An accurate and early diagnosis of degenerative parkinsonian syndromes is a major need for their correct and timely therapeutic management. The current diagnostic criteria are mostly based on clinical features and molecular imaging. However, diagnostic doubts often persist especially in the early stages of diseases when signs are slight, ambiguous and overlapping among different syndromes. Molecular imaging may not be altered in the early stages of diseases, also failing to discriminate among different syndromes. Cerebrospinal fluid (CSF) represents an ideal source of biomarkers reflecting different pathways of neuropathological changes taking place in the brain and preceding the clinical onset. The aim of this review is to provide un update on CSF biomarkers in parkinsonian disorders, discussing in detail their association with neuropathological correlates. Their potential contribution in differential diagnosis and prognostic assessment of different parkinsonian syndromes is also discussed. Before entering the clinical use both for diagnostic and prognostic purposes, these CSF biomarkers need to be thoroughly assessed in terms of pre-analytical and analytical variability, as well as to clinical validation in independent cohorts.

中文翻译：

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帕金森综合征中的分子谱：CSF生物标志物。

对退行性帕金森综合征的准确和早期诊断是对其正确和及时的治疗管理的主要需求。当前的诊断标准主要基于临床特征和分子影像学。但是，诊断疑惑常常持续存在，尤其是在疾病的早期，即各种症状之间的征兆轻微，模棱两可和重叠时。在疾病的早期阶段，分子成像可能不会改变，也无法区分不同的综合征。脑脊液（CSF）代表了生物标志物的理想来源，反映了发生在大脑中并在临床发作之前发生的神经病理变化的不同途径。这篇综述的目的是提供帕金森病中CSF生物标志物的最新信息，详细讨论它们与神经病理学相关性的关系。还讨论了它们在不同帕金森综合症的鉴别诊断和预后评估中的潜在作用。在进入用于诊断和预后目的的临床用途之前，这些CSF生物标记物需要在分析前和分析变异性以及独立队列中的临床验证方面进行全面评估。