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Table 3 The spectrum of synucleinopathies: Main clinical features and diagnostic tests

From: Towards an improved early diagnosis of neurodegenerative diseases: the emerging role of in vitro conversion assays for protein amyloids

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
  1. 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
  2. a Duration as “isolate” disorder, and rate of phenotypic conversion are highly variable