Evidence map›Paper›PMID 41929295›Full record

ArticlemedRxiv : the preprint server for health sciences2026

Brain-Only Versus GI-Only Synucleinopathy: A Comprehensive Autopsy Study With Both IHC and SAA.

Christina D Orru, Thomas G Beach, Charles H Adler, Holly A Shill, Erika Driver-Dunckley, Shyamal H Mehta, Alireza Atri, Ileana Lorenzini, Sanaria H Qiji, Anthony J Intorcia and 8 more

Abstract readPreprint
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Christina D OrruLaboratory of Neurological Infections and Immunity, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), Hamilton, MT.
Thomas G BeachBanner Sun Health Research Institute, Sun City, AZ.
Charles H AdlerMayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ.
Holly A ShillBarrow Neurological Institute, Phoenix, AZ.
Erika Driver-DunckleyMayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ.
Shyamal H MehtaMayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ.
Alireza AtriBanner Sun Health Research Institute, Sun City, AZ.
Ileana LorenziniBanner Sun Health Research Institute, Sun City, AZ.
Sanaria H QijiBanner Sun Health Research Institute, Sun City, AZ.
Anthony J IntorciaBanner Sun Health Research Institute, Sun City, AZ.
Andrew G HughsonLaboratory of Neurological Infections and Immunity, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), Hamilton, MT.
Bradley R GrovemanLaboratory of Neurological Infections and Immunity, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), Hamilton, MT.
Samantha KingLaboratory of Neurological Infections and Immunity, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), Hamilton, MT.
Parvez AlamLaboratory of Neurological Infections and Immunity, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), Hamilton, MT.
Sabiha ParveenLaboratory of Neurological Infections and Immunity, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), Hamilton, MT.
Sarah VascellariDepartment of Biomedical Sciences, University of Cagliari, Cagliari, Italy.
Byron CaugheyLaboratory of Neurological Infections and Immunity, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), Hamilton, MT.
Geidy E SerranoBanner Sun Health Research Institute, Sun City, AZ.ORCID 0000-0002-9527-2011

Funding

Research Education ComponentP30AG019610 · NIA · SUN HEALTH RESEARCH INSTITUTE · PI REIMAN, ERIC MICHAEL · 2001 to 2020
$32.5M
Research Education ComponentP30AG072980 · NIA · BANNER HEALTH · PI ALIREZA ATRI · 2021 to 2026
$24.9M
National Brain and Tissue Resource for Parkinson's Disease and Related DisordersU24NS072026 · NINDS · BANNER SUN HEALTH RESEARCH INSTITUTE · PI BEACH, THOMAS G · 2011 to 2015
$7.8M
NIA NIH HHS P30 AG019610NIA NIH HHS P30 AG072980NINDS NIH HHS U24 NS072026
6 · The paper itself

Abstract

Braak and others have proposed that Lewy body pathology (LBP) in Parkinson's disease (PD) may arise not only in the brain but alternatively from an initial site in the gastrointestinal (GI) tract with subsequent passage to the central nervous system CNS through the vagus nerve or other routes. We tested this hypothesis by using both immunohistochemistry (IHC) and RT QuIC a form of alpha synuclein seed amplification assay (SAA) to detect alpha synuclein LBP in samples from selected brain regions and 10 GI tract sites taken from autopsies of 50 PD subjects and 128 elderly subjects without parkinsonism or dementia including 34 with IHC identified CNS incidental Lewy body disease (ILBD) and 94 with no Lewy body IHC pathology detected (NLB). A positive SAA or IHC result was restricted to the GI tract in only 2 subjects while LBP by either SAA or IHC was restricted to the brain in 11 subjects. To fairly compare GI-only with brain-only synucleinopathy, however, we would have to do SAA on brain samples from all ILBD and NLB cases in at least 4 critical brain regions: olfactory bulb, medulla, pons, and amygdala. Further SAA of brain regions is estimated, based on the proportional results to date, to potentially identify 21 additional brain-only LBP subjects, for a total of 32, if it were done on all of the NLB subjects. From this brain-only LBP is estimated to be 16 times more common than GI-only LBP. To assess the clinical impact of SAA-positive GI sites we found that the number of positive sites per subject is significantly correlated with UPDRS motor score and SCOPA-AUT GI related scores including those for salivation, straining, constipation, and bowel movement.

Indexed as

autopsyetiologygastrointestinalimmunohistochemistryperipheral nervous systemphosphorylated alpha-synucleinRT-QuIC

Identifiers

PMID41929295
PMCPMC13042094

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.