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Blood‐based transcriptional risk score for Parkinson's disease is associated with cognitive decline in Alzheimer's disease

Year: 2025
Type: article
Abstract: BACKGROUND: Mixed pathology in Alzheimer's disease (AD) contributes to diverse endophenotypes and disease progression. While alpha-synucleinopathy often co-occurs with AD, its transcriptional risk effect on clinical outcomes is not well understood. We developed a blood-based transcriptional risk score for Parkinson's disease (PD-TRS), a neurodegenerative disease resulting from alpha-synucleinopathy. METHOD: We prioritized target genes by integrating PD genome-wide association study summary and expression quantitative trait locus data using Mendelian randomization and calculated PD-TRS using blood transcriptome data in two independent cohorts: Alzheimer's Disease Neuroimaging Initiative (ADNI, n = 661) and ANMerge (ANM, n = 665). We performed association analysis of PD-TRS with longitudinal cognitive function. Additionally, we investigated the association between PD-TRS and the presence of alpha-synuclein seeds in cerebrospinal fluid (CSF) detected using a seed amplification assay (SAA), and the effect of PD-TRS on longitudinal cognition in CSF alpha-synuclein SAA-stratified groups (Figure 1). RESULT: Our analysis revealed that higher PD-TRS was associated with rapid cognitive decline rates in both cohorts (Figure 2). Furthermore, higher PD-TRS was significantly associated with the CSF alpha-synuclein SAA positivity in the ADNI (Figure 3). We also found a significant interaction effect of PD-TRS and the CSF SAA positivity on longitudinal cognitive changes. Only in the CSF SAA-positive group, higher PD-TRS was associated with faster cognitive decline. CONCLUSION: Our findings suggest that blood-based PD-TRS may reflect the CSF alpha-synuclein SAA positivity and longitudinal cognitive decline in comorbid alpha-synucleinopathy in AD, advancing the identification of a blood-based biomarker to assess mixed pathology in AD.
Language: English
Subfield: Neurology
Field: Medicine
Open Access status: hybrid
Estimated APC paid: $4,200
OpenAlex ID: W7117239352
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