1
|
Dang THT, Tran TN, Xing F, Ha ULN, Vo KCN, Nguyen TV, Nguyen KV, Le HT, Truong D. Diagnostic value of vietnamese smell identification test in Parkinson's disease. J Neurol Sci 2024; 459:122958. [PMID: 38522243 DOI: 10.1016/j.jns.2024.122958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/04/2024] [Accepted: 03/10/2024] [Indexed: 03/26/2024]
Abstract
INTRODUCTION The Vietnamese Smell Identification Test (VSIT) has been validated in determining olfactory dysfunction in the Vietnamese population; however, its value in diagnosing Parkinson's disease (PD) has not been established. METHODS This case-control study was conducted at University Medical Center HCMC, Ho Chi Minh City, Vietnam. The study sample included non-demented PD patients and healthy controls (HC) who were gender- and age-matched. All participants were evaluated for odor identification ability using the VSIT and the Brief Smell Identification Test (BSIT). RESULTS A total of 218 HCs and 218 PD patients participated in the study. The median VSIT and BSIT scores were significantly different between PD and HC groups (VSIT, 5 (3) vs. 9 (2), P < 0.0001; BSIT, 6 (3) vs 8 (2), P < 0.0001). Using the cut-off of <8 for correct answers out of 12 odorants, the VSIT had higher sensitivity (84.4%) and specificity (86.2%) than those of the BSIT (sensitivity of 81.7% and specificity of 69.3%) for the diagnosis of PD. The area under the curve (AUC) value was greater for the VSIT than for the BSIT (0.909 vs 0.818). The smell identification scores were not significantly correlated with disease duration, disease severity, or LEDD (all p > 0.05). CONCLUSION The VSIT can be a valuable ancillary tool for supporting the diagnosis of PD in Vietnam. Olfactory dysfunction in PD was unrelated to the disease duration and severity. The VSIT can be applied to improve the accuracy of clinical PD diagnosis.
Collapse
Affiliation(s)
- Thuong Huyen Thi Dang
- Movement Disorder Unit, Neurology Department, University Medical Center HCMC, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
| | - Tai Ngoc Tran
- Movement Disorder Unit, Neurology Department, University Medical Center HCMC, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
| | - Frank Xing
- The Truong Neurosciences Institute, Parkinson and Movement Disorder Institute, Orange Coast Memorial Medical Center, Fountain Valley, CA 92708, USA
| | - Uyen Le Ngoc Ha
- Movement Disorder Unit, Neurology Department, University Medical Center HCMC, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
| | - Khang Chung Ngoc Vo
- Movement Disorder Unit, Neurology Department, University Medical Center HCMC, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
| | - Thanh Vinh Nguyen
- Movement Disorder Unit, Neurology Department, University Medical Center HCMC, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
| | - Khang Vinh Nguyen
- Movement Disorder Unit, Neurology Department, University Medical Center HCMC, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
| | - Hien Thi Le
- Movement Disorder Unit, Neurology Department, University Medical Center HCMC, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
| | - Daniel Truong
- The Truong Neurosciences Institute, Parkinson and Movement Disorder Institute, Orange Coast Memorial Medical Center, Fountain Valley, CA 92708, USA; Department of Psychiatry and Neuroscience, University of California Riverside, Riverside, CA, USA.
| |
Collapse
|
2
|
Kovalová M, Gottfriedová N, Mrázková E, Janout V, Janoutová J. Cognitive impairment, neurodegenerative disorders, and olfactory impairment: A literature review. OTOLARYNGOLOGIA POLSKA 2024; 78:1-17. [PMID: 38623856 DOI: 10.5604/01.3001.0053.6158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
<br><b>Introduction:</b> The early detection and diagnosis of dementia are of key importance in treatment, slowing disease progression, or suppressing symptoms. The possible role of changes in the sense of smell is considered with regard to potential markers for early detection of Alzheimer's disease (AD).</br> <br><b>Materials and methods:</b> A literature search was conducted using the electronic databases PubMed, Scopus, and Web of Science between May 30, 2022 and August 2, 2022. The term "dementia" was searched with keyword combinations related to olfaction.</br> <br><b>Results:</b> A total of 1,288 records were identified through the database search. Of these articles, 49 were ultimately included in the analysis. The results showed the potential role of changes in the sense of smell as potential biomarkers for early detection of AD. Multiple studies have shown that olfactory impairment may be observed in patients with AD, PD, MCI, or other types of dementia. Even though smell tests are able to detect olfactory loss caused by neurodegenerative diseases, they cannot reliably distinguish between certain diseases.</br> <br><b>Conclusions:</b> In individuals with cognitive impairment or neurodegenerative diseases, olfactory assessment has repeatedly been reported to be used for early diagnosis, but not for differential diagnosis.</br>.
Collapse
Affiliation(s)
- Martina Kovalová
- Center for Research and Science, Faculty of Health Sciences, Palacký University Olomouc, Czech Republic
| | - Nikol Gottfriedová
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Eva Mrázková
- Center for Research and Science, Faculty of Health Sciences, Palacký University Olomouc, Czech Republic
| | - Vladimír Janout
- Center for Research and Science, Faculty of Health Sciences, Palacký University Olomouc, Czech Republic
| | - Jana Janoutová
- Center for Research and Science, Faculty of Health Sciences, Palacký University Olomouc, Czech Republic
| |
Collapse
|
3
|
Olfactory Impairment Correlates with Executive Functions Disorders and Other Specific Cognitive Dysfunctions in Parkinson's Disease. BIOLOGY 2023; 12:biology12010112. [PMID: 36671804 PMCID: PMC9855400 DOI: 10.3390/biology12010112] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/21/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Olfactory and cognitive disorders represent important non-motor symptoms in Parkinson's disease (PD). No clear evidence was reported about association of specific cognitive domains and olfactory impairment. OBJECTIVE The aim of this study was to evaluate the association between olfactory dysfunction and specific cognitive domains in PD patients compared to controls. METHODS 178 PD patients and 98 controls were enrolled and evaluated for odor threshold (OT), discrimination (OD), identification (OI), and TDI score using the Sniffin' Sticks test. Cognitive function was evaluated using the Montreal Cognitive Assessment scale with six sub-scores: Orientation (OIS), Attention (AIS), Language (LIS), Visuospatial (VIS), Memory (MIS), and Executive index scores (EIS). RESULTS Statistically significant correlations were observed between OT versus, LIS, and between TDI score versus EIS. Multivariate linear regression analysis, including age and sex which are well-known predictors of olfactory dysfunction, showed that, among specific cognitive domains, only LIS was significant predictor for OT, VIS was a significant predictor for OD, while both EIS and AIS were significant predictors for OI, and finally only EIS was significant predictor for TDI score. CONCLUSIONS Olfactory disorders in PD patients appear commonly related to dysfunction of specific cognitive domains, with strict association between global olfactory impairment and executive function deficits.
Collapse
|
4
|
Paracha M, Herbst K, Kieburtz K, Venuto CS. Prevalence and incidence of non‐motor symptoms in individuals with and without Parkinson's disease. Mov Disord Clin Pract 2022; 9:961-966. [PMID: 36247906 PMCID: PMC9547141 DOI: 10.1002/mdc3.13533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 11/19/2022] Open
Abstract
Background The prevalence ratio (PR) and incidence rate ratio (IRR) of nonmotor symptoms (NMS) were calculated for early Parkinson's disease (PD) versus non‐PD from 2 observational studies. Methods NMS were assessed through the self‐reported Non‐Motor Symptom Questionnaire in the online Fox Insight study and through self‐ and clinician‐rated scales in the Parkinson's Progression Marker Initiative (PPMI) study. Age‐ and sex‐adjusted/matched PR and IRR were estimated for each NMS by PD status using Poisson regression. Results Most NMS occurred more frequently in PD. Among 15,194 Fox Insight participants, sexual dysfunction had the largest adjusted PR (12.4 [95% CI, 6.9–22.2]) and dysgeusia/hyposmia had the largest adjusted IRR over a 2‐year median follow‐up (17.0 [95% CI, 7.8–37.1]). Among 607 PPMI participants, anosmia had the largest PR (16.6 [95% CI, 6.1–44.8]). During the 7‐year median follow‐up, hallucinations had the largest IRR (13.5 [95% CI, 6.3–28.8]). Conclusion Although many NMS are more common in early PD than in non‐PD, their occurrence may differ with time (hallucinations) or data collection methods (sexual dysfunction).
Collapse
Affiliation(s)
- Mariam Paracha
- Center for Health + Technology University of Rochester Rochester NY
- Department of Science and Mathematics, National Technical Institute for the Deaf Rochester Institute of Technology Rochester NY
- Department of Neurology University of Rochester Rochester NY
| | - Konnor Herbst
- Center for Health + Technology University of Rochester Rochester NY
| | - Karl Kieburtz
- Center for Health + Technology University of Rochester Rochester NY
- Department of Neurology University of Rochester Rochester NY
| | - Charles S. Venuto
- Center for Health + Technology University of Rochester Rochester NY
- Department of Neurology University of Rochester Rochester NY
| |
Collapse
|
5
|
Carnemolla S, Kumfor F, Liang CT, Foxe D, Ahmed R, Piguet O. Olfactory Bulb Integrity in Frontotemporal Dementia and Alzheimer’s Disease. J Alzheimers Dis 2022; 89:51-66. [DOI: 10.3233/jad-220080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Olfactory dysfunction is highly prevalent in dementia syndromes, including Alzheimer’s disease (AD) and frontotemporal dementia (FTD). The structural integrity of the olfactory bulb (OB) is thought to play a critical role in odor detection and identification, but no MRI study has measured OB volume in FTD, or measured OB volume longitudinally in AD. Objective: To measure OB volume in FTD and AD patients longitudinally using MRI. Methods: This study measured OB volumes using MRI in patients diagnosed with behavioral-variant FTD (n = 55), semantic dementia (n = 34), progressive non-fluent aphasia (n = 30), AD (n = 50), and healthy age-matched controls (n = 55) at their first visit to a dementia research clinic (‘baseline’). Imaging data in patients 12-months later were analyzed where available (n = 84) for longitudinal assessment. Volumes of subcortical and cortical olfactory regions (‘olfactory network’) were obtained via surface-based morphometry. Results: Results revealed that in AD and FTD at baseline, OB volumes were similar to controls, whereas volumes of olfactory network regions were significantly reduced in all patient groups except in progressive non-fluent aphasia. Longitudinal data revealed that OB volume became significantly reduced (10–25% volume reduction) in all dementia groups with disease progression. Conclusion: Olfactory dysfunction is common in patients diagnosed with AD or FTD, but our results indicate that there is no detectable volume loss to the OBs upon first presentation to the clinic. Our findings indicate that the OBs become detectably atrophied later in the disease process. OB atrophy indicates the potential usefulness for OBs to be targeted in interventions to improve olfactory function.
Collapse
Affiliation(s)
- Sarah Carnemolla
- University of Sydney, School of Psychology, Sydney, New South Wales, Australia
- University of Sydney, Brain & Mind Centre, Sydney, New South Wales, Australia
| | - Fiona Kumfor
- University of Sydney, School of Psychology, Sydney, New South Wales, Australia
- University of Sydney, Brain & Mind Centre, Sydney, New South Wales, Australia
| | - Cheng Tao Liang
- University of Sydney, School of Psychology, Sydney, New South Wales, Australia
- University of Sydney, Brain & Mind Centre, Sydney, New South Wales, Australia
| | - David Foxe
- University of Sydney, School of Psychology, Sydney, New South Wales, Australia
- University of Sydney, Brain & Mind Centre, Sydney, New South Wales, Australia
| | - Rebekah Ahmed
- University of Sydney, Brain & Mind Centre, Sydney, New South Wales, Australia
- Memory and Cognition Clinic, Department of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- University of Sydney, Central Sydney Medical School, Sydney, New South Wales, Australia
| | - Olivier Piguet
- University of Sydney, School of Psychology, Sydney, New South Wales, Australia
- University of Sydney, Brain & Mind Centre, Sydney, New South Wales, Australia
| |
Collapse
|
6
|
Almeida WRPL, Gomes ADOC, Belo LR, Leal LB, Coriolano MDGWDS. Olfative and taste perception in Parkinson's disease. Codas 2021; 33:e20200038. [PMID: 34586294 DOI: 10.1590/2317-1782/20202020038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 09/30/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To analyze the olfactory and gustatory perception and discrimination and self-perception of smell and taste in people with Parkinson's disease, comparing them with healthy nodes. METHODS Observational, analytical, cross-sectional, and quantitative study. Olfactory and gustatory perception and discrimination were verified following Parkinson's disease, compared to a control group, matched by sex and age, using the Olfactory Perception and Taste Strips Tests, respectively, after nasal cleaning and oral brushing. Self-perception was assessed by the Visual Analogue Scale before and after specific tests of perception and discrimination. RESULTS We included individuals of both sexes, 35 with Parkinson's Disease and 20 assigned to the control group, matched for mean age. The olfactory self-perception of the group with Parkinson's disease improved after the olfactory test. There was no difference in taste self-perception in the Parkinson's disease group before and after the taste test. In the olfactory perception assessment test, the Parkinson's disease group discriminated fewer essences than the control group. Both groups have similar generation and taste discrimination. CONCLUSION The olfactory perception of people with Parkinson's disease was lower, compared to the group of healthy desires, and the self-perception of olfactory efficacy improved after the test, in both groups. As for taste, there was no difference in perception and discrimination between groups, the sour taste was the most identified and there was an improvement in self-perception of taste efficiency in the group without Parkinson's disease after the test.
Collapse
Affiliation(s)
| | - Adriana de Oliveira C Gomes
- Programa de Pós-graduação em Saúde da Comunicação Humana, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
| | - Luciana Rodrigues Belo
- Departamento de Fonoaudiologia, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
| | - Leila Bastos Leal
- Departamento de Ciências Farmacêuticas, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
| | | |
Collapse
|
7
|
Parvand M, Rankin CH. Is There a Shared Etiology of Olfactory Impairments in Normal Aging and Neurodegenerative Disease? J Alzheimers Dis 2021; 73:1-21. [PMID: 31744002 DOI: 10.3233/jad-190636] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
As we age, our olfactory function declines. In addition to occurring in normal aging, more rapid decrement of olfactory decline has been associated with several neurodegenerative diseases including Alzheimer's disease (AD) and Parkinson's disease (PD). It has been argued that since olfactory deficits occur less frequently or are absent in diseases such as progressive supranuclear palsy, corticobasal degeneration, and multiple system atrophy, olfactory deficits can be used for differential diagnoses of AD and PD. The purpose of this review is to provide a survey of current knowledge about the molecular bases and differential patterns of olfactory deficits present in normal aging, AD, and PD. As substantial research has been conducted in this area, the majority of the content of this review focuses on articles published in the past decade. We hypothesize that olfactory deficits in normal aging, AD, and PD may have different underlying causes, and propose the use of model organisms with small, tractable nervous systems and/or easy to manipulate genomes to further investigate the cellular mechanisms responsible for these deficits.
Collapse
Affiliation(s)
- Mahraz Parvand
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Catharine H Rankin
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.,Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
8
|
Meta-Analysis of Cognition in Parkinson's Disease Mild Cognitive Impairment and Dementia Progression. Neuropsychol Rev 2021; 32:149-160. [PMID: 33860906 DOI: 10.1007/s11065-021-09502-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 03/24/2021] [Indexed: 12/19/2022]
Abstract
Mild cognitive changes, including executive dysfunction, are seen in Parkinson's Disease (PD). Approximately 30% of individuals with PD develop Parkinson's disease dementia (PDD). Mild cognitive impairment (MCI) has been identified as a transitional state between normal cognition and dementia. Although PD-MCI and its cognitive correlates have been increasingly studied as a risk indicator for development of PDD, investigations into the PD-MCI construct have yielded heterogeneous findings. Thus, a typical PD-MCI cognitive profile remains undefined. The present meta-analysis examined published cross-sectional studies of PD-MCI and cognitively normal PD (PD-CN) groups to provide aggregated effect sizes of group test performance by cognitive domain. Subsequently, longitudinal studies examining PD-MCI to PDD progression were meta-analyzed. Ninety-two cross-sectional articles of PD-MCI vs. PD-CN were included; 5 longitudinal studies of PD-MCI conversion to PDD were included. Random effects meta-analytic models were constructed resulting in effect sizes (Hedges' g) for cognitive domains. Overall performance across all measures produced a large effect size (g = 0.83, 95% CI [0.79, 0.86], t2 = 0.18) in cross-sectional analyses, with cognitive screeners producing the largest effect (g = 1.09, 95% CI [1.00, 1.17], t2 = 0.19). Longitudinally, overall measures produced a moderate effect (g = 0.47, 95% CI [0.40, 0.53], t2 = 0.01), with measures of executive functioning exhibiting the largest effect (g = 0.70, 95% CI [0.51, 0.89], t2 = 0.01). Longitudinal effects were made more robust by low heterogeneity. This report provides the first comprehensive meta-analysis of PD-MCI cognitive outcomes and predictors in PD-MCI conversion to PDD. Limitations include heterogeneity of cross-sectional effect sizes and the potential impact of small-study effects. Areas for continued research include visuospatial skills and visual memory in PD-MCI and longitudinal examination of executive dysfunction in PD-MCI.
Collapse
|
9
|
Ebihara T, Yamasaki M, Kozaki K, Ebihara S. Medical aromatherapy in geriatric syndrome. Geriatr Gerontol Int 2021; 21:377-385. [PMID: 33789361 DOI: 10.1111/ggi.14157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 03/03/2021] [Accepted: 03/15/2021] [Indexed: 12/15/2022]
Abstract
Geriatric syndromes are symptoms and signs, such as falls, incontinence, delirium, pressure ulcers, dysphagia and so on, that often threaten the independence of older adults, rather than the disease itself. Although the syndromes are very common in older people, it is difficult to treat those by modern medicine due to their complexity. To mitigate the intractable geriatric symptoms, we review the efficacy of aromatherapy, especially for dysphagia, dyspnea, cognitive dysfunction and falls in geriatric syndrome. Olfactory stimulation using a volatile black pepper oil on institutional residents improved the swallowing reflex, which is a crucial risk factor of aspiration pneumonia. Brain imaging study showed that olfactory stimulation using volatile black pepper oil activated cerebral regions of the anterior cingulate and the insular cortex, which play a role in controlling appetite and swallowing. Also, aromatherapy with volatile l-menthol decreased the sense of dyspnea and improved the efficacy of exercise therapy. The fragrance of the combination of rosemary and lemon oils in the morning, and the combination of lavender and orange oils in the night-time were reported to improve cognition and behavioural and psychological symptoms of dementia, respectively. Also, the combination of lavender and lemon balm oils was reported to be effective for irritability-related agitation in older adults. Furthermore, aromatherapy with lavender fragrance could improve both static and dynamic balance, resulting in a reduction in the number of fallers and the incidence rate in older people. Thus, aromatherapy is a promising remedy for geriatric syndrome. Geriatr Gerontol Int 2021; 21: 377-385.
Collapse
Affiliation(s)
- Takae Ebihara
- Department of Geriatric Medicine, Graduate School of Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Miyako Yamasaki
- National Health Insurance Kuzumaki Hospital, Kuzumaki, Iwate, Japan
| | - Koichi Kozaki
- Department of Geriatric Medicine, Graduate School of Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Satoru Ebihara
- Department of Rehabilitation Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
| |
Collapse
|
10
|
Invalid Self-Assessment of Olfactory Functioning in Parkinson's Disease Patients May Mislead the Neurologist. PARKINSONS DISEASE 2020; 2020:7548394. [PMID: 33274040 PMCID: PMC7683170 DOI: 10.1155/2020/7548394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022]
Abstract
Olfactory dysfunction (OD) is a prominent nonmotor symptom in Parkinson's disease (PD), and OD is a supportive diagnostic criterion for PD. Physicians often ask their patients if they have noticed a smell disorder. This study evaluates the diagnostic validity of OD self-assessment in PD. To this end, 64 PD patients and 33 age-matched healthy controls were enrolled in a study assessing subjective and objective olfactory functioning. To examine subjective olfactory abilities, first, patients and controls had to classify their olfactory sense as “impaired” or “unimpaired,” comparable to a realistic situation in an outpatient setting. Second, to evaluate subjective olfactory acuity, a visual analogue scale (VAS) was used. Third, the Sniffin' Sticks test battery was used as an objective instrument to diagnose OD. Categorical olfactory self-assessment predicts the classification normosmic versus hyposmic based on the global Sniffin' Sticks score (TDI) with a sensitivity of 0.79 and a specificity of 0.45. TDI correlated significantly with the VAS (r = 0.297, p = 0.017). The ROC curve analysis, using the VAS rating as a predictor for objective olfaction, revealed 42 as the best possible cutoff score with an area under the curve of 0.63. These results demonstrate that olfactory self-assessments show a low accuracy and are not suitable for the diagnosis of a smell disorder in PD. Objective measures are necessary to evaluate olfactory sense in clinical and research settings.
Collapse
|
11
|
Niu H, Wang Q, Zhao W, Liu J, Wang D, Muhammad B, Liu X, Quan N, Zhang H, Zhang F, Wang Y, Li H, Yang R. IL-1β/IL-1R1 signaling induced by intranasal lipopolysaccharide infusion regulates alpha-Synuclein pathology in the olfactory bulb, substantia nigra and striatum. Brain Pathol 2020; 30:1102-1118. [PMID: 32678959 PMCID: PMC7754320 DOI: 10.1111/bpa.12886] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Olfactory dysfunction is one of the early symptoms seen in Parkinson's disease (PD). However, the mechanisms underlying olfactory pathology that impacts PD disease progression and post-mortem appearance of alpha-Synuclein (α-Syn) inclusions in and beyond olfactory bulb in PD remain unclear. It has been suggested that environmental toxins inhaled through the nose can induce inflammation in the olfactory bulb (OB), where Lewy body (LB) is the first to be found, and then, spread to related brain regions. We hypothesize that OB inflammation triggers local α-Syn pathology and promotes its spreading to cause PD. In this study, we evaluated this hypothesis by intranasal infusion of lipopolysaccharides (LPS) to induce OB inflammation in mice and examined cytokines expression and PD-like pathology. We found intranasal LPS-induced microglia activation, inflammatory cytokine expression and α-Syn overexpression and aggregation in the OB via interleukin-1β (IL-1β)/IL-1 receptor type I (IL-1R1) dependent signaling. In addition, an aberrant form of α-Syn, the phosphorylated serine 129 α-Syn (pS129 α-Syn), was found in the OB, substantia nigra (SN) and striatum 6 weeks after the LPS treatment. Moreover, 6 weeks after the LPS treatment, mice showed reduced SN tyrosine hydroxylase, decreased striatal dopaminergic metabolites and PD-like behaviors. These changes were blunted in IL-1R1 deficient mice. Further studies found the LPS treatment inhibited IL-1R1-dependent autophagy in the OB. These results suggest that IL-1β/IL-1R1 signaling in OB play a vital role in the induction and propagation of aberrant α-Syn, which may ultimately trigger PD pathology.
Collapse
Affiliation(s)
- Haichen Niu
- Jiangsu Key Laboratory of Brain Disease and Bioinformation, Xuzhou Medical University, Xuzhou, 221004, China.,Department of Genetics, Xuzhou Medical University, Xuzhou, 221004, China
| | - Qian Wang
- Graduate School, Xuzhou Medical University, Xuzhou, 221004, China.,Department of Geriatric Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221004, China
| | - Weiguang Zhao
- Jiangsu Key Laboratory of Brain Disease and Bioinformation, Xuzhou Medical University, Xuzhou, 221004, China.,Department of Clinical Medicine, Xuzhou Medical University, Xuzhou, 221004, China
| | - Jianxin Liu
- Department of human anatomy, Xuzhou Medical University, Xuzhou, 221004, China
| | - Deguang Wang
- Department of human anatomy, Xuzhou Medical University, Xuzhou, 221004, China
| | - Bilal Muhammad
- Graduate School, Xuzhou Medical University, Xuzhou, 221004, China.,Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221004, China
| | - Xiaoyu Liu
- Department of Biomedical Science, Charles E. Schmidt College of Medicine and Brain Institute, Florida Atlantic University, Jupiter, FL, 33458, USA
| | - Ning Quan
- Department of Biomedical Science, Charles E. Schmidt College of Medicine and Brain Institute, Florida Atlantic University, Jupiter, FL, 33458, USA
| | - Haoyu Zhang
- School of Marine Sciences, Nanjing University of Information Science and Technology, Nanjing, 210044, China
| | - Fang Zhang
- Laboratory of Morphology, Xuzhou Medical University, Xuzhou, 221004, China
| | - Yong Wang
- Department of Neurology, First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Haiying Li
- Jiangsu Key Laboratory of Brain Disease and Bioinformation, Xuzhou Medical University, Xuzhou, 221004, China.,Department of Pathology, Xuzhou Medical University, Xuzhou, 221004, China
| | - Rongli Yang
- Department of Geriatric Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221004, China.,Department of Geriatrics, Xuzhou Medical University, Xuzhou, 221004, China
| |
Collapse
|
12
|
Chase BA, Markopoulou K. Olfactory Dysfunction in Familial and Sporadic Parkinson's Disease. Front Neurol 2020; 11:447. [PMID: 32547477 PMCID: PMC7273509 DOI: 10.3389/fneur.2020.00447] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/27/2020] [Indexed: 12/26/2022] Open
Abstract
This minireview discusses our current understanding of the olfactory dysfunction that is frequently observed in sporadic and familial forms of Parkinson's disease and parkinsonian syndromes. We review the salient characteristics of olfactory dysfunction in these conditions, discussing its prevalence and characteristics, how neuronal processes and circuits are altered in Parkinson's disease, and what is assessed by clinically used measures of olfactory function. We highlight how studies of monogenic Parkinson's disease and investigations in ethnically diverse populations have contributed to understanding the mechanisms underlying olfactory dysfunction. Furthermore, we discuss how imaging and system-level approaches have been used to understand the pathogenesis of olfactory dysfunction. We discuss the challenging, remaining gaps in understanding the basis of olfactory dysfunction in neurodegeneration. We propose that insights could be obtained by following longitudinal cohorts with familial forms of Parkinson's disease using a combination of approaches: a multifaceted longitudinal assessment of olfactory function during disease progression is essential to identify not only how dysfunction arises, but also to address its relationship to motor and non-motor Parkinson's disease symptoms. An assessment of cohorts having monogenic forms of Parkinson's disease, available within the Genetic Epidemiology of Parkinson's Disease (GEoPD), as well as other international consortia, will have heuristic value in addressing the complexity of olfactory dysfunction in the context of the neurodegenerative process. This will inform our understanding of Parkinson's disease as a multisystem disorder and facilitate the more effective use of olfactory dysfunction assessment in identifying prodromal Parkinson's disease and understanding disease progression.
Collapse
Affiliation(s)
- Bruce A. Chase
- Department of Biology, University of Nebraska at Omaha, Omaha, NE, United States
| | - Katerina Markopoulou
- Department of Neurology, NorthShore University HealthSystem, Evanston, IL, United States
- Department of Neurology, University of Chicago, Chicago, IL, United States
| |
Collapse
|
13
|
Hattori M, Tsuboi T, Yokoi K, Tanaka Y, Sato M, Suzuki K, Arahata Y, Hori A, Kawashima M, Hirakawa A, Washimi Y, Watanabe H, Katsuno M. Subjects at risk of Parkinson’s disease in health checkup examinees: cross-sectional analysis of baseline data of the NaT-PROBE study. J Neurol 2020; 267:1516-1526. [DOI: 10.1007/s00415-020-09714-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/10/2020] [Accepted: 01/13/2020] [Indexed: 01/25/2023]
|
14
|
Wearable Sensors to Characterize the Autonomic Nervous System Correlates of Food-Like Odors Perception: A Pilot Study. ELECTRONICS 2019. [DOI: 10.3390/electronics8121481] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: The sense of smell has been recently recognized as one of the most important sensory features in the human being, representing a reliable biomarker for a number of clinical conditions. The relationship between olfactory function and the person’s attitude towards food has frequently been investigated, often using questionnaires. The administration of minimally invasive methods for characterizing autonomic nervous system (ANS) functionality could help in objectivizing such measurements. Methods: The present study assessed ANS activation through the analysis of the electrocardiogram (ECG) and galvanic skin response (GSR) signals, in response to olfactory stimuli using non-invasive wearable devices. The ANS activation was also studied with respect to the odor familiarity, as well as with other olfactory and food dimensions (e.g., odor identification, odor pleasantness, food neophobia). Results: We demonstrated a significant activation of the ANS, in particular of its sympathetic branch, during the olfactory stimulation, with the ECG signal seen as more sensitive to detect ANS response to moderate olfactory stimuli rather than the GSR. Conclusions: When applied to a greater number of subjects, or to specific groups of patients, this methodology could represent a promising, reliable addition to diagnostic methods currently used in clinical settings.
Collapse
|
15
|
Cammisuli DM, Cammisuli SM, Fusi J, Franzoni F, Pruneti C. Parkinson's Disease-Mild Cognitive Impairment (PD-MCI): A Useful Summary of Update Knowledge. Front Aging Neurosci 2019; 11:303. [PMID: 31780918 PMCID: PMC6856711 DOI: 10.3389/fnagi.2019.00303] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 10/23/2019] [Indexed: 11/22/2022] Open
Abstract
Mild cognitive impairment (MCI) is a common feature in Parkinson's Disease (PD), even at the time of diagnosis. Some levels of heterogeneity in nature and severity of cognitive impairment and risk of conversion to Parkinson's Disease Dementia (PDD) exist. This brief overview summarized the current understanding of MCI in PD, by considering the following major points: historical development of the clinical entity, evaluation, epidemiology, predictors and outcomes, neuroimaging findings, pathophysiology, treatment, and pharmacological and non-pharmacological intervention. MCI in PD represents a concept in evolution and plays a pivotal role in advancing our understanding of the disease mechanisms, with the ultimate goal of building effective strategies to prevent conversion into PDD. Challenges for future research are also discussed.
Collapse
Affiliation(s)
- Davide Maria Cammisuli
- Laboratories of Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | | | - Jonathan Fusi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ferdinando Franzoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Carlo Pruneti
- Laboratories of Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| |
Collapse
|
16
|
Yoo HS, Chung SJ, Lee YH, Ye BS, Sohn YH, Lee PH. Olfactory anosognosia is a predictor of cognitive decline and dementia conversion in Parkinson's disease. J Neurol 2019; 266:1601-1610. [PMID: 31011798 DOI: 10.1007/s00415-019-09297-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/21/2019] [Accepted: 03/23/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Parkinson's disease (PD) patients are often unaware of olfactory deficits despite having hyposmia from the early stages. We aimed to evaluate whether olfactory anosognosia is a predictor of cognitive decline in PD. METHODS In this retrospective cohort study, we recruited 77 PD patients who underwent both olfactory and neuropsychological tests and were followed-up for over 5 years. Based on the degree of olfactory dysfunction and awareness of its presence, patients were classified as normosmic patients (Normosmia group, n = 15), hyposmic patients without olfactory anosognosia (Hyposmia-OA-, n = 40), or hyposmic patients with olfactory anosognosia (Hyposmia-OA+, n = 22). We compared the rates of cognitive decline using linear mixed model and dementia conversion using a survival analysis among the groups. RESULTS A higher proportion of patients in the Hyposmia-OA+ group had mild cognitive impairment at baseline (77.3%) and dementia converter at follow-up (50.0%). The Hyposmia-OA+ group exhibited a faster decline in frontal executive and global cognitive function than did the Normosmia and Hyposmia-OA- groups. A Kaplan-Meier analysis demonstrated that the conversion rate to dementia was significantly higher in the Hyposmia-OA+ group than in the Normosmia (P = 0.007) and Hyposmia-OA- (P = 0.038) groups. A Cox regression analysis showed that olfactory anosognosia remained a significant predictor of time to develop dementia in the Hyposmia-OA+ group compared to the Normosmia group (adjusted hazard ratio 3.30; 95% confidence interval 1.10-8.21). CONCLUSION This study suggests that olfactory anosognosia is a predictor of cognitive decline and dementia conversion in PD.
Collapse
Affiliation(s)
- Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. .,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
| |
Collapse
|
17
|
Cecchini MP, Federico A, Zanini A, Mantovani E, Masala C, Tinazzi M, Tamburin S. Olfaction and taste in Parkinson's disease: the association with mild cognitive impairment and the single cognitive domain dysfunction. J Neural Transm (Vienna) 2019; 126:585-595. [PMID: 30911822 DOI: 10.1007/s00702-019-01996-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 03/19/2019] [Indexed: 01/01/2023]
Abstract
Mild cognitive impairment (MCI) and chemosensory dysfunction are non-motor symptoms of Parkinson's disease (PD), but their association is unclear. We explored if MCI and the involvement of single cognitive domains influence olfaction and taste in PD. The role of demographic, clinical and neuropsychiatric variables was tested. We recruited 50 PD patients without dementia, no other reasons for cognitive impairment, no condition that could influence evaluation of cognition, olfaction and taste. They underwent a full neuropsychological and chemosensory (i.e., olfaction and taste) test with the Sniffin' Sticks Extended test (SSET), Whole Mouth test (WMT) and Taste Strips test (TST). Fifty age- and sex-matched healthy subjects served as controls. Olfactory function and sweet identification were worse in PD than controls. MCI negatively influenced odor identification. Factors associated with poor olfactory function were age, overall cognition, apathy, and visuospatial dysfunction. Sour identification was affected by MCI and executive dysfunction, and salty identification by executive dysfunction. MCI, age and executive dysfunction worsened TST score. Awareness of olfactory dysfunction was impaired in PD with MCI. Education positively influenced SSET and TST scores. Our data confirmed that olfaction is abnormal in PD, while taste was only slightly impaired. Olfaction was worse in PD patients with visuospatial dysfunction, while sour and salty identification was worse in those with MCI and executive dysfunction, suggesting different underlying anatomical abnormalities. Future studies should incorporate neuroimaging and cerebrospinal fluid data to confirm this hypothesis. SSET odor identification and TST sour identification could be explored as quick screening tests for PD-MCI.
Collapse
Affiliation(s)
- Maria Paola Cecchini
- Section of Anatomy and Histology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy.
| | - Angela Federico
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy
| | - Alice Zanini
- Section of Anatomy and Histology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy
| | - Elisa Mantovani
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy
| | - Carla Masala
- Department of Biomedical Sciences, Section of Physiology, University of Cagliari, Cagliari, Italy
| | - Michele Tinazzi
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy
| | - Stefano Tamburin
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy.
| |
Collapse
|
18
|
Durcan R, Wiblin L, Lawson RA, Khoo TK, Yarnall AJ, Duncan GW, Brooks DJ, Pavese N, Burn DJ. Prevalence and duration of non-motor symptoms in prodromal Parkinson's disease. Eur J Neurol 2019; 26:979-985. [PMID: 30706593 PMCID: PMC6563450 DOI: 10.1111/ene.13919] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 01/22/2019] [Indexed: 12/15/2022]
Abstract
Background and purpose The prevalence and duration of non‐motor symptoms (NMS) in prodromal Parkinson's disease (PD) has not been extensively studied. The aim of this study was to determine the prevalence and duration of prodromal NMS (pNMS) in a cohort of patients with recently diagnosed PD. Methods We evaluated the prevalence and duration of pNMS in patients with early PD (n = 154). NMS were screened for using the Non‐Motor Symptom Questionnaire (NMSQuest). We subtracted the duration of the presence of each individual NMS reported from the duration of the earliest motor symptom. NMS whose duration preceded the duration of motor symptoms were considered a pNMS. Individual pNMS were then grouped into relevant pNMS clusters based on the NMSQuest domains. Motor subtypes were defined as tremor dominant, postural instability gait difficulty (PIGD) and indeterminate type according to the Movement Disorder Society Unified Parkinson's Disease Rating Scale revision. Results Prodromal NMS were experienced by 90.3% of patients with PD and the median number experienced was 4 (interquartile range, 2–7). A gender difference existed in the pNMS experienced, with males reporting more sexual dysfunction, forgetfulness and dream re‐enactment, whereas females reported more unexplained weight change and anxiety. There was a significant association between any prodromal gastrointestinal symptoms [odds ratio (OR), 2.30; 95% confidence interval (CI), 1.08–4.89, P = 0.03] and urinary symptoms (OR, 2.54; 95% CI, 1.19–5.35, P = 0.016) and the PIGD phenotype. Further analysis revealed that total pNMS were not significantly associated with the PIGD phenotype (OR, 1.10; 95% CI, 0.99–1.21, P = 0.068). Conclusions Prodromal NMS are common and a gender difference in pNMS experienced in prodromal PD may exist. The PIGD phenotype had a higher prevalence of prodromal gastrointestinal and urinary tract symptoms.
Collapse
Affiliation(s)
- R Durcan
- Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK
| | - L Wiblin
- Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK
| | - R A Lawson
- Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK
| | - T K Khoo
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia.,School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - A J Yarnall
- Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK
| | - G W Duncan
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - D J Brooks
- Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK.,Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - N Pavese
- Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK.,Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - D J Burn
- Faculty of Medical Science, Newcastle University, Newcastle Upon Tyne, UK
| | | |
Collapse
|
19
|
Pekel NB, Yildiz D, Taymur İ, Budak E, Özmen S, Çapkur Ç, Seferoğlu M, Güneş A, Siğirli D. Associations Between Olfactory Impairment and Cognitive Functions in Patients with Parkinson Disease. ACTA ACUST UNITED AC 2019; 57:216-221. [PMID: 32952424 DOI: 10.29399/npa.23070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 07/14/2018] [Indexed: 12/30/2022]
Abstract
Introduction Olfactory impairment and cognitive impairment are common non-motor symptoms in Parkinson's disease (PD). Olfactory impairment may be present even many years before the main symptoms of the disease develop. The associations between olfactory loss and cognition in PD are evaluated in this study. Methods 31 patients with PD and 31 healthy subjects were included in this study. The Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn and Yahr Scale (H&Y Scale) were administered to all subjects. Butanol threshold test and Sniffin'Sticks test were used to assess olfaction. The Mini Mental State Examination (MMSE) and Clock Drawing Test (CDT) and Stroop Color Word Test (SCWT) were used to assess cognition. Results The Sniffin'Sticks test scores were significantly lower in the Parkinson group in comparison to the control group (p<0.001). The rate of anosmia was 90% in the PD group while this rate was found to be 54.8% in control group (p=0.005). A significant correlation was found between butanol test scores and stoop 5 and 5 errors. Significant correlations were found between the Sniffin'Sticks scores and MMSE scores (p=0.047) and orientation (p=0.041) and language (p=0.003) functions of the MMSE test. Worse olfaction was associated with worse memory. Conclusions In PD, olfactory impairment correlates with cognitive impairment and olfactory tests may be used to predict the likelihood of developing dementia in this patient population.
Collapse
Affiliation(s)
- Nilüfer Büyükkoyuncu Pekel
- Department of Neurology, University of Health Science, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Demet Yildiz
- Department of Neurology, University of Health Science, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - İbrahim Taymur
- Department of Psychiatry, University of Health Science, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Ersin Budak
- Department of Psychiatry, University of Health Science, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Suay Özmen
- Department of Otorhinolaryngology, University of Health Science, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Çağla Çapkur
- Department of Otorhinolaryngology, University of Health Science, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Meral Seferoğlu
- Department of Neurology, University of Health Science, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Aygül Güneş
- Department of Neurology, University of Health Science, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Deniz Siğirli
- Department of Biostatistics, University of Uludağ, School of Medicine, Bursa, Turkey
| |
Collapse
|
20
|
He R, Yan X, Guo J, Xu Q, Tang B, Sun Q. Recent Advances in Biomarkers for Parkinson's Disease. Front Aging Neurosci 2018; 10:305. [PMID: 30364199 PMCID: PMC6193101 DOI: 10.3389/fnagi.2018.00305] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 09/14/2018] [Indexed: 02/04/2023] Open
Abstract
Parkinson's disease (PD) is one of the common progressive neurodegenerative disorders with several motor and non-motor symptoms. Most of the motor symptoms may appear at a late stage where most of the dopaminergic neurons have been already damaged. In order to provide better clinical intervention and treatment at the onset of disease, it is imperative to find accurate biomarkers for early diagnosis, including prodromal diagnosis and preclinical diagnosis. At the same time, these reliable biomarkers can also be utilized to monitor the progress of the disease. In this review article, we will discuss recent advances in the development of PD biomarkers from different aspects, including clinical, biochemical, neuroimaging and genetic aspects. Although various biomarkers for PD have been developed so far, their specificity and sensitivity are not ideal when applied individually. So, the combination of multimodal biomarkers will greatly improve the diagnostic accuracy and facilitate the implementation of personalized medicine.
Collapse
Affiliation(s)
- Runcheng He
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xinxiang Yan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
| | - Jifeng Guo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, China
- Parkinson’s Disease Center of Beijing Institute for Brain Disorders, Beijing, China
- Collaborative Innovation Center for Brain Science, Shanghai, China
- Collaborative Innovation Center for Genetics and Development, Shanghai, China
| | - Qian Xu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
| | - Beisha Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, China
- Parkinson’s Disease Center of Beijing Institute for Brain Disorders, Beijing, China
- Collaborative Innovation Center for Brain Science, Shanghai, China
- Collaborative Innovation Center for Genetics and Development, Shanghai, China
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Qiying Sun
- National Clinical Research Center for Geriatric Disorders, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
21
|
Cova I, Priori A. Diagnostic biomarkers for Parkinson's disease at a glance: where are we? J Neural Transm (Vienna) 2018; 125:1417-1432. [PMID: 30145631 PMCID: PMC6132920 DOI: 10.1007/s00702-018-1910-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/24/2018] [Indexed: 12/19/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder whose aetiology remains unclear: degeneration involves several neurotransmission systems, resulting in a heterogeneous disease characterized by motor and non-motor symptoms. PD causes progressive disability that responds only to symptomatic therapies. Future advances include neuroprotective strategies for use in at-risk populations before the clinical onset of disease, hence the continuing need to identify reliable biomarkers that can facilitate the clinical diagnosis of PD. In this evaluative review, we summarize information on potential diagnostic biomarkers for use in the clinical and preclinical stages of PD.
Collapse
Affiliation(s)
- Ilaria Cova
- Neurology Unit, L. Sacco University Hospital, Milan, Italy
| | - Alberto Priori
- Department of Health Sciences, "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan and ASST Santi Paolo e Carlo, Milan, Italy.
| |
Collapse
|
22
|
Maier F, Prigatano GP. Impaired Self-Awareness of Motor Disturbances in Parkinson's Disease. Arch Clin Neuropsychol 2018; 32:802-809. [PMID: 29028874 DOI: 10.1093/arclin/acx094] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 09/13/2017] [Indexed: 01/01/2023] Open
Abstract
Traditionally, anosognosia for cognitive or motor impairments in patients with Parkinson's disease (PD) was viewed as unlikely unless the patient was demented. More recent research has suggested that a portion of non-demented PD patients (30%-50%) in fact have impaired subjective awareness (ISA) of their motor impairments (ISAm). This empirical finding has implications for the clinical neuropsychological examination of PD patients and raises theoretical questions relevant to the broader study of anosognosia seen in other patient groups. The purpose of this paper is to primarily review our own research in this area and to summarize research findings of other investigators who have examined ISA in PD patients. Our secondary goal is to demonstrate the relevance of assessing ISA when conducting a neuropsychological examination of PD patients. Our findings suggest ISAm in PD patients is related to motor signs of right hemispheric dysfunction, but the brain imaging correlates of ISA for hypokinesias appear different than those obtained for ISA for dyskinesia in this patient group.
Collapse
Affiliation(s)
- Franziska Maier
- Department of Neurology, University of Marburg, Marburg, Germany.,Klinik und Poliklinik für Neurologie, Universitätsklinikum Köln (AöR), Cologne, Germany
| | - George P Prigatano
- Department of Clinical Neuropsychology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| |
Collapse
|
23
|
Georgiopoulos C, Warntjes M, Dizdar N, Zachrisson H, Engström M, Haller S, Larsson EM. Olfactory Impairment in Parkinson's Disease Studied with Diffusion Tensor and Magnetization Transfer Imaging. JOURNAL OF PARKINSONS DISEASE 2018; 7:301-311. [PMID: 28482644 PMCID: PMC5438470 DOI: 10.3233/jpd-161060] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background: Olfactory impairment is an early manifestation of Parkinson’s disease (PD). Diffusion Tensor Imaging (DTI) and Magnetization Transfer (MT) are two imaging techniques that allow noninvasive detection of microstructural changes in the cerebral white matter. Objective: To assess white matter alterations associated with olfactory impairment in PD, using a binary imaging approach with DTI and MT. Methods: 22 PD patients and 13 healthy controls were examined with DTI, MT and an odor discrimination test. DTI data were first analyzed with tract-based spatial statistics (TBSS) in order to detect differences in fractional anisotropy, mean, radial and axial diffusivity between PD patients and controls. Voxelwise randomized permutation was employed for the MT analysis, after spatial and intensity normalization. Additionally, ROI analysis was performed on both the DTI and MT data, focused on the white matter adjacent to olfactory brain regions. Results: Whole brain voxelwise analysis revealed decreased axial diffusivity in the left uncinate fasciculus and the white matter adjacent to the left olfactory sulcus of PD patients. ROI analysis demonstrated decreased axial diffusivity in the right orbitofrontal cortex, as well as decreased mean diffusivity and axial diffusivity in the white matter of the left entorhinal cortex of PD patients. There were no significant differences regarding fractional anisotropy, radial diffusivity or MT between patients and controls. Conclusions: ROI analysis of DTI could detect microstructural changes in the white matter adjacent to olfactory areas in PD patients, whereas MT imaging could not.
Collapse
Affiliation(s)
- Charalampos Georgiopoulos
- Department of Radiology and Department ofMedical and Health Sciences, Linköping University, Linköping, Sweden.,Center for Medical ImageScience and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Marcel Warntjes
- Center for Medical ImageScience and Visualization (CMIV), Linköping University, Linköping, Sweden.,SyntheticMR AB, Linköping, Sweden
| | - Nil Dizdar
- Department of Neurologyand Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Helene Zachrisson
- Center for Medical ImageScience and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Clinical Physiology and Departmentof Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Maria Engström
- Center for Medical ImageScience and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Medical andHealth Sciences, Linköping University, Linköping, Sweden
| | - Sven Haller
- Affidea CDRC Centre de Diagnostic Radiologiquede Carouge SA, Geneva, Switzerland.,Departmentof Surgical Sciences/Radiology, Uppsala University, AkademiskaSjukhuset, Uppsala, Sweden
| | - Elna-Marie Larsson
- Departmentof Surgical Sciences/Radiology, Uppsala University, AkademiskaSjukhuset, Uppsala, Sweden
| |
Collapse
|
24
|
Park JW, Kwon DY, Choi JH, Park MH, Yoon HK. Olfactory dysfunctions in drug-naïve Parkinson's disease with mild cognitive impairment. Parkinsonism Relat Disord 2017; 46:69-73. [PMID: 29233469 DOI: 10.1016/j.parkreldis.2017.11.334] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 09/21/2017] [Accepted: 11/13/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Evaluation of olfactory function is valuable for the detection of pre-motor state of Parkinson's disease (PD). PD patients have an increased risk of associated dementia and one-third of PD patients have mild cognitive impairment (MCI) at the time of diagnosis. However, the characteristics of olfactory dysfunction in PD-MCI patients are unclear. This study examined the relationship between olfactory dysfunction and cognitive function in drug-naïve PD at the time of diagnosis with the patterns of olfactory function in PD-MCI patients using the Korean version of the Sniffin' stick test II (KVSS II). METHODS A total of 66 drug-naïve PD patients were enrolled. A neuropsychiatric assessment battery and KVSS II were performed. For the statistical analyses, univariate, multivariable linear regression and Student's t-test were used to determine the relationship between the variables and olfactory function. RESULTS Olfactory dysfunction was more prevalent in the PD-MCI group than in the PD-normal cognition (PD-CN) group. Each domains of odor threshold, discrimination, identification and total olfactory score were more impaired in the PD-MCI group than the PD-CN group. Whether cognitive impairment was single or multiple domain was not affected. CONCLUSION PD-MCI is more likely to be associated with severe olfactory impairment than PD-CN. There may be more extensive neurodegenerative processes affecting olfaction in PD-MCI patients. With further investigation and validation using neuropathological data, an objective olfactory function test could be used as a tool to evaluate disease progression. Further studies with prospective design investigating the prognostic value of olfactory dysfunction in PD-MCI patients are essential.
Collapse
Affiliation(s)
- Jin-Woo Park
- Department of Neurology, Korea University Ansan Hospital, Ansan, South Korea
| | - Do-Young Kwon
- Department of Neurology, Korea University Ansan Hospital, Ansan, South Korea.
| | - Ji Ho Choi
- Department of Otorhinolaryngology, Soonchunhyang University College of Medicine, Bucheon, South Korea
| | - Moon-Ho Park
- Department of Neurology, Korea University Ansan Hospital, Ansan, South Korea
| | - Ho-Kyoung Yoon
- Department of Psychiatry, Korea University Ansan Hospital, Ansan, South Korea
| |
Collapse
|
25
|
Mao CJ, Wang F, Chen JP, Yang YP, Chen J, Huang JY, Liu CF. Odor selectivity of hyposmia and cognitive impairment in patients with Parkinson's disease. Clin Interv Aging 2017; 12:1637-1644. [PMID: 29070942 PMCID: PMC5640420 DOI: 10.2147/cia.s147588] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Objective Hyposmia is one of the earliest non-motor features of Parkinson’s disease (PD) and can precede the onset of motor symptoms by years. Most of the current olfactory detection tests are targeted at Western populations. The exact relationship between hyposmia and cognitive impairment is unknown. The purpose of the study was to find bromines that can effectively identify olfactory dysfunction and investigate the relationship between hyposmia and cognitive function in early, non-demented, drug-naïve patients with PD in the People’s Republic of China. Methods Sixty-three early, non-demented, drug-naïve patients with PD and 55 healthy controls were enrolled in the study. The T&T olfactometer and a Chinese version of Montreal Cognitive Assessment (MoCA) were applied to assess subjects’ olfactory and cognitive functions. Patients with PD also completed the Modified Unified Parkinson’s disease-rating scale (UPDRS) and Hoehn and Yahr (H&Y) scale. Results Patients with PD had lower scores of visuospatial and executive function (p=0.000), attention (p=0.03), and delayed recall (p=0.001) than controls. β-phenylethyl alcohol (floral smell, smell of rose petals) and isovaleric acid (smell of sweat, stuffy socks) were more sensitive for identifying hyposmia in patients with PD than three other odors. Multivariate logistic regression analysis showed that impaired visuospatial and executive function was associated with hyposmia (p=0.013), but was independent of other PD-associated variables. Conclusion Hyposmia was common in early, non-demented, drug-naïve PD patients. β-Phenylethyl alcohol and isovaleric acid were more superior for identifying hyposmia in early non-demented Chinese patients with PD. Hyposmia was associated with impaired visuospatial and executive function in patients with PD. Further prospective studies that apply a series of neuropsychological tests and functional magnetic resonance imaging methods in large samples in multicenter studies are needed to confirm our findings and to investigate the relationship between hyposmia and cognitive function with disease progression in patients with PD.
Collapse
Affiliation(s)
- Cheng-Jie Mao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University
| | - Fen Wang
- Institute of Neuroscience, Soochow University, Suzhou
| | - Ju-Ping Chen
- Department of Neurology, Hospital of Changshu Traditional Chinese Medicine, Changshu, People's Republic of China
| | - Ya-Ping Yang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University
| | - Jing Chen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University
| | - Juan-Ying Huang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University
| | - Chun-Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University.,Institute of Neuroscience, Soochow University, Suzhou
| |
Collapse
|
26
|
Tarakad A, Jankovic J. Anosmia and Ageusia in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:541-556. [PMID: 28802932 DOI: 10.1016/bs.irn.2017.05.028] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Anosmia, the loss of sense of smell, is a common nonmotor feature of Parkinson's disease (PD). Ageusia, the loss of sense of taste, is additionally an underappreciated nonmotor feature of PD. The olfactory tract is involved early in PD as indicated by frequent occurrence of hyposmia or anosmia years or decades before motor symptoms and by autopsy studies showing early synuclein pathology in the olfactory tract and anterior olfactory nucleus even in the early stages of PD. Testing for olfaction consists of evaluation of olfactory thresholds, smell identification and discrimination, and olfactory memory. Testing for gustation involves evaluating thresholds and discrimination of five basic tastes (salty, sweet, bitter, sour, and umami). The presence of a specific pattern of loss in both olfaction and gustation in PD has been proposed, but this has not yet been confirmed. Within PD, olfactory loss is strongly tied with cognitive status though links to other features of PD or a particular PD phenotype is debated. Hyposmia is more often present and typically more severe in PD patients than other parkinsonian syndromes, making it a potentially useful biomarker for the disease.
Collapse
Affiliation(s)
- Arjun Tarakad
- Parkinson's Disease Center and Movement Disorder Clinic, Baylor College of Medicine, Houston, TX, United States
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorder Clinic, Baylor College of Medicine, Houston, TX, United States.
| |
Collapse
|
27
|
Domellöf ME, Lundin KF, Edström M, Forsgren L. Olfactory dysfunction and dementia in newly diagnosed patients with Parkinson's disease. Parkinsonism Relat Disord 2017; 38:41-47. [PMID: 28242255 DOI: 10.1016/j.parkreldis.2017.02.017] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/13/2017] [Accepted: 02/17/2017] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Studies report that up to 90% of patients with idiopathic Parkinson's disease (PD) have olfactory dysfunction (hyposmia). Hyposmia has also been connected to cognitive impairment and dementia in PD, but no studies of newly diagnosed patients followed longer than three years exists. The present study investigates the prevalence of olfactory dysfunction at PD diagnosis, how it evolves over time and whether hyposmia increases the risk of dementia in Parkinson's disease. METHODS Olfactory function was assessed with Brief Smell Identification Test (B-SIT) in 125 newly diagnosed patients with PD. They were followed for a maximum of 10 years (median six years) with extensive investigations at baseline, 12, 36, 60 and 96 months. Patients with B-SIT<9 were considered hyposmic. RESULTS Hyposmia was found in 73% of the patients at diagnosis. During the follow up period of ten years 42 (46%) patients with hyposmia at baseline developed dementia compared to seven (21%) of the normosmic patients. Cox proportional hazards model showed that hyposmia at baseline (controlled for age, gender, UPDRS III and Mild Cognitive Impairment) increased the risk of developing dementia (hazard ratio (95%CI): 3.29 (1.44-7.52), p = 0.005). Only one of 22 patients with normal cognition and normal olfaction at baseline developed dementia. CONCLUSIONS Olfactory dysfunction was common at the time of PD diagnosis and increased the risk of dementia up to ten years after PD diagnosis regardless of baseline cognitive function. Normal olfaction together with normal cognition at baseline predicted a benign cognitive course up to ten years after diagnosis.
Collapse
Affiliation(s)
| | - Karl-Fredrik Lundin
- Department of Pharmacology and Clinical Neuroscience, Umeå University, Sweden
| | - Mona Edström
- Department of Pharmacology and Clinical Neuroscience, Umeå University, Sweden
| | - Lars Forsgren
- Department of Pharmacology and Clinical Neuroscience, Umeå University, Sweden
| |
Collapse
|
28
|
Friedman JH. Misperceptions and Parkinson's disease. J Neurol Sci 2017; 374:42-46. [PMID: 28073433 DOI: 10.1016/j.jns.2016.12.059] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 12/27/2016] [Indexed: 01/08/2023]
Abstract
Most of the neurobehavioral aspects of Parkinson's disease have been well established and studied, but many are not well known, and hardly studied. This article focuses on several behavioral abnormalities that are common, and frequently cause difficulty for the patient and family due to lack of recognition as part of the disease. While it is well known that L-Dopa dyskinesias are frequently not recognized or under appreciated by patients, a similar lack of recognition may affect the patient's own speech volume, where their center of gravity is located, whether they are tilted to one side, and their under-recognition of others' emotional displays. In addition, PD patients are often misperceived by others incorrect impression of their emotional and cognitive state based purely on facial expression. These changes and others are briefly reviewed.
Collapse
Affiliation(s)
- Joseph H Friedman
- Butler Hospital, Dept of Neurology, Warren Alpert Medical School of Brown University, 345 Blackstone Blvd, Providence, RI 02906, USA.
| |
Collapse
|