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01-02-2009 | Original Paper

Olfactory bulb α-synucleinopathy has high specificity and sensitivity for Lewy body disorders

Authors: Thomas G. Beach, Charles L. White III, Christa L. Hladik, Marwan N. Sabbagh, Donald J. Connor, Holly A. Shill, Lucia I. Sue, Jeanne Sasse, Jyothi Bachalakuri, Jonette Henry-Watson, Haru Akiyama, Charles H. Adler, The Arizona Parkinson’s Disease Consortium

Published in: Acta Neuropathologica | Issue 2/2009

Abstract

Involvement of the olfactory bulb by Lewy-type α-synucleinopathy (LTS) is known to occur at an early stage of Parkinson’s disease (PD) and Lewy body disorders and is therefore of potential usefulness diagnostically. An accurate estimate of the specificity and sensitivity of this change has not previously been available. We performed immunohistochemical α-synuclein staining of the olfactory bulb in 328 deceased individuals. All cases had received an initial neuropathological examination that included α-synuclein immunohistochemical staining on sections from brainstem, limbic and neocortical regions, but excluded olfactory bulb. These cases had been classified based on their clinical characteristics and brain regional distribution and density of LTS, as PD, dementia with Lewy bodies (DLB), Alzheimer’s disease with LTS (ADLS), Alzheimer’s disease without LTS (ADNLS), incidental Lewy body disease (ILBD) and elderly control subjects. The numbers of cases found to be positive and negative, respectively, for olfactory bulb LTS were: PD 55/3; DLB 34/1; ADLS 37/5; ADNLS 19/84; ILBD 14/7; elderly control subjects 5/64. The sensitivities and specificities were, respectively: 95 and 91% for PD versus elderly control; 97 and 91% for DLB versus elderly control; 88 and 91% for ADLS versus elderly control; 88 and 81% for ADLS versus ADNLS; 67 and 91% for ILBD versus elderly control. Olfactory bulb synucleinopathy density scores correlated significantly with synucleinopathy scores in all other brain regions (Spearman R values between 0.46 and 0.78) as well as with scores on the Mini-Mental State Examination and Part 3 of the Unified Parkinson’s Disease Rating Scale (Spearman R −0.27, 0.35, respectively). It is concluded that olfactory bulb LTS accurately predicts the presence of LTS in other brain regions. It is suggested that olfactory bulb biopsy be considered to confirm the diagnosis in PD subjects being assessed for surgical therapy.

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Title: Olfactory bulb α-synucleinopathy has high specificity and sensitivity for Lewy body disorders
Authors: Thomas G. Beach
Charles L. White III
Christa L. Hladik
Marwan N. Sabbagh
Donald J. Connor
Holly A. Shill
Lucia I. Sue
Jeanne Sasse
Jyothi Bachalakuri
Jonette Henry-Watson
Haru Akiyama
Charles H. Adler
The Arizona Parkinson’s Disease Consortium
Publication date: 01-02-2009
Publisher: Springer-Verlag
Published in: Acta Neuropathologica / Issue 2/2009
Print ISSN: 0001-6322
Electronic ISSN: 1432-0533
DOI: https://doi.org/10.1007/s00401-008-0450-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Olfactory bulb α-synucleinopathy has high specificity and sensitivity for Lewy body disorders

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

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