A BS TRACT: Background: Synaptic dysfunction and degeneration are central contributors to the pathogenesis and progression of parkinsonian disorders. Therefore, identification and validation of biomarkers reflecting pathological synaptic alterations are greatly needed and could be used in prognostic assessment and to monitor treatment effects. Objective: To explore candidate biomarkers of synaptic dysfunction in Parkinson's disease (PD) and related disorders. Methods: Mass spectrometry was used to quantify 15 synaptic proteins in two clinical cerebrospinal fluid (CSF) cohorts, including PD (n 1 = 51, n 2 = 101), corticobasal degeneration (CBD) (n 1 = 11, n 2 = 3), progressive supranuclear palsy (PSP) (n 1 = 22, n 2 = 21), multiple system atrophy (MSA) (n 1 = 31, n 2 = 26), and healthy control (HC) (n 1 = 48, n 2 = 30) participants, as well as Alzheimer's disease (AD) (n 2 = 23) patients in the second cohort.Results: Across both cohorts, lower levels of the neuronal pentraxins (NPTX; 1, 2, and receptor) were found in PD, MSA, and PSP, compared with HC. In MSA and PSP, lower neurogranin, AP2B1, and complexin-2 levels compared with HC were observed. In AD, levels of 14-3-3 zeta/delta, beta-and gamma-synuclein were higher compared with the parkinsonian disorders. Lower pentraxin