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These chronic attributes are generally associated with selective degeneration of dopaminergic neurons, corollary de-pigmentation of substantia nigra pars compacta (SNpc) and concomitant accumulation of α-synuclein in insoluble inclusions called Lewy bodies 2,3

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In some cases, the sequential use of different B12 status biomarkers or the calculation of a composite B12 status score (derived from a panel of B12 biomarkers and adjusted for folate status and age) can be used to detect deficient states that may otherwise be overlooked when using a single biomarker approach such as a B12 level (92)