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Neuronal synuclein disease, and the companion Integrated Staging System, are a biologic definition and staging system conceptualized by multiple stakeholders including academia, industry, advocacy organizations, and importantly, people with lived experiences. In large part, this was informed and enabled by the knowledge garnered from the Parkinson's Progression Markers Initiative. This review provides a historical perspective and details contributions from the Parkinson's Progression Markers Initiative, among others, that made this advancement possible. These include the key role it played in validation of an in vivo biomarker of neuronal alpha\u2010synuclein, longitudinal characterization of dopaminergic dysfunction imaging, biospecimen collection and assays, comprehensive genetic characterization, and clinical phenotyping. 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