{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T05:18:45Z","timestamp":1787635125372,"version":"build-2736575974"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The neurodegenerative disorders characterized by deposition of phosphorylated alpha-synuclein (P-SYN) include Parkinson\u2019s disease (PD), multiple system atrophy (MSA) and dementia with Lewy bodies (DLB). Diagnosis of synucleinopathies in clinical practice has been enhanced by recent updates to diagnostic guidelines. Despite these advances, many patients still fall between diagnostic guideline criteria creating challenges to clinical care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective chart review of patients seen in an outpatient private practice. The objective of this study was to determine the impact of skin biopsy detection of phosphorylated alpha-synuclein (P-SYN) in the clinical care of patients with movement or cognitive symptoms in whom a synucleinopathy was part of the differential diagnosis. The clinical diagnosis and treatment plan before, and after, skin biopsy detection for P-SYN was determined through detailed chart extraction, with ICD-10 codes used to define clinical diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred patients with suspected neurodegenerative disease were included in the chart review, 47 presenting with tremor, 18 with gait dysfunction, 11 with rigidity or bradykinesia and 24 with cognitive dysfunction. After skin biopsy testing for P-SYN, 60% of patients had a change in their ICD-10 documented diagnosis and 91% had a change to their clinical treatment plan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with suspected neurodegenerative disease, skin biopsy detection of P-SYN supported changes in the diagnostic impression or management in the majority of patients in this study. These findings support the growing role of diagnostic biomarkers in the diagnosis and management of patients with suspected neurodegenerative synucleinopathies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1868980","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T04:23:41Z","timestamp":1787631821000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical utility of skin biopsy detection of phosphorylated alpha-synuclein in an outpatient practice"],"prefix":"10.3389","volume":"17","author":[{"given":"Todd","family":"Levine","sequence":"first","affiliation":[{"name":"CND Life Sciences","place":["Scottsdale, AZ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Freeman","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center","place":["Boston, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Murray","sequence":"additional","affiliation":[{"name":"CND Life Sciences","place":["Scottsdale, AZ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandria","family":"Swanson","sequence":"additional","affiliation":[{"name":"CND Life Sciences","place":["Scottsdale, AZ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin T.","family":"Gibbons","sequence":"additional","affiliation":[{"name":"Wesleyan University","place":["Middletown, CT, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Crowell","sequence":"additional","affiliation":[{"name":"Norton Neurosciences","place":["Louisville, KY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Phillips","sequence":"additional","affiliation":[{"name":"Norton Neurosciences","place":["Louisville, KY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher H.","family":"Gibbons","sequence":"additional","affiliation":[{"name":"CND Life Sciences","place":["Scottsdale, AZ, United States"]},{"name":"Beth Israel Deaconess Medical Center","place":["Boston, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1002\/mds.26424","article-title":"MDS clinical diagnostic criteria for Parkinson's disease","volume":"30","author":"Postuma","year":"2015","journal-title":"Movement Disorders"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1212\/WNL.0000000000004058","article-title":"Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB consortium","volume":"89","author":"McKeith","year":"2017","journal-title":"Neurology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1002\/mds.29005","article-title":"The Movement Disorder Society criteria for the diagnosis of multiple system atrophy","volume":"37","author":"Wenning","year":"2022","journal-title":"Movement Disorders"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.1002\/mds.29556","article-title":"Accuracy of the early diagnosis of Parkinson's disease","volume":"38","author":"Beach","year":"2023","journal-title":"Movement Disorders"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e414","DOI":"10.1212\/CPJ.0000000000001016","article-title":"Clinical diagnostic accuracy of early\/advanced Parkinson disease: an updated clinicopathologic study","volume":"11","author":"Adler","year":"2020","journal-title":"Neurol Clin Pract"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1298","DOI":"10.1001\/jama.2024.0792","article-title":"Skin biopsy detection of phosphorylated alpha-synuclein in patients with synucleinopathies","volume":"331","author":"Gibbons","year":"2024","journal-title":"JAMA"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e1529","DOI":"10.1212\/WNL.0000000000206772","article-title":"Cutaneous alpha-synuclein signatures in patients with multiple system atrophy and Parkinson disease","volume":"100","author":"Gibbons","year":"2023","journal-title":"Neurology"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.parkreldis.2021.04.007","article-title":"Consistent skin alpha-synuclein positivity in REM sleep behavior disorder - 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