PuSH - Publikationsserver des Helmholtz Zentrums München: Consistent skin alpha-synuclein positivity in REM sleep behavior disorder-A two center two-to-four-year follow-up study.

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Doppler, K.* ; Antelmi, E.* ; Kuzkina, A.* ; Donadio, V.* ; Incensi, A.* ; Plazzi, G.* ; Pizza, F.* ; Marelli, S.* ; Ferini-Strambi, L.* ; Tinazzi, M.* ; Mayer, G.* ; Sittig, E.* ; Booij, J.* ; Sedghi, A.* ; Oertel, W.H. ; Volkmann, J.* ; Sommer, C.* ; Janzen, A.* ; Liguori, R.*

Consistent skin alpha-synuclein positivity in REM sleep behavior disorder-A two center two-to-four-year follow-up study.

Parkinsonism Relat. Disord. 86, 108-113 (2021)

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Open Access Green möglich sobald Postprint bei der ZB eingereicht worden ist.

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Objective/methods: Phosphorylated alpha-synuclein (p-syn) in dermal nerves of patients with isolated REM sleep behavior disorder (iRBD) is detectable by immunofluorescence-labeling. Skin-biopsy-p-syn-positivity was recently postulated to be a prodromal marker of Parkinson's disease (PD) or related synucleinopathies. Here, we provide two-to four-year clinical and skin biopsy follow-up data of 33 iRBD patients, whose skin biopsy findings at baseline were reported in 2017. Results: Follow-up biopsies were available from 25 patients (18 positive at baseline) and showed consistent findings over time in 24 patients. One patient converted from skin-biopsy-negativity to -positivity. P-syn-positivity was observed in iRBD patients who still had a normal FP-CIT-SPECT two years later. Clinically, five of the 23 at baseline skin-biopsy-positive patients (21.7%) had converted to PD or dementia with Lewy bodies at follow-up, but none of the skin-biopsy-negative patients. Conclusions: Dermal p-syn in iRBD is most probably an early consistent marker of synucleinopathy and may support other indicators of conversion to manifest disease state.

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