Early Parkinson’s disease is defined by α-synuclein oligomer-driven aggregation susceptible cells
Identifier: idr0173
Published: 2025-11-20 Licence: CC BY 4.0 Publisher: Image Data Resource
The mechanisms underlying early Parkinson’s disease (PD) remain unexplained. While the aggregation of alpha-synuclein (αSyn) into Lewy bodies (LBs) characterises the pathology of later stages, emerging evidence suggests that small, toxic αSyn oligomers may drive disease during the pre-symptomatic phase. Here, we introduce the concept of Aggregation-Susceptible Cells (ASCs): neurons that, due to elevated intracellular αSyn concentration, are predisposed to forming pathological aggregates. Using quantitative imaging, we identified 9,882 neurons containing 112 million αSyn oligomers across multiple brain regions from post-mortem human tissue of early-stage PD cases and controls. No increase in intracellular αSyn concentration in early disease was found; in other words, there is no “unique cell” in PD with an unexpectedly high αSyn oligomer concentration. However, the proportion of ASCs was significantly elevated in brain regions undergoing early pathological manifestation. This finding supports a model in which idiopathic PD pathogenesis is not driven by a change in αSyn aggregation kinetics at the protein level, but rather by an increased prevalence of neurons stochastically crossing a critical concentration threshold for aggregation at the cell-population level. These results identify cell aggregation susceptibility as a fundamental mechanism in the earliest transition to pathology and offer a new quantitative framework for understanding early-stage protein misfolding in PD.
Imaging Methods: spinning disk confocal microscopy
Organisms: Homo sapiens