Table 2.

Key differences and similarities between real-time quaking-induced conversion (RT-QuIC) and protein misfolding cyclic amplification (PMCA)

	RT-QuIC	PMCA
Purpose	Detecting misfolded αSyn	Detecting misfolded αSyn
Amplification mechanism	Physical shaking (quaking) to induce protein aggregation	Cycles of sonication and incubation to amplify aggregates
Substrate	Recombinant αSyn produced in vitro, highly purified	Either recombinant αSyn or tissue-derived αSyn (e.g., from brain samples)
Real-time detection	Yes. Real-time monitoring based on ThT fluorescence	No. Post-amplification detection such as immunoblotting is required
Sensitivity	High	Extremely high
Operational complexity	Simple and suitable for high-throughput and fast detection	Complex and time-consuming, often for research use
Time	Short, providing results rapidly	Longer, requiring more time for amplification and analysis
Clinical application	Common in clinical diagnostics, fast and efficient	Less commonly used in clinical settings, mainly for research purpose
Safety	Simple and safe, with lower biological hazard	More complex handling with additional experimental steps