▁years ▁after ▁R BD ▁diagn osis . ▁ ▁Al pha - syn uc lein ▁depos its ▁can ▁affect ▁the ▁card iac ▁mus cle ▁and ▁blood ▁vessels . ▁Al most ▁all ▁people ▁with ▁syn uc lein op ath ies ▁have ▁card i ov asc ular ▁d ys function , ▁although ▁most ▁are ▁asympt om atic . ▁ ▁From ▁che wing ▁to ▁def ec ation , ▁alpha - syn uc lein ▁depos its ▁affect ▁every ▁level ▁of ▁g astro int est inal ▁function . ▁ ▁Sym pt oms ▁include ▁upper ▁g astro int est inal ▁tract ▁d ys function ▁such ▁as ▁delayed ▁g astr ic ▁empty ing ▁or ▁lower ▁g astro int est inal ▁d ys function , ▁such ▁as ▁const ip ation ▁and ▁prolong ed ▁st ool ▁trans it ▁time . ▁ ▁Ur inary ▁ret ention , ▁w aking ▁at ▁night ▁to ▁ur inate , ▁increased ▁ur inary ▁frequency ▁and ▁ur gency , ▁and ▁over - ▁or ▁under active ▁bl ad der ▁are ▁common ▁in ▁people ▁with ▁syn uc lein op ath ies . ▁Sex ual ▁d ys function ▁usually ▁appears ▁early ▁in ▁syn uc lein op ath ies , ▁and ▁may ▁include ▁ere ct ile ▁d ys function , ▁and ▁difficulties ▁ach ieving ▁org asm ▁or ▁ej ac ulating . ▁ ▁Di agn osis ▁ ▁D iffer ential ▁diagn osis ▁Pers ons ▁with ▁P D ▁are ▁typically ▁less ▁caught ▁up ▁in ▁their ▁visual ▁hall uc in ations ▁than ▁those ▁with ▁D L B . ▁There ▁is ▁a ▁lower ▁inc idence ▁of ▁trem or