The Future of Tears as a Biomarker for Neurodegenerative Disorders: Mark Lew, MD

WATCH TIME: 4 minutes

“It’s extremely important that if we have a biomarker, it can discern the difference between Parkinson disease and the atypical syndromes, both in the synucleinopathies and the tauopathies. We need to look at [multiple system atrophy], Lewy body disease, [progressive supranuclear palsy], and corticobasal syndrome as well.”

There has been little movement in the field of disease-modifying therapies for patients with Parkinson disease (PD), mainly because it has been difficult to identify the correct biomarker or group of biomarkers needed to target to show change. Using an unanesthetized Schirmer’s test, a group of investigators, led by Mark Lew, MD, looked at the protein composition of reflex tears and found elevated levels of oligomeric α-synuclein, a biomarker long-believed to show neurodegeneration.

The first study, which concluded a few years ago, identified the elevated levels, while a new analysis showed that the increased levels do not discriminate between various stages of early-, intermediate-, and late-stage PD.¹ Presented at the 2022 American Academy of Neurology (AAN) Annual Meeting, April 2-7, in Seattle, Washington, the new analysis further validated previous findings and suggested sustained levels of oligomeric α-synuclein throughout disease process.

Lew, director of the Division of Movement Disorders at the USC Keck School of Medicine, sat down with NeurologyLive^® at AAN 2022 to discuss the next steps in expanding on these results. He emphasized starting clinical trials in patients with other neurodegenerative disorders such as Alzheimer disease, multiple system atrophy, and Lewy body disease.

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REFERENCE
1. Lew M, Janga S, Ju Y, et al. Biomarkers for Parkinson disease with reflex tears stratified by disease duration. Presented at: 2022 AAN Annual Meeting; April 2-7, Seattle, Washington. Abstract 3750