Serum Trace-Element Profiles and Exploratory Composite Indices in Multiple System Atrophy: A Case-Control Study

Area of Science:

• Neuroscience
• Toxicology
• Biochemistry

Background:

• Neurodegenerative disorders are associated with trace element imbalances.
• Data on trace elements in multiple system atrophy (MSA) are limited.
• This study investigates trace element profiles in MSA patients.

Purpose of the Study:

• To compare eleven trace elements between MSA patients and controls.
• To evaluate composite indices, including the Metal Burden Index (MBI), for their association with MSA.
• To explore potential biomarkers for MSA.

Main Methods:

• A case-control study involving 30 MSA patients and 30 controls.
• Quantification of eleven trace elements using ICP-MS.
• Calculation of the raw Metal Burden Index (MBI) and Neurotoxic Metal Score (NMS), with sensitivity analyses.

Main Results:

• MSA patients exhibited significantly higher serum aluminum and copper, and lower iron and zinc compared to controls.
• The raw MBI was significantly higher in MSA patients and associated with MSA status.
• Aluminum was the primary driver of the MBI difference; MBIz showed a significant association with MSA.

Conclusions:

• Multiple system atrophy is associated with distinct alterations in serum trace elements, notably elevated aluminum and copper, and reduced iron and zinc.
• The utility of the raw MBI as a standalone diagnostic tool for MSA is questionable due to its strong reliance on aluminum levels.
• Further validation in larger, multicenter cohorts is essential to confirm these findings and their clinical implications.