Skin Nerve Phosphorylated α-Synuclein Deposits in Parkinson Disease With Orthostatic Hypotension

被引:45
作者
Donadio, Vincenzo [1 ]
Incensi, Alex [1 ]
Del Sorbo, Francesca [2 ]
Rizzo, Giovanni [1 ,4 ]
Infante, Rossella [1 ,4 ]
Scaglione, Cesa [1 ]
Modugno, Nicola [3 ]
Fileccia, Enrico [1 ,4 ]
Elia, Antonio E. [2 ]
Cencini, Federica [1 ,4 ]
Liguori, Rocco [1 ,4 ]
机构
[1] IRCCS Ist Sci Neurol Bologna, Bologna, Italy
[2] Fdn IRCCS Ist Neurol Carlo Besta, Milan, Italy
[3] IRCCS Neuromed Pozzilli, Isernia, Italy
[4] Univ Bologna, Dipartimento Sci Biomed & Neuromotorie, Bologna, Italy
关键词
Idiopathic Parkinson disease; Orthostatic hypotension; Phosphorylated alpha-synuclein; Skin biopsy; SLEEP BEHAVIOR DISORDER; PURE AUTONOMIC FAILURE; POTENTIAL BIOMARKER; NEURODEGENERATION; DYSAUTONOMIA; DENERVATION; NEUROPATHY;
D O I
10.1093/jnen/nly074
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
This study aimed to investigate phosphorylated alpha-synuclein (p-syn) in autonomic skin nerves of Parkinson disease (PD) patients with and without orthostatic hypotension (OH). We studied 28 PD patients with normal corrected Mini-Mental State Examination including 14 patients with neurogenic OH (PD + OH) and 14 matched patients did not complain of OH (PD - OH); 7 of whom were re-evaluated over a follow-up period (4 +/- 2 years). Skin biopsy was performed in proximal and distal sites. PD + OH patients showed a higher p-syn deposition than PD - OH, with widespread autonomic cholinergic and adrenergic skin nerve involvement. Over the follow-up period, PD - OH patients showed an increase in motor dysfunction scores without autonomic symptoms and a slight increase of skin p-syn deposition but still lower than PD + OH, mainly restricted to adrenergic fibers of skin vessels (SV). In summary, PD - OH patients showed a wide involvement of p-syn deposits in autonomic cholinergic and adrenergic skin nerves compared with PD -OH, and PD -OH patients showed a lower load of skin p-syn restricted to adrenergic fibers of SV still persisting over the follow-up period. The data supported a different pathogenesis between PD + OH and PD - OH and may help to identify a specific diagnostic trait for PD + OH.
引用
收藏
页码:942 / 949
页数:8
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