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. 2025 Sep;12(9):1919-1925.
doi: 10.1002/acn3.70133. Epub 2025 Aug 5.

Identification of Dementia With Lewy Bodies by Skin Biopsy in Recent-Onset Cognitive Impairment

Alessandro Furia  1 , Alex Incensi  2 , Cecilia Delprete  2 , Giovanni Rizzo  2 , Salvatore Bonvegna  3 , Marco Piatti  3   4 , Enrica Olivola  5 , Francesco Ventruto  1 , Veria Vacchiano  2 , Enrico Fileccia  6 , Roberto Cilia  7 , Nicola Modugno  5 , Rocco Liguori  1   2 , Vincenzo Donadio  1   2
Affiliations

Identification of Dementia With Lewy Bodies by Skin Biopsy in Recent-Onset Cognitive Impairment

Alessandro Furia et al. Ann Clin Transl Neurol. 2025 Sep.

Abstract

Immunofluorescence for phosphorylated alpha-synuclein in skin biopsy samples is an emerging biomarker in synucleinopathies comprising Dementia with Lewy bodies. In this pilot study, 19 patients with recent-onset (≤ 18 months) cognitive impairment underwent skin biopsy at baseline, with follow-up clinical re-evaluation. Five patients fulfilled the Dementia with Lewy bodies diagnosis, all of them positive for skin phosphorylated alpha-synuclein. The remaining 14 patients were all negative. Skin tissue immunofluorescence may represent a promising technique in identifying synuclein pathology in recent-onset cognitive decline: larger cohorts are needed to confirm our preliminary data.

Keywords: Lewy bodies; dementia; immunofluorescence; skin biopsy; synucleinopathy.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Confocal microscope analysis (×400) of skin tissue from the cervical (C7) region of patient 5, showing innervation of arterioles. Signals from nerve fibers (PGP9.5, green), nuclei (DAPI, blue) and phosphorylated α‐synuclein (red) are merged in (A), showing PGP9.5 in (B) and p‐syn signals in (C). P‐syn accumulates in nerve fibers, as shown by co‐localization of p‐syn (red) and PGP9.5 (green) signal.
See this image and copyright information in PMC

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