TY - JOUR
T1 - Diagnostic Value of Glycocalyx Shedding in Blood for Differentiating between Parkinson's Disease and Multiple System Atrophy
AU - Folke, Jonas
AU - DellaValle, Brian
AU - Jørgensen, Mathias Lindh
AU - Mogensen, Phillip Bredahl
AU - Hempel, Casper
AU - Rungby, Jørgen
AU - Hejl, Anne-Mette
AU - Løkkegaard, Annemette
AU - Salvesen, Lisette
AU - Bech, Sara
AU - Møller, Mette
AU - Danielsen, Erik Hvid
AU - Blaabjerg, Morten
AU - Bode, Matthias
AU - Brudek, Tomasz
AU - Aznar, Susana
N1 - © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
PY - 2026/3/19
Y1 - 2026/3/19
N2 - BACKGROUND: Blood-brain barrier disruption is increasingly recognized in synucleinopathies, but the role of the endothelial glycocalyx (GLX) in Parkinson's disease (PD) and multiple system atrophy (MSA) remains unclear.OBJECTIVES: The aim was to determine whether plasma GLX markers differ between PD, MSA, and healthy controls (HC), relate to clinical measures, and support differential diagnosis.METHODS: Nine GLX analytes were quantified in plasma from 38 PD, 24 MSA, and 46 HC. Group differences were tested with multilinear regression including age and sex; associations with disease duration, Hoehn and Yahr stage, and Montreal Cognitive Assessment score were examined; gradient boosting classifiers plus Shapley Additive Explanations and univariate receiver operating characteristic (ROC) analyses evaluated discriminative performance.RESULTS: PD showed reduced biglycan and cluster of differentiation 44 (CD44), whereas MSA showed increased chondroitin sulfate and reduced perlecan and CD44 versus comparators. Several GLX markers correlated with duration and cognition. Multianalyte GLX signatures classified groups with ROC area under curve, 0.79 to 0.88.CONCLUSIONS: In this exploratory cohort, distinct GLX signatures reflect disease-specific neurovascular dysfunction and may aid stratification and monitoring. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
AB - BACKGROUND: Blood-brain barrier disruption is increasingly recognized in synucleinopathies, but the role of the endothelial glycocalyx (GLX) in Parkinson's disease (PD) and multiple system atrophy (MSA) remains unclear.OBJECTIVES: The aim was to determine whether plasma GLX markers differ between PD, MSA, and healthy controls (HC), relate to clinical measures, and support differential diagnosis.METHODS: Nine GLX analytes were quantified in plasma from 38 PD, 24 MSA, and 46 HC. Group differences were tested with multilinear regression including age and sex; associations with disease duration, Hoehn and Yahr stage, and Montreal Cognitive Assessment score were examined; gradient boosting classifiers plus Shapley Additive Explanations and univariate receiver operating characteristic (ROC) analyses evaluated discriminative performance.RESULTS: PD showed reduced biglycan and cluster of differentiation 44 (CD44), whereas MSA showed increased chondroitin sulfate and reduced perlecan and CD44 versus comparators. Several GLX markers correlated with duration and cognition. Multianalyte GLX signatures classified groups with ROC area under curve, 0.79 to 0.88.CONCLUSIONS: In this exploratory cohort, distinct GLX signatures reflect disease-specific neurovascular dysfunction and may aid stratification and monitoring. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
KW - Parkinson's disease
KW - blood-brain barrier
KW - differential diagnosis
KW - endothelial glycocalyx
KW - multiple system atrophy
KW - neurovascular dysfunction
KW - plasma biomarkers
KW - synucleinopathy
U2 - 10.1002/mds.70274
DO - 10.1002/mds.70274
M3 - Journal article
C2 - 41853966
SN - 0885-3185
JO - Movement disorders : official journal of the Movement Disorder Society
JF - Movement disorders : official journal of the Movement Disorder Society
ER -