Objective:

Here we tested if p-syn deposits can be detected with the same approach in patients affected with idiopathic RBD (iRBD), as an early histopathological marker of impending synucleinopathy.

Background: Searching for phosphorylated α-synuclein (p-syn) deposits by means of skin biopsy has been reported to be an extremely sensitive method in Parkinson’s disease

Methods:

Proximal (cervical) and distal (legs) samples of skin biopsy have been obtained in 12 patients with polysomnographic-confirmed iRBD and 55 sex and age-matched healthy controls (HC). P-syn deposits were assessed by a monoclonal antibody against phosphorylated α-synuclein at Serine 129, disclosed by an immunofluorescence method. Patients underwent also an extensive work-up in order to search for non-motor symptoms and neuroimaging findings usually associated with impending neurodegeneration and to exclude subtle motor or cognitive signs.

Results:

p-syn deposits were detected in 9 (75%) out of 12 patients affected with iRBD and none of the HC. In iRBD, p-syn deposits showed a rostro-caudal gradient of sensitivity, with the highest positivity at the cervical site (67%) and the lowest one at the leg site (58%).

Conclusions: Our preliminary findings suggest that skin biopsy in patients with iRBD might be a safe and sensible procedure in order to detect p-syn deposits in the pre-motor stage of synucleinopaties.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/skin-nerve-phosphorylated-%ce%b1-synuclein-deposits-in-idiopathic-rem-sleep-behavior-disorder/