Abstract Details

Title Salivary Gland Biopsy as a Diagnostic Test for Parkinson's Disease

Topic Movement Disorders

Presentation(s) IN2 - (-)

Poster/Presentation
Number 002

Objective

Background There is no diagnostic test for LTS in living patients with PD. We have found LTS in autopsied PD submandibular glands and others found LTS in the minor salivary gland.

Design/Methods Patients with PD for >5 years, responsive to dopaminergic medication, without dementia or known salivary gland disorder were included. Core needle biopsies (18 or 16 gauge) of one submandibular gland were performed percutaneously. Minor salivary glands were removed via a small incision in the lower lip. Tissue was fixed in formalin and serial 5um paraffin sections were immunohistochemically stained for phosphorylated alpha-synuclein and reviewed for evidence of LTS.

Results To date biopsies from 10 PD subjects (6 female, 4 male) have been fully completed. Mean age was 67.8 yrs (range 61-76) and mean PD duration was 10.4 yrs (range 6-14). We extracted 1-5 core needle samples of submandibular gland (240-535 um thick) and 2-5 minor salivary glands requiring 1-3 stiches. Three patients had one adverse event each: swollen cheek, sore throat, excess fluid expelled from the needle biopsy site after a sneeze. Positive LTS staining was detected in 4/6 submandibular gland biopsies (4 cases did not have sufficient glandular tissue). Only 1/10 minor salivary gland biopsies was positive despite sufficient glandular tissue in all 10.

Conclusions This feasibility study provides the first evidence for the use of submandibular, but not minor salivary, gland biopsies as a diagnostic test for LTS in patients with PD. Data from 15 cases will be presented. This finding may be of great use when needing confirmatory tissue proof of PD especially when considering performing invasive procedures (ie. deep brain stimulation surgery or gene therapy).

Authors/Disclosures
Charles H. Adler, MD, PhD, FAAN (Mayo Clinic Arizona) PRESENTER	Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Avion. Dr. Adler has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for CND Life Sci. Dr. Adler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Jazz. Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Precon. Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine. The institution of Dr. Adler has received research support from NIH. The institution of Dr. Adler has received research support from Michael J. Fox Foundation. The institution of Dr. Adler has received research support from Arizona Biomedical Research Commission. Dr. Adler has received publishing royalties from a publication relating to health care.
Thomas Beach (Banner Sun Health Research Institute)	Thomas Beach has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Vivid Genomics. Thomas Beach has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche Diagnostics. The institution of Thomas Beach has received research support from National Institutes of Health. The institution of Thomas Beach has received research support from Michael J Fox Foundation . The institution of Thomas Beach has received research support from State of Arizona.
Brittany Dugger, BS	No disclosure on file
	No disclosure on file
	No disclosure on file
Erika Driver-Dunckley, MD, FAAN	Dr. Driver-Dunckley has nothing to disclose.
Matthew L. Flaherty, MD	Dr. Flaherty has received personal compensation for serving as an employee of Sense Diagnostics, Inc. Dr. Flaherty has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boeringher Engelheim. Dr. Flaherty has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for CSL Behring. Dr. Flaherty has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Alexion. Dr. Flaherty has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for various law firms. Dr. Flaherty has stock in Sense Diagnostics, Inc. The institution of Dr. Flaherty has received research support from NINDS. Dr. Flaherty has received intellectual property interests from a discovery or technology relating to health care.
	No disclosure on file
	No disclosure on file

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