Misfolded α-Synuclein in Autosomal Dominant Alzheimer's Disease

We analyzed Lewy body (LB) pathology in 18 autosomal dominant Alzheimer's disease (ADAD) brains via immunohistochemistry. Real-time quaking induced conversion was used to detect misfolded alpha-synuclein (alpha-syn) in 18 living ADAD cerebrospinal fluid (CSF) samples. Concomitant LB pathology was present in 44% ADAD brains. Only 6% CSF samples were positive for misfolded alpha-syn. In an additional AD sample, all patients with confirmed LB presented misfolded alpha-syn in postmortem CSF regardless of the LB staging. In conclusion, misfolded alpha-syn in CSF was scarce in symptomatic living ADAD individuals, in contrast to postmortem brain tissue. These results suggest late appearance of LB pathology in ADAD.