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Ryu DW, Yoo SW, Choi KE, Oh YS, Kim JS. Correlation of olfactory function factors with cardiac sympathetic denervation in Parkinson's disease. J Neurol 2024; 271:1397-1407. [PMID: 37940708 DOI: 10.1007/s00415-023-12080-8] [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: 08/10/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Hyposmia is a common nonmotor symptom of Parkinson's disease (PD) and reportedly associated with dysautonomia in PD. The smell identification test for measuring olfactory function consists of multiple items to discriminate specific scents. In the present study, factor analysis of the smell identification test was performed, and the correlation of extracted factors with cardiac sympathetic denervation (CSD) in patients with PD was investigated. METHODS The present study included 183 early PD patients who underwent the Cross-Cultural Smell Identification Test (CC-SIT) and 123I-meta-iodobenzylguanidine (123I-MIBG) myocardial scintigraphy. Factor analysis of 12 items on the CC-SIT was performed using the computed correlation matrix for the binary items, and five smell factors were extracted. Multiple linear regression was performed to determine the correlation of olfactory function with late heart-to-mediastinum (H/M) ratio of 123I-MIBG uptake. RESULTS The mean CC-SIT score was 6.1 ± 2.6, and 133 patients (72.7%) had CSD. The CC-SIT score and five smell factors were not associated with dopamine transporter uptake or cognitive functions. However, the CC-SIT score significantly correlated with age (P < 0.001) and late H/M ratio (P < 0.001). Factors 1 and 5 showed an increasing trend with larger H/M ratio, although it was not statistically significant (β = 0.203, P = 0.085 and β = 0.230, P = 0.085, respectively). Factor 5 significantly correlated with the H/M ratio in PD patients with CSD (β = 0.676, P = 0.036). DISCUSSION The results showed olfactory dysfunction to be selectively associated with cardiac sympathetic burden in PD. The correlation of certain factors with CSD indicates the possibility of selective hyposmia in PD patients.
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Affiliation(s)
- Dong-Woo Ryu
- Department of Neurology, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Sang-Won Yoo
- Department of Neurology, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Ko-Eun Choi
- Department of Neurology, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Yoon-Sang Oh
- Department of Neurology, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Joong-Seok Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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Lin YH, Fang TC, Lei HB, Chiu SC, Chang MH, Guo YJ. UPSIT subitems may predict motor progression in Parkinson's disease. Front Neurol 2023; 14:1265549. [PMID: 37936914 PMCID: PMC10625917 DOI: 10.3389/fneur.2023.1265549] [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: 07/23/2023] [Accepted: 10/05/2023] [Indexed: 11/09/2023] Open
Abstract
Background The relationship between hyposmia and motor progression is controversial in Parkinson's disease (PD). The aim of this study was to investigate whether preserved identification of Chinese-validated University of Pennsylvania Smell Identification Test (UPSIT) odors could predict PD motor progression. Methods PD patients with two consecutive clinical visits while taking medication were recruited. Based on mean changes in Movement Disorder Society Unified Parkinson's Disease Rating Scale part 3 score and levodopa equivalent daily dosage, the participants were categorized into rapid progression, medium progression, and slow progression groups. Odors associated with the risk of PD motor progression were identified by calculating the odds ratios of UPSIT item identification between the rapid and slow progression groups. Receiver operating characteristic curve analysis of these odors was conducted to determine an optimal threshold for rapid motor progression. Results A total of 117 PD patients were screened for group classification. Preserved identification of neutral/pleasant odors including banana, peach, magnolia, and baby powder was significantly correlated with rapid motor progression. The risk of rapid progression increased with more detected risk odors. Detection of ≥1.5 risk odors could differentiate rapid progression from slow progression with a sensitivity of 85.7%, specificity of 45.8%, and area under the receiver operating characteristic curve of 0.687. Conclusion Preserved identification of neutral/pleasant odors may help to predict PD motor progression, and detection of ≥1.5 UPSIT motor progression risk odors could improve the predictive power. In PD patients with a similar level of motor disability during initial screening, preserved pleasant/neutral odor identification may imply relatively better cortical odor discriminative function, which may suggest the body-first (caudo-rostral) subtype with faster disease progression.
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Affiliation(s)
- Yu-Hsuan Lin
- The Department of Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ting-Chun Fang
- The Department of Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hsin-Bei Lei
- The Department of Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shih-Chi Chiu
- The Department of Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ming-Hong Chang
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Brain and Neuroscience Research Center, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Yi-Jen Guo
- The Department of Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
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Ishida N, Ono S, Suzuki R, Nojiri K, Ootsuki S, Zakoji N. Comparison of factors associated with drooling between intractable neuromuscular disease and cerebral palsy. J Clin Neurosci 2023; 115:71-76. [PMID: 37499322 DOI: 10.1016/j.jocn.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/17/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023]
Abstract
Drooling represents a common and noteworthy symptom in patients with intractable neuromuscular disease (IND) and cerebral palsy (CP) and can lead to poor quality of life (QOL) and higher incidence of death due to aspiration of saliva. Identifying the factors affecting drooling is crucial to improving QOL and improving the poor prognosis of patients with IND and CP. This study sought to assess the prevalence of drooling and to elucidate the associated factors, drugs, and differences between patients with IND and CP. We included hospitalized patients with IND and CP. Among the 269 patients, 69 of 162 patients with IND (42.6%) and 75 of 107 patients with CP (70.1%) exhibited drooling. Drooling in IND was significantly higher in patients with tube feeding and those who had a previous stroke than in patients with potential oral intake and those having no history of stroke. In individuals with CP, drooling was significantly negatively associated with age. Taltirelin in patients with IND had a significant positive association with drooling, and antipsychotics and centrally acting muscle relaxants in those with CP had a significant negative association with drooling. Our results suggest that the factors associated with frequent drooling differ between IND and CP cases, and patients who should be screened for drooling are those with decreased swallowing function, those with IND who have had a previous stroke, and young patients with CP. Moreover, clinicians should consider the impact of drugs on drooling in IND and CP cases.
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Affiliation(s)
- Natsuko Ishida
- Clinical Pharmacy and Healthcare Sciences, Faculty of Pharmacy, Institute of Medical, Pharmaceutical & Health Science, Kanazawa University, Ishikawa, Japan.
| | - Shunsuke Ono
- Clinical Pharmacy and Healthcare Sciences, Faculty of Pharmacy, Institute of Medical, Pharmaceutical & Health Science, Kanazawa University, Ishikawa, Japan
| | - Ryohei Suzuki
- Department of Pharmacy, National Hospital Organization Higashinagoya National Hospital, Aichi, Japan
| | - Kei Nojiri
- Department of Pharmacy, National Hospital Organization Suzuka National Hospital, Mie, Japan; Department of Pharmacy, National Hospital Organization Shizuoka Medical Center, Shizuoka, Japan
| | - Shinnosuke Ootsuki
- Department of Pharmacy, Hokuriku Brain and Neuromuscular Disease Center, National Hospital Organization Iou National Hospital, Ishikawa, Japan
| | - Nobuyuki Zakoji
- Department of Pharmacy, National Hospital Organization Shizuoka Medical Center, Shizuoka, Japan
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Xiao Z, Wu W, Zhao Q, Zhang J, Hong Z, Ding D. Sensory impairments and cognitive decline in older adults: A review from a population-based perspective. AGING AND HEALTH RESEARCH 2021. [DOI: 10.1016/j.ahr.2020.100002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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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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Savant Sankhla C, Patel U. Unawareness of hyposmia in patients with idiopathic Parkinson’s disease. ANNALS OF MOVEMENT DISORDERS 2020. [DOI: 10.4103/aomd.aomd_24_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Zhang Y, Li L, Li T, Xin Y, Liu J, Ma F, Mao L. In vivo measurement of the dynamics of norepinephrine in an olfactory bulb following ischemia-induced olfactory dysfunction and its responses to dexamethasone treatment. Analyst 2018; 143:5247-5254. [PMID: 30276380 DOI: 10.1039/c8an01300d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Information on the dynamics of molecules following olfactory dysfunction remains essential for understanding the molecular events involved in the pathological process of olfactory dysfunction. This study for the first time demonstrates a method based on the combination of in vivo microdialysis with high performance liquid chromatography (HPLC) and electrochemical detection (ECD) for the measurement of the dynamics of norepinephrine (NE) in the olfactory bulbs of Sprague-Dawley rats following olfactory dysfunction induced by brain ischemia and its responses toward dexamethasone treatment. The method possesses a high spatial resolution and benefits from in vivo microdialysis and high selectivity and is thus capable of measuring NE in the olfactory bulb of rats. With this method, the basal level of NE in the olfactory bulb was evaluated to be ca. 235 ± 25 nM (n = 6). This level was found to increase by 260 ± 90% at a time point of 240 min after brain ischemia with bilateral ligation of both common carotid arteries. The increase was found to be suppressed upon the treatment of the animals with 0.2% dexamethasone in the olfactory bulb. These results suggest that NE is involved in the pathological process of ischemia-induced olfactory dysfunction and this information is useful to further understand the molecular events involved in olfactory dysfunction.
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Affiliation(s)
- Yinghong Zhang
- Department of Otorhinolaryngology, Peking University Third Hospital, Beijing 100083, China.
| | - Lijuan Li
- Department of Otorhinolaryngology, Peking University Third Hospital, Beijing 100083, China.
| | - Tao Li
- Department of Otorhinolaryngology, Peking University Third Hospital, Beijing 100083, China.
| | - Ying Xin
- Department of Otorhinolaryngology, Peking University Third Hospital, Beijing 100083, China.
| | - Junxiu Liu
- Department of Otorhinolaryngology, Peking University Third Hospital, Beijing 100083, China.
| | - Furong Ma
- Department of Otorhinolaryngology, Peking University Third Hospital, Beijing 100083, China.
| | - Lanqun Mao
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Analytical Chemistry for Living Biosystems, Institute of Chemistry, The Chinese Academy of Sciences, Beijing 100190, China.
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