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Abstract Details

Cutaneous Alpha-Synuclein Deposition in Multiple System Atrophy
Neuromuscular and Clinical Neurophysiology (EMG)
S18 - Autonomic Disorders (3:52 PM-4:03 PM)
003
We recently reported that α-synuclein can be detected within cutaneous autonomic nerve fibers of patients with Parkinson’s disease (PD).  We now report the deposition of phosphorylated and total alpha-synuclein in patients with MSA, and compare those findings to controls and individuals with PD.
To define the peripheral neural deposition of alpha-synuclein in MSA.
Twenty-nine individuals with MSA, 22 individuals with PD and 10 healthy control subjects had clinical examinations, autonomic function testing and skin biopsies taken from multiple proximal and distal sites.  Skin biopsies were stained for PGP9.5, phosphorylated and total α-synuclein and results compared to autonomic function tests. 
Patients with MSA had evidence of peripheral phosphorylated α-synuclein deposits in all subjects (P<0.001 vs controls, where no α-synuclein was detected) at proximal and distal biopsy sites.  Significant differences in synuclein deposition between MSA subjects and PD subjects (P<0.01) was noted at all biopsy sites.

We report the largest study of cutaneous alpha synuclein in individuals with multiple system atrophy.  Contrary to expectations, peripheral deposition of phosphorylated α-synuclein was present in all subjects with MSA and PD.  These findings may offer insights into the different patterns of synuclein deposition across a spectrum of neurodegenerative diseases.  The results carry significant implications for disease diagnosis, prognosis and therapeutic interventions that alter the natural history of the disease.
Authors/Disclosures
Christopher H. Gibbons, MD, FAAN (Beth Israel Deaconess Medical Center)
PRESENTER 		Dr. Gibbons has received personal compensation for serving as an employee of CND Life Sciences. Dr. Gibbons has stock in CND Life Sciences. Dr. Gibbons has received publishing royalties from a publication relating to health care. Dr. Gibbons has received personal compensation in the range of $5,000-$9,999 for serving as a Expert Advisor with Department of Justice.
Ningshan Wang, MD, PhD (BIDMC) Dr. Wang has nothing to disclose.
Drew S. Kern, MD, FAAN (University of Colorado) Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. The institution of Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. The institution of Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott. The institution of Dr. Kern has received research support from Boston Scientific. The institution of Dr. Kern has received research support from AbbVie Pharmaceticals. Dr. Kern has received research support from Medtronic.
Jose-Alberto Palma, MD, PhD, FAAN (New York University Grossman School of Medicine) Dr. Palma has received personal compensation for serving as an employee of Novartis. Dr. Palma has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Clinical Autonomic Research. The institution of Dr. Palma has received research support from National Institutes of Health. Dr. Palma has received publishing royalties from a publication relating to health care.
Horacio C. Kaufmann, MD, FAAN (NYU Langone Health - NYU Dysautonomia Center) Dr. Kaufmann has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Theravance. Dr. Kaufmann has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly USA. Dr. Kaufmann has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Takeda Pharmaceuticals. Dr. Kaufmann has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ono Pharma UK Ltd. Dr. Kaufmann has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Vaxxinity. Dr. Kaufmann has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Spinger. The institution of Dr. Kaufmann has received research support from Biogen. Dr. Kaufmann has received publishing royalties from a publication relating to health care.
Roy L. Freeman, MD (Beth Israel Deaconess Hosp) Dr. Freeman has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Regenacy. Dr. Freeman has received personal compensation in the range of $100,000-$499,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurobo. Dr. Freeman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Vertex. Dr. Freeman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli-Lilly. Dr. Freeman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Theravance. Dr. Freeman has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Inhibikase. Dr. Freeman has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Freeman has stock in Neurobo. Dr. Freeman has stock in Cutaneous NeuroDiagnostics. The institution of Dr. Freeman has received research support from NIH. The institution of Dr. Freeman has received research support from Theravance. The institution of Dr. Freeman has received research support from Biohaven. The institution of Dr. Freeman has received research support from Lundbeck.