February 11, 2026

@michaelokun

Blood and CSF biomarkers take a multiplex leap in Parkinson’s and MSA. What does NULISA mean? NULISA stands for Nucleic Acid Linked Immuno-Sandwich Assay, a highly sensitive method that can measure many proteins at once from very small blood or CSF samples. Vijiaratnam and colleagues describe in a new paper in Brain Communications how a 120 protein NULISA panel was used to study peripheral blood and CSF biomarkers across Parkinson’s disease and multiple system atrophy. Key points: - Oligomeric alpha synuclein and related protein ratios in blood differed between Parkinson’s disease and healthy controls, and some tracked disease severity. - Neurofilament light and inflammatory markers clearly distinguished multiple system atrophy from controls, and some measures that were related to clinical severity. - CSF profiling revealed distinct protein signatures between Parkinson’s disease and multiple system atrophy, highlighting differences in neurodegeneration and inflammation. My take: This is a serious scale up of biomarker thinking. Instead of chasing a single magic marker, this work embraces biology as a network problem. Parkinson’s disease and multiple system atrophy look less like single protein disorders and more like shifting constellations of aggregation, metabolism and inflammation. Here are 5 points that resonated w/ me: 1- Parkinson’s disease and multiple system atrophy cannot be explained by one protein alone and multiplex approaches may better reflect real biology. 2- Blood based biomarkers are getting closer to being useful for trials even if they are not yet ready for routine care. 3- Some protein changes track disease severity which is likely critical for testing disease modifying therapies. 4- Differences between blood and CSF remind us that ‘where you sample matters.’ 5- The future likely combines panels like this w/ clinical data, imaging and digital measures that may enable us to better follow folks over time. https://academic.oup.com/braincomms/advance-article/doi/10.1093/braincomms/fcag035/8461556 #michaelokun #fixelinstitute #parkinson