Article
Phosphorylated α-synuclein in skin nerve fibers differentiates Parkinson’s disease from multiple system atrophy
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Published: | August 25, 2015 |
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Deposition of phosphorylated α-synuclein in cutaneous nerve fibers has been shown pre- and postmortem in Parkinson’s disease. No premortem studies about presence of phosphorylated α-synuclein in skin sympathetic nerve fibers of multiple system atrophy, another synucleinopathy, have been conducted yet. In this in vivo study, skin of the ventral forearm of 10 multiple system atrophy and Parkinson’s disease patients, respectively, together with 6 control subjects with essential tremor were examined by immunohistochemistry. Phosphorylated α-synuclein deposits in skin sympathetic nerve fibers and dermal nerve fiber density were assessed. All Parkinson patients expressed phosphorylated α-synuclein in sympathetic skin nerve fibers, correlating with an age-independent denervation of autonomic skin elements. In contrast, no phosphorylated α-synuclein was found in autonomic skin nerve fibers of multiple system atrophy and essential tremor patients. These findings support that phosphorylated α-synuclein deposition is causative for nerve fiber degeneration in Parkinson’s disease. Moreover, premortem investigation of phosphorylated α-synuclein in cutaneous nerve fibers may prove a relevant and easily conductible diagnostic procedure to differentiate Parkinson’s disease from multiple system atrophy.