Clinical availability of skin biopsy in the diagnosis of Parkinson's disease

To determine whether skin biopsy is practically useful in the premortem diagnosis for Parkinson's disease (PD), we examined Lewy pathology in the skin of the chest wall and leg, obtained from 6-mm punch biopsies, using phosphorylated alpha-synuclein antibody in 20 patients with clinically diagnosed PD. Abnormal accumulation of alpha-synuclein was found in the chest skin of two (10%) of 20 patients, but not in the leg. Although skin biopsy combined with a conventional immunohistochemistry for alpha-synuclein is not sufficient as a diagnostic tool, we could firstly demonstrate Lewy pathology in premortem tissue. The skin remains to be a promising tissue to be examined for the premortem diagnosis of PD.

[1]  Satoshi Orimo,et al.  Axonal α-synuclein aggregates herald centripetal degeneration of cardiac sympathetic nerve in Parkinson's disease , 2008 .

[2]  T. Iwatsubo,et al.  Analysis of the Adrenal Gland Is Useful for Evaluating Pathology of the Peripheral Autonomic Nervous System in Lewy Body Disease , 2007, Journal of neuropathology and experimental neurology.

[3]  Bernardo Lanzillo,et al.  Sensory deficit in Parkinson's disease: evidence of a cutaneous denervation. , 2008, Brain : a journal of neurology.

[4]  S Minoshima,et al.  Diagnosis and management of dementia with Lewy bodies , 2005, Neurology.

[5]  T. Iwatsubo,et al.  Accumulation of Phosphorylated α‐Synuclein in Aging Human Brain , 2003 .

[6]  D. Munoz,et al.  Do α-synuclein aggregates in autonomic plexuses predate Lewy body disorders? , 2007, Neurology.

[7]  D. Dickson,et al.  Cardiac sympathetic denervation correlates with clinical and pathologic stages of Parkinson's disease , 2008, Movement disorders : official journal of the Movement Disorder Society.

[8]  E. Masliah,et al.  α-Synuclein is phosphorylated in synucleinopathy lesions , 2002, Nature Cell Biology.

[9]  J. Hughes,et al.  Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. , 1992, Journal of neurology, neurosurgery, and psychiatry.

[10]  R. Djaldetti,et al.  Skin biopsy for assessment of autonomic denervation in Parkinson’s disease , 2006, Journal of Neural Transmission.

[11]  Hitoshi Takahashi,et al.  The Lewy body in Parkinson's disease: Molecules implicated in the formation and degradation of α‐synuclein aggregates , 2007, Neuropathology : official journal of the Japanese Society of Neuropathology.

[12]  A. Kakita,et al.  Degeneration of Cardiac Sympathetic Nerve Begins in the Early Disease Process of Parkinson’s Disease , 2007, Brain pathology.

[13]  A. Probst,et al.  α‐Synuclein pathology of the spinal and peripheral autonomic nervous system in neurologically unimpaired elderly subjects , 2006, Neuropathology and applied neurobiology.

[14]  H. Braak,et al.  Gastric α-synuclein immunoreactive inclusions in Meissner's and Auerbach's plexuses in cases staged for Parkinson's disease-related brain pathology , 2006, Neuroscience Letters.

[15]  H. Braak,et al.  Staging of brain pathology related to sporadic Parkinson’s disease , 2003, Neurobiology of Aging.

[16]  J. P. Seibyl,et al.  [sup 123 I] beta-CIT/SPECT imaging demonstrates bilateral loss of dopamine transporters in hemi-Parkinson's disease , 1996, Neurology.

[17]  T. Iwatsubo,et al.  Lewy Body Pathology Involves Cutaneous Nerves , 2008, Journal of neuropathology and experimental neurology.