Autonomic dysfunction in the synucleinopathies

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2 Scopus citations


Autonomic dysfunction is a characteristic feature in the synucleinopathies. Differences in cellular deposition and neuronal populations affected by α-synuclein aggregation influence the manifestations and severity of autonomic failure in the different synucleinopathy disorders. The Lewy body disorders (Parkinson's disease, dementia with Lewy bodies, and pure autonomic failure) have predominantly peripheral involvement, whereas multiple system atrophy chiefly manifests as central autonomic failure. Clinical and laboratory features may be useful in distinguishing the different synucleinopathies based on the pattern and severity of autonomic failure. Treatment recommendations are aimed at the underlying pathophysiology and utilize non-pharmacologic and pharmacologic approaches. This review will focus on pathophysiology, clinical manifestations, and management recommendations for autonomic failure including neurogenic orthostatic hypotension, thermoregulatory dysfunction, genitourinary dysfunction, and gastrointestinal dysfunction in the synucleinopathies.

Original languageEnglish (US)
Pages (from-to)492-501
Number of pages10
JournalSeminars in Neurology
Issue number5
StatePublished - Oct 1 2020


  • Parkinson's disease
  • dementia with Lewy bodies
  • multiple system atrophy
  • orthostatic hypotension
  • pure autonomic failure
  • α-synuclein

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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