Differentiating clinically between Parkinson's disease (PD) and the atypical parkinsonian syndromes of Progressive supranuclear palsy (PSP), corticobasal syndrome (CBS) and multiple system atrophy (MSA) is challenging but crucial for patient management and recruitment into clinical trials. Because PD (and the related disorder Dementia with Lewy bodies (DLB)) and MSA are characterised by the deposition of aggregated forms of α-synuclein protein (α-syn) in the brain, whereas CBS and PSP are tauopathies, we have developed immunoassays to detect levels of total and oligomeric forms of α-syn, and phosphorylated and phosphorylated oligomeric forms of α-syn, within body fluids, in an attempt to find a biomarker that will differentiate between these disorders. Levels of these 4 different forms of α-syn were measured in post mortem samples of ventricular cerebrospinal fluid (CSF) obtained from 76 patients with PD, DLB, PSP or MSA, and in 20 healthy controls. Mean CSF levels of total and oligomeric α-syn, and phosphorylated α-syn, did not vary significantly between the diagnostic groups, whereas mean CSF levels of phosphorylated oligomeric α-syn did differ significantly (p < 0.001) amongst the different diagnostic groups. Although all 4 measures of α-syn were higher in patients with MSA compared to all other diagnostic groups, these were only significantly raised (p < 0.001) in MSA compared to all other diagnostic groups, for phosphorylated oligomeric forms of α-syn. This suggests that this particular assay may have utility in differentiating MSA from control subject and patients with other α-synucleinopathies. However, it does not appear to be of help in distinguishing patients with PD and DLB from those with PSP or from control subjects. Western blots show that the principal form of α-syn within CSF is phosphorylated, and the finding that the phosphorylated oligomeric α-syn immunoassay appears to be the most informative of the 4 assays would be consistent with this observation.

BackgroundThe person with the diagnosis and their friends/family should be able to talk things over with a range of agencies to ask questions about the diagnosis and what it means for them. Information on help and support is available but is often poorly signposted. People with dementia (PwD) should have access to information on how to stay physically and mentally well in their own homes.AimsDementia hubs aim to fill this gap, providing practical information and support for PwD and their families/carers, and also for those who are worried about their memory. With clear and sensible information about recognising symptoms, research, getting help, managing financially, staying at home, treatment, being a carer and staying positive, these events will help PwD and their families to make sure that they can stay well and happy as long as possible.MethodsA ‘Listening Event’ was held before both Dementia Hubs commenced, with the purpose of allowing PwD and their families the chance to have their say about what support they would like to see at a new hub initiative. The Hubs provide advice/information from a wide range of organisations and individuals, eg nurses, financial planners, social workers, benefits advisers, carers support, the CQC, the Alzheimer’s Society, Age UK and many others.ResultsThe Bay Dementia Hub which is held at St John’s Hospice commenced Sept 2016 and has gone from strength to strength. Over 16 service-providers attend every month. The Fylde Coast Dementia Hub is held at Trinity Hospice has only recently started but it is hoped that it will be just as successful.ConclusionThe Hubs bring together people from many organisations and disciplines, within and beyond the hospice, to facilitate a ‘one-stop shop’. To have service providers and health care support, all under one roof is quite unique!