COQ2 and multiple system atrophy: Additional evidence in support of shared pathogenic mechanisms among synucleinopathies was suggested by recent genetic findings demonstrating that variants at the SNCA locus, coding for the deposited α-synuclein protein, are associated with increased risk for PD and MSA.7,8 In addition, the (MAPT) H1 haplotype has been associated with MSA.7,9 More recently, the COQ2 gene was reported to harbor mutations in familial MSA cases from Japan.10 However, follow-up studies in non-Asian ethnic cohorts were unable to replicate this finding.11,12 Thus, many prior observations require further evaluation.