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We determined the accuracy of skin biopsy SAA in predicting the clinical diagnoses of Parkinson disease (PD), PD with dementia (PDD) and dementia with Lewy bodies (DLB). Blinded SAAs were performed in 3 independent laboratories. Subjects diagnosed with PD, PDD and DLB were analyzed together as group 1, clinically unaffected subjects as group 2 and those with risk factors for LBD as group 3. Punch biopsies were taken from the posterior neck and analyzed by the 3 labs in 6 separate SAAs. Pairwise agreement between labs and assays ranged from excellent (kappa 0.82) to moderate (kappa 0.40-0.68). Sensitivity across assays ranged between 50.0% and 61.3%; specificity ranged between 68.6% and 100%. Comparisons of group 1 vs group 2 produced the greatest specificities, between 77.3% and 100%. In 17 cases that subsequently came to autopsy, 93% of SAAs were positive in those at the neocortical LBD stage but in only &amp;lt;10% of those at lower stages. Skin biopsy \u03b1-synuclein SAA may be useful as a diagnostic and progression biomarker in Lewy body dementia clinical trials.<\/jats:p>","DOI":"10.1093\/jnen\/nlag048","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T11:27:23Z","timestamp":1776770843000},"page":"1020-1032","source":"Crossref","is-referenced-by-count":2,"title":["Multisite study: Predicting Lewy body disease using skin biopsy \u03b1-synuclein seed amplification assays"],"prefix":"10.1093","volume":"85","author":[{"given":"Chelva","family":"Janarthanam","sequence":"first","affiliation":[{"name":"Isakson Center for Neurological Disease Research, The University of Georgia , Athens, GA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina D","family":"Orr\u00fa","sequence":"additional","affiliation":[{"name":"Laboratory of Neurological Infections and Immunity, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID) , Hamilton, MT,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew G","family":"Hughson","sequence":"additional","affiliation":[{"name":"Laboratory of Neurological Infections and Immunity, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID) , Hamilton, MT,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Holzinger","sequence":"additional","affiliation":[{"name":"AbbVie Deutschland GmbH & Co. KG, Neuroscience Discovery , Ludwigshafen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keenan","family":"Taylor","sequence":"additional","affiliation":[{"name":"AbbVie Bioresearch Center, Biotherapeutics and Genetic Medicine Technologies , Worcester, MA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anumantha G","family":"Kanthasamy","sequence":"additional","affiliation":[{"name":"Isakson Center for Neurological Disease Research, The University of Georgia , Athens, GA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byron","family":"Caughey","sequence":"additional","affiliation":[{"name":"Laboratory of Neurological Infections and Immunity, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID) , Hamilton, MT,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland G","family":"Heym","sequence":"additional","affiliation":[{"name":"AbbVie Deutschland GmbH & Co. KG, Neuroscience Discovery , Ludwigshafen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles H","family":"Adler","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona , Scottsdale, AZ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly A","family":"Shill","sequence":"additional","affiliation":[{"name":"Department of Neurology, Barrow Neurological Institute , Phoenix, AZ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shyamal","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona , Scottsdale, AZ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Driver-Dunckley","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona , Scottsdale, AZ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew H","family":"Ho","sequence":"additional","affiliation":[{"name":"Banner Sun Health Research Institute , Sun City, AZ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parichita","family":"Choudhury","sequence":"additional","affiliation":[{"name":"Banner Sun Health Research Institute , Sun City, AZ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R","family":"Shprecher","sequence":"additional","affiliation":[{"name":"Banner Sun Health Research Institute , Sun City, AZ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M","family":"Belden","sequence":"additional","affiliation":[{"name":"Banner Sun Health Research Institute , Sun City, AZ,","place":["United 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