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Updated: May 5, 2026
11:40
Quantitative Autonomic Testing
Published on: July 19, 2011
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Phenoconversion in Pure Autonomic Failure: A Systematic Review and Meta-Analysis
Sasivimol Virameteekul1,2, Ilenia Bonini3, Nicole Campese3,4
1Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.
JAMA Neurology
|May 4, 2026
Summary
Pure autonomic failure (PAF) can precede Parkinson disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). Clinical predictors like RBD and hyposmia aid early diagnosis for these α-synucleinopathies.
Area of Science:
- Neurology
- Neuroscience
- Clinical Medicine
Background:
- Pure autonomic failure (PAF) is increasingly recognized as a potential prodromal stage for α-synucleinopathies.
- The phenoconversion rates and clinical predictors for progression from PAF to Parkinson disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA) require systematic evaluation.
Conclusions:
- PAF represents a significant prodromal stage for PD, DLB, and MSA, with phenoconversion rates comparable to those of RBD.
- Combining clinical indicators (RBD, motor signs, hyposmia) with emerging biomarkers can enhance early diagnosis and intervention strategies for individuals with PAF.
- These findings highlight the potential for early identification and management of neurodegenerative diseases originating from PAF.
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