title: Prevalence of Submandibular Gland Synucleinopathy in Parkinson's Disease, Dementia with Lewy Bodies and other Lewy Body Disorders.
abstract: BACKGROUND
  Clinical misdiagnosis, particularly at early disease stages, is a roadblock to finding new therapies for Lewy body disorders. Biopsy of a peripheral site might provide improved diagnostic accuracy. Previously, we reported, from both autopsy and needle biopsy, a high prevalence of submandibular gland synucleinopathy in Parkinson's disease (PD). Here, we report on an extension of these studies to subjects with dementia with Lewy bodies (DLB) and other Lewy body disorders in 228 autopsied subjects from the Arizona Study of Aging and Neurodegenerative Disorders.
  
  
  OBJECTIVE
  To provide an estimate of the prevalence of histological synucleinopathy in the submandibular glands of subjects with PD and other Lewy body disorders.
  
  
  METHODS
  Submandibular gland sections from autopsied subjects were stained with an immunohistochemical method for α-synuclein phosphorylated at serine 129. Included were 146 cases with CNS Lewy-type synucleinopathy (LTS), composed of 46 PD, 28 DLB, 14 incidental Lewy body disease (ILBD), 33 Alzheimer's disease with Lewy bodies (ADLB) and 2 with progressive supranuclear palsy and Lewy bodies (PSPLB). Control subjects included 79 normal elderly, 15 AD, 12 PSP, 2 conticobasal degeneration (CBD) and 2 multiple system atrophy (MSA).
  
  
  RESULTS
  Submandibular gland LTS was found in 42/47 (89%) of the PD subjects, 20/28 (71%) DLB, 4/33 (12%) ADLB and 1/9 (11%) ILBD subjects but none of the 110 control subjects.
  
  
  CONCLUSIONS
  These results provide support for further clinical trials of in vivo submandibular gland diagnostic biopsy for PD and DLB. An accurate peripheral biopsy diagnosis would assist subject selection for clinical trials and could also be used to verify other biomarkers.
authors.affiliation: Banner Sun Health Research Institute, Sun City, AZ, USA.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Beach
authors.affiliation: Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Adler
authors.affiliation: Banner Sun Health Research Institute, Sun City, AZ, USA.
authors.forename: Geidy
authors.initials: G
authors.lastname: Serrano
authors.affiliation: Banner Sun Health Research Institute, Sun City, AZ, USA.
authors.forename: Lucia I
authors.initials: LI
authors.lastname: Sue
authors.affiliation: Banner Sun Health Research Institute, Sun City, AZ, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Walker
authors.affiliation: University of California at San Francisco, USA.
authors.forename: Brittany N
authors.initials: BN
authors.lastname: Dugger
authors.affiliation: Barrow Neurological Institute, Phoenix, AZ, USA.
authors.forename: Holly A
authors.initials: HA
authors.lastname: Shill
authors.affiliation: Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: Erika
authors.initials: E
authors.lastname: Driver-Dunckley
authors.affiliation: Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: John N
authors.initials: JN
authors.lastname: Caviness
authors.affiliation: Banner Sun Health Research Institute, Sun City, AZ, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Intorcia
authors.affiliation: Banner Sun Health Research Institute, Sun City, AZ, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Filon
authors.affiliation: Banner Sun Health Research Institute, Sun City, AZ, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Scott
authors.affiliation: Banner Sun Health Research Institute, Sun City, AZ, USA.
authors.forename: Angelica
authors.initials: A
authors.lastname: Garcia
authors.affiliation: Banner Sun Health Research Institute, Sun City, AZ, USA.
authors.forename: Brittany
authors.initials: B
authors.lastname: Hoffman
authors.affiliation: Banner Sun Health Research Institute, Sun City, AZ, USA.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Belden
authors.affiliation: Banner Sun Health Research Institute, Sun City, AZ, USA.
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Davis
authors.affiliation: Barrow Neurological Institute, Phoenix, AZ, USA.
authors.forename: Marwan N
authors.initials: MN
authors.lastname: Sabbagh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D020961:Lewy Body Disease / Q000150:complications* / Q000175:diagnosis; D008297:Male; D010300:Parkinson Disease / Q000150:complications* / Q000175:diagnosis; D015995:Prevalence; D013364:Submandibular Gland Diseases / Q000453:epidemiology* / Q000209:etiology; D051844:alpha-Synuclein / Q000378:metabolism
chemical_list: D051844:alpha-Synuclein
keywords: Biopsy; biomarker; clinical trial; diagnosis; pathology; therapy