Association between Serum Alpha-Synuclein Levels and Parkinson's Disease Stage

Yuliarni Syafrita, Restu Susanti


Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's. It is chronically progressive with the main symptoms of resting tremor, rigidity, bradykinesia, and postural disturbances. Lewy's body and Lewy's neurite are the main findings in brain biopsies of patients with PD. The main component is alpha-synuclein, a misfolding protein that plays an essential role in the pathogenesis of PD. This study aims to determine the association between serum alpha-synuclein levels during the PD stage and compare the levels between PD patients and healthy populations of the same age. A case-control study was conducted on 62 people with PD and 20 normal subjects as controls in the outpatient Department of Neurology of Dr. M. Djamil General Hospital and Ibnu Sina Islamic Hospital, Padang, from March to September 2020. The ELISA method examined serum alpha-synuclein examination, and the PD stage was assessed according to Hoehn and Yahr stages. The differences in alpha-synuclein levels between cases and controls and between stages of PD were analyzed by the Mann-Whitney test. Alpha-synuclein levels in PD patients were higher than in controls, and this difference was statistically significant (p<0.05). On the other hand, alpha-synuclein levels were higher in the severe stage than in the mild stage but not statistically significant (p>0.05). In conclusion, there was no association between alpha-synuclein levels and the stage of Parkinson's disease. Still, serum alpha-synuclein levels in PD patients were significantly higher than in the healthy population.


Alpha-synuclein; Hoehn and Yahr stage; Parkinson's disease

Full Text:



Pringsheim T, Jette N, Frolkis A, Steeves TD. The prevalence of Parkinson’s disease: a systematic review and meta-analysis. Mov Disord. 2014;29(13):1583–90.

Wang M, Ling KH, Tan JJ, Lu CB. Development and differentiation of midbrain dopaminergic neuron: from bench to bedside. Cells. 2020;9(6):1489.

Poewe W, Seppi K, Tanner CM, Halliday GM, Brundin P, Volkmann J, et al. Parkinson disease. Nat Rev Dis Primers. 2017;3:17013.

Bobela W, Aebischer P, Schneider BL. Alpha-synuclein as a mediator in the interplay between aging and Parkinson’s disease. Biomolecules. 2015;5(4):2675–700.

Taguchi K, Watanabe Y, Tsujimura A, Tanaka M. Expression of α-synuclein is regulated in a neuronal cell type-dependent manner. Anat Sci Int. 2019;94(1):11–22.

Henderson MX, Peng C, Trojanowski JQ, Lee VMY. LRRK2 activity does not dramatically alter alpha-synuclein pathology in primary neurons. Acta Neuropathol Commun. 2018;6(1):45.

Dryanovski DI, Guzman JN, Xie Z, Galteri DJ, Volpicelli-Daley LA, Lee VM, et al. Calcium entry and α-synuclein inclusions elevate dendritic mitochondrial oxidant stress in dopaminergic neurons. J Neurosci. 2013;33(24):10154–64.

Dickson DW. Neuropathology of Parkinson disease. Parkinsonism Relat Disord. 2018;46(Suppl 1):S30–33.

Marsili L, Rizzo G, Colosimo C. Diagnostic criteria for Parkinson’s disease: from James Parkinson to the concept of prodromal disease. Front Neurol. 2018;9:156.

Sveinbjornsdottir S. The clinical symptoms of Parkinson's disease. J Neurochem. 2016;139(Suppl 1):318–24.

Solla P, Cannas A, Ibba FC, Loi F, Corona M, Orofino G, et al. Gender differences in motor and non-motor symptoms among Sardinian patients with Parkinson’s disease. J Neurol Sci. 2012;323(1–2):33–9.

Cerri S, Mus L, Blandini F. Parkinson's disease in women and men: what´s differences? J Parkinsons Dis. 2019;9(3):501–15.

Moisan F, Kab S, Mohamed F, Canonico M, Le Guern M, Quintin C, et al. Parkinson disease male-to-female ratios increase with age: French nationwide study and meta-analysis. J Neurol Neurosurg Psychiatry. 2016;87(9):952–7.

Dahodwala N, Shah K, He Y, Wu SS, Schmidt P, Cubillos F, et al. Sex disparities in access to caregiving in Parkinson disease. Neurology. 2018;90(1):e48–54.

Mallach A, Weinert M, Arthur J, Gveric D, Tierney TS, Alavian KN. Post mortem examination of Parkinson’s disease brains suggests decline in mitochondrial biomass, reversed by deep brain stimulation of subthalamic nucleus. FASEB J. 2019;33(6):6957–61.

Dickson DW. Parkinson’s disease and parkinsonism: neuropathology. Cold Spring Harb Perspect Med. 2012;2(8):a009258.

Kouli A, Torsney KM, Kuan WL. Parkinson’s disease: etiology, neuropathology, and pathogenesis. In: Stoker TB, Greenland JC, editors. Parkinson’s disease: pathogenesis and clinical aspects [Internet]. Brisbane (AU): Codon Publications; 2018. p. 3–26.

Marino BLB, de Souza LR, Sousa KPA, Ferreira JV, Padilha EC, da Silva CHTP, et al. Parkinson's disease: a review from pathophysiology to treatment. Mini Rev Med Chem. 2020;20(9):754–67.

Chang CW, Yang SY, Yang CC, Chang CW, Wu YR. Plasma and serum alpha-synuclein as a biomarker of diagnosis in patients with Parkinson’s disease. Front Neurol. 2020;10:1388.

Chang KH, Liu KC, Lai CS, Yang SY, Chen CM. Assessing plasma levels of α-synuclein and neurofilament light chain by different blood preparation methods. Front Aging Neurosci. 2021;13:759182.

Ding J, Zhang J, Wang X, Zhang L, Jiang S, Yuan Y, et al. Relationship between the plasma levels of neurodegenerative proteins and motor subtypes of Parkinson’s disease. J Neural Transm (Vienna). 2017;124(3):353–60.

Lin CH, Yang SY, Horng HE, Yang CC, Chieh JJ, Chen HH, et al. Plasma α-synuclein predicts cognitive decline in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2017;88(10):818–24.

Wang L, Wang G, Duan Y, Wang F, Lin S, Zhang F, et al. A comparative study of the diagnostic potential of plasma and erythrocytic α-synuclein in Parkinson’s disease. Neurodegener Dis. 2019;19(5–6):204–10.

Zhao ZH, Chen ZT, Zhou RL, Zhang X, Ye QY, Wang YZ. Increased DJ-1 and α-synuclein in plasma neural-derived exosomes as potential markers for Parkinson’s disease. Front Aging Neurosci. 2019;10:438.


pISSN 2301-9123 | eISSN 2460-5441

Visitor since 19 October 2016: 

View My Stats

Free counters!

Global Medical and Health Communication is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.