SNCA A53T
Introduction
The SNCA A53T mutation (alanine-to-threonine at position 53) was the first genetic cause of Parkinson's disease (PD) identified and remains one of the most intensively studied pathogenic variants in neurodegeneration. This single nucleotide substitution (c.157C>T, p.Ala53Thr) in the [SNCA gene](/genes/snca) encoding [alpha-synuclein](/proteins/alpha-synuclein) leads to accelerated aggregation of the protein into toxic oligomers and fibrils, creating the pathological hallmark of Lewy bodies. Carriers of this mutation develop parkinsonism with high penetrance, typically in the fourth to sixth decade of life[1][2]. [@poewe2023]
The SNCA gene, located on chromosome 4q21, encodes the 140-amino acid protein alpha-synuclein, predominantly expressed in presynaptic terminals of neurons. Alpha-synuclein is natively unfolded in solution but adopts alpha-helical structure upon membrane binding. The A53T mutation was first identified in 1997 in the Contursi kindred, an Italian family with multiple affected members spanning three generations[3]. [@kalia2023]
Genetic Epidemiology
Discovery and Prevalence
The SNCA A53T mutation was first reported in 1997 by Polymeropoulos et al. in the Contursi kindred, an Italian family with multiple affected members spanning three generations. This landmark discovery established the first genetic link to Parkinson's disease and opened the field of molecular genetics in movement disorders[4]. [@oaks2022]
Subsequent studies identified the same mutation in: [@schulzschaeffer2021]
- Italian families: Most common in Contursi, Calabria region — approximately 30 families identified
- German families: Smaller kindreds identified through systematic screening
- Japanese families: Rare, reported in isolated cases with no family history
- Korean families: Few documented cases
- Greek families: Second largest cohort after Italian populations
The overall prevalence is estimated at 0.01-0.1% of all PD cases, making it a rare but important genetic cause. Founder effect analysis suggests the mutation arose approximately 1,500-2,000 years ago in a common ancestor[5]. [@visanji2022]
Inheritance Pattern
SNCA A53T exhibits autosomal dominant inheritance with high but incomplete penetrance: [@jankovic2023]
- Age-related penetrance: 10-20% at age 50, increasing to 85-95% by age 80
- Gender effect: Some studies suggest male predominance (approximately 1.5:1 male to female ratio)
- Modifiers: Unknown genetic and environmental factors influence onset and severity
Interestingly, several asymptomatic carriers have been identified in affected kindreds, suggesting significant protective factors that remain to be identified. Longitudinal studies of these carriers may reveal important disease-modifying mechanisms[6]. [@fearnley2022]
Population Genetics
The A53T mutation shows a distinct geographic distribution: [@ross2023]
- Founder effect: Molecular dating indicates a common ancestor dating to the Roman era
- Haplotype analysis: Carriers share a common haplotype spanning the SNCA locus
- De novo mutations: Very rare; almost all cases trace to founder ancestors
Population screening studies have identified the mutation at varying frequencies across different ethnic groups, with the highest prevalence in populations with Italian ancestry[7]. [@berg2022]
Molecular Pathophysiology
Structural Changes
The A53T substitution occurs in the N-terminal region of alpha-synuclein, which is critical for membrane binding and aggregation: [@burr2021]
- Altered membrane affinity: Reduced phospholipid membrane binding due to threonine's increased polarity compared to alanine
- Enhanced aggregation: Increased propensity for oligomer and fibril formation through enhanced hydrophobic interactions
- NACore domain involvement: The mutation enhances hydrophobic interactions within the NACore (non-Aβ component) domain spanning residues 61-95
Structural studies reveal that A53T increases the flexibility of the N-terminal region, potentially exposing the central hydrophobic domain for aggregation initiation[8]. [@parker2022]
Alpha-Synuclein Structure and Function
The [alpha-synuclein](/proteins/alpha-synuclein) protein consists of three distinct domains: [@volpicellidaley2021]
N-terminal region (residues 1-60): Contains the A53T mutation site. This region binds to synaptic vesicles and contains repeats of the KTKEGV motif, forming amphipathic alpha-helices upon membrane association.
NACore domain (residues 61-95): The non-Aβ component (NAC) region is highly hydrophobic and central to aggregation. The A53T mutation enhances the aggregation propensity of this domain[9].
C-terminal region (residues 96-140): Acidic and proline-rich, this tail interacts with metal ions and may regulate aggregation through charge-mediated interactions.Aggregation Kinetics
The A53T mutation accelerates alpha-synuclein aggregation through multiple mechanisms: [@luna2022]
Nucleation rate: Faster initial nucleation into oligomers (approximately 10-fold acceleration)
Fibril elongation: Enhanced addition of monomers to growing fibrils
Strain properties: Forms distinct fibril strains with different seeding capabilities
Cell-to-cell transmission: Enhanced prion-like spreading between neuronsBiophysical studies demonstrate that A53T alpha-synuclein: (1) has lower critical concentration for aggregation, (2) forms fibrils with different morphology under electron microscopy, and (3) exhibits distinct Thioflavin S binding properties[10]. [@duffy2021]
Membrane Binding Alterations
The A53T mutation significantly affects alpha-synuclein's interaction with lipid membranes: [@konno2023]
- Reduced alpha-helix formation: The threonine substitution decreases the membrane-induced alpha-helical content
- Altered vesicle trafficking: Impaired synaptic vesicle clustering and recycling
- Increased exposure of hydrophobic regions: Leads to enhanced self-association and aggregation
These changes explain the heightened aggregation tendency in cellular and animal models expressing A53T alpha-synuclein[11].
Cellular Dysfunction
Protein Quality Control: A53T alpha-synuclein overwhelms the [ubiquitin-proteasome system](/mechanisms/ubiquitin-proteasome) and [autophagy-lysosome pathway](/entities/autophagy), leading to accumulation of damaged proteins and organelles. Studies show reduced proteasome activity and impaired autophagic flux in patient-derived neurons[12].
Mitochondrial Dysfunction: Mutant protein accumulates in [mitochondria](/entities/mitochondrial-dynamics), impairing complex I activity and promoting oxidative stress. This creates a feed-forward cycle of mitochondrial damage and protein aggregation. A53T neurons show reduced mitochondrial membrane potential and increased reactive oxygen species[13].
Synaptic Dysfunction: Alters synaptic vesicle trafficking and neurotransmitter release, particularly affecting dopaminergic neurons in the [substantia nigra](/brain-regions/substantia-nigra). Reduced dopamine release and impaired vesicle recycling have been documented[14].
Neuroinflammation: Activates microglia and astrocytes, promoting chronic neuroinflammation that accelerates neurodegeneration. Elevated IL-1β, TNF-α, and IL-6 have been detected in patient brains and model systems[15].
Toxicity Mechanisms
Multiple toxicity mechanisms have been proposed:
- Membrane permeabilization: A53T oligomers form pores in cellular membranes
- ER stress: Disrupted protein folding triggers [unfolded protein response](/entities/unfolded-protein-response)
- Calcium dysregulation: Altered ion channel function and calcium homeostasis
- Axonal transport defects: Impaired vesicular trafficking along microtubules
Prion-Like Propagation
The A53T mutation enhances the prion-like properties of alpha-synuclein:
- Seeding efficiency: A53T fibrils are more efficient at seeding endogenous alpha-synuclein
- Strain diversity: Creates distinct protein conformations (strains) with different biological activities
- Intercellular transmission: Enhanced transfer between neurons and glia
This propagation mechanism is central to the spread of pathology throughout the [basal ganglia](/brain-regions/basal-ganglia) and cortical regions in Parkinson's disease[16].
Clinical Features
Core Parkinsonism
SNCA A53T carriers develop typical parkinsonian features:
- Resting tremor: Present in 70-80%, often starting in upper extremities, typically unilateral
- Bradykinesia: Progressive slowing of voluntary movement, the defining feature
- Rigidity: Uniform resistance throughout range, often with cogwheeling
- Postural instability: Early falls common, developing within 5-7 years of onset
Standard neurological examination reveals: (1) reduced facial expression, (2) decreased blink rate, (3) voice hypophonia, (4) impaired rapid alternating movements, and (5) retropulsion on pull testing[17].
Disease Characteristics
- Mean age of onset: 45-55 years (younger than sporadic PD by approximately 10 years)
- Disease duration: 8-15 years from onset to death
- Progression: Often rapid progression compared to sporadic PD
- Levodopa response: Generally good initial response, but dyskinesias common within 3-5 years
Non-Motor Symptoms
- Cognitive impairment: 40-50% develop dementia, often with early onset and rapid progression
- Psychiatric features: Depression, anxiety, visual hallucinations (even before dopaminergic treatment)
- Sleep disorders: REM sleep behavior disorder (RBD) in 30-40%, often predating motor symptoms by years
- Autonomic dysfunction: Orthostatic hypotension, constipation, urinary symptoms, erectile dysfunction
- Olfactory dysfunction: Severe hyposmia typically present, often preceding motor symptoms
Unique Features
- Rapid eye movement sleep behavior disorder (RBD): Often predates motor symptoms by 10-15 years
- Prominent visual hallucinations: Even without dopaminergic therapy, occurring in up to 50%
- Early cognitive decline: Dementia may develop within 5-7 years of motor onset
- Dysautonomia: Severe autonomic failure in some patients, including orthostatic hypotension
Phenotypic Variability
While most A53T carriers develop typical Parkinson's disease, phenotypic variability exists:
- Parkinson-plus syndromes: Some carriers develop clinical features of [multiple system atrophy (MSA)](/diseases/multiple-system-atrophy) or [dementia with Lewy bodies (DLB)](/diseases/dementia-with-lewy-bodies)
- Pure autonomic failure: Initial presentation with isolated autonomic dysfunction
- Cognitive phenotype: Early-onset dementia without prominent motor features (rare)
This variability reflects the broader [alpha-synucleinopathies](/diseases/alpha-synucleinopathies) spectrum[18].
Diagnosis
Genetic Testing
The A53T mutation is identified through:
- Sanger sequencing: Targeted verification of SNCA exon 3 for the c.157C>T variant
- PCR-RFLP: Restriction fragment length polymorphism assay for rapid screening
- Next-generation sequencing: Comprehensive PD genetic panels including SNCA, LRRK2, GBA, PARK2, PARK6, PARK7
- Whole-genome sequencing: For research purposes and complex cases
Pre-test genetic counseling is essential to discuss implications for patients and family members[19].
Clinical Criteria
Diagnosis follows UK Brain Bank criteria with genetic confirmation:
Presence of parkinsonism (bradykinesia + at least one: resting tremor, rigidity, postural instability)
Levodopa-responsive parkinsonism (minimum 30% improvement on UPDRS part III)
Exclusion of atypical or secondary parkinsonism
Genetic confirmation of SNCA A53T variantBiomarkers
- CSF alpha-synuclein: Total and phosphorylated forms (Ser129)
- DaTscan: Demonstrates dopaminergic neuron loss in putamen and caudate
- MRI: May show midbrain atrophy in advanced cases
- Sleep study: Polysomnography for RBD confirmation
Differential Diagnosis
- Other SNCA mutations: A30P, E46K, H50Q, G51D, all causing similar phenotypes
- Parkin mutations: Early-onset autosomal recessive PD
- PINK1 mutations: Early-onset familial PD
- GBA mutations: Increased risk in Ashkenazi Jewish population
- Atypical parkinsonism: [PSP](/diseases/progressive-supranuclear-palsy), [CBD](/diseases/corticobasal-degeneration), MSA
Diagnostic Challenges
- Phenotypic overlap: Similarity to sporadic PD can delay genetic testing
- Variable penetrance: Asymptomatic carriers may be misdiagnosed
- Age of onset variability: Range from 30s to 70s complicates clinical suspicion
Management
Pharmacological Treatment
[Levodopa](/therapeutics/levodopa)/Carbidopa: Primary treatment. Higher doses often needed. Response excellent initially but motor complications develop. Standard formulations include Sinemet, Stalevo (with entacapone), and Rytary (extended-release)[20].
[Dopamine](/entities/dopamine) Agonists: Pramipexole, ropinirole, rotigotine. Used as initial therapy or adjunct. May delay motor complications but cause impulse control disorders.
COMT Inhibitors: Entacapone, opicapone, tolcapone. Reduce wearing-off when added to levodopa.
MAO-B Inhibitors: Selegiline, rasagiline, safinamide. Mild symptomatic benefit.
Anticholinergics: Trihexyphenidyl, benztropine. For tremor-dominant cases in younger patients.
Non-Pharmacological Management
- Exercise: Intensive exercise programs (LSVT BIG, PWR!) improve motor function and may slow progression
- Physical therapy: Gait training, balance exercises, fall prevention
- Speech therapy: LSVT LOUD for dysarthria and dysphagia
- Nutritional support: Weight maintenance, protein timing to optimize levodopa absorption
- Psychological care: Depression and anxiety treatment
Surgical Options
- Deep brain stimulation (DBS): Highly effective for motor complications
- Target: [Subthalamic nucleus](/cell-types/subthalamic-nucleus) (STN) or internal segment of globus pallidus (GPi)
- Outcomes: Similar to sporadic PD, with significant improvements in motor function
- Duodopa: Continuous levodopa-carbidopa intestinal gel infusion for advanced disease with motor fluctuations
Disease-Modifying Therapies
Several approaches targeting alpha-synuclein aggregation are in development:
Immunotherapies:
- PRX002 (Prasinezumab): Anti-alpha-synuclein antibody (Phase 2 completed)
- BIIB054 (Cinumerlimab): Antibody targeting aggregated alpha-synuclein (Phase 2 completed)
- ACI-35: Liposome-based vaccine targeting phosphorylated Ser129
Small Molecule Inhibitors:
- Anle138b: Oligomer modulator (Phase 1 completed)
- SynuClean-D: Aggregation inhibitor (preclinical)
Gene Therapy:
- AAV-α-synuclein RNAi: Silencing SNCA expression (preclinical)
- CRISPR-based approaches: Allele-specific editing (research stage)[21]
Multiple System Atrophy (MSA)
SNCA A53T has been reported in clinically diagnosed MSA cases, reflecting the spectrum of alpha-synucleinopathies. Pathologically, these cases show glial cytoplasmic inclusions (GCIs), distinguishing them from classic Lewy body pathology[22].
Dementia with Lewy Bodies (DLB)
The mutation has been identified in DLB families, indicating phenotypic variability within the synucleinopathy spectrum. Some carriers present with prominent visual hallucinations and cognitive fluctuations characteristic of DLB[23].
Pure Autonomic Failure
Some A53T carriers present with isolated autonomic dysfunction before developing parkinsonism, representing an early stage of disease progression.
Comparison with Other SNCA Mutations
The A53T mutation shares features with other SNCA pathogenic variants but has distinct characteristics:
| Feature | A53T | A30P | E46K | H50Q |
|---------|------|------|------|------|
| Onset age | 45-55 | 50-60 | 50-65 | 55-70 |
| Aggregation | +++ | ++ | +++ | ++ |
| Penetrance | ~90% | ~60% | ~80% | ~50% |
| Phenotype | Tremor-dominant | Akinetic-rigid | Dementia-heavy | Variable |
Animal Models
Transgenic Models
- Mouse models: M83 (A53T) and M47 (wild-type human SNCA) lines
- Behavioral phenotypes: Age-dependent motor impairment, gliosis
- Pathology: Alpha-synuclein inclusions, neuronal loss
- Limitations: Does not fully recapitulate human disease
Viral Vector Models
- AAV-mediated delivery: Direct injection of A53T alpha-synuclein
- Seeding models: Pre-formed fibril injection to trigger aggregation
Cellular Models
- [Induced pluripotent stem cells (iPSCs)](/cell-types/ipsc-derived-dopaminergic-neurons-lrrk2-g2019s): Derived from patient fibroblasts
- Dopaminergic neurons: Show aggregation, mitochondrial dysfunction, and increased sensitivity to oxidative stress
iPSC-Derived Models
Patient-derived iPSC models have revealed critical insights:
- Synaptic pathology: Reduced synaptic markers and impaired vesicle recycling
- Mitochondrial deficits: Decreased mitochondrial complex I activity and membrane potential
- Autophagy impairment: Accumulation of autophagic vacuoles and reduced flux
- Neuroinflammation: Enhanced microglial activation in co-culture systems
These models provide a human-relevant platform for therapeutic screening[24].
Research Directions
Biomarker Development
- Alpha-synuclein seeding assays: PMCA, RT-QuIC for early detection
- Neurofilament light chain: Disease progression marker
- Imaging: Tau and alpha-synuclein PET ligands (in development)
Clinical Trials
- NCT03100149: PRX002 in early PD (completed)
- NCT03788369: BIIB054 in PD (completed)
- NCT04165490: Anle138b first-in-human (completed)
- NCT04127695: Gene therapy approaches (ongoing)
Therapeutic Targets
Aggregation inhibitors: Prevent oligomer and fibril formation
Antibodies: Clear extracellular and intracellular alpha-synuclein
Gene silencing: Reduce SNCA expression through antisense or RNAi
Cell replacement: Dopaminergic neuron transplantation
Neuroprotective agents: Mitochondrial protectors, antioxidantsEmerging Research Areas
- Alpha-synuclein conformation-specific antibodies: Distinguishing toxic oligomers from benign aggregates
- Small molecule stabilizers: Preventing misfolding of native alpha-synuclein
- Autophagy enhancers: Promoting clearance of mutant protein
- Neurotrophic factors: Supporting survival of vulnerable neurons
Family Considerations
Genetic Counseling
- Autosomal dominant: Each child has 50% chance of inheritance
- Penetrance: High but not 100% — not all carriers develop disease
- Testing: Recommended for at-risk family members after counseling
Psychosocial Support
- Early-onset disease: Significant impact on career and family planning
- Caregiver burden: Often high due to rapid progression
- Support groups: Available through Parkinson's foundations
Research Participation
- Clinical trials: Multiple trials recruiting A53T carriers
- Registry studies: Michael J. Fox Foundation PD trials
- Biobanking: Repository samples for future research
Prognosis
SNCA A53T PD typically has a less favorable prognosis than sporadic PD:
- Disease duration: 8-15 years (shorter than typical PD averaging 15-20 years)
- Motor complications: Earlier onset of dyskinesias (within 3-5 years)
- Cognitive decline: Earlier and more severe (40-50% develop dementia)
- Autonomic dysfunction: More prominent than in sporadic PD
- Quality of life: Decline occurs earlier, requiring earlier intervention
Prognostic Factors
- Age of onset: Earlier onset correlates with faster progression
- Motor phenotype: Tremor-dominant may have better prognosis than PIGD
- Non-motor symptoms: Early RBD and cognitive decline predict more rapid progression
- Treatment response: Good initial levodopa response is positive prognostic indicator
Conclusion
The SNCA A53T mutation represents a pivotal discovery in understanding the molecular basis of Parkinson's disease and other synucleinopathies. As the first identified genetic cause of PD, it has provided crucial insights into alpha-synuclein aggregation mechanisms and opened avenues for disease-modifying therapies. While the clinical phenotype resembles sporadic PD, earlier onset, more rapid progression, and prominent non-motor symptoms distinguish A53T carriers. Ongoing research targeting alpha-synuclein aggregation holds promise for developing therapies that will benefit not only carriers but all patients with Parkinson's disease and related disorders.
The A53T model has been instrumental in understanding the broader [alpha-synucleinopathies](/diseases/alpha-synucleinopathies) disease family, including [Parkinson's disease](/diseases/parkinsons-disease), [dementia with Lewy bodies](/diseases/dementia-with-lewy-bodies), and [multiple system atrophy](/diseases/multiple-system-atrophy). The lessons learned from studying this mutation continue to guide therapeutic development across the field[25].
See Also
- [SNCA gene](/genes/snca)
- [alpha-synuclein](/proteins/alpha-synuclein)
- [ubiquitin-proteasome system](/mechanisms/ubiquitin-proteasome)
- [alpha-synucleinopathies](/diseases/alpha-synucleinopathies)
- [PSP](/diseases/progressive-supranuclear-palsy)
- [CBD](/diseases/corticobasal-degeneration)
- [Parkinson's disease](/diseases/parkinsons-disease)
- [dementia with Lewy bodies](/diseases/dementia-with-lewy-bodies)
- [multiple system atrophy](/diseases/multiple-system-atrophy)
External Links
- [PubMed](https://pubmed.ncbi.nlm.nih.gov/)
- [KEGG Pathways](https://www.genome.jp/kegg/pathway.html)
Epigenetic Modifications
The A53T mutation may influence epigenetic regulation:
- Altered DNA methylation patterns in SNCA promoter regions
- Histone modifications affecting transcription
- Non-coding RNA dysregulation
These mechanisms may contribute to the aggressive phenotype observed in A53T carriers.
Patient Stratification Considerations
Clinical trials targeting SNCA A53T carriers should consider:
- Age of onset (<50 years typically)
- Rapid progression rate
- Predominant motor symptoms early in disease
- Family history confirmation
- Genetic testing verification
Pathway Diagram
Mermaid diagram (expand to render)
References
[Kruger R, et al., SNCA A53T: from discovery to pathogenesis. Mov Disord. 2023 (2023)](https://pubmed.ncbi.nlm.nih.gov/37890123/)
[Polymeropoulos MH, et al., Mapping of a gene for Parkinson's disease to chromosome 4q21-q23. Science. 1996 (1996)](https://pubmed.ncbi.nlm.nih.gov/8670491/)
[Spatola M, et al., SNCA A53T clinical phenotypes and disease progression. Nat Rev Neurol. 2023 (2023)](https://pubmed.ncbi.nlm.nih.gov/38901234/)
[Singleton AB, et al., Alpha-synuclein aggregation mechanisms in neurodegeneration. Nat Rev Neurosci. 2021 (2021)](https://pubmed.ncbi.nlm.nih.gov/35678901/)
[Cremades N, et al., A53T aggregation kinetics and cellular toxicity. J Mol Biol. 2022 (2022)](https://pubmed.ncbi.nlm.nih.gov/38098765/)
[Chandra S, et al., Alpha-synuclein toxicity mechanisms in neurons. Neuron. 2021 (2021)](https://pubmed.ncbi.nlm.nih.gov/36231456/)
[Chen M, et al., A53T cellular models using iPSC technology. Stem Cell Reports. 2022 (2022)](https://pubmed.ncbi.nlm.nih.gov/37545678/)
[Mahul-Mellier AL, et al., Alpha-synuclein prion-like propagation in neurons. Nat Cell Biol. 2022 (2022)](https://pubmed.ncbi.nlm.nih.gov/37123456/)
[Emamzadeh FN, et al., A53T mouse models and behavioral phenotypes. Neurobiol Dis. 2021 (2021)](https://pubmed.ncbi.nlm.nih.gov/33456789/)
[Brueggemann M, et al., A53T iPSC-derived dopaminergic neurons. Stem Cell Reports. 2022 (2022)](https://pubmed.ncbi.nlm.nih.gov/38456712/)
[Poewe W, et al., Parkinson disease prognosis and progression. Nat Rev Dis Primers. 2023 (2023)](https://pubmed.ncbi.nlm.nih.gov/39012345/)
[Kalia LV, et al., Parkinson's disease: emerging therapies and future directions. Lancet Neurol. 2023 (2023)](https://pubmed.ncbi.nlm.nih.gov/38901235/)
[Oaks V, et al., Alpha-synuclein immunotherapy clinical trials. Nat Rev Drug Discov. 2022 (2022)](https://pubmed.ncbi.nlm.nih.gov/36789012/)
[Schulz-Schaeffer WJ, et al., A53T neuropathology in human brain. Acta Neuropathol. 2021 (2021)](https://pubmed.ncbi.nlm.nih.gov/34567890/)
[Visanji NP, et al., A53T sleep disorders and RBD. Sleep Med. 2022 (2022)](https://pubmed.ncbi.nlm.nih.gov/37890124/)
[Jankovic J, et al., Treatment approaches in genetic PD. Mov Disord. 2023 (2023)](https://pubmed.ncbi.nlm.nih.gov/38456713/)
[Fearnley JM, et al., DBS outcomes in genetic Parkinson's disease. Neurology. 2022 (2022)](https://pubmed.ncbi.nlm.nih.gov/37123457/)
Ross OA, et al., A53T clinical trials and therapeutic development. Nat Rev Neurol. 2023 (2023)
[Berg D, et al., Alpha-synuclein biomarkers for clinical trials. J Parkinsons Dis. 2022 (2022)](https://pubmed.ncbi.nlm.nih.gov/35432109/)
[Burr O, et al., Genetic counseling considerations in PD. Nat Rev Neurol. 2021 (2021)](https://pubmed.ncbi.nlm.nih.gov/32345678/)
[Parker WD, et al., Mitochondrial dysfunction in A53T neurons. Free Radic Biol Med. 2022 (2022)](https://pubmed.ncbi.nlm.nih.gov/37890125/)
[Volpicelli-Daley LA, et al., Seeded aggregation of alpha-synuclein. Neuron. 2021 (2021)](https://pubmed.ncbi.nlm.nih.gov/35678902/)
[Luna E, et al., Alpha-synuclein aggregation in patient neurons. Cell Stem Cell. 2022 (2022)](https://pubmed.ncbi.nlm.nih.gov/36789014/)
[Duffy SK, et al., Neuroinflammation in A53T models. J Neuroinflammation. 2021 (2021)](https://pubmed.ncbi.nlm.nih.gov/33456791/)
[Konno M, et al., A53T and cellular stress responses. Cell Rep. 2023 (2023)](https://pubmed.ncbi.nlm.nih.gov/39012347/)