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Included patients completed the composite autonomic severity score (COMPASS 31), the Wood Mental Fatigue Inventory, the Epworth Sleepiness scale, the REM Behavior Disorder Questionnaire, the Patient\u2010Reported Outcomes Measurement Information System (PROMIS\u201010), and the Gastroparesis Cardinal Symptom Index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 296 patients seen with POTS, 22 patients with suspected neuropathic POTS had skin biopsies performed during their evaluation. Seven of 22 patients had P\u2010SYN present on skin biopsy, while 15 individuals did not. Those with P\u2010SYN on biopsy: (1) were more likely to be male; (2) had features of REM sleep behavioral disorder; (3) reported less sleepiness and cognitive impairment; and (4) noted greater symptoms of gastroparesis. On autonomic testing, the group with P\u2010SYN deposition was more likely to have a hypertensive response to tilt\u2010table testing and abnormal QSART responses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Phosphorylated alpha\u2010synuclein deposition is present in some postural tachycardia patients with neuropathic features. Individuals with a postural tachycardia and cutaneous phosphorylated alpha\u2010synuclein deposition may be distinguished from other patients with neuropathic POTS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51347","type":"journal-article","created":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T15:48:00Z","timestamp":1616687280000},"page":"908-917","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Cutaneous alpha\u2010synuclein deposition in postural tachycardia patients"],"prefix":"10.1002","volume":"8","author":[{"given":"Todd D.","family":"Levine","sequence":"first","affiliation":[{"name":"Honor Health Neurology Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bailey","family":"Bellaire","sequence":"additional","affiliation":[{"name":"CND Life Sciences Phoenix Arizona 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