Patients with Parkinson's disease present with signs and symptoms of dysregulation of the peripheral autonomic nervous system that can even precede motor deficits. This dysregulation might reflect early pathology and therefore could be targeted for the development of prodromal or diagnostic biomarkers. Only a few objective clinical tests assess disease progression and are used to evaluate the entire spectrum of autonomic dysregulation in patients with Parkinson's disease. However, results from epidemiological studies and findings from new animal models suggest that the dysfunctional autonomic nervous system is a probable route by which Parkinson's disease pathology can spread both to and from the CNS. The autonomic innervation of the gut, heart, and skin is affected by α-synuclein pathology in the early stages of the disease and might initiate α-synuclein spread via the autonomic connectome to the CNS. The development of easy-to-use and reliable clinical tests of autonomic nervous system function seems crucial for early diagnosis, and for developing strategies to stop or prevent neurodegeneration in Parkinson's disease.

帕金森病患者会出现外周自主神经系统失调的体征和症状，甚至可以先于运动缺陷。这种失调可能反映了早期病理，因此可以成为开发前驱或诊断生物标志物的目标。只有少数客观的临床测试评估疾病进展，并用于评估帕金森病患者自主神经失调的整个范围。然而，流行病学研究的结果和新动物模型的发现表明，自主神经系统功能失调是帕金森病病理可以传播到中枢神经系统或从中枢神经系统传播的可能途径。肠道、心脏的自主神经支配，皮肤在疾病的早期阶段受到 α-突触核蛋白病理的影响，并可能启动 α-突触核蛋白通过自主神经连接组传播到中枢神经系统。开发易于使用且可靠的自主神经系统功能临床测试对于早期诊断以及制定阻止或预防帕金森病神经变性的策略至关重要。