes things a step further. It measures the specific pattern of alpha-synuclein build-up.

We discovered that alpha-synuclein from people with MSA clumps together more quickly and strongly than in Parkinson’s disease. By measuring how long it takes for the protein to start clumping and how intense the clumping becomes, we can tell which disease is present.

This could form the basis for a much more precise diagnostic test that relies on biology, not just symptoms.

 

Toward Simple, Non-Invasive Testing

Our current study used samples from brain tissue and spinal fluid after death. However, we are now working on adapting this technology to work with samples that are easier to collect, such as blood, urine, or even a simple nasal swab.

This means that in the near future, someone could get tested for Parkinson’s disease or MSA using a sample collected at their local clinic or laboratory, without needing complex or invasive procedures.

This kind of test could be a game-changer, especially for people who live far from specialist medical centres or do not yet show apparent symptoms. It could allow for earlier diagnosis and more personalised treatment.

 

How Early Can We Detect These Diseases?

The ultimate goal is to detect Parkinson’s disease and MSA before symptoms even begin — when the disease is still in its earliest stages.

Our current work lays the foundation for this. By refining seed amplification assays to detect not just the presence but also the behaviour of alpha-synuclein, we are creating a more sensitive and informative diagnostic tool. It offers a detailed biological snapshot of what is happening inside the brain, long before symptoms take over.

 

What This Means for the Future

This research could mark a turning point in how we diagnose Parkinson’s disease and MSA. We are moving toward a future where diagnosis is not based on observation alone, but on a precise, molecular test.

By understanding the unique signatures of each disease, we can help patients avoid harmful misdiagnoses and get the care they truly need — earlier, more accurately, and with more confidence.

  Dr Victor Dieriks

This research was led by Dr James Wiseman, under the supervision of Professor Glenda Halliday at the University of Sydney and Dr Victor Dieriks at the University of Auckland. We thank the Neurological Foundation Human Brain Bank of New Zealand and the Sydney Brain Banks for providing the brain tissue samples used in this study.

Read the complete study in Translational Neurodegeneration here

 
 
 

2 Comments


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Will this have any signicant impact on producing a cure or perhaps a treatment for MSA in the near future since the disease can be detected early on?

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