{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:23:30Z","timestamp":1789647810953,"version":"4.0.0"},"reference-count":101,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Neurol"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Autonomic dysfunction is a characteristic feature in the synucleinopathies. Differences in cellular deposition and neuronal populations affected by \u03b1-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.<\/jats:p>","DOI":"10.1055\/s-0040-1713844","type":"journal-article","created":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T23:03:41Z","timestamp":1599692621000},"page":"492-501","source":"Crossref","is-referenced-by-count":28,"title":["Autonomic Dysfunction in the Synucleinopathies"],"prefix":"10.1055","volume":"40","author":[{"given":"Elizabeth A.","family":"Coon","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,9,9]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/j.1749-6632.2000.tb06900.x","article-title":"The alpha-synucleinopathies: Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy","volume":"920","author":"M G Spillantini","year":"2000","journal-title":"Ann N Y Acad Sci"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1046\/j.1471-4159.2001.00021.x","article-title":"The solubility of alpha-synuclein in multiple system atrophy differs from that of dementia with Lewy bodies and Parkinson's disease","volume":"76","author":"B C Campbell","year":"2001","journal-title":"J Neurochem"},{"issue":"38","key":"ref3","doi-asserted-by":"crossref","first-page":"E5308","DOI":"10.1073\/pnas.1514475112","article-title":"Evidence for \u03b1-synuclein prions causing multiple system atrophy in humans with parkinsonism","volume":"112","author":"S B Prusiner","year":"2015","journal-title":"Proc Natl Acad Sci U S A"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1038\/nature14547","article-title":"\u03b1-Synuclein strains cause distinct synucleinopathies after local and systemic administration","volume":"522","author":"W Peelaerts","year":"2015","journal-title":"Nature"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1093\/brain\/117.2.235","article-title":"The distribution of oligodendroglial inclusions in multiple system atrophy and its relevance to clinical symptomatology","volume":"117","author":"M I Papp","year":"1994","journal-title":"Brain"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.1093\/brain\/awv114","article-title":"Expanding the spectrum of neuronal pathology in multiple system atrophy","volume":"138","author":"M D Cykowski","year":"2015","journal-title":"Brain"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/B978-0-444-53491-0.00005-5","article-title":"Central control of autonomic function and involvement in neurodegenerative disorders","volume":"117","author":"M G Cersosimo","year":"2013","journal-title":"Handb Clin Neurol"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1002\/mds.25445","article-title":"Prodromal autonomic symptoms and signs in Parkinson's disease and dementia with Lewy bodies","volume":"28","author":"R B Postuma","year":"2013","journal-title":"Mov Disord"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/S1474-4422(14)70287-X","article-title":"Prediagnostic presentations of Parkinson's disease in primary care: a case-control study","volume":"14","author":"A Schrag","year":"2015","journal-title":"Lancet Neurol"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1001\/jamaneurol.2017.4243","article-title":"When do \u03b1-synucleinopathies start? 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