Interesting, yet not surprising. alpha-synuclein is absent from almost all Submandibular gland biopsy in individuals with LRRK2 p.G2019S variant, with and without PD.
1...
https://www.researchsquare.com/article/rs-34261/v1
IMO, LRRK2-associated neurodegeneration should not be considered as a synucleinopathy. Nor as PD. About half of patients with available neuropathology do not have Lewy bodies or other forms of alpha-synuclein accumulation.
2...
In this study of 37 LRRK2-associated neurodegeneration patients, less than half had Lewy pathology.
3... https://jamanetwork.com/journals/jamaneurology/article-abstract/1934714
Lewy Body Pathology in LRRK2-Related Parkinson Disease

This case series reports clinicopathological correlations in a series of LRRK2-related Parkinson disease cases. Findings from this selected group of patients demonstrated that parkinsonian motor...

https://jamanetwork.com/journals/jamaneurology/article-abstract/1934714
There are also clinical differences between patients with LRRK2 variants and other, "sporadic PD" patients. They are difficult to distinguish on the individual level, but as a group, the differences are there. So, should we start considering it a different disease?
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