Fig. 5: Relationship between pSer129 and CTT122 α-synuclein synaptic enrichment and LB density in anatomically connected regions.

The top row illustrates the relationship between synaptic terminals in the putamen and their projection neurons in the SN and cortex. A–L illustrates the correlation of A–F pSer129 and G–L CTT122 α-synuclein positive synaptic terminals, and LB density in projection neurons in SN and cortex (data points in A, G are average per case across all six ROIs; data points in B, H are average per case across the four ROIs spanning the ACC innervation area of the putamen; data points in C and I are average per case across the two ROIs spanning the PFC innervation area of the putamen; all points are colour-coded for Braak α-synuclein stage; the grey area around the regression line represents the standard error). The grey line in D–F and J–L shows the mean LB density in the input region (right y axis), and the magenta (DAT) or red line (VGLUT1) shows the mean α-synuclein proteoform+ synaptic density in the putamen (left y axis) per Braak α-synuclein stage (x axis). Statistical test used in A–C and G–I is a two-sided Spearman’s correlation with age and sex as covariates. Exact p values: A: rho = 0.42, p < 0.001; B: rho = 0.71, p < 0.001; C: rho = 0.54, p < 0.001; G: rho = 0.35, p = 0.035; H: rho = 0.71, p < 0.001; I: rho = 0.74, p < 0.001. Statistical test used in E, F, K, and L is a two-sided LMM with age and sex as covariates, and nested for case ID, on the original log-transformed values that are scaled as a percentage (0–100%). Exact p values: E: Braak 3 p = 0.003, Braak 3 p = 0.035; F: Braak 3 p = 0.008, Braak 3 p = 0.002; K: Braak 3 p = 0.003, Braak 3 p > 0.05; L: Braak 3 p = 0.004, Braak 3 p > 0.05. Source data are provided as a Source Data file. Figure partially created in BioRender. Van de berg (2025) https://BioRender.com/duygz72. α-syn α-synuclein, ACC anterior cingulate cortex, DAT dopaminergic transporter, Lb Lewy body, PFC prefrontal cortex, PSD95 post-synaptic density 95, SN substantia nigra, VGLUT1 vesicular glutamatergic transporter 1. 0.10 < p ≤ 0.05#, p < 0.05*, p < 0.01**, p < 0.001***.