Usefulness of α-synuclein as a Marker for Early Diagnosis of Parkinson's Disease in Skin Biopsy.
Usefulness of α-synuclein as a Marker for Early Diagnosis of Parkinson's Disease in Skin Biopsy.
Parkinson's disease (PD) is a degenerative disease that can be difficult to diagnose. The
 clinicopathological studies had demonstrated a 76% accuracy in the clinical diagnosis of PD.

 At the beginning of PD is difficult for the clinician to distinguish from Parkinsonism Plus
 Syndromes (PPS) due to the similarity of symptoms and the lack of specific diagnostic tests.

 Specific biomarkers to help improve the accuracy of diagnosis and to separate these two
 entities are highly needed

 The histological hallmark for definite diagnosis of PD is the presence of fibrillar
 aggregates of phosphorylated alpha-synuclein called Lewy bodies (LBs) and Lewy neurites.
 Previous autopsy-based studies have revealed that alpha-synuclein is deposited in the
 peripheral autonomic nervous system including the enteric nervous system of the alimentary
 tract, cardiac plexus, adrenal medulla and skin.

 For this reason, in patients with parkinsonism, an alternative tool could be to demonstrate
 alpha-synuclein fibrillar aggregates in the skin, allowing early and appropriate diagnosis.
Parkinsonism, the syndrome, is a common movement disorder, and Parkinson's disease, the most
 common cause of parkinsonism, is the second most prevalent neurodegenerative disease after
 Alzheimer's disease.

 The clinical diagnosis of PD is based on the presence of the four common features: tremor
 when the limb is at rest, resistance to passive movement of the joints (rigidity), slowness
 and paucity of movement (bradykinesia and akinesia) and postural abnormalities.

 Approximately 25 percent of patients who received an initial clinical diagnosis of PD are
 found to have parkinsonism as part of another disorder, such as one of the so-called
 Parkinsonism-Plus Syndromes (PPS) The number and complexity of PPS seem to be increasing.
 This, along with the lack of diagnostic tests, makes it difficult for the clinician to
 distinguish between disease types.

 Some characteristic clinical features are used for the differential diagnosis, this
 manifestations include early and severe postural instability, falls in the first year of
 onset, abnormal eye movements, autonomic dysfunction, cerebellar signs and upper motor neuron
 signs. The PPS respond poorly to antiparkinsonian medications and have a worse prognosis than
 does PD. In spite of these suggestive features, not all PD patients have the same
 progression, in some cases it is impossible to separate typical PD from PPS, especially at
 the early stage. In this context, biological markers must be of great usefulness for the
 differential diagnosis of these entities.

 Some reports have described early features of PD such as (SPECT) imaging of the dopamine
 transporter that demonstrated the reduction of dopamine transporter in the striatum body at
 the early stage of PD and degeneration of the cardiac sympathetic nerve at the beginning of
 the disease process of PD; this occurs before neuronal cell loss is present in the dorsal
 vagal nucleus; This fact accounts for reduced cardiac uptake of meta-iodobenzylguanidine
 (MIBG), a physiological analog of norepinephrine. However, these diagnostic methods are not
 often performed. Therefore, more sensitive methods are needed to help improve the accuracy of
 diagnosis of PD.
Inclusion Criteria:

 -  Clinical diagnosis of Parkinson's Disease or Parkinson Plus Syndrome

 -  Subject is a male or female between the age of 50 and 95

 -  Subject will write the informed consent

 Exclusion Criteria:

 -  History of stroke or/and trauma

 -  Signs of cerebrovascular pathology

 -  Brain tumor

 -  Severe unrelated neurological or physical disease