Table 3.
The spectrum of synucleinopathies: Main clinical features and diagnostic tests
| Disease | Mean duration | Main affected brain regions | Main clinical features | Main diagnostic tests |
|---|---|---|---|---|
| PD | 10–20 | Brainstem | L-DOPA responsive parkinsonism | DaTSCAN (ioflupane) |
| DLB | 8 | Neocortices, limbic system, brainstem | Cognitive decline with fluctuations, parkinsonism, visual hallucinations, changes to cognitive ability, RBD | DaTSCAN (ioflupane), MIBG, PSG, EEG |
| MSA | 7–9 | Striatum, cerebellum, brainstem | Autonomic failure with various degree of parkinsonism, cerebellar and pyramidal signs | DaTSCAN (ioflupane), MRI, autonomic tests, FDG-PET |
| PAF | a | PNS | Isolate autonomic failure | Autonomic tests |
| iRBD | a | Lower brainstem | IRBD | PSG |
Abbreviations: PD Parkinson’s disease, DLB Dementia with Lewy bodies, MSA Multiple system atrophy, PAF Pure autonomic failure, iRBD Isolate REM sleep behavior disorder, PNS Peripheral nervous system, MIBG Metaiodobenzylguanidine, PSG Polysomnography, EEG Electroencephalography, FDG-PET Fluorodeoxyglucose-positron emission tomography
a Duration as “isolate” disorder, and rate of phenotypic conversion are highly variable