Table 1 Core neuropathological and clinical features of α-synucleinopathies

From: Biomarkers for cognitive impairment in alpha-synucleinopathies: an overview of systematic reviews and meta-analyses

α-synucleinopathy

Neuropathology

Clinical features

Cognitive features

PD, PD-D

Mild-to-moderate dopaminergic neuronal loss in the ventrolateral part of the substantia nigra; limbic and neocortical α-syn pathology1

Bradykinesia, rigidity, resting tremor, non-motor features (e.g., olfactory loss, RBD, depression, cognitive impairment)

Impairment in executive domain in PD; deficits in multiple domains in PD-D

DLB

Moderate-to-severe dopaminergic neuronal loss in the ventrolateral part of the substantia nigra; limbic and neocortical α-syn pathology

Dementia, fluctuating cognition, visual hallucinations, RBD, parkinsonism

Significant impairment in executive, language, visuo-spatial domains

MSA

Glial cytoplasmatic inclusions in the basal ganglia, substantia nigra, pontine nuclei, medulla, cerebellum

Dysautonomia, parkinsonism, cerebellar syndrome, cognitive impairment

Significant deficit in executive (i.e., shifting) domain

  1. 1For PD-D only.
  2. α-syn alpha-synuclein, DLB dementia with Lewy bodies, MSA multiple system atrophy, PD Parkinson’s disease, PD-D Parkinson’s disease-related dementia, RBD rapid eye movement sleep behavior disorder.
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