title: Distinctive distribution of phospho-alpha-synuclein in dermal nerves in multiple system atrophy.
abstract: BACKGROUND
  MSA is characterized by deposition of alpha-synuclein (α-Syn) in oligodendrocytes and central nervous system (CNS) neurons. After recently detecting phospho-α-Syn (p-α-Syn) in dermal nerve fibers of patients with Parkinson's disease (PD), we assessed skin biopsies from patients with MSA to evaluate its potential role as a biomarker.
  
  
  METHODS
  Skin biopsies of patients with MSA (n = 12), idiopathic PD (n = 30), tauopathies (n = 15), and normal controls (n = 39) were analyzed. P-α-Syn within dermal nerves was detected by immunofluorescence staining.
  
  
  RESULTS
  p-α-Syn was found in 67% of patients with MSA and Parkinson's disease, but not in patients with tauopathy or controls when analyzing 15 consecutive sections. Sensitivity could be increased to 75% and 73%, respectively, by analyzing serial sections. In contrast to PD, where p-α-Syn clustered in autonomic fibers, deposits were mainly found in unmyelinated somatosensory fibers in MSA.
  
  
  CONCLUSIONS
  α-Syn pathology in MSA is not restricted to the CNS, and skin biopsy may be useful for the premortem study of p-α-Syn.
authors.affiliation: Department of Neurology, University of Würzburg, Würzburg, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Doppler
authors.affiliation: Department of Neurology, University of Würzburg, Würzburg, Germany.
authors.forename: Jessica
authors.initials: J
authors.lastname: Weis
authors.affiliation: Department of Neurology, University of Würzburg, Würzburg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Karl
authors.affiliation: Department of Neurology, University of Würzburg, Würzburg, Germany.
authors.forename: Sönke
authors.initials: S
authors.lastname: Ebert
authors.affiliation: Paracelsus-Elena-Klinik, Kassel, Kassel, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Ebentheuer
authors.affiliation: Paracelsus-Elena-Klinik, Kassel, Kassel, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Trenkwalder
authors.affiliation: Department of Neurology, University of Würzburg, Würzburg, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Klebe
authors.affiliation: Department of Neurology, University of Würzburg, Würzburg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Volkmann
authors.affiliation: Department of Neurology, University of Würzburg, Würzburg, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Sommer
mesh_terms: D000368:Aged; D001706:Biopsy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000473:pathology*; D009412:Nerve Fibers / Q000378:metabolism* / Q000473:pathology; D010300:Parkinson Disease / Q000473:pathology; D012867:Skin / Q000294:innervation / Q000473:pathology*; D043222:Ubiquitin Thiolesterase / Q000378:metabolism; D051844:alpha-Synuclein / Q000378:metabolism*
chemical_list: C482860:UCHL1 protein, human; D051844:alpha-Synuclein; D043222:Ubiquitin Thiolesterase
keywords: Parkinson's disease; multiple system atrophy; phospho-alpha-synuclein; skin biopsy