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The International Congress of Parkinson’s Disease and Movement Disorders® held this past October in Hawaii marked another highlight for CND Life Sciences. The company showcased its ongoing commitment to advancing the field of neurodegenerative diseases through research on skin biopsy-based testing for phosphorylated alpha-synuclein (P-SYN). These efforts, broadly shared at the congress, aim to enhance early identification and support for individuals at risk for synucleinopathies.

Dr. Christopher Gibbons, CND’s chief scientific officer, was a key presenter and panelist throughout the Congress. He presented several abstracts, including an interim readout of the NIH-funded Syn-Sleep Study focused on rates of P-SYN deposition in patients with REM sleep behavior disorder and another interim readout of the Syn-D Study that assesses the quantitative change in cutaneous phosphorylated alpha-synuclein (P-SYN) deposition over time in patients with dementia with Lewy bodies (DLB) in a longitudinal clinical trial.

Dr. Gibbons also was invited to join a scientific platform presentation about the clinical utility of cutaneous P-SYN deposition in various presentations of MSA.

Research related to the Proactive Brain Health Alliance, an initiative launched through the collaborative efforts of PMD Alliance, with educational support from CND Life Sciences, to improve resources for individuals who are prodromal, pre-clinical, and at-risk for synucleinopathies, was also presented.

Optimizing Test Performance with Three Biopsies for the Detection of Cutaneous Phosphorylated Alpha­ Synuclein¹
This study evaluated two large datasets to assess the diagnostic performance of skin biopsies for detecting phosphorylated alpha-synuclein (P-SYN) in patients with various synucleinopathies, with a specific focus on understanding the utility of multiple biopsies. In the Syn-One Study (n=432), of patients with clinically confirmed diagnoses, P-SYN was detected in up to 60% of cases with one biopsy and 82% with two biopsies. In the clinical ICD-10 cohort (n=6,966), detection rates were 58% with one biopsy and 75% with two biopsies increasing to 100% with three biopsies, with proximal sites showing higher yield in Parkinson’s disease and distal sites most effective at detecting peripheral nerve degeneration. The findings indicate that three biopsies across proximal and distal sites could optimize diagnostic accuracy and help detect both P-SYN and peripheral nerve degeneration, reducing the likelihood of false negatives.

Quantitative Measures of Cutaneous Phosphorylated Alpha-Synuclein: Powering a Disease Modification Clinical Trial In Parkinson’s Disease²
This pilot study evaluated a novel AI-based quantitative method for measuring cutaneous phosphorylated alpha-synuclein (P-SYN) in 10 patients with Parkinson’s disease (PD) and 10 healthy volunteers (HVs) across three time points (baseline, 4 weeks, 8 weeks). Mean P-SYN deposition was 11.5 ± 12.6 µm²/mm² in PD versus 0 µm²/mm² in controls (P < 0.0001), showing clear differentiation between groups. Power calculations indicated that detecting a 25% treatment effect would require only 24 patients per arm, highlighting this method’s potential for dramatically reducing sample sizes in α-synuclein–targeted clinical trials.

Cutaneous Phosphorylated Alpha-Synuclein Deposition in Multiple System Atrophy³
This study analyzed 55 confirmed cases of multiple system atrophy (MSA)—including 31 parkinsonian (MSA-P) and 24 cerebellar (MSA-C) variants—to compare cutaneous phosphorylated alpha-synuclein (P-SYN) deposition patterns. P-SYN was detected in 54 of 55 cases (98%), with similar quantities and distributions between MSA-P and MSA-C despite clinical differences. Across all patients, P-SYN was present in 75% of posterior cervical, 76% of distal thigh, and 64% of distal leg biopsies, primarily within somatic nerve fibers rather than autonomic fibers. These findings demonstrate that skin biopsy detection of P-SYN shows high sensitivity (98%) for MSA and open the door to longitudinal follow-up studies to determine the role of skin biopsy-based P-SYN assessment as a potential biomarker for tracking disease progression, regardless of clinical presentation.

A Longitudinal Quantitative Assessment of Phosphorylated Alpha-Synuclein Deposition in Dementia with Lewy Bodies⁴
This longitudinal study evaluated 109 patients with dementia with Lewy bodies (DLB) over six months to quantify changes in cutaneous phosphorylated alpha-synuclein (P-SYN) deposition over time. P-SYN was detected in 83% of participants at baseline and 88% at follow-up, with mean levels increasing by 11% over six months, providing an analogue for disease progression. No adverse events related to biopsies were noted during this study. These findings demonstrate that skin biopsy quantification of P-SYN is a safe and sensitive biomarker that reflects disease progression and may serve as a surrogate endpoint for clinical trials targeting synuclein.

The Syn-Sleep Study Detection of Cutaneous Phosphorylated Alpha-Synuclein in REM Sleep Behavior Disorder⁵
This ongoing longitudinal study of 80 participants with REM sleep behavior disorder (RBD) (mean age 67.8 ± 8.6 years, 30% female) aims to assess cutaneous phosphorylated alpha-synuclein (P-SYN) deposition and its role in predicting conversion to other synucleinopathies. Briefly, RBD is a known prodromal syndrome associated with prognostic risk for developing synucleinopathies. At baseline, 60 of 80 subjects (75%) were P-SYN positive, with P-SYN–positive individuals being slightly older (68.8 ± 7.4 vs. 64.9 ± 10.9 years). P-SYN detection rates were similar between participants confirmed by polysomnography (73%) and those diagnosed via questionnaire (74%). These findings show that skin biopsy detection of P-SYN is a feasible and sensitive test that may serve as a biomarker in prodromal RBD. Ongoing longitudinal follow-up is underway to determine P-SYN’s predictive value for phenoconversion to Parkinson’s disease, MSA, or DLB.

Proactive Brain Health Alliance Serving Those at Risk for Neurodegenerative Disease⁶
The Proactive Brain Health Alliance (PBHA), launched in 2024 by the Parkinson & Movement Disorder Alliance with educational support from CND Life Sciences, provides resources to individuals in the “space between” risk and formal diagnosis of neurodegenerative diseases. Through expert-led education on topics such as lifestyle medicine, genetics, and environmental exposures, PBHA aims to empower participants with actionable knowledge and peer support. In surveys, 87% of participants (n=63) reported gaining useful knowledge, 70% planned lifestyle changes, and 80% expressed interest in clinical trials and cited unmet needs for guidance and emotional support. These findings emphasize the importance of structured education and psychosocial resources for individuals in the “space between” risk and diagnosis, promoting proactive brain health and engagement in prevention-focused research.

We at CND Life Sciences are grateful for the ongoing dedication and contributions of our Research & Development and Clinical Research teams, as well as our collaborators at multiple private and academic institutions, who continue to drive progress within the field of neurodiagnostics.

^References

¹Levine T, Bellaire B, Khona H, et al. Three Biopsies Optimizes Test Performance for the Detection of Cutaneous Phosphorylated Alpha-Synuclein [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/three-biopsies-optimizes-test-performance-for-the-detection-of-cutaneous-phosphorylated-alpha-synuclein/. Accessed November 21, 2025.
²Gibbons C, Bellaire B, Khona H, et al. Quantitative Measures of Cutaneous Phosphorylated Alpha-Synuclein: Powering a Disease Modification Clinical Trial In Parkinson’s Disease [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/quantitative-measures-of-cutaneous-phosphorylated-alpha­synuclein-powering-a-disease-modification-clinical-trial-in-parkinsons-disease/. Accessed November 21, 2025.
³Freeman R, Levine T, Bellaire B, et al. Cutaneous Phosphorylated Alpha-Synuclein Deposition in Multiple System Atrophy [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/cutaneous-phosphorylated-alpha-synuclein-deposition-in­-multiple-system-atrophy/. Accessed November 21, 2025.
⁴Gibbons C, Levine T, Bellaire B, Freeman R. A Longitudinal Quantitative Assessment of Phosphorylated Alpha-Synuclein Deposition in Dementia with Lewy Bodies [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/a-longitudinal-quantitative-assessment-of-phosphorylated-alpha-synuclein-deposition-in-dementia-with-lewy-bodies/ Accessed November 21, 2025.2
⁵Levine T, Bellaire B, Freeman R, Gibbons C. The Syn-Sleep Study Detection of Cutaneous Phosphorylated Alpha-Synuclein in REM Sleep Behavior Disorder [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/the-syn-sleep-study-detection-of-cutaneous­-phosphorylated-alpha-synuclein-in-rem-sleep-behavior-disorder/. Accessed November 21, 2025.
⁶Mitchell A, Mahant P, Winter S, Merkel K. Proactive Brain Health Alliance Serving Those at Risk for Neurodegenerative Disease [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/proactive-brain-health-alliance-serving-those-at-risk-for­-neurodegenerative-disease/. Accessed November 21, 2025.