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Yoo SW, Ryu DW, Oh Y, Ha S, Lyoo CH, Kim JS. Unraveling olfactory subtypes in Parkinson's disease and their effect on the natural history of the disease. J Neurol 2024:10.1007/s00415-024-12586-9. [PMID: 39043904 DOI: 10.1007/s00415-024-12586-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Hyposmia in Parkinson's disease (PD) had been studied before but had not been detailed by its temporal progression. This study observed how each olfactory subtype evolved in terms of motor symptoms, cardiac sympathetic innervation, and cognition. METHODS Two hundred and three early PD patients were classified as normosmia, hyposmia-converter (hypo-converter), and hyposmia. Their presynaptic monoamine availability at the time of diagnosis was assessed by positron emission tomography imaging using 18F-N-(3-fluoropropyl)-2beta-carbon ethoxy-3beta-(4-iodophenyl) nortropane and compared across the subtypes. Motor symptoms were evaluated in all patients, cardiac denervation was examined in 183 patients, and cognition in 195 patients were assessed using a neuropsychological battery. The domains were re-assessed 2-4 times, and the longitudinal data were analyzed to discern the natural course of each subtype. RESULTS Twenty-nine (14.3%) patients belonged to the normosmia group, 34 (16.7%) to the hypo-converter group, and the rest to the hyposmia (69.0%) group. 85.7% of the total population became hyposmic during an average 3 years of follow-up. The baseline motor symptoms, cardiac denervation, and cognition were comparable across the olfactory subtypes. Across the subtypes, a decline in the presynaptic monoamine densities of the caudate, especially the ventral-anterior subdivisions, correlated inversely with olfaction dysfunction. Over time, motor and cardiac denervation burdens worsened regardless of olfactory subtypes, but hypo-converters experienced faster cognitive deterioration than the other two groups. CONCLUSIONS The results suggest that the olfactory subtypes have differential significance along the disease course, which might reflect the involvement of different neuro-biochemical circuitries.
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Affiliation(s)
- Sang-Won Yoo
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Dong-Woo Ryu
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Yoonsang Oh
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Seunggyun Ha
- Division of Nuclear Medicine, Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Joong-Seok Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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Yoon SH, You DH, Na HK, Kang S, Baik K, Park M, Lyoo CH, Sohn YH, Lee PH. Parkinson's disease with hyposmia and dysautonomia: does it represent a distinct subtype? J Neurol 2024:10.1007/s00415-024-12332-1. [PMID: 38806701 DOI: 10.1007/s00415-024-12332-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/26/2024] [Accepted: 03/13/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND AND PURPOSE Olfactory dysfunction or dysautonomia is one of the earliest prodromal nonmotor symptoms of Parkinson's disease (PD). We aimed to investigate whether PD patients with dysautonomia and hyposmia at the de novo stage present different prognoses regarding PD dementia (PDD) conversion, motor complication development, and change in levodopa-equivalent doses (LED). METHODS In this retrograde cohort study, we included 105 patients with newly diagnosed PD patients who underwent cross-cultural smell identification test (CC-SIT), autonomic function tests (AFT), and dopamine transporter (DAT) scan at the de novo stage. PD patients were divided into Hyposmia + /Dysautonomia + (H + /D +) and Hyposmia - /Dysautonomia - (H - /D -) groups depending on the result of AFT and CC-SIT. Baseline clinical, cognitive, imaging characteristics, longitudinal risks of PDD development and motor complication occurrence, and longitudinal LED changes were compared between the two groups. RESULTS When compared with the H - /D - group, the H + /D + group showed lower standardized uptake value ratios in all subregions, lower asymmetry index, and steeper ventral - dorsal gradient in the DAT scan. The H + /D + group exhibited poorer performance in frontal/executive function and a higher risk of PDD development. The risk of motor complications including levodopa-induced dyskinesia, wearing off, and freezing of gait, was comparable between the two groups. The analysis of longitudinal changes in LED using a linear mixed model showed that the increase of LED in the H + /D + group was more rapid. CONCLUSIONS Our results suggest that PD patients with dysautonomia and hyposmia at the de novo stage show a higher risk of PD dementia conversion and rapid progression of motor symptoms.
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Affiliation(s)
- So Hoon Yoon
- Department of Neurology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea
| | - Dae Hyuk You
- College of Letters and Science, University of Wisconsin-Madison, Madison, WI, USA
| | - Han Kyu Na
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Sungwoo Kang
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyoungwon Baik
- Department of Neurology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Mincheol Park
- Department of Neurology, Gwangmyeong Hospital, Chung-Ang University College of Medicine and Graduate School of Medicine, Gwangmyeong, South Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
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Wang R, Lian T, He M, Guo P, Yu S, Zuo L, Hu Y, Zhang W. Clinical features and neurobiochemical mechanisms of olfactory dysfunction in patients with Parkinson disease. J Neurol 2024; 271:1959-1972. [PMID: 38151574 DOI: 10.1007/s00415-023-12122-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/29/2023]
Abstract
This study aimed to investigate clinical features, influencing factors and neurobiochemical mechanisms of olfactory dysfunction (OD) in Parkinson disease (PD). Total 39 patients were divided into the PD with OD (PD-OD) and PD with no OD (PD-nOD) groups according to overall olfactory function, including threshold, discrimination and identification, assessed by Sniffin' Sticks test. Motor function and non-motor symptoms were rated by multiple scales. Dopamine, acetylcholine, norepinephrine and 5-hydroxytryptamine levels in cerebrospinal fluid (CSF) were measured. We found that the PD-OD group showed significantly lower score of Montreal Cognitive Assessment Scale, higher scores of rapid eye movement sleep behavior disorder (RBD) Screening Questionnaire and Epworth Sleepiness Scale than the PD-nOD group (p < 0.05). RBD Screening Questionnaire score was independently associated with the scores of overall olfactory function and discrimination (p < 0.05). Dopamine and acetylcholine levels in CSF from the PD-OD group was significantly lower than that from the PD-nOD group (p < 0.05). Dopamine and acetylcholine levels in CSF were significantly and positively correlated with the scores of overall olfactory function, threshold, discrimination and identification in PD patients (p < 0.05). RBD Screening Questionnaire score was significantly and negatively correlated with acetylcholine level in CSF in PD patients with poor olfactory detection (p < 0.05). This investigation reveals that PD-OD is associated with cognitive impairment, probable RBD and excessive daytime sleepiness. PD-OD is correlated with the decreased levels of dopamine and acetylcholine in CSF. RBD is an independent influencing factor of overall olfactory function and discrimination, and the decreased acetylcholine level in CSF may be the common neurobiochemical basis of RBD and OD in PD patients.
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Grants
- 2016YFC1306000 National Key Research and Development Program of China
- 2016YFC1306300 National Key Research and Development Program of China
- 81970992 National Natural Science Foundation of China
- 81571229 National Natural Science Foundation of China
- 81071015 National Natural Science Foundation of China
- 30770745 National Natural Science Foundation of China
- 82201639 National Natural Science Foundation of China
- 2022-2-2048 Capital's Funds for Health Improvement and Research (CFH)
- kz201610025030 Key Technology R&D Program of Beijing Municipal Education Commission
- 4161004 Key Project of Natural Science Foundation of Beijing, China
- 7082032 Natural Science Foundation of Beijing, China
- JJ2018-48 Project of Scientific and Technological Development of Traditional Chinese Medicine in Beijing
- Z121107001012161 Capital Clinical Characteristic Application Research
- 2009-3-26 High Level Technical Personnel Training Project of Beijing Health System, China
- BIBD-PXM2013_014226_07_000084 Project of Beijing Institute for Brain Disorders
- 20071D0300400076 Excellent Personnel Training Project of Beijing, China
- IDHT20140514 Project of Construction of Innovative Teams and Teacher Career Development for Universities and Colleges Under Beijing Municipality
- JING-15-2 Beijing Healthcare Research Project, China
- 2015-JL-PT-X04 Basic-Clinical Research Cooperation Funding of Capital Medical University, China
- 10JL49 Basic-Clinical Research Cooperation Funding of Capital Medical University, China
- 14JL15 Basic-Clinical Research Cooperation Funding of Capital Medical University, China
- PYZ2018077 Natural Science Foundation of Capital Medical University, Beijing, China
- 2019-028 Science and Technology Development Fund of Beijing Rehabilitation Hospital, Capital Medical University
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Affiliation(s)
- Ruidan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Tenghong Lian
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Mingyue He
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Peng Guo
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Shuyang Yu
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Lijun Zuo
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Yang Hu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Wei Zhang
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
- Center of Parkinson's Disease, Beijing Institute for Brain Disorders, Beijing, 100053, China.
- Beijing Key Laboratory on Parkinson Disease, Beijing Institute for Brain Disorders, Beijing, 10053, China.
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Lin CY, Tsai YS, Chang MH. Impact of olfactory function on the trajectory of cognition, motor function, and quality of life in Parkinson's disease. Front Aging Neurosci 2024; 16:1329551. [PMID: 38501060 PMCID: PMC10944858 DOI: 10.3389/fnagi.2024.1329551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 02/13/2024] [Indexed: 03/20/2024] Open
Abstract
Background Olfactory dysfunction in Parkinson's disease (PD) is associated with more severe phenotypes, but trajectories of cognitive function, disease severity, and subdomains of quality-of-life measurements in patients with distinct olfactory profiles remain underexplored. Objective To analyze the influence of olfaction on trajectories of clinical parameters in patients with PD. Design Retrospective cohort study. Subjects From October 2016 to May 2021, the study tracked 58 participants over 3 years. Participants completed follow-up assessments using tools including the Chinese version of the University of Pennsylvania's Smell Identification Test (UPSIT), Montreal Cognitive Assessment (MoCA), Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale, and the Chinese translation of the 39-item Parkinson's Disease Questionnaire (PDQ-39). Methods Participants were divided into anosmia (UPSIT < 19) and non-anosmia (UPSIT ≥ 19) groups based on initial scores. Generalized estimating equations and repeated measures correlations were used to examine longitudinal associations and correlations between olfaction and clinical parameters. Results Divergent cognitive trajectories were observed between groups. The anosmia group exhibited a faster cognitive decline (adjusted B [beta coefficient] = -1.8, p = 0.012) according to the interaction effect of olfaction and time on the MoCA score. The anosmia group exhibited no longitudinal correlation between cognition and olfactory function but showed correlations with age (rrm [coefficient of repeated measures correlation] = -0.464, p = 0.004) and disease duration (rrm = -0.457, p = 0.005). The non-anosmia group's UPSIT scores decreased over time (B = -2.3, p = 0.005) alongside a significant correlation with motor function (rrm = -0.479, p = 0.006). Conclusion The anosmia group's accelerated cognitive decline correlated with age and disease duration, but not olfactory function, suggesting a poor cognitive outcome in this population despite the lack of longitudinal correlation between cognition and olfaction. The non-anosmia group exhibited progressive olfactory degradation and notable correlations between motor function and UPSIT scores, implying pathological accumulation in the olfactory structure and basal ganglia.
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Affiliation(s)
- Chia-Yen Lin
- Department of Neurology, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Shan Tsai
- Department of Neurology, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ming-Hong Chang
- Department of Neurology, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine and Brain and Neuroscience Research Center, College of Medicine, National Chung Hsing University, Taichung, Taiwan
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5
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Saunders-Pullman R, Ortega RA, Wang C, Raymond D, Elango S, Leaver K, Urval N, Katsnelson V, Gerber R, Swan M, Shanker V, Alcalay RN, Mirelman A, Brumm MC, Mejia-Santana H, Coffey CS, Marek K, Ozelius LJ, Giladi N, Marder KS, Bressman SB. Association of Olfactory Performance With Motor Decline and Age at Onset in People With Parkinson Disease and the LRRK2 G2019S Variant. Neurology 2022; 99:e814-e823. [PMID: 35995594 PMCID: PMC9484727 DOI: 10.1212/wnl.0000000000200737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 03/30/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There is clinical and phenotypic heterogeneity in LRRK2 G2019S Parkinson disease (PD), including loss of smell. Olfactory scores have defined subgroups of LRRK2 PD at baseline. We now extend this work longitudinally to better determine features associated with olfactory classes and to gain further insight into this heterogeneity. METHODS Evaluation of 162 patients with LRRK2 PD and 198 patients with idiopathic PD (IPD) from the LRRK2 Ashkenazi Jewish Consortium was performed, with follow-up available for 92 patients with LRRK2 PD and 74 patients with IPD. Olfaction (University of Pennsylvania Smell Identification Test [UPSIT]), motor function (Unified Parkinson Disease Rating Scale), and cognition (Montreal Cognitive Assessment), as well as sleep, nonmotor, and mood, were measured. Gaussian mixture models were applied on the UPSIT percentile score to determine subgroups based on olfactory performance. Linear mixed effects models, using PD duration as the time scale, assessed the relationship between UPSIT subgroup membership and motor/cognitive change. RESULTS Baseline olfaction was better in LRRK2 PD compared with IPD (mean UPSIT ± SD: 24.2 ± 8.8 vs 18.9 ± 7.6), with higher mean percentile scores (difference: 15.3 ± 11.6) (p < 0.001) and less frequent hyposmia (55.6% vs 85.4%; p < 0.001). Analysis suggested 3 classes among LRRK2 PD. Age at onset in LRRK2 PD was earlier in the worst olfaction group (group 1), compared with groups 2 and 3 (54.5 ± 11.1 vs 61.7 ± 9.3) (p = 0.012), and separately in the hyposmic group overall (55.0 ± 11.3 vs 61.7 ± 9.1) (p < 0.001). Longitudinal motor deterioration in LRRK2 PD was also significantly faster in the worst UPSIT group than the best UPSIT group (group 3 vs group 1: B = 0.31, SE = 0.35 vs B = 0.96, SE = 0.28) (rate difference = -0.65, SE = 0.29) (p = 0.03). However, olfactory group membership was not significantly associated with cognitive decline. DISCUSSION In this large LRRK2 cohort with longitudinal analysis, we extend prior work demonstrating subgroups defined by olfaction in LRRK2 G2019S PD and show that the worst olfaction group has earlier age at PD onset and more rapid motor decline. This supports a subgroup of LRRK2 PD that might show more rapid change in a clinical trial of LRRK2-related agents and highlights the need to integrate careful phenotyping into allocation schema in clinical trials of LRRK2-related agents. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that worse olfactory scores were associated with an earlier age at symptomatic onset and a faster rate of motor deterioration in patients with LRRK2 PD.
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Affiliation(s)
- Rachel Saunders-Pullman
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston.
| | - Roberto Angel Ortega
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Cuiling Wang
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Deborah Raymond
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Sonya Elango
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Katherine Leaver
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Nikita Urval
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Viktoriya Katsnelson
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Rachel Gerber
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Matthew Swan
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Vicki Shanker
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Roy N Alcalay
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Anat Mirelman
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Michael C Brumm
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Helen Mejia-Santana
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Christopher S Coffey
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Kenneth Marek
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Laurie J Ozelius
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Nir Giladi
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Karen S Marder
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
| | - Susan B Bressman
- From the Department of Neurology (R.S.-P., R.A.O., D.R., S.E., K.L., N.U., V.K., R.G., M.S., V.S., S.B.B.), Mount Sinai Beth Israel; Albert Einstein College of Medicine (C.W.), Bronx, NY; Department of Neurology (R.N.A., H.M.-S., K.S.M.), Columbia University Irving Medical Center, New York; Neurological Institute (A.M., N.G.), Tel Aviv Sourasky Medical Center, Sackler School of Medicine and Sagol School of Neurosciences, Tel Aviv University, Israel; University of Iowa Carver College of Medicine (M.C.B., C.S.C.), and Biostatistics (M.C.B., C.S.C.), University of Iowa, Iowa City; Department of Neurology (K.M.), Institute for Neurodegenerative Disorders, New Haven, CT; and Department of Genetics (L.J.O.), Massachusetts General Hospital, Boston
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6
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Nabizadeh F, Sodeifian F, Pirahesh K. Olfactory dysfunction and striatal dopamine transporter binding in motor subtypes of Parkinson's disease. Neurol Sci 2022; 43:4745-4752. [PMID: 35508569 DOI: 10.1007/s10072-022-06110-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/29/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Olfactory dysfunction is one of the earliest non-motor symptoms (NMS) in Parkinson's disease (PD). There are contradictory results regarding the association of olfactory dysfunction and dopamine uptake in striatal nuclei among PD patients. It has been suggested that different motor subtypes of PD vary in the disease pathophysiology and progression. Thus, we hypothesized that there might be different associations between olfactory dysfunction and striatal dopaminergic neuronal loss among three motor subtypes of PD, namely, indeterminate, postural instability and gait difficulty (PIGD), and tremor-dominant (TD). METHODS We recruited 162 healthy controls (HCs) and 464 drug-naïve PD patients from PPMI who underwent common PD scaling tests. Striatal binding ratios (SBRs) of DaTSCAN images in caudate and putamen nuclei were calculated. To assess the olfactory function, the University of Pennsylvania Smell Identification Test (UPSIT) was carried out. RESULTS The UPSIT score was significantly correlated with MDS-UPDRS part I (p value: 0.002, correlation coefficient: - 0.160), MDS-UPDRS part III (p value: 0.000, correlation coefficient: - 0.248), and SBR score in right (p value: 0.000, correlation coefficient: 0.240) and left caudate (p value: 0.000, correlation coefficient: 0.221) and right (p value: 0.000, correlation coefficient: 0.323) and left putamen (p value: 0.000, correlation coefficient: 0.335) nucleus in TD subtype. There were no significant correlations in HC, PIGD, and indeterminate subjects. CONCLUSION The olfactory dysfunction was correlated with dopamine transporter activity in striatal nuclei only in the TD subtype. Therefore, the olfactory dysfunction in PIGD and indeterminate subtype may not be a predictive factor for the future decrease in dopamine uptake.
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Affiliation(s)
- Fardin Nabizadeh
- Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran. .,School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Sodeifian
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Kasra Pirahesh
- School of Medicine, Tehran University of Medical Science, Tehran, Iran
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7
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Nabizadeh F, Pirahesh K, Khalili E. Olfactory dysfunction is associated with motor function only in tremor-dominant Parkinson's disease. Neurol Sci 2022; 43:4193-4201. [PMID: 35166976 DOI: 10.1007/s10072-022-05952-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/10/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The prevalence of olfactory impairment in patients with Parkinson's disease (PD) is 50-90%, and therefore, olfactory dysfunction is one of the most prevalent non-motor symptoms (NMSs) in patients with PD. Numerous studies have evaluated the association between motor and non-motor symptoms and olfactory dysfunction in PD. AIM In this study, we investigated the relationship between olfactory dysfunction, which is measured using the UPSIT test, with other motor and non-motor symptoms separately in three motor subtypes of PD, including tremor dominant (TD), postural instability and gait difficulty (PIGD), and indeterminate and healthy subjects. METHODS We recruited 487 early-stage PD patients (43 PIGD, 406 TD, and 38 indeterminate) and healthy controls (HCs) (n = 197) from the Parkinson Progression Markers Initiative (PPMI). All participants completed motor and non-motor tests at baseline visit and after 4 years of follow-up. Subjects underwent common PD scaling tests. RESULTS Olfactory dysfunction was significantly correlated with declined motor functions only in the TD subtype. Also, significant correlations were noticed between olfactory dysfunction and speed-attention processing and executive function in the HCs as well. Finally, no significant or meaningful association was observed in the PIGD and indeterminate subtype. Anosmia and hyposmia subjects in the TD group had the worse motor and non-motor scores compared to normosmia subjects after 4 years. CONCLUSION Olfactory dysfunction was significantly correlated with declined motor functions in the TD subtype. This is indicating that olfactory dysfunction may be an early motor and non-motor biomarker only in the TD subtype. However, it is possible that the involvement of olfactory function in other subtypes is not strong enough to make it a useful marker of diseases progression.
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Affiliation(s)
- Fardin Nabizadeh
- Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran. .,School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Kasra Pirahesh
- School of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Elham Khalili
- Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran.,Universal Scientific Education and Research Network (USERN), Bandar Abbas, Hormozgan, Iran
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8
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Dysosmia Is a Predictor of Motor Function and Quality of Life in Patients with Parkinson's Disease. J Pers Med 2022; 12:jpm12050754. [PMID: 35629176 PMCID: PMC9143120 DOI: 10.3390/jpm12050754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 12/10/2022] Open
Abstract
(1) Background: The correlation between dysosmia with quality of life (QoL) in patients with PD was rarely reported. The study aimed to examine the effect of dysosmia on motor function and QoL in PD. (2) Methods: This cross-sectional study, performed between October 2016 and February 2021, recorded the traditional Chinese version of the University of Pennsylvania Smell Identification Test (UPSIT), the Montreal Cognitive Assessment (MoCA), the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS UPDRS), and the 39-item Parkinson’s Disease Questionnaire (PDQ-39) in patients with PD. UPSIT = 19 was applied to separate the total anosmia and non-anosmia groups. (3) Results: 243 patients with PD were recruited. The total anosmia group had higher MDS UPDRS total, part II, and part III scores than the non-anosmia group. They also had worse scores on the dimensions of activities of daily living (ADL) and cognition of the PDQ-39 than the non-anosmia group. The UPSIT score correlated MDS UPDRS part III score (p < 0.0001), PDQ-39 ADL quartile (p = 0.0202), and Dopamine transporter scan (p = 0.0082) in the linear regression. (4) Conclusions: Dysosmia in PD predicted a phenotype with defective motor function, ADL, and cognition QoL. The findings supported the olfactory transmission of α-synuclein to the cortices, substantia nigra.
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9
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Motor and non-motor circuit disturbances in early Parkinson disease: which happens first? Nat Rev Neurosci 2022; 23:115-128. [PMID: 34907352 DOI: 10.1038/s41583-021-00542-9] [Citation(s) in RCA: 80] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 12/15/2022]
Abstract
For the last two decades, pathogenic concepts in Parkinson disease (PD) have revolved around the toxicity and spread of α-synuclein. Thus, α-synuclein would follow caudo-rostral propagation from the periphery to the central nervous system, first producing non-motor manifestations (such as constipation, sleep disorders and hyposmia), and subsequently impinging upon the mesencephalon to account for the cardinal motor features before reaching the neocortex as the disease evolves towards dementia. This model is the prevailing theory of the principal neurobiological mechanism of disease. Here, we scrutinize the temporal evolution of motor and non-motor manifestations in PD and suggest that, even though the postulated bottom-up mechanisms are likely to be involved, early involvement of the nigrostriatal system is a key and prominent pathophysiological mechanism. Upcoming studies of detailed clinical manifestations with newer neuroimaging techniques will allow us to more closely define, in vivo, the role of α-synuclein aggregates with respect to neuronal loss during the onset and progression of PD.
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10
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Kim JS, Son HJ, Oh M, Lee DY, Kim HW, Oh J. 60 Years of Achievements by KSNM in Neuroimaging Research. Nucl Med Mol Imaging 2022; 56:3-16. [PMID: 35186156 PMCID: PMC8828843 DOI: 10.1007/s13139-021-00727-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/01/2021] [Accepted: 12/07/2021] [Indexed: 02/03/2023] Open
Abstract
Nuclear medicine neuroimaging is able to show functional and molecular biologic abnormalities in various neuropsychiatric diseases. Therefore, it has played important roles in the clinical diagnosis and in research on the normal and pathological states of the brain. More than 400 outstanding studies have been conducted by Korean researchers over the past 60 years. In the 1990s, when multiheaded single-photon emission computed tomography (SPECT) scanners were first introduced in South Korea, stroke research using brain perfusion SPECT was conducted. With the spread of positron emission tomography (PET) scanners in the 2000s, research on the clinical usefulness of PET and the evaluation of pathophysiology in various diseases such as epilepsy, brain tumors, degenerative brain diseases, and other neuropsychiatric diseases were actively conducted using [18F]FDG and various neuroreceptor tracers. In the 2010s, with the clinical application of new radiopharmaceuticals for amyloid and tau imaging, research demonstrating the clinical usefulness of PET imaging and the pathophysiology of dementia has increased rapidly. It is expected that the role of nuclear medicine will expand with the development of new radiopharmaceuticals and analysis technologies, along with the application of artificial intelligence for early and differential diagnosis, and the development of therapeutic agents for degenerative brain diseases.
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Affiliation(s)
- Jae Seung Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hye Joo Son
- Department of Nuclear Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Minyoung Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dong Yun Lee
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hae Won Kim
- Department of Nuclear Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea
| | - Jungsu Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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11
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Fang TC, Chang MH, Yang CP, Chen YH, Lin CH. The Association of Olfactory Dysfunction With Depression, Cognition, and Disease Severity in Parkinson's Disease. Front Neurol 2021; 12:779712. [PMID: 34880827 PMCID: PMC8645582 DOI: 10.3389/fneur.2021.779712] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 10/27/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Non-motor subtypes of Parkinson's disease (PD) include the limbic, cognitive, and brainstem phenotype, which may have different pathological pathways with olfaction. In this work, we aim to clarify the association between olfactory dysfunction, depression, cognition, and disease severity in PD. Methods: A total of 105 PD subjects were included and divided into anosmia and non-anosmic groups, using the University of Pennsylvania Smell Identification Test (UPSIT). All patients were evaluated with the movement disorder society unified Parkinson's disease rating scale (MDS-UPDRS), the Beck depression inventory (BDI)-II, and the Montreal cognitive assessment (MoCA). Results: The BDI-II and UPSIT scores had a trend of reverse correlation without statistical significance (β-coefficient −0.12, p = 0.232). However, the odds ratio (OR) in anosmia was 2.74 (95% CI 1.01–7.46) for depression and 2.58 (95% CI 1.06–6.29) for cognitive impairment. For the MDS-UPDRS total and Part 3 score, the anosmia had a β-coefficient of 12.26 (95% CI 5.69–18.82) and 8.07 (95% CI 3.46–12.67), respectively. Neither depression nor cognitive impairment is associated with motor symptoms. Conclusion: More severe olfactory dysfunction in PD is associated with cognitive impairment and greater disease severity. Depression in PD may involve complex pathways, causing relatively weak association with olfactory dysfunction.
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Affiliation(s)
- Ting-Chun Fang
- Department of Neurology, Taichung Veteran General Hospital, Taichung City, Taiwan
| | - Ming-Hong Chang
- Department of Neurology, Taichung Veteran General Hospital, Taichung City, Taiwan.,School of medicine, National Chung Hsing University, Taichung City, Taiwan
| | - Chun-Pai Yang
- Department of Neurology, Kuang Tien General Hospital, Taichung City, Taiwan
| | - Yi-Huei Chen
- Department of Medical Education and Research, Taichung Veteran General Hospital, Taichung City, Taiwan
| | - Ching-Heng Lin
- Department of Medical Education and Research, Taichung Veteran General Hospital, Taichung City, Taiwan
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12
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Rodriguez-Sanchez F, Rodriguez-Blazquez C, Bielza C, Larrañaga P, Weintraub D, Martinez-Martin P, Rizos A, Schrag A, Chaudhuri KR. Identifying Parkinson's disease subtypes with motor and non-motor symptoms via model-based multi-partition clustering. Sci Rep 2021; 11:23645. [PMID: 34880345 PMCID: PMC8654994 DOI: 10.1038/s41598-021-03118-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/29/2021] [Indexed: 12/27/2022] Open
Abstract
Identification of Parkinson's disease subtypes may help understand underlying disease mechanisms and provide personalized management. Although clustering methods have been previously used for subtyping, they have reported generic subtypes of limited relevance in real life practice because patients do not always fit into a single category. The aim of this study was to identify new subtypes assuming that patients could be grouped differently according to certain sets of related symptoms. To this purpose, a novel model-based multi-partition clustering method was applied on data from an international, multi-center, cross-sectional study of 402 Parkinson's disease patients. Both motor and non-motor symptoms were considered. As a result, eight sets of related symptoms were identified. Each of them provided a different way to group patients: impulse control issues, overall non-motor symptoms, presence of dyskinesias and pyschosis, fatigue, axial symptoms and motor fluctuations, autonomic dysfunction, depression, and excessive sweating. Each of these groups could be seen as a subtype of the disease. Significant differences between subtypes (P< 0.01) were found in sex, age, age of onset, disease duration, Hoehn & Yahr stage, and treatment. Independent confirmation of these results could have implications for the clinical management of Parkinson's disease patients.
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Affiliation(s)
| | - Carmen Rodriguez-Blazquez
- National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Concha Bielza
- Computational Intelligence Group, Universidad Politécnica de Madrid, Madrid, Spain
| | - Pedro Larrañaga
- Computational Intelligence Group, Universidad Politécnica de Madrid, Madrid, Spain
| | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Alexandra Rizos
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - K Ray Chaudhuri
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
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13
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Dan X, Wechter N, Gray S, Mohanty JG, Croteau DL, Bohr VA. Olfactory dysfunction in aging and neurodegenerative diseases. Ageing Res Rev 2021; 70:101416. [PMID: 34325072 PMCID: PMC8373788 DOI: 10.1016/j.arr.2021.101416] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 12/15/2022]
Abstract
Alterations in olfactory functions are proposed to be early biomarkers for neurodegeneration. Many neurodegenerative diseases are age-related, including two of the most common, Parkinson's disease (PD) and Alzheimer's disease (AD). The establishment of biomarkers that promote early risk identification is critical for the implementation of early treatment to postpone or avert pathological development. Olfactory dysfunction (OD) is seen in 90% of early-stage PD patients and 85% of patients with early-stage AD, which makes it an attractive biomarker for early diagnosis of these diseases. Here, we systematically review widely applied smelling tests available for humans as well as olfaction assessments performed in some animal models and the relationships between OD and normal aging, PD, AD, and other conditions. The utility of OD as a biomarker for neurodegenerative disease diagnosis and future research directions are also discussed.
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Affiliation(s)
- Xiuli Dan
- Section on DNA Repair, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Noah Wechter
- Section on DNA Repair, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Samuel Gray
- Section on DNA Repair, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Joy G Mohanty
- Section on DNA Repair, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Deborah L Croteau
- Section on DNA Repair, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Vilhelm A Bohr
- Section on DNA Repair, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA; Danish Center for Healthy Aging, University of Copenhagen, 2200 Copenhagen, Denmark.
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14
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Glover A, Pillai L, Dhall R, Virmani T. Olfactory Deficits in the Freezing of Gait Phenotype of Parkinson's Disease. Front Neurol 2021; 12:656379. [PMID: 34456839 PMCID: PMC8397477 DOI: 10.3389/fneur.2021.656379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/12/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Olfactory dysfunction often occurs before motor onset in Parkinson's disease (PD) and can be detected with the University of Pennsylvania Smell Identification Test (UPSIT). Based on the Braak hypothesis, the olfactory bulb is one of two sites where disease pathology may start and spread to deeper brain structures. Objective: To evaluate whether a specific pattern of odorant identification on the UPSIT discriminated Parkinson's disease patients with and without freezing of gait. Methods: One hundred and twenty four consecutive participants (33 controls, 31 non-freezers, and 60 freezers) were administered the UPSIT. Using the chi-square test, each odorant on the UPSIT was ranked based on the differential ability of freezers and non-freezers to identify them correctly. Using predictive statistics and confusion matrices, the best combination of odorants and a cut-off score was determined. Results: Freezers had a shift toward a more severe hyposmia classification based on age and sex based normative values. The correct identification of nine odors (bubblegum, chocolate, smoke, wintergreen, paint thinner, orange, strawberry, grass, and peanut) was significantly worse in freezers compared to non-freezers. Correctly identifying ≤ 2 out of 3-odorants (bubblegum, chocolate, and smoke) had a 77% sensitivity and 61% specificity for categorizing freezers. The 3-odorant score was not correlated with disease duration, motor or total UPDRS scores, MoCA scores or age at testing. The predictive statistics were similar when sexes were separately categorized. Conclusions: A 3-odorant score helped categorize freezers and non-freezers with similar sensitivity and specificity to short odorant Parkinson's disease identification batteries.
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Affiliation(s)
- Aliyah Glover
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Lakshmi Pillai
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Rohit Dhall
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Tuhin Virmani
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Center for Translational Neuroscience, University of Arkansas for Medical Sciences, Little Rock, AR, United States
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15
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Olfaction in patients with Parkinson's disease: a new threshold test analysis through turning points trajectories. J Neural Transm (Vienna) 2021; 128:1641-1653. [PMID: 34328564 PMCID: PMC8536637 DOI: 10.1007/s00702-021-02387-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/19/2021] [Indexed: 12/02/2022]
Abstract
Olfactory deficit is a widely documented non-motor symptom in Parkinson’s disease (PD). Abnormal turning points trajectories through olfactory threshold testing have been recently reported in patients with olfactory dysfunction, who seem to adapt faster to olfactory stimuli, but data on PD patients are lacking. The aim of this study is to perform olfactory threshold test and explore the turning points trajectories in PD patients in comparison to normal controls. We recruited 59 PD patients without dementia, and no conditions that could influence evaluation of olfaction and cognition. Sixty healthy subjects served as controls. Patients and controls underwent a comprehensive olfactory evaluation with the Sniffin’ Sticks extended test assessing threshold, discrimination and identification and a full neuropsychological evaluation. Besides, threshold test data were analyzed examining all the turning points trajectories. PD patients showed a different olfactory threshold test pattern, i.e., faster olfactory adaptation, than controls with no effect of age. Normosmic PD patients showed different olfactory threshold test pattern, i.e., better threshold score, than normosmic controls. Visuospatial dysfunction was the only factor that significantly influenced this pattern. Olfactory threshold trajectories suggested a possible adaptation phenomenon in PD patients. Our data offered some new insights on normosmic PD patients, which appear to be a subset with a specific psychophysical profile. The analysis of the turning points trajectories, through an olfactory threshold test, could offer additional information on olfactory function in PD patients. Future larger studies should confirm these preliminary findings.
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16
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Yoo HS, Lee YG, Jeong SH, Ye BS, Sohn YH, Yun M, Lee PH. Clinical and Dopamine Depletion Patterns in Hyposmia- and Dysautonomia-Dominant Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2021; 11:1703-1713. [PMID: 34275910 DOI: 10.3233/jpd-212747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Olfactory or autonomic dysfunction is one of the earliest prodromal symptoms of Parkinson's disease (PD). It has not been investigated whether PD patients have different phenotypes depending on the presence of these prodromal symptoms. OBJECTIVE To investigate whether hyposmia-dominant and dysautonomia-dominant patients with early PD have different clinical manifestations and nigrostriatal degeneration. METHODS This cross-sectional study recruited 168 drug-naive PD patients and 34 control subjects. PD patients were classified as patients without hyposmia and dysautonomia (PD-H-D-, n = 51), hyposmia-dominant patients (PD-H+D-, n = 36), dysautonomia-dominant patients (PD-H-D+, n = 33), and patients with hyposmia and dysautonomia (PD-H+D+, n = 48). We then compared the baseline clinical characteristics, striatal specific to non-specific binding ratio (SNBR), neuropsychological performance, and neuropsychiatric symptoms among the groups. RESULTS The PD-H+D-group had a lower SNBR in the ventral striatum (p = 0.013), a greater asymmetric index of striatal SNBRs, and higher prevalence of apathy (p = 0.021) than the PD-H-D+ group. The PD-H-D+ group had older age at onset (p = 0.043) and a higher prevalence of REM sleep behavior disorder (p = 0.041) than the PD-H+D-group. The PD-H+D+ group had higher motor deficits, lower cognitive function, and lower SNBRs in all striatal subregions than the PD-H-D-group. Decreased SNBRs in the anterior caudate, posterior caudate, and ventral striatum were associated with the presence of apathy. CONCLUSION The present study suggests that hyposmia-dominant and dysautonomia-dominant PD have different clinical characteristics and patterns of striatal dopamine depletion.
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Affiliation(s)
- Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young-Gun Lee
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Seong Ho Jeong
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
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17
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Hyposmia may predict development of freezing of gait in Parkinson's disease. J Neural Transm (Vienna) 2021; 128:763-770. [PMID: 34014391 DOI: 10.1007/s00702-021-02347-7] [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] [Received: 02/06/2021] [Accepted: 04/30/2021] [Indexed: 10/21/2022]
Abstract
To explore the effect of olfactory dysfunction on treatment of motor manifestations in Parkinson's disease (PD). The current longitudinal retrospective cohort study consecutively recruited 108 de novo PD patients. Of whom 29 were normosmia and 79 were hyposmia, respectively, which was determined by the Korean Version of Sniffin' Sticks Test II at the time of diagnosis. All the participants underwent serial clinical examinations including Unified Parkinson's Disease Rating Scale (UPDRS), Mini-Mental State Examination, and Montreal Cognitive Assessment. The normosmic group demonstrated a significantly greater reduction of the UPDRS III score (30.3 ± 5.9 to 21.9 ± 5.1) than that of the hyposmic group (34.5 ± 9.3 to 28.5 ± 8.1) from baseline to 1-year later (p, 0.003; Bonferroni correction for p < 0.0045). Of subdomains in UPDRS III, the axial domain revealed a remarkable decrease in the normosmic group. Further, the hyposmic group exhibited a higher development rate of freezing of gait (FOG) compared to the normosmic group (29/79 (36.7%) vs 2/29 (6.9%); p, 0.002) during 33.9 ± 7.7 months of the mean follow-up period. A Cox proportional hazards model demonstrated the hyposmia to be a significant risk factor for the future development of FOG (HR, 4.23; 95% CI 1.180-17.801; p, 0.05). Our data demonstrated the olfactory dysfunction to be a significant risk factor for the development of the FOG in PD. Hyposmic PD patients should be paid more careful attention to the occurrence of FOG in the clinical practice.
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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.
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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
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19
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Araki N, Yamanaka Y, Poudel A, Fujinuma Y, Katagiri A, Kuwabara S, Asahina M. Electrogastrography for diagnosis of early-stage Parkinson's disease. Parkinsonism Relat Disord 2021; 86:61-66. [PMID: 33865071 DOI: 10.1016/j.parkreldis.2021.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/28/2021] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Patients with Parkinson's disease (PD) often present with gastric symptoms. Electrogastrography (EGG) can noninvasively assess gastric electric activity and may be useful for early PD diagnosis. The present study aimed to compare the efficacy of EGG in early PD diagnosis with those of 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy and odor stick identification test -Japanese version (OSIT-J). METHODS Thirty-seven untreated PD patients (mean age ± SD, 66 ± 8years; disease duration < 3 years) and 20 healthy control subjects (68 ± 6.9 years) were recruited. EGG and OSIT-J were performed in both groups, and MIBG scintigraphy in the PD group. EGG parameters were assessed in the preprandial and early and late postprandial segments using power spectrum analysis. RESULTS Irregular EGG waves were observed in PD patients. The preprandial instability coefficient of dominant frequency (ICDF), an index of EGG irregularity, in PD patients (9.5% [6.3%]) was higher than that in controls (3.9% [3.9%], p = 0.00005). The OSIT-J score was also lower in PD patients (4.6 [3.3]) than in controls (7.7 [3.3], p = 0.006). In receiver operating characteristics analyses, the areas under the curves of preprandial ICDF and OSIT-J were 0.83 and 0.72, respectively. The sensitivities of preprandial ICDF and MIBG (delayed-phase) scintigraphy were 73% and 70%, respectively. CONCLUSIONS Early and untreated PD patients showed irregular EGG waves and high ICDF. EGG showed better accuracy than the olfactory test for early PD diagnosis and similar sensitivity to MIBG scintigraphy.
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Affiliation(s)
- Nobuyuki Araki
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuoku, Chiba City, Chiba, 260-8677, Japan.
| | - Yoshitaka Yamanaka
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuoku, Chiba City, Chiba, 260-8677, Japan; Urayasu Rehabilitation Education Center, Chiba University Hospital, 7-2-32 Takasu, Urayasu City, Chiba, 279-0023, Japan; TUMS Urayasu Hospital, 7-2-32 Takasu, Urayasu City, Chiba, 279-0023, Japan.
| | - Anupama Poudel
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuoku, Chiba City, Chiba, 260-8677, Japan.
| | - Yoshikatsu Fujinuma
- Department of Neurology Kimitsu Chuo Hospital, 1010 Sakurai, Kisarazu City, Chiba, 292-0822, Japan.
| | - Akira Katagiri
- Department of Neurology Kimitsu Chuo Hospital, 1010 Sakurai, Kisarazu City, Chiba, 292-0822, Japan.
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuoku, Chiba City, Chiba, 260-8677, Japan.
| | - Masato Asahina
- Department of Neurology, Kanazawa Medical University, 1-1, Daigaku, Uchinada cho, Kahoku gun, Ishikawa, 920-0293, Japan.
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20
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Chung SJ, Lee S, Yoo HS, Baik K, Lee HS, Jung JH, Choi Y, Hong JM, Kim YJ, Ye BS, Sohn YH, Yun M, Lee PH. Different patterns of β-amyloid deposition in patients with Alzheimer's disease according to the presence of mild parkinsonism. Neurobiol Aging 2021; 101:199-206. [PMID: 33631471 DOI: 10.1016/j.neurobiolaging.2021.01.022] [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: 10/18/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 10/22/2022]
Abstract
This study aimed to compare the patterns of β-amyloid deposition between patients with early-stage Alzheimer's disease (AD) with mild parkinsonism and those without parkinsonism. Sixty-one patients with early-stage AD (Clinical Dementia Rating [CDR], 0.5 or 1) who underwent 18F-florbetaben (18F-FBB) PET scans were enrolled. We performed comparative analyses of regional FBB uptake in the frontal, parietal, lateral temporal, medial temporal, occipital, anterior cingulate, and posterior cingulate cortices and in the precuneus, striatum, and thalamus between AD patients with mild parkinsonism (AD-p+; n = 23) and those without parkinsonism (AD-p-; n = 38). There was no significant difference in age, sex, years of education, Mini-Mental State Examination score, and white matter hyperintensity severity between groups. The AD-p+ group had lower composite scores in frontal/executive function domain than the AD-p- group. The AD-p+ group had a higher FBB uptake in the occipital cortex, but not in other cortical regions, than the AD-p- group. Our findings suggest that additional β-amyloid deposition in the occipital region is associated with mild parkinsonism in early-stage AD.
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Affiliation(s)
- Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Sangwon Lee
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - KyoungWon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Ho Jung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yonghoon Choi
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji-Man Hong
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Yun Joong Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
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21
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He R, Zhao Y, He Y, Zhou Y, Yang J, Zhou X, Zhu L, Zhou X, Liu Z, Xu Q, Sun Q, Tan J, Yan X, Tang B, Guo J. Olfactory Dysfunction Predicts Disease Progression in Parkinson's Disease: A Longitudinal Study. Front Neurosci 2020; 14:569777. [PMID: 33381006 PMCID: PMC7768001 DOI: 10.3389/fnins.2020.569777] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 11/11/2020] [Indexed: 12/22/2022] Open
Abstract
Background and Objective Olfactory dysfunction (hyposmia) is an important non-motor symptom of Parkinson's disease (PD). To investigate the potential prognostic value of hyposmia as a marker for disease progression, we prospectively assessed clinical manifestations and longitudinal changes of hyposmic PD patients and normosmic ones. Methods Olfactory function was evaluated with the Sniffin' Sticks in PD patients at baseline. One hundred five hyposmic PD patients and 59 normosmic PD patients were enrolled and followed up for 2 years. They were subsequently evaluated at baseline and during follow-up periods with neurological and neuropsychological assessments. Clinical manifestations and disease progressions were compared between hyposmic and normosmic patients. In addition, the relationship between disease progressions and olfactory function was analyzed. Results Our study suggested that hyposmic PD patients and normosmic ones were similar in gender, age, education levels, age of onset, disease duration, and clinical features at baseline. Hyposmic PD patients exhibited more severe Unified Parkinson's Disease Rating Scale Part II-III (UPDRS II-III) scores, higher levodopa equivalent dose (LED) needs, and poorer Mini-Mental State Examination (MMSE) score at follow-up visits compared to those in normosmic PD patients. Hyposmia also showed greater rates in the increase of LED needs, improvement of UPDRS III score, and deterioration of MMSE score. Both improvement of UPDRS III score and decline of MMSE score were associated with poorer odor identification. Conclusion Our prospective study demonstrated that hyposmic PD patients showed a relatively worse clinical course compared with normosmic patients. Olfactory dysfunction is a useful predictor of disease progression.
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Affiliation(s)
- Runcheng He
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yuwen Zhao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yan He
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yangjie Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Jinxia Yang
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoting Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Liping Zhu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xun Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Zhenhua Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Qian Xu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Qiying Sun
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jieqiong Tan
- Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, China
| | - Xinxiang Yan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Beisha Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jifeng Guo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, China
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22
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Chung SJ, Lee JJ, Lee PH, Sohn YH. Emerging Concepts of Motor Reserve in Parkinson's Disease. J Mov Disord 2020; 13:171-184. [PMID: 32854486 PMCID: PMC7502292 DOI: 10.14802/jmd.20029] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/05/2020] [Indexed: 01/18/2023] Open
Abstract
The concept of cognitive reserve (CR) in Alzheimer's disease (AD) explains the differences between individuals in their susceptibility to AD-related pathologies. An enhanced CR may lead to less cognitive deficits despite severe pathological lesions. Parkinson's disease (PD) is also a common neurodegenerative disease and is mainly characterized by motor dysfunction related to striatal dopaminergic depletion. The degree of motor deficits in PD is closely correlated to the degree of dopamine depletion; however, significant individual variations still exist. Therefore, we hypothesized that the presence of motor reserve (MR) in PD explains the individual differences in motor deficits despite similar levels of striatal dopamine depletion. Since 2015, we have performed a series of studies investigating MR in de novo patients with PD using the data of initial clinical presentation and dopamine transporter PET scan. In this review, we summarized the results of these published studies. In particular, some premorbid experiences (i.e., physical activity and education) and modifiable factors (i.e., body mass index and white matter hyperintensity on brain image studies) could modulate an individual's capacity to tolerate PD pathology, which can be maintained throughout disease progression.
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Affiliation(s)
- Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.,Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, Korea
| | - Jae Jung Lee
- Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
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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.
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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
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24
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Umehara T, Oka H, Nakahara A, Matsuno H, Murakami H. Differential leukocyte count is associated with clinical phenotype in Parkinson's disease. J Neurol Sci 2019; 409:116638. [PMID: 31865186 DOI: 10.1016/j.jns.2019.116638] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 11/15/2019] [Accepted: 12/15/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Elevated proinflammatory cytokines are associated with disease progression in patients with Parkinson's disease (PD). The aim of study is to investigate whether components of peripheral blood leukocyte are associated with clinical symptoms in patients with de novo PD. METHODS We analyzed data from 123 newly diagnosed de novo patients who had no focal and systemic inflammatory diseases. Associations between clinical symptoms and differential leukocyte count (DLC) or DLC associated peripheral inflammatory biomarkers were examined. RESULTS Altered DLC and DLC associated peripheral inflammatory biomarkers were associated with PD related symptoms even though there was no sign of clinical inflammation. After controlling for covariables, olfaction and body mass index (BMI) were inversely associated with percentage of neutrophil, neutrophil to lymphocyte ratio, derived neutrophil to lymphocyte ratio, and positively associated with percentage of lymphocyte, lymphocyte to monocyte ratio. Patients with tremor-dominant or mixed type had lower peripheral inflammatory indices than those with akinetic rigid type. CONCLUSION Components of peripheral blood leukocytes reflect some clinical symptoms of PD. Patients with normosmia, tremor-dominant or mixed type, and patients without low BMI have low peripheral inflammatory indices. Relative mild peripheral inflammation may play one of major roles in developing mild disease phenotype in these patients.
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Affiliation(s)
- Tadashi Umehara
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
| | - Hisayoshi Oka
- Department of Neurology, Daisan Hospital, The Jikei University School of Medicine, Tokyo, Japan
| | - Atsuo Nakahara
- Department of Neurology, Daisan Hospital, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiromasa Matsuno
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hidetomo Murakami
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
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25
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Hyposmia as a marker of (non-)motor disease severity in Parkinson's disease. J Neural Transm (Vienna) 2019; 126:1471-1478. [PMID: 31515655 PMCID: PMC6815277 DOI: 10.1007/s00702-019-02074-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 08/31/2019] [Indexed: 12/18/2022]
Abstract
The aim of this study was to evaluate the relationship of hyposmia in Parkinson’s disease (PD) with other motor and non-motor symptoms and with the degree of nigrostriatal dopaminergic cell loss. A total of 295 patients with a diagnosis of PD were included. Olfactory function was measured using the University of Pennsylvania Smell Identification Test (UPSIT). Motor symptoms were rated using the Unified Parkinson’s Disease Rating Scale motor subscale (UPDRS III). To evaluate other non-motor symptoms, we used the Mini-Mental State Examination (MMSE) as a measure of global cognitive function and validated questionnaires to assess sleep disturbances, psychiatric symptoms, and autonomic dysfunction. A linear regression model was used to calculate correlation coefficients between UPSIT score and motor and non-motor variables [for psychiatric symptoms a Poisson regression was performed]. In a subgroup of patients (n = 155) with a dopamine transporter (DaT) SPECT scan, a similar statistical analysis was performed, now including striatal DaT binding. In the regression models with correction for age, sex, disease duration, and multiple testing, all motor and non-motor symptoms were associated with UPSIT scores. In the subgroup of patients with a DaT-SPECT scan, there was a strong association between olfactory test scores and DaT binding in both putamen and caudate nucleus. Hyposmia in PD is associated with various motor and non-motor symptoms, like cognition, depression, anxiety, autonomic dysfunction and sleep disturbances, and with the degree of nigrostriatal dopaminergic cell loss. This finding adds further confirmation that hyposmia holds significant promise as a marker of disease progression.
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26
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Bäckström D, Domellöf ME, Forsgren L. Author response: Early predictors of mortality in parkinsonism and Parkinson disease: A population-based study. Neurology 2019; 93:279. [PMID: 31383808 DOI: 10.1212/wnl.0000000000007908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hwang EJ, Ryu DW, Lee JE, Park SH, Choi HS, Kim JS. Magnetic resonance imaging assessment of the substrate for hyposmia in patients with Parkinson's disease. Clin Radiol 2019; 74:489.e9-489.e15. [DOI: 10.1016/j.crad.2019.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 02/06/2019] [Indexed: 01/12/2023]
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Chung SJ, Yoo HS, Lee YH, Lee HS, Ye BS, Sohn YH, Kwon H, Lee PH. Frontal atrophy as a marker for dementia conversion in Parkinson's disease with mild cognitive impairment. Hum Brain Mapp 2019; 40:3784-3794. [PMID: 31090134 DOI: 10.1002/hbm.24631] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 05/03/2019] [Accepted: 05/04/2019] [Indexed: 12/11/2022] Open
Abstract
This study aimed to investigate the cortical neural correlates of dementia conversion in Parkinson's disease with mild cognitive impairment (PD-MCI). We classified 112 patients with drug-naïve early stage PD meeting criteria for PD-MCI into either PD with dementia (PDD) converters (n = 34) or nonconverters (n = 78), depending on whether they developed dementia within 4 years of PD diagnosis. Cortical thickness analyses were performed in 34 PDD converters and 34 matched nonconverters. Additionally, a linear discriminant analysis was performed to distinguish PDD converters from nonconverters using cortical thickness of the regions that differed between the two groups. The PDD converters had higher frequencies of multiple domain MCI and amnestic MCI with storage failure, and poorer cognitive performances on frontal/executive, memory, and language function domains than did the nonconverters. Cortical thinning extending from the posterior cortical area into the frontal region was observed in PDD converters relative to nonconverters. The discriminant analysis showed that the prediction model with two cortical thickness variables in the right medial superior frontal and left olfactory cortices optimally distinguished PDD converters from nonconverters. Our data suggest that cortical thinning in the frontal areas including the olfactory cortex is a marker for early dementia conversion in PD-MCI.
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Affiliation(s)
- Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Sun Lee
- Department of Biostatistics, Yonsei University College of Medicine, Seoul, South Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hunki Kwon
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
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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.
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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.
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Lin YQ, Cui SS, Du JJ, Li G, He YX, Zhang PC, Fu Y, Huang P, Gao C, Li BY, Chen SD. N1 and P1 Components Associate With Visuospatial-Executive and Language Functions in Normosmic Parkinson's Disease: An Event-Related Potential Study. Front Aging Neurosci 2019; 11:18. [PMID: 30804778 PMCID: PMC6370661 DOI: 10.3389/fnagi.2019.00018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/21/2019] [Indexed: 01/17/2023] Open
Abstract
Background: Hyposmia is one of the most important clinical markers of Parkinson's disease (PD) with a prevalence ranging from 50 to 96% of PD patients. A significant association was found between hyposmia and cognitive impairment of PD. However, there were no reports of event-related potentials (ERP) performance in PD patients with and without hyposmia for cognitive functions assessment. Purpose: The aim of our study was to compare ERP performance and its association with cognitive domains between PD with and without hyposmia. Methods: Olfactory functions were assessed by Sniffin' Sticks test-16 (SS-16). Twenty-four subjects were included in PD with hyposmia group and nineteen were in PD without hyposmia group. ERP measures were recorded during a delayed match to sample (DMS) task with Chinese characters. The parameters of ERP components including N1, N2, P1, P2, and P3 in retrieval epoch were compared between the two groups and the correlation between ERP results and MOCA item score was also analyzed. Results: No significant difference was found in ERP performance between PD with and without hyposmia. Among all participants, N1 latency was significantly negatively related to visuospatial-executive item score of Montreal Cognitive Assessment (MOCA) (r s = -0.381, P = 0.012) and P1 amplitude was positively associated with language item score of MOCA (r s = 0.302, P = 0.049). Within the normosmic group, a significant association was found between N1 latency and visuospatial-executive item score (r s = -0.619, P = 0.005) and there was also a correlation between language score and P1 amplitude (r s = 0.537, P = 0.018). In the hyposmic group, only a significant correlation was found between N1 latency and clock drawing test performance (r s = -0.413, P = 0.045) rather than visuospatial-executive item score. Furthermore, SS-16 score was not found to be significantly associated with either visuospatial-executive or language item score of MOCA. Conclusion: No significant difference was found in ERP components between PD with and without hyposmia. N1 latency and P1 amplitude were respectively associated with visuospatial-executive and language functions in the normosmic group while in the hyposmic group, only a significant correlation was found between N1 latency and clock drawing test performance rather than visuospatial-executive item score in MOCA.
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Affiliation(s)
- Yi-Qi Lin
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shi-Shuang Cui
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juan-Juan Du
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gen Li
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi-Xi He
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ping-Chen Zhang
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Fu
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pei Huang
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Gao
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin-Yin Li
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sheng-Di Chen
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Dall’Antonia I, Šonka K, Dušek P. Olfaction and Colour Vision: What Can They Tell Us about Parkinson’s Disease? Prague Med Rep 2018; 119:85-96. [DOI: 10.14712/23362936.2018.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Parkinson’s disease is a neurodegenerative disorder with the pathological accumulation of alpha synuclein in the brain and peripheral nerve tissue. Early stages of synucleinopathies, often present clinically with rapid eye movement (REM) sleep disorder (RBD). Clinical markers that indicate early progression from RBD to manifest synucleinopathies include abnormal dopamine transporter (DAT) imaging, motor and non-motor symptoms. Despite the high diagnostic strength of DAT imaging and motor abnormalities, they are not the earliest biomarkers. Non-motor signs of neurodegeneration such as colour vision and olfaction abnormalities are detectable by clinical examination as early as 20 years before disease onset. Detailed analysis of olfactory and colour vision dysfunction can provide valuable information regarding brain pathologies, further specifying clinical phenotypes, and giving clues to underlying pathophysiological mechanisms in Parkinson’s disease and related disorders.
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Oh YS, Kim JS, Hwang EJ, Lyoo CH. Striatal dopamine uptake and olfactory dysfunction in patients with early Parkinson's disease. Parkinsonism Relat Disord 2018; 56:47-51. [DOI: 10.1016/j.parkreldis.2018.06.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 06/04/2018] [Accepted: 06/12/2018] [Indexed: 12/26/2022]
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Lee Y, Oh JS, Chung SJ, Lee JJ, Chung SJ, Moon H, Lee PH, Kim JS, Sohn YH. The presence of depression in de novo Parkinson's disease reflects poor motor compensation. PLoS One 2018; 13:e0203303. [PMID: 30231066 PMCID: PMC6145582 DOI: 10.1371/journal.pone.0203303] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 08/18/2018] [Indexed: 11/18/2022] Open
Abstract
Depression frequently accompanies Parkinson's disease and often precedes the onset of motor symptoms. This study aimed to evaluate the impact of depression on motor compensation in patients with de novo Parkinson's disease. This retrospective cohort study analyzed data from 474 non-demented patients with de novo Parkinson's disease (mean age, 64.6±9.8 years; 242 men) who underwent both dopamine transporter PET scan and depression assessment using the Beck Depression Inventory at baseline. Patients were classified into tertiles by Beck Depression Inventory score. At baseline, high-tertile group (Beck Depression Inventory score ≥15, n = 157) showed more severe motor deficits and lower cognitive function than low-tertile group (Beck Depression Inventory score ≤7, n = 158, P = 0.034 and P = 0.008, respectively). Greater motor deficits in high-tertile group than low-tertile group remained significant after controlling for dopamine transporter binding in the posterior putamen, as well as other confounding variables. During follow-up of a median duration of 47 months, high-tertile group received higher levodopa-equivalent doses for symptom control than did low-tertile group after controlling for age, gender, and initial motor deficit severity. These results demonstrate that depression in de novo Parkinson's disease is associated with motor deficit severity at baseline and dose of PD medications during follow-up, suggesting that the presence of depression in de novo Parkinson's disease represents poor motor compensation.
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Affiliation(s)
- Yoonju Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jungsu S. Oh
- Department of Nuclear Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Jung Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
| | - Su Jin Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- Department of Neurology, Myongji Hospital, Goyang, South Korea
| | - Hyojeong Moon
- Department of Nuclear Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea
| | - Young H. Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- * E-mail:
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Chung SJ, Lee Y, Oh JS, Kim JS, Lee PH, Sohn YH. Putaminal dopamine depletion in de novo Parkinson's disease predicts future development of wearing-off. Parkinsonism Relat Disord 2018; 53:96-100. [DOI: 10.1016/j.parkreldis.2018.05.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/23/2018] [Accepted: 05/08/2018] [Indexed: 01/10/2023]
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Kim KH, Kang SY, Shin DA, Yi S, Ha Y, Kim KN, Sohn YH, Lee PH. Parkinson's disease-related non-motor features as risk factors for post-operative delirium in spinal surgery. PLoS One 2018; 13:e0195749. [PMID: 29630637 PMCID: PMC5891024 DOI: 10.1371/journal.pone.0195749] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 03/28/2018] [Indexed: 02/06/2023] Open
Abstract
Background The clinical features of postoperative delirium are similar to the core features of alpha synuclein-related cognitive disorders, such as Parkinson’s disease dementia (PDD) or dementia with Lewy bodies (DLB). Therefore, we hypothesized that the non-motor symptoms (NMSs) in Parkinson’s disease (PD), which precede the cardinal motor features of PD, are likely to be risk factors for developing postoperative delirium. We investigated the association between PD-related NMSs and postoperative delirium in old people undergoing elective spinal surgery. Methods This study was a prospective study. Participants were aged 65 years and older and scheduled to undergo elective spinal surgery. During the enrollment period, 338 individuals were screened, 104 participants were included in the analysis. We assessed eight easily-assessed and representative PD-related NMSs 1 day before the scheduled surgery using tests or questionnaires for each symptom. The presence of delirium was determined by using the short version of the Confusion Assessment Method (CAM). Results Fifteen (14.4%) of the 104 participants (age, 71.7 ± 4.7 years; men, 34.6%) met the CAM criteria for post-operative delirium. Multivariate logistic analysis showed that decreased olfactory function (odds ratio [OR] 0.63, 95% CI 0.44–0.91) and exhibiting rapid eye movement sleep behavior disorder (RBD, OR 1.45, 95% CI 1.09–1.93) were significantly independent predictors of postoperative delirium. Conclusions Our study shows that hyposmia and RBD are significantly independent risk factors for postoperative delirium in general elderly population. Considering that NMSs may represent burden of alpha synuclein deposit, we postulate that an underlying alpha synucleinopathy may correlates with postoperative delirium. Significance This study gives a novel insight for the risk factor of postoperative delirium.
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Affiliation(s)
- Ki Hoon Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk Yun Kang
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Gyeonggi-do, Republic of Korea
| | - Dong Ah Shin
- Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seong Yi
- Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yoon Ha
- Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Keung Nyun Kim
- Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Ho Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
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Bohnen NI, Muller MLTM, Sohn YH, Lee DH. Is normosmic Parkinson disease a unique clinical phenotype? Neurology 2017; 86:1649-50. [PMID: 27164644 DOI: 10.1212/wnl.0000000000002647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Lee Y, Oh JS, Chung SJ, Chung SJ, Kim SJ, Nam CM, Lee PH, Kim JS, Sohn YH. Does smoking impact dopamine neuronal loss in de novo Parkinson disease? Ann Neurol 2017; 82:850-854. [DOI: 10.1002/ana.25082] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Yoonju Lee
- Department of Neurology; Yonsei University College of Medicine; Seoul South Korea
| | - Jungsu S. Oh
- Department of Nuclear Medicine, Asan Medical Center, College of Medicine; University of Ulsan; Seoul South Korea
| | - Seok Jong Chung
- Department of Neurology; Yonsei University College of Medicine; Seoul South Korea
| | - Su Jin Chung
- Department of Neurology; Yonsei University College of Medicine; Seoul South Korea
| | - Soo-Jong Kim
- Department of Nuclear Medicine, Asan Medical Center, College of Medicine; University of Ulsan; Seoul South Korea
| | - Chung Mo Nam
- Department of Preventive Medicine; Yonsei University College of Medicine; Seoul South Korea
| | - Phil Hyu Lee
- Department of Neurology; Yonsei University College of Medicine; Seoul South Korea
- Severance Biomedical Science Institute; Yonsei University College of Medicine; Seoul South Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine, Asan Medical Center, College of Medicine; University of Ulsan; Seoul South Korea
| | - Young H. Sohn
- Department of Neurology; Yonsei University College of Medicine; Seoul South Korea
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Chung SJ, Lee Y, Lee JJ, Lee PH, Sohn YH. Rapid eye movement sleep behaviour disorder and striatal dopamine depletion in patients with Parkinson's disease. Eur J Neurol 2017; 24:1314-1319. [DOI: 10.1111/ene.13388] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 06/28/2017] [Indexed: 01/20/2023]
Affiliation(s)
- S. J. Chung
- Department of Neurology Yonsei University College of Medicine SeoulSouth Korea
- Department of Neurology Myongji Hospital GoyangSouth Korea
| | - Y. Lee
- Department of Neurology Yonsei University College of Medicine SeoulSouth Korea
| | - J. J. Lee
- Department of Neurology Yonsei University College of Medicine SeoulSouth Korea
- Department of Neurology Ilsan Paik Hospital Inje University College of Medicine GoyangSouth Korea
| | - P. H. Lee
- Department of Neurology Yonsei University College of Medicine SeoulSouth Korea
- Severance Biomedical Science Institute Yonsei University College of Medicine Seoul South Korea
| | - Y. H. Sohn
- Department of Neurology Yonsei University College of Medicine SeoulSouth Korea
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Ryu DW, Lee SH, Oh YS, An JY, Park JW, Song IU, Lee KS, Kim JS. Clinical Characteristics of Parkinson’s Disease Developed from Essential Tremor. JOURNAL OF PARKINSONS DISEASE 2017; 7:369-376. [DOI: 10.3233/jpd-160992] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Campabadal A, Uribe C, Segura B, Baggio HC, Abos A, Garcia-Diaz AI, Marti MJ, Valldeoriola F, Compta Y, Bargallo N, Junque C. Brain correlates of progressive olfactory loss in Parkinson's disease. Parkinsonism Relat Disord 2017; 41:44-50. [PMID: 28522171 DOI: 10.1016/j.parkreldis.2017.05.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/04/2017] [Accepted: 05/08/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Olfactory dysfunction is present in a large proportion of patients with Parkinson's disease (PD) upon diagnosis. However, its progression over time has been poorly investigated. The few available longitudinal studies lack control groups or MRI data. OBJECTIVE To investigate the olfactory changes and their structural correlates in non-demented PD over a four-year follow-up. METHODS We assessed olfactory function in a sample of 25 PD patients and 24 normal controls of similar age using the University of Pennsylvania Smell Identification test (UPSIT). Structural magnetic resonance imaging data, obtained with a 3-T Siemens Trio scanner, were analyzed using FreeSurfer software. RESULTS Analysis of variance showed significant group (F = 53.882; P < 0.001) and time (F = 6.203; P = 0.016) effects, but the group-by-time interaction was not statistically significant. UPSIT performance declined ≥1.5 standard deviations in 5 controls and 7 patients. Change in UPSIT scores of patients correlated positively with volume change in the left putamen, right thalamus, and right caudate nucleus. CONCLUSION Olfactory loss over time in PD and controls is similar, but we have observed significant correlation between this loss and basal ganglia volumes only in patients.
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Affiliation(s)
- Anna Campabadal
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
| | - Carme Uribe
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Barbara Segura
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Hugo C Baggio
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Alexandra Abos
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Anna Isabel Garcia-Diaz
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Maria Jose Marti
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain; Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Francesc Valldeoriola
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain; Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Yaroslau Compta
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain; Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Nuria Bargallo
- Centre de Diagnòstic per la Imatge, Hospital Clínic, Barcelona, Catalonia, Spain.
| | - Carme Junque
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain.
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Qamar MA, Sauerbier A, Politis M, Carr H, Loehrer PA, Chaudhuri KR. Presynaptic dopaminergic terminal imaging and non-motor symptoms assessment of Parkinson's disease: evidence for dopaminergic basis? NPJ Parkinsons Dis 2017; 3:5. [PMID: 28649605 PMCID: PMC5445592 DOI: 10.1038/s41531-016-0006-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/04/2016] [Accepted: 11/25/2016] [Indexed: 02/08/2023] Open
Abstract
Parkinson's disease (PD) is now considered to be a multisystemic disorder consequent on multineuropeptide dysfunction including dopaminergic, serotonergic, cholinergic, and noradrenergic systems. This multipeptide dysfunction leads to expression of a range of non-motor symptoms now known to be integral to the concept of PD and preceding the diagnosis of motor PD. Some non-motor symptoms in PD may have a dopaminergic basis and in this review, we investigate the evidence for this based on imaging techniques using dopamine-based radioligands. To discuss non-motor symptoms we follow the classification as outlined by the validated PD non-motor symptoms scale.
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Affiliation(s)
- MA Qamar
- National Parkinson’s Foundation International Center of Excellence, King’s College London and King’s College Hospital NHS Foundation Trust, London, UK
| | - A Sauerbier
- National Parkinson’s Foundation International Center of Excellence, King’s College London and King’s College Hospital NHS Foundation Trust, London, UK
| | - M Politis
- Neurodegeneration Imaging Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, UK
| | - H Carr
- National Parkinson’s Foundation International Center of Excellence, King’s College London and King’s College Hospital NHS Foundation Trust, London, UK
| | - P A Loehrer
- National Parkinson’s Foundation International Center of Excellence, King’s College London and King’s College Hospital NHS Foundation Trust, London, UK
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - K Ray Chaudhuri
- National Parkinson’s Foundation International Center of Excellence, King’s College London and King’s College Hospital NHS Foundation Trust, London, UK
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Aerobic Exercise Preserves Olfaction Function in Individuals with Parkinson's Disease. PARKINSONS DISEASE 2016; 2016:9725089. [PMID: 27999706 PMCID: PMC5141565 DOI: 10.1155/2016/9725089] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 10/24/2016] [Indexed: 11/17/2022]
Abstract
Introduction. Based on anecdotal reports of improved olfaction following aerobic exercise, the aim of this study was to evaluate the effects of an 8-week aerobic exercise program on olfaction function in individuals with Parkinson's disease (PD). Methods. Thirty-eight participants with idiopathic PD were randomized to either an aerobic exercise group (n = 23) or a nonexercise control group (n = 15). The aerobic exercise group completed a 60-minute cycling session three times per week for eight weeks while the nonexercise control group received no intervention. All participants completed the University of Pennsylvania Smell Identification Test (UPSIT) at baseline, end of treatment, and a four-week follow up. Results. Change in UPSIT scores between the exercise and nonexercise groups from baseline to EOT (p = 0.01) and from baseline to EOT+4 (p = 0.02) favored the aerobic exercise group. Individuals in the nonexercise group had worsening olfaction function over time, while the exercise group was spared from decline. Discussion. The difference in UPSIT scores suggested that aerobic exercise may be altering central nervous system pathways that regulate the physiologic or cognitive processes controlling olfaction in individuals with PD. While these results provide promising preliminary evidence that exercise may modify the disease process, further systematic evaluation is necessary.
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Hayes M, Puhl P, Hagenah J, Russo R. A Brief Nonmotor Screen Combined with Transcranial Ultrasound may Improve Diagnostic Accuracy of Parkinson's Disease. Mov Disord Clin Pract 2016; 4:397-402. [PMID: 30363362 DOI: 10.1002/mdc3.12450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 08/18/2016] [Accepted: 09/06/2016] [Indexed: 11/10/2022] Open
Abstract
Background The addition of a simple nonmotor symptom (NMS) screen and transcranial sonography (TCS) to standard clinical assessment may improve the diagnostic accuracy of Parkinson's disease (PD). Methods Sixty-nine subjects (23 established PD group, 23 healthy controls, and 23 possible PD) were enrolled. All completed 3 "yes-no" NMS questions (score, 0-3) and had a transcranial ultrasound assessing nigral hyperechogenicity (score, 0-1). A combined PD risk score of 0 to 4 was obtained for each subject. A PD risk score of ≥2 was used as the diagnostic cutoff for PD. Results In the established PD group, there was an average of 2 NMSs per person or a group total of 46 of 69 possible NMSs, but only 4 of 69 NMSs in the healthy control group. Of the technically satisfactory TCS, 16 of 20 (80%) of the established PD group and 2 of 16 (12.5%) of the healthy control group were TCS positive. Using ≥2 NMSs alone as the cutoff identified 17 of 23 (74%) of the established PD and 100% of the healthy controls. The PD risk score of ≥2 identified 21 of 23 (91%) of the established PD as PD and 22 of 23 (96%) of the healthy control group as non-PD. In the possible PD group, the PD risk score identified 9 of 18 (50%) of those with a final clinical diagnosis of PD and 4 of 5 (80%) of non-PD. Conclusions The combination of a brief NMS screen and TCS discriminated well between normal healthy controls and established PD. A positive TCS and one NMS, or a negative TCS with two NMSs, indicated a likely diagnosis of PD.
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Affiliation(s)
- Michael Hayes
- Department of Neurology Concord Hospital Sydney Australia
| | - Peter Puhl
- Department of Neurology Concord Hospital Sydney Australia
| | - Johann Hagenah
- Department of Neurology Westküstenklinikum Heide Germany.,Department of Neurology University of Lübeck Lübeck Germany
| | - Robert Russo
- Department of Nuclear Medicine Concord Hospital Sydney Australia
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Chung SJ, Lee JJ, Ham JH, Ye BS, Lee PH, Sohn YH. Striatal Dopamine Depletion Patterns and Early Non-Motor Burden in Parkinsons Disease. PLoS One 2016; 11:e0161316. [PMID: 27529171 PMCID: PMC4986981 DOI: 10.1371/journal.pone.0161316] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/03/2016] [Indexed: 11/19/2022] Open
Abstract
Background The mechanism underlying non-motor symptoms in Parkinson’s disease has not yet been elucidated. In this study, we hypothesized that Parkinson patients with more non-motor symptoms have a different pattern of striatal dopamine depletion, particularly in areas other than the sensorimotor striatum, compared to those with fewer non-motor symptoms. Methods We conducted a prospective survey of the degree of non-motor symptoms (using the Korean version of the Non-Motor Symptoms Scale; K-NMSS) in 151 patients with early-stage Parkinson’s disease who had undergone a dopamine transporter PET scan as an initial diagnostic procedure. We classified the patients into two groups; high non-motor patients (HNM-PD; K-NMSS score ≥ 41) and low non-motor patients (LNM-PD). Results Patients in the HNM-PD group (n = 71) were older, had longer symptom duration, exhibited more severe motor deficits, and had been prescribed higher levodopa-equivalent doses at follow-up than those in the LNM-PD group. However, dopamine transporter binding to the striatal sub-regions and inter-sub-regional binding ratios were comparable between the two groups. A general linear model showed that the HNM-PD group had significantly more severe motor deficits than the LNM-PD group after controlling for age, gender, symptom duration, and dopamine transporter binding to the sensorimotor striatum. Conclusions This study demonstrated that the pattern of striatal dopamine depletion does not contribute to early non-motor burden in Parkinson’s disease. Our results suggest that LNM-PD patients may have a more benign course of motor symptom progression than HNM-PD patients.
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Affiliation(s)
- Su Jin Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Jung Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Jee Hyun Ham
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H. Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- * E-mail:
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Rossi M, Escobar AM, Bril A, Millar Vernetti P, De Palo JI, Cerquetti D, Merello M. Motor features in Parkinson's disease with normal olfactory function. Mov Disord 2016; 31:1414-7. [PMID: 27277396 DOI: 10.1002/mds.26687] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/04/2016] [Accepted: 05/08/2016] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Normosmic Parkinson's disease (PD) might be a unique clinical phenotype with a more benign course when compared with hyposmic PD. OBJECTIVE The objective of this study was to evaluate motor features and the acute levodopa response according to olfactory function. METHODS A total of 169 de novo PD patients that underwent olfactory testing and acute levodopa challenge for clinical prediction of sustained long-term dopaminergic response were evaluated. RESULTS The overall frequency of normosmia was 33%. Normosmic PD patients scored nonsignificantly different to hyposmic/anosmic patients on motor scale and on degree of improvement with levodopa. Motor scores at follow-up were comparable among groups. CONCLUSIONS Normal olfactory function is common in early PD and was not associated with a different motor phenotype when compared with PD patients with olfactory dysfunction. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Malco Rossi
- Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research (FLENI), Ciudad Autónoma de Buenos Aires, Argentina
| | - Alex Medina Escobar
- Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research (FLENI), Ciudad Autónoma de Buenos Aires, Argentina
| | - Andrea Bril
- Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research (FLENI), Ciudad Autónoma de Buenos Aires, Argentina
| | - Patricio Millar Vernetti
- Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research (FLENI), Ciudad Autónoma de Buenos Aires, Argentina
| | - Juan Ignacio De Palo
- Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research (FLENI), Ciudad Autónoma de Buenos Aires, Argentina
| | - Daniel Cerquetti
- Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research (FLENI), Ciudad Autónoma de Buenos Aires, Argentina
| | - Marcelo Merello
- Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research (FLENI), Ciudad Autónoma de Buenos Aires, Argentina. .,Argentine National Scientific and Technological Research Council (CONICET), Buenos Aires, Argentina.
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Prevalence of impaired odor identification in Parkinson disease with imaging evidence of nigrostriatal denervation. J Neural Transm (Vienna) 2016; 123:421-4. [PMID: 26911386 DOI: 10.1007/s00702-016-1524-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 02/09/2016] [Indexed: 10/22/2022]
Abstract
There is wide variability in the reported prevalence rates of abnormal smell in Parkinson disease (PD). This study assessed the prevalence of abnormal smell, using the University of Pennsylvania Smell Identification Test (UPSIT), in 183 patients with PD with confirmed PET imaging evidence of nigrostriatal denervation. Impaired olfaction in this sample was nearly universal (97.8 %). Wide-ranging prior olfactory impairment estimates may reflect not only uncertainty regarding diagnostic classification, but also the use of inaccurate normative data and differences in olfactory tests used.
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Sunwoo MK, Hong JY, Lee JJ, Lee PH, Sohn YH. Does education modify motor compensation in Parkinson's disease? J Neurol Sci 2016; 362:118-20. [PMID: 26944130 DOI: 10.1016/j.jns.2016.01.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 12/31/2015] [Accepted: 01/18/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND In Alzheimer's disease, higher educational attainment is associated with fewer cognitive deficits despite similar pathological lesions. In animal models of Parkinson's disease (PD), enhanced levels of cognitive and physical stimulation can reduce motor deficits due to dopaminergic neuronal loss. Therefore, in this study, we tested whether higher educational attainment has a beneficial influence on PD motor symptoms. METHODS We included data from 182 patients with de novo PD without dementia, who underwent dopamine transporter (DAT) scans for an initial diagnostic work-up. Patients were divided into 2 groups according to their educational attainment; high education (HE-PD; ≥12years of education) and low education (LE-PD; <12years of education). RESULTS The HE-PD group exhibited significantly higher mini-mental state exam scores, fewer motor deficits, and lower DAT binding to the posterior putamen than the LE-PD group, despite a similar duration of PD symptoms. A general linear model revealed that this difference in motor deficits remained statistically significant after controlling for potential confounding factors (p=0.032). CONCLUSION These results suggest that higher educational attainment can lead to reduced motor deficits in PD despite greater reductions in dopamine levels.
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Affiliation(s)
- Mun K Sunwoo
- Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, South Korea
| | - Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Jae J Lee
- Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil H Lee
- Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
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