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In people with Alzheimer’s disease biofluid markers, SAA positivity associates with poorer cognitive decline and may shift expectations for amyloid-targeting drug effectiveness. Objective: characterize current clinical use and potential impact of the alpha-synuclein seeding amplification assay in a tertiary behavioral neurology clinic. Methods used retrospective lumbar puncture cohorts and reviewed diagnoses, symptoms, tests, imaging, and resulting clinical decisions.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/alpha-synuclein-seeding-amplification-assay-use-and-potential-impact-in-a-behavioral-neurology-clinic/459414/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/alpha-synuclein-seeding-amplification-assay-use-and-potential-impact-in-a-behavioral-neurology-clinic/459414.png","ImageObject",300,407,{"name":92,"@type":93},"Rowan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":19},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study objective regarding SAA in a behavioral neurology clinic?","Question",{"text":112,"@type":113},"To characterize current clinical use and potential impact of the alpha-synuclein seeding amplification assay for clinical decision-making in a tertiary behavioral neurology clinic.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were the retrospective cohorts constructed for analysis?",{"text":117,"@type":113},"From all patients who underwent clinical lumbar puncture: one cohort had a commercial SAA test (Amprion) ordered clinically, and the other used CSF stored for research with SAA performed later.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main findings about SAA implementation and its clinical implications?",{"text":121,"@type":113},"In the first year, SAA was performed clinically in 21 patients, with 43% showing abnormal results. Subsequent decisions included additional testing and medication changes, and the study concluded that implementation was successful; probable DLB was accurate while meeting possible DLB criteria was poorly predictive.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},459414,1790755868,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":24,"preview_page_count":4},1099514067415,"https://ap-avatar.wpscdn.com/avatar/100002539d78ffe74a7?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779092875211072502","DOI: 10. 1002/alz70856_106298  \nBIOMARKERS  \nPOSTER PRESENTATION  \nBIOMARKERS (NON-NEUROIMAGING)  \nAlpha-synuclein seeding amplification assay use and potential impact in a behavioral neurology clinic  \nD. Luke Fischer  Tara N. Ellingson  Bruce L. Miller  Lawren VandeVrede  \nMemory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA  \nCorrespondence  \nD. Luke Fischer, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.  \n[Email:](Email: david.fischer2@ucsf.edu)[ david.fischer2@ucsf.edu](Email: david.fischer2@ucsf.edu)  \nAbstract  \nBackground: The cerebrospinal fluid (CSF) SAA has high specificity for Lewy body disease (LBD) in well-defined research cohorts, but real-world use data are sparse. In persons with Alzheimer’s disease markers, SAA positivity correlates with worse cognitive decline and may alter expectations for amyloid-targeting drugs’effectiveness. The study objective was to characterize current use and potential impact for clinical decision-making of the alpha-synuclein seeding amplification assay (SAA) ina tertiary behavioral neurology clinic.  \nMethod: Two retrospective cohorts were derived from all cases who underwent clinical lumbar puncture: 1) those with a commercial SAA test (Amprion) ordered clinically, and 2) those with CSF stored for research and SAA obtained later. Records were reviewed for diagnosis, clinical syndrome/affected cognitive domain(s), cognitive tests, presence of core LBD features and other symptoms, MRI, PET, and SPECT imaging, Alzheimer’s disease biofluid markers, tests ordered by the clinician, and subsequent clinical decisions.  \nResult: In the first year, the SAA was performed clinically for 21 patients (cohort 1). Most were men (76%). Patients at time of testing were between 53-86 years old (mean 74). Mild cognitive impairment was the most common severity (71%) followed by dementia (19%) and subjective cognitive impairment or normal (9.5%). The SAA was abnormal in9patients(43%). Thep(181)-tau/amyloid-beta(42)ratio was abnormal in 44% of SAA-positive cases and 45% of SAA-negative cases. In SAA-positive cases, 5 met the core features from McKeith et al. for probable and 2 for possible LBD syndrome; in SAA-negative cases, none were probable and 7 were possible. Seventeen had questionable or mild motor parkinsonism. Clinical syndromes varied and included amnestic, multidomain(2/6positive), non-amnestic, dysexecutive and behavioral(0/5), logopenic primary progressive aphasia (1/1), corticobasal syndrome (1/1), behavioral variant frontotemporal dementia (0/1), multiple system atrophy (0/1), and Parkinson’s disease (0/1); no purely amnestic patients were tested. Subsequent clinical decisions  \nThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \n© 2025 The Alzheimer’s Association. Alzheimer’s & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer’s Association.  \nAlzheimer’s Dement. 2025;21(Suppl. 2):e106298.  \n[https://doi.org/10.1002/alz70856_106298](https://doi.org/10.1002/alz70856_106298)  \nwi[leyonlinelibrary.com/journal/alz](leyonlinelibrary.com/journal/alz)  \n1of2  \nBIOMARKERS  \nincluded additional tests and medication changes (lecanemab included). In cohort 2, SAA was positive in 12 of 50 cases (24%) with similar analyses to be completed soon. Conclusion: Implementation of SAA was successful and used in patients with or without DLB. Meeting possible DLB criteria was poorly predictive, whereas probable DLB was accurate.","cbCaik4Xpz5vx9pE","https://ap.wps.com/l/cbCaik4Xpz5vx9pE","pdf",85116,"English","# Background and Objective\n# Methods\n# Results\n## Clinical use and patient characteristics\n## SAA and LBD feature alignment\n## Subsequent clinical decisions\n# Conclusion","[{\"question\":\"What was the study objective regarding SAA in a behavioral neurology clinic?\",\"answer\":\"To characterize current clinical use and potential impact of the alpha-synuclein seeding amplification assay for clinical decision-making in a tertiary behavioral neurology clinic.\"},{\"question\":\"How were the retrospective cohorts constructed for analysis?\",\"answer\":\"From all patients who underwent clinical lumbar puncture: one cohort had a commercial SAA test (Amprion) ordered clinically, and the other used CSF stored for research with SAA performed later.\"},{\"question\":\"What were the main findings about SAA implementation and its clinical implications?\",\"answer\":\"In the first year, SAA was performed clinically in 21 patients, with 43% showing abnormal results. Subsequent decisions included additional testing and medication changes, and the study concluded that implementation was successful; probable DLB was accurate while meeting possible DLB criteria was poorly predictive.\"}]","Alpha-synuclein seeding amplification assay use and potential impact in a behavioral neurology clinic | PDF"]