CSF Protein Concentrations Associated with Parkinson Disease Progression

After 5 years, total cerebrospinal fluid (CSF) protein concentrations are elevated among individuals with Parkinson disease (PD) compared to individuals without PD. However, higher CSF protein concentrations correlate with a decreased likelihood of PD progression. These are the results of a study presented at the 2023 Future of Parkinson’s Disease Conference, held from November 30 to December 3 in Austin, Texas.

Altered protein concentrations in the CSF have been linked to aging and neurodegeneration. CSF proteins may demonstrate extended lifespans and begin to accumulate due to lack of CSF production or decreased CSF circulation. Research has not yet described how patterns of CSF protein concentrations correlate to PD progression.

Researchers at the University of Cincinnati in Ohio performed a longitudinal analysis to investigate whether total CSF protein concentrations were associated with progression of PD severity. CSF protein concentrations and PD severity were measured at baseline and again after at least 54 weeks of follow-up. The researchers assessed changes in PD severity according to Hoehn and Yahr staging and total scores on the Movement Disorder Society’s Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) III.

At baseline, the researchers calculated significantly higher total CSF protein concentrations among 37 individuals with PD with a disease duration of more than 5 years compared to 148 control participants (median total CSF protein concentrations: 49 mg/dL vs 40 mg/dL; P =.014).

During the 54-week follow-up period, lower total CSF protein concentrations were found in individuals whose PD progressively worsened according to the Hoehn and Yahr staging compared to individuals whose Hoehn and Yahr staging stayed the same (median: 34.5 mg/dL vs 40 mg/dL; P =.009).

“Total CSF protein values are increased in PD patients with disease duration longer than 5 years,” the researchers concluded. “Higher protein [concentrations] are associated with lower likelihood of [Hoehn and Yahr] progression.”