title: Spine Topographical Distribution of Skin α-Synuclein Deposits in Idiopathic Parkinson Disease.
abstract: Phosphorylated α-synuclein (p-syn) in skin nerves mainly in the proximal sites is a promising neurodegenerative biomarker for idiopathic Parkinson disease (IPD). However, the p-syn spine distribution particularly in patients with unilateral motor dysfunctions remains undefined. This study aimed to investigate in IPD p-syn differences between left and right cervical spine sites in patients with prevalent unilateral motor symptoms, and cervical and thoracic spine sites in patients with bilateral motor symptoms. We enrolled 28 IPD patients fulfilling clinical diagnostic criteria associated with abnormal nigro-striatal DatScan and cardiac MIBG: 15 with prevalently unilateral motor symptoms demonstrated by DatScan; 13 with bilateral motor symptoms and DatScan abnormalities. Patients underwent skin biopsy searching for intraneural p-syn deposits: skin samples were taken from C7 paravertebral left and right sites in unilateral patients and from cervical (C7) and thoracic (Th12) paravertebral spine regions in bilateral patients. Unilateral patients displayed 20% of abnormal p-syn deposits in the affected motor site, 60% in both sites and 20% only in the non-affected site. P-syn was found in all patients in C7 but in only 62% of patients in Th12. Our data showed that cervical p-syn deposits displayed a uniform distribution between both sides not following the motor dysfunction in unilateral patients, and skin nerve p-syn deposits demonstrated a spine gradient with the cervical site expressing the highest positivity.
authors.affiliation: From the IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy (VD, AI, GR, CS, SC, EF, PA, RL); and Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Italy (GR, SC, EF, PA, RL).
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Donadio
authors.affiliation: From the IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy (VD, AI, GR, CS, SC, EF, PA, RL); and Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Italy (GR, SC, EF, PA, RL).
authors.forename: Alex
authors.initials: A
authors.lastname: Incensi
authors.affiliation: From the IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy (VD, AI, GR, CS, SC, EF, PA, RL); and Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Italy (GR, SC, EF, PA, RL).
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rizzo
authors.affiliation: From the IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy (VD, AI, GR, CS, SC, EF, PA, RL); and Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Italy (GR, SC, EF, PA, RL).
authors.forename: Cesa
authors.initials: C
authors.lastname: Scaglione
authors.affiliation: From the IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy (VD, AI, GR, CS, SC, EF, PA, RL); and Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Italy (GR, SC, EF, PA, RL).
authors.forename: Sabina
authors.initials: S
authors.lastname: Capellari
authors.affiliation: From the IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy (VD, AI, GR, CS, SC, EF, PA, RL); and Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Italy (GR, SC, EF, PA, RL).
authors.forename: Enrico
authors.initials: E
authors.lastname: Fileccia
authors.affiliation: From the IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy (VD, AI, GR, CS, SC, EF, PA, RL); and Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Italy (GR, SC, EF, PA, RL).
authors.forename: Patrizia
authors.initials: P
authors.lastname: Avoni
authors.affiliation: From the IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy (VD, AI, GR, CS, SC, EF, PA, RL); and Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Italy (GR, SC, EF, PA, RL).
authors.forename: Rocco
authors.initials: R
authors.lastname: Liguori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy / Q000379:methods; D050483:Dopamine Plasma Membrane Transport Proteins / Q000378:metabolism; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology / Q000503:physiopathology; D017072:Neostriatum / Q000000981:diagnostic imaging; D010300:Parkinson Disease / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology; D010766:Phosphorylation; D049268:Positron-Emission Tomography; D012867:Skin / Q000737:chemistry / Q000294:innervation* / Q000378:metabolism*; D013378:Substantia Nigra / Q000000981:diagnostic imaging; D051844:alpha-Synuclein / Q000032:analysis / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D050483:Dopamine Plasma Membrane Transport Proteins; C497604:SNCA protein, human; D051844:alpha-Synuclein
keywords: Diagnostic test assessment; Idiopathic Parkinson disease; Phosphorylated α-synuclein; Skin biopsy; Topography