Skin nerve α-synuclein deposits

Abstract

This study provides Class III evidence that the presence of phosphorylated α-synuclein in skin nerve fibers on skin biopsy accurately distinguishes IPD from other forms of parkinsonism.

Peripheral synuclein tissue markers: a step closer to Parkinson’s disease diagnosis: Figure 1

“…Zange et al also describe changes compatible with a neuropathy in their subjects with Parkinson's disease. As they observed a correlation between the pSNCA deposits and denervation of autonomic skin elements that was independent of age or disease duration, they suggest, as others have previously (Donadio et al, 2014), that pSNCA is causative for the nerve fibre degeneration. (Fanciulli and Wenning, 2015) but not uncommonly fail to solve the problem conclusively.…”

“…The optimal site for study, for example, needs to be determined. We and others (Miki et al, 2010;NavarroOtano et al, 2014) have failed to find pSNCA deposits in skin from the supramalleolar region and current evidence suggests that the highest yield may occur in skin tissue obtained in the cervical region (Donadio et al, 2014). Zange et al promote the ventral forearm as the optimal site based on the assumption that there is a higher sweat gland density in this specific area.…”

“…In postmortem tissues, pSNCA has been detected in skin samples from the upper extremities, abdomen and scalp (Ikemura et al, 2008;Beach et al, 2010). In vivo studies assessing skin pSNCA deposits have reported on the presence of SNCA aggregates in patients with Parkinson's disease, with variable frequencies ranging from 0% to 100% (Wang et al, 2013;Donadio et al, 2014;Navarro-Otano et al, 2014), probably in part because different sites were selected for the skin biopsy. Zange et al chose skin tissue obtained from punch biopsies from the forearm for their study and found SNCA aggregates in all 10 of their patients with Parkinson's disease, but in none of the patients with MSA or essential tremor.…”

Abnormal thermography in Parkinson's disease

“…Cardiac scintigraphy with [ 123 I]-metaiodobenzylguanidine (MIBG) is the autonomic test most frequently used for PD diagnosis in the clinical setting [6]. Biopsies have recently been validated for this purpose in various organs, including the skin [7,8].…”

Peripheral nervous system involvement in Parkinson's disease: Evidence and controversies

“…Both findings were not present in healthy controls and in patients with other parkinsonian syndromes such as vascular parkinsonism, tauopathies and Parkin mutation carriers. Furthermore, no differences in disease duration, LD exposure and risk factors for neuropathy, including VB12 deficiency, were found in idiopathic PD compared to other parkinsonian syndromes [21] (Table 1). Similar results were recently reported by Doppler et al who detected a significant difference in both phosphorylated a-synuclein deposition and loss of small nerve fibers between idiopathic PD patients and controls.…”