Olfactory Dysfunction Predicts Disease Progression in Parkinson's Disease: A Longitudinal Study.
Olfactory Dysfunction Predicts Disease Progression in Parkinson's Disease: A Longitudinal Study.
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DOI：
10.3389/fnins.2020.569777
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发表时间：
2020
影响因子：
4.3
通讯作者：
Guo J
中科院分区：
文献类型：
--
作者：
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
嗅觉功能障碍（嗅觉减退）是帕金森病（PD）的重要非运动症状。为了研究嗅觉减退作为疾病进展标志物的潜在预后价值，我们前瞻性地评估了嗅觉减退患者和嗅觉正常患者的临床表现和纵向变化。在基线时用 Sniffin’ Sticks 评估 PD 患者的嗅觉功能。 105 名嗅觉低下的 PD 患者和 59 名嗅觉正常的 PD 患者入组并随访 2 年。随后在基线和随访期间对他们进行神经学和神经心理学评估。比较嗅觉低下和正常患者的临床表现和疾病进展。此外，还分析了疾病进展与嗅觉功能之间的关系。我们的研究表明，嗅觉低下的帕金森病患者和嗅觉正常的帕金森病患者在性别、年龄、教育水平、发病年龄、病程和基线临床特征方面相似。与渗透压正常的帕金森病患者相比，低血压帕金森病患者在随访时表现出更严重的统一帕金森病评定量表第二部分至第三部分（UPDRS II-III）评分、更高的左旋多巴等效剂量（LED）需求以及较差的简易精神状态检查（MMSE）评分。情绪减退症在 LED 需求的增加、UPDRS III 评分的改善和 MMSE 评分的恶化方面也表现出更大的比率。 UPDRS III 评分的提高和 MMSE 评分的下降均与较差的气味识别相关。我们的前瞻性研究表明，与嗅觉正常的患者相比，嗅觉低下的帕金森病患者表现出相对较差的临床病程。嗅觉功能障碍是疾病进展的有用预测指标。
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. 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. 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. 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.