Objective: To develop a novel method for the detection of P-SYN within superficial colon biopsies that can be obtained during routine colonoscopy.
Background: Parkinson’s disease (PD) is characterized by progressive pathological alpha-synuclein (P-SYN) deposition in the central and peripheral nervous system. Both the Braak hypothesis and the newer Brain/Body hypothesis of synuclein proliferation suggest the gastrointestinal tract as a major portal of disease. Although multiple autopsy studies have confirmed the presence of P-SYN within the GI tract, routine sampling of tissue through GI biopsies has never achieved satisfactory utility for clinical care
Method: After consent, participants with a clinical diagnosis of Parkinson’s disease (PD) who were undergoing routine colonoscopy were asked to have four superficial 3-millimeter colon biopsies taken, two from the ascending and two from the descending colon. Samples were fixed, frozen, and sectioned into 50-micrometer sections. Tissue was stained for P-SYN and protein gene product 9.5. Complete confocal imaging of the slides at 20x magnification with 2 um Z-plane steps was taken through the tissue. Digital quantitative analysis of intra-axonal P-SYN deposition was measured (NerValence, CND Life Sciences).
Results: A total of 4 patients have completed colonoscopy. Two patients had a low probability of PD, and two patients had a high probability of PD (based on duration of disease, response to Levodopa, comorbid clinical features, and disease confirmation by a movement disorder specialist). Both patients with a high probability of PD had a history of constipation and had multiple P-SYN positive regions within all 4 biopsies. The two patients with a low probability of PD had no history of constipation, and biopsies were P-SYN negative.
Conclusion: In this pilot study, we demonstrate that P-SYN is present in routine colon biopsy samples from patients with PD and a history of constipation. Further study is required to define the number of biopsies, location of biopsies, sensitivity and specificity, but this preliminary data strongly suggests a potential role for immunostaining of colonic tissue in the evaluation of patients with PD.
To cite this abstract in AMA style:
T. Levine, R. Freeman, B. Bellaire, J. Parent, S. Marcotte, M. Duval, C. Gibbons. A Pilot Study of Phosphorylated Alpha-Synuclein Detection and Quantitation from Routine Colonic Biopsies in Patients with Parkinson’s disease [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/a-pilot-study-of-phosphorylated-alpha-synuclein-detection-and-quantitation-from-routine-colonic-biopsies-in-patients-with-parkinsons-disease/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/a-pilot-study-of-phosphorylated-alpha-synuclein-detection-and-quantitation-from-routine-colonic-biopsies-in-patients-with-parkinsons-disease/