Multisite study: Predicting Lewy body disease using skin biopsy α-synuclein seed amplification assays.

Cohort studyJournal of neuropathology and experimental neurology· Jun 2026

Multisite study: Predicting Lewy body disease using skin biopsy α-synuclein seed amplification assays.

Chelva Janarthanam, Christina D Orrú, Andrew G Hughson … Thomas G Beach

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DermatopathologyCohort studyDiagnosisQ1IF 2.4

Skin α-synuclein seed test was positive in 93% of neocortical-stage Lewy body disease at autopsy.

Multisite study: Predicting Lewy body disease using skin biopsy α-synuclein seed amplification assays.

Chelva Janarthanam … Thomas G Beach

Journal of neuropathology and experimental neurology · Jun 2026 · Q1 in General Medicine

Background

Skin biopsies analyzed with α-synuclein seed amplification assays (seed amplification assays) are a simple way to clinically interrogate the presence of α-synuclein aggregates.

Results

positive skin test tracked advanced brain-wide Lewy body spread

Neocortical LBD stage

93%

Lower stages

10%

More results

Punch biopsies were taken from the posterior neck and analyzed by the 3 labs in 6 separate seed amplification assays.

Pairwise agreement between labs and assays ranged from excellent (kappa 0.82) to moderate (kappa 0.40-0.68).

Sensitivity across assays ranged between 50.0% and 61.3%; specificity ranged between 68.6% and 100%.

More results

Comparisons of group 1 vs group 2 produced the greatest specificities, between 77.3% and 100%.

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Conclusion

Skin biopsy α-synuclein seed amplification assays may be useful as a diagnostic and progression biomarker in Lewy body dementia clinical trials.

Multisite study: Predicting Lewy body disease using skin biopsy α-synuclein seed amplification assays.

Multisite study: Predicting Lewy body disease using skin biopsy α-synuclein seed amplification assays.

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