Reader Response: In Vivo Distribution of {alpha}-Synuclein in Multiple Tissues and Biofluids in Parkinson Disease

We read with interest the publication entitled “In vivo distribution of α-synuclein in multiple tissues and biofluids in Parkinson disease.”1 In the article, Chahine et al.1 discuss the results of the Systemic Synuclein Sampling Study (S4 study). This was an important step toward the in vivo diagnosis of synucleinopathy. Unfortunately, although the detection of phosphorylated alpha-synuclein was highly specific, sensitivity was quite poor, particularly for skin (with a sensitivity of 24.1%). The authors note that there were several explanations for such findings, including the earlier diagnosis of PD in the S4 study compared with the relatively small studies performed at other centers.

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