Submandibular gland needle biopsy for the diagnosis of Parkinson disease.
OBJECTIVE
This study investigates salivary gland biopsies in living patients with Parkinson disease (PD).


METHODS
Patients with PD for ≥5 years underwent outpatient transcutaneous needle core biopsies (18-gauge or 16-gauge) of 1 submandibular gland. Minor salivary glands were removed via a small incision in the lower lip. Tissue was fixed in formalin and serial 6-µm paraffin sections were immunohistochemically stained for phosphorylated α-synuclein and reviewed for evidence of Lewy type α-synucleinopathy (LTS).


RESULTS
Fifteen patients with PD were biopsied: 9 female/6 male, mean age 68.7 years, mean PD duration 11.8 years. Twelve of the needle core biopsies had microscopically evident submandibular gland tissue to assess and 9/12 (75%) had LTS. Only 1/15 (6.7%) minor salivary gland biopsies were positive for LTS. Five patients had an adverse event; all were minor and transient.


CONCLUSIONS
This study demonstrates the feasibility of performing needle core biopsies of the submandibular gland in living patients with PD to assess LTS. Although this was a small study, this tissue biopsy method may be important for tissue confirmation of PD in patients being considered for invasive procedures and in research studies of other PD biomarkers.
From the Parkinson's Disease and Movement Disorders Center (C.H.A., E.D.-D., A.D.), Department of Neurology, Mayo Clinic, Scottsdale; Banner Sun Health Research Institute (B.N.D., J.H., J.H.-W., G.S., L.I.S., H.A.S., D.G.W., T.G.B.), Sun City; the Department of Otolaryngology (M.L.H., D.G.L., T.N.), Mayo Clinic, Phoenix, AZ; and the Tokyo Institute of Psychiatry (H.A.), Tokyo, Japan.
Charles H
CH
Adler
Brittany N
BN
Dugger
Michael L
ML
Hinni
David G
DG
Lott
Erika
E
Driver-Dunckley
Jose
J
Hidalgo
Jonette
J
Henry-Watson
Geidy
G
Serrano
Lucia I
LI
Sue
Thomas
T
Nagel
Amy
A
Duffy
Holly A
HA
Shill
Haruhiko
H
Akiyama
Douglas G
DG
Walker
Thomas G
TG
Beach
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D001707:Biopsy, Needle / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000378:metabolism* / Q000473:pathology; D013363:Submandibular Gland / Q000378:metabolism* / Q000473:pathology; D051844:alpha-Synuclein / Q000378:metabolism*
D015415:Biomarkers; D051844:alpha-Synuclein