MAPT and multiple system atrophy: While our understanding of tau aggregation in peripheral nerve tissues is still limited in histopathological studies,11-13 it has been well documented in α-synucleinopathies.5 In PD/LBD, α-synuclein predominantly accumulates in the axons,32 and in multiple system atrophy (MSA), it accumulates in Schwann cells.21 Furthermore, animal studies have suggested that α-synuclein may accumulate in the PNS before affecting the corresponding nuclei in the CNS.33,34 In addition, these models have been shown to result in associated peripheral neurological symptoms.35,36