Objective: The aim of the PARKSYN study was to test the utility of salivary alpha-synuclein (a-syn) concentration in the differential diagnosis between Parkinson’s disease (PD) and Drug-Induced Parkinsonism (DIP).

Background: A previous study found reduced total a-syn and increased a-syn oligomer concentrations in the saliva of PD patients. To date, no previous study has measured a-syn concentrations in DIP patients.

Methods: We collected salivary samples from 30 consecutive PD patients, 30 DIP patients and 30 age- and sex-matched controls from three centers. PD patients were older than 45 years, with PD diagnosis made within the last three years. DATscan was used to differentiate PD and DIP patients, using diminished striatal isotope binding to define the PD group. Clinical recordings of motor and non-motor signs were performed using MDS-UPDRS, UDysRS, PDNMS and MOCA tests. DATscan interpretation and a-syn measurements were made by operators blinded to the clinical group.

Results: In total, 39 subjects were analysed: 16 PD, 11 DIP and 12 controls. Asymmetric parkinsonian syndrome was more frequently found in the PD group compared to the DIP group. The salivary total a-syn, oligomeric a-syn and a-syn oligomeric/total ratio did not differ among PD, DIP and control groups (p=0.89; p=0.25; p=0.47, respectively).

Conclusions: Quantification of salivary a-syn is not a reliable marker for differentiating early PD and DIP.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/salivary-alpha-synuclein-a-new-tool-for-the-diagnosis-of-parkinsons-disease/