Objective: The aim of our study was to investigate the alpha synuclein deposition at the enteric nerve system on patient with Parkinson’s disease and provide clinical-histological correlations arising toward a valid biomarker.

Background: Parkinson’s disease is a neurodegenerative disorder with the clinical hallmarks of motor parkinsonism. Non-motor signs including autonomic dysfunction, sleep disturbances, psychiatric and cognitive disturbances may precede the first signs of motor parkinsonism. Dopaminergic neuronal loss involved occurs early and is not just nigrostriatal. It affects other structures such as enteric nervous system .

Methods: We conducted a retrospective study in over 3 years (2013-2015) including PD patients. Clinical data were collected and analyzed. Digestive endoscopy with biopsies of upper digestive tract and immunohistochemistry study were performed.

Results: The immunohistochemical study of α -synuclein showed that 100 % of our patients had positive immunostaining. The rostrocaudal gradient of disease progression was: 66.6 % for the density α –synuclein and 50% intensity in α –synuclein.The density and intensity of α -synuclein in the digestive tract was higher in patients with an age of onset of motor symptoms earlier (p= .567), duration of the shorter pre symptomatic phase (p = .178), UPDRS score and stage of Hohen and Yahr with higher respectively p = .002 and p = .004. if we look to lesion load in α -synuclein and precocity and severity of the PD,we found that the Scopa Score is largest there is a higher number of NMS and greater Α -synuclein density and intensity.

Conclusions: We can conclude that based on the theory of Braak rostrocaudal gradient deposits of α-synuclein, our study identified a static and kinetic parameter correlated with neuropathological process of living MPI patient. This biomarker enteric reflects, through its density and intensity, severity of disease and appears to be correlated with different clinical aspects. However, it should valid the α-synuclein on pre-motor phase at which the therapeutic issue is important to consider if neuroprotective alternatives have emerged. During the symptomatic motor phase, it could serve as predictive prognostic marker for the occurrence of axial symptoms and cognitive decline, allowing the optimization of treatment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/toward-a-new-biomarker-on-parkinsons-disease-study-of-alpha-synuclein-on-upper-enteric-system-by-endoscopy/