Submandibular gland needle biopsy for the diagnosis of Parkinson disease

Charles H. Adler, Brittany N. Dugger, Michael L. Hinni, David G. Lott, Erika Driver-Dunckley, Jose Hidalgo, Jonette Henry-Watson, Geidy Serrano, Lucia I. Sue, Thomas Nagel, Amy Duffy, Holly A. Shill, Haruhiko Akiyama, Douglas G. Walker, Thomas G. Beach

Research output: Contribution to journalArticle

78 Scopus citations

Abstract

Objective: This study investigates salivary gland biopsies in living patients with Parkinson disease (PD). Methods: Patients with PD for $5 years underwent outpatient transcutaneous needle core biopsies (18-gauge or 16-gauge) of 1 submandibular gland. Minor salivary glands were removed via a small incision in the lower lip. Tissue was fixed in formalin and serial 6-mm paraffin sections were immunohistochemically stained for phosphorylated a-synuclein and reviewed for evidence of Lewy type a-synucleinopathy (LTS). Results: Fifteen patients with PD were biopsied: 9 female/6 male, mean age 68.7 years, mean PD duration 11.8 years. Twelve of the needle core biopsies had microscopically evident submandibular gland tissue to assess and 9/12 (75%) had LTS. Only 1/15 (6.7%) minor salivary gland biopsies were positive for LTS. Five patients had an adverse event; all were minor and transient. Conclusions: This study demonstrates the feasibility of performing needle core biopsies of the submandibular gland in living patients with PD to assess LTS. Although this was a small study, this tissue biopsy method may be important for tissue confirmation of PD in patients being considered for invasive procedures and in research studies of other PD biomarkers.

Original languageEnglish (US)
Pages (from-to)858-864
Number of pages7
JournalNeurology
Volume82
Issue number10
DOIs
StatePublished - Mar 11 2014

ASJC Scopus subject areas

  • Clinical Neurology

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    Adler, C. H., Dugger, B. N., Hinni, M. L., Lott, D. G., Driver-Dunckley, E., Hidalgo, J., Henry-Watson, J., Serrano, G., Sue, L. I., Nagel, T., Duffy, A., Shill, H. A., Akiyama, H., Walker, D. G., & Beach, T. G. (2014). Submandibular gland needle biopsy for the diagnosis of Parkinson disease. Neurology, 82(10), 858-864. https://doi.org/10.1212/WNL.0000000000000204