Phenoconversion in Pure Autonomic Failure

What are the incidence rate and predictors of phenoconversion to central α-synucleinopathies in pure autonomic failure (PAF)?In this systematic review and meta-analysis of 9 longitudinal cohort studies including 900 patients with PAF during 6.4 years of follow-up, phenoconversion incidence rate to any central α-synucleinopathy was markedly higher than that of the general population, approximately 5% per year.Findings suggest that PAF may be a prodromal presentation of central α-synucleinopathies, and future research should focus on the accurate identification of those at high risk of phenoconversion using a combination of clinical features and biomarkers to allow potential early interventions.

Corresponding Authors: Eduardo de Pablo-Fernández, MD, PhD, Centre for Preventive Neurology, Charterhouse Square, Queen Mary University of London, London EC1M 6BQ, United Kingdom (e.depablofernandez@qmul.ac.uk); Alessandra Fanciulli, MD, PhD, Department of Neurology, Dysautonomia Center, Division of Neurobiology, Anichstraße 35, 6020 Innsbruck, Austria (alessandra.fanciulli@i-med.ac.at).

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