Association of olfactory dysfunction with risk for future Parkinson's disease

Ross, G. Webster; Petrovitch, Helen; Abbott, Robert D.; Tanner, Caroline M.; Popper, Jordan S.; Masaki, Kamal; Launer, Lenore J.; White, Lon R.

doi:10.1002/ana.21291

Cited by 615 publications

(501 citation statements)

References 48 publications

(59 reference statements)

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“…All relatives with hyposmia who developed PD had abnormal dopamine transporter binding at baseline [517]. In the Honolulu-Asia Aging study, individuals were tested for olfactory dysfunction at baseline and followed for incident PD [518]. Olfactory dysfunction was associated with increased risk of PD at four years of follow-up (OR 5.2, 95% CI 1.5-25.6 for lowest quartile versus top two quartiles), whereas at 8 years of follow-up, there was no association [518].…”

Section: Olfactory Dysfunctionmentioning

confidence: 99%

Epidemiology and etiology of Parkinson’s disease: a review of the evidence

et al. 2011

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Section: Olfactory Dysfunctionmentioning

confidence: 99%

Epidemiology and etiology of Parkinson’s disease: a review of the evidence

et al. 2011

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“…Olfactory deficits affect 75% to 90% of patients with Parkinson's disease (PD), and olfactory testing may also represent a sensitive screening test for individuals at risk of developing PD,1, 2, 3, 4 whereas olfactory function is normal or only mildly impaired in other forms of degenerative parkinsonism or essential tremor (ET) 2, 5. Olfactory testing has recently been incorporated in the newly established International Parkinson and Movement Disorder Society criteria for PD6 and prodromal PD 7…”

mentioning

confidence: 99%

Optimizing odor identification testing as quick and accurate diagnostic tool for Parkinson's disease

Mahlknecht

Pechlaner²,

Boesveldt

et al. 2016

Mov Disord.

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IntroductionThe aim of this study was to evaluate odor identification testing as a quick, cheap, and reliable tool to identify PD.MethodsOdor identification with the 16‐item Sniffin' Sticks test (SS‐16) was assessed in a total of 646 PD patients and 606 controls from three European centers (A, B, and C), as well as 75 patients with atypical parkinsonism or essential tremor and in a prospective cohort of 24 patients with idiopathic rapid eye movement sleep behavior disorder (center A). Reduced odor sets most discriminative for PD were determined in a discovery cohort derived from a random split of PD patients and controls from center A using L1‐regularized logistic regression. Diagnostic accuracy was assessed in the rest of the patients/controls as validation cohorts.ResultsOlfactory performance was lower in PD patients compared with controls and non‐PD patients in all cohorts (each P < 0.001). Both the full SS‐16 and a subscore of the top eight discriminating odors (SS‐8) were associated with an excellent discrimination of PD from controls (areas under the curve ≥0.90; sensitivities ≥83.3%; specificities ≥82.0%) and from non‐PD patients (areas under the curve ≥0.91; sensitivities ≥84.1%; specificities ≥84.0%) in all cohorts. This remained unchanged when patients with >3 years of disease duration were excluded from analysis. All 8 incident PD cases among patients with idiopathic rapid eye movement sleep behavior disorder were predicted with the SS‐16 and the SS‐8 (sensitivity, 100%; positive predictive value, 61.5%).ConclusionsOdor identification testing provides excellent diagnostic accuracy in the distinction of PD patients from controls and diagnostic mimics. A reduced set of eight odors could be used as a quick tool in the workup of patients presenting with parkinsonism and for PD risk indication. © 2016 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society

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“…In PD, in particular, olfactory dysfunction may precede the motor symptoms of the disease by up to 7 years 1. Indeed, during the earliest premotor stages of PD, there is associated pathology in olfactory‐related areas 2.…”

Section: Introductionmentioning

confidence: 99%

Improved diagnosis of Parkinson's disease from a detailed olfactory phenotype

Gerkin

Adler

Hentz

et al. 2017

Ann Clin Transl Neurol

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ObjectiveTo assess the predictive potential of the complete response pattern from the University of Pennsylvania Smell Identification Test for the diagnosis of Parkinson's disease.MethodsWe analyzed a large dataset from the Arizona Study of Aging and Neurodegenerative Disorders, a longitudinal clinicopathological study of health and disease in elderly volunteers. Using the complete pattern of responses to all 40 items in each subject's test, we built predictive models of neurodegenerative disease, and we validated these models out of sample by comparing model predictions against postmortem pathological diagnosis.ResultsConsistent with anatomical considerations, we found that the specific test response pattern had additional predictive power compared with a conventional measure – total test score – in Parkinson's disease, but not Alzheimer's disease. We also identified specific test questions that carry the greatest predictive power for disease diagnosis.InterpretationOlfactory ability has typically been assessed with either self‐report or total score on a multiple choice test. We showed that a more accurate clinical diagnosis can be made using the pattern of responses to all the test questions, and validated this against the “gold standard” of pathological diagnosis. Information in the response pattern also suggests specific modifications to the standard test that may optimize predictive power under the typical clinical constraint of limited time. We recommend that future studies retain the individual item responses for each subject, and not just the total score, both to enable more accurate diagnosis and to enable additional future insights.

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Association of olfactory dysfunction with risk for future Parkinson's disease

Abstract: Impaired olfaction can predate clinical PD in men by at least 4 years and may be a useful screening tool to detect those at high risk for development of PD in later life.

Cited by 615 publications

References 48 publications

Epidemiology and etiology of Parkinson’s disease: a review of the evidence

Epidemiology and etiology of Parkinson’s disease: a review of the evidence

Optimizing odor identification testing as quick and accurate diagnostic tool for Parkinson's disease

Improved diagnosis of Parkinson's disease from a detailed olfactory phenotype

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