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Abstract Details

Alpha-Synucleinopathy is a Potential Modifier of Neuro-Oncologic Outcome
Neuro-oncology
P13 - Poster Session 13 (8:00 AM-9:00 AM)
4-002
Neurological deficits in patients with primary and secondary brain tumors are most often caused by their malignancies or treatment sequelae.  But some may develop de novo neurodegeneration that requires objective diagnostic studies for confirmation.  
To analyze the features of alpha-synucleinopathy in symptomatic neuro-oncology patients. 
Between April and October 2021, patients with neuro-oncologic disorders and suspected to have alpha-synucleinopathy underwent skin punch biopsies as part of routine neurologic evaluation.  Neurologic symptoms were collated retrospectively along with cerebrospinal results and DaTscans when available.  Pearson correlation was performed between datasets.

The analysis included ten patients with IDH-1 wild-type (n=2) and mutant (n=1) glioblastomas, grade 1 meningioma (n=2), primary central nervous system lymphoma (n=1), hemangioblastoma (n=1), pilocytic astrocytoma (n=1), melanoma brain metastasis (n=1) and systemic metastases from colon cancer (n=1).  Median age was 77 (range 63-89) years.  Symptoms included constipation (n=8), bladder dysfunction (n=5), confusion or hallucination (n=5), REM sleep behavioral disorder (n=4), dementia (n=4), tremors (n=2), orthostasis (n=2) and anosmia (n=2).  Three individuals were L-dopa responsive.  Only one patient had a clinical diagnosis of Parkinson’s disease but he also had phospho-tau elevation in the cerebrospinal fluid indicating concurrent tauopathy.  Two had DaTscans; one showed a marked decrease of dopamine in both putamen and globus pallidus while the other had a more severe decrease of dopamine in the ipsilateral globus pallidus after treatment with radiosurgery.  There is a weak correlation between age and the number of symptoms (Pearson r2=0.4545).   Phosphorylated alpha-synuclein was found in 7 of 10 patients but no correlation was noted between the number of positive skin sites and symptoms (Pearson r2=0.1309).
Alpha-synucleinopathy is a potential modifier in the well-being of neuro-oncology patients.  Skin punch biopsy, DaTscan or both can be used to improve diagnostic certainty and lead to appropriate symptomatic treatment.
Authors/Disclosures
Eric T. Wong, MD, FAAN (Rhode Island Hospital)
PRESENTER 		Dr. Wong has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novocure. Dr. Wong has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ZaiLab. Dr. Wong has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Turning Point Therapeutics. The institution of Dr. Wong has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novocure. The institution of Dr. Wong has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Turning Point Therapeutics. The institution of Dr. Wong has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cancer Commons. The institution of Dr. Wong has received research support from Novocure. Dr. Wong has received intellectual property interests from a discovery or technology relating to health care. Dr. Wong has received publishing royalties from a publication relating to health care.
No disclosure on file
Lan Luo, MD (Beth Israel Deaconess Medical Center) Dr. Luo has received personal compensation in the range of $0-$499 for serving as a Consultant for Destum Partners. Dr. Luo has received personal compensation in the range of $0-$499 for serving as a Consultant for Guidepoint Global. Dr. Luo has received research support from BIDMC/HMS.
Roy L. Freeman, MD (Beth Israel Deaconess Hosp) Dr. Freeman has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Regenacy. Dr. Freeman has received personal compensation in the range of $100,000-$499,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurobo. Dr. Freeman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Vertex. Dr. Freeman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli-Lilly. Dr. Freeman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Theravance. Dr. Freeman has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Inhibikase. Dr. Freeman has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Freeman has stock in Neurobo. Dr. Freeman has stock in Cutaneous NeuroDiagnostics. The institution of Dr. Freeman has received research support from NIH. The institution of Dr. Freeman has received research support from Theravance. The institution of Dr. Freeman has received research support from Biohaven. The institution of Dr. Freeman has received research support from Lundbeck.
Christopher H. Gibbons, MD, FAAN (Beth Israel Deaconess Medical Center) Dr. Gibbons has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Autonomic Neuroscience. Dr. Gibbons has stock in CND Life Sciences. Dr. Gibbons has received publishing royalties from a publication relating to health care. Dr. Gibbons has received personal compensation in the range of $5,000-$9,999 for serving as a Expert Advisor with Department of Justice.