Can we find dementia in the skin? Paul Donaghy Academic Clinical Lecturer Institute for Ageing/Institute of Neuroscience 10 minute talk then some questions

Dementia with Lewy bodies Cognitive Impairment Whole body symptoms of DLB/PD In

Dementia with Lewy bodies Cognitive Impairment Visual Hallucinations Fluctuations Acting out dreams Parkinsonism Whole body symptoms of DLB/PD In

Dementia with Lewy bodies Cognitive Impairment Visual Hallucinations Fluctuations Loss of sense of smell Difficulty swallowing Acting out dreams Drops in blood pressure Change in handwriting Tremor Constipation Incontinence Muscle stiffness Whole body symptoms of DLB/PD In Shuffling walk Instability/falls

α-synuclein Image: Suraj Rajan (CC License) I will present just a few slides of background on dementia with Lewy bodies It is a common form of dementia, …… The pathological hallmarks are Lewy bodies and Lewy neurites, seen here with aSyn staining Image: Suraj Rajan (CC License)

Diagnosing DLB Important to identify as certain medication should be avoided in DLB Can be difficult to identify clinically

Diagnosing DLB Cognitive Impairment Visual Hallucinations Fluctuations Loss of sense of smell Difficulty swallowing Acting out dreams Drops in blood pressure Change in handwriting Tremor Constipation Incontinence Muscle stiffness Whole body symptoms of DLB/PD In Shuffling walk Instability/falls

PuSkAS Study A pilot study looking at skin biopsy in DLB and Parkinson’s disease (PD) 10 DLB, 10 PD and 10 healthy control volunteers 3mm skin biopsies from upper back and arms Hypothesis: α-synuclein will be detectable in PD and DLB volunteers, but not healthy older people

Possible future use More accurate diagnosis Earlier diagnosis Identification of volunteers for early intervention studies

Progress so far 15 volunteers have completed baseline (50%) Further 6 awaiting baseline assessment Final 8 volunteerrs to be recruited prior to September 2018 (2 DLB, 2 PD, 4 conntrol)

Results - Tolerability

Was the procedure painful?

If so, how severe was the pain in the days following the procedure?

Are you happy with how the wound is healing?

Procedure acceptable for use in the diagnosis of dementia/PD?

Further Information paul.donaghy@ncl.ac.uk