Is alpha-synuclein in the colon a biomarker for premotor Parkinson's Disease? Evidence from 3 cases

Kathleen M. Shannon, Ali Keshavarzian, Hemraj B. Dodiya, Shriram Jakate, Jeffrey H. Kordower

Research output: Contribution to journalArticlepeer-review

330 Scopus citations


Background: Despite clinicopathological evidence that Parkinson's disease (PD) may begin in peripheral tissues, identification of premotor Parkinson's disease is not yet possible. Alpha-synuclein aggregation underlies Parkinson's disease pathology, and its presence in peripheral tissues may be a reliable disease biomarker. Objective: We sought evidence of alpha-synuclein pathology in colonic tissues before the development of characteristic Parkinson's disease motor symptoms. Methods: Old colon biopsy samples were available for three subjects with PD. Biopsies were obtained 2-5 years before PD onset. We performed immunohistochemistry studies for the presence of alpha-synuclein and Substance P in these samples. Results: All subjects showed immunostaining for alpha-synuclein (two, five and two years before first motor Parkinson's disease symptom). No similar alpha-synuclein immunostaining was seen in 23 healthy controls. Staining of samples for substance P suggested colocalization of alpha-synuclein and substance P in perikarya and neurites. Conclusions: This is the first demonstration of alpha-synuclein in colon tissue prior to onset of PD. Additional study is required to determine whether colonic mucosal biopsy may be a biomarker of premotor PD.

Original languageEnglish (US)
Pages (from-to)716-719
Number of pages4
JournalMovement Disorders
Issue number6
StatePublished - May 2012
Externally publishedYes


  • Alpha-synuclein
  • Biomarker
  • Colon
  • Parkinson's disease
  • Substance P

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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