Idiopathic hyposmia as a preclinical sign of Parkinson's disease
Idiopathic hyposmia as a preclinical sign of Parkinson's disease
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DOI：
10.1002/ana.20160
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发表时间：
2004-08-01
影响因子：
11.2
通讯作者：
Berendse, HW
中科院分区：
文献类型：
--
作者：
Ponsen, MM;Stoffers, D;Berendse, HW
嗅觉功能障碍是帕金森病(PD)的早期和常见症状。为了确定其他原因不明的(特发性)嗅觉障碍是否与发展为帕金森病的风险增加有关，我们在361名帕金森病患者的无症状亲属(父母、兄弟姐妹或子女)的队列中设计了一项前瞻性研究。嗅觉检测、识别和辨别任务的组合被用来选择低血压组(n=40)和正常组(n=38)进行为期两年的临床随访评估和序贯单光子发射计算机断层扫描(SPECT)，使用[I-123]β-CIT作为多巴胺转运体配基，评估基线时和基线后两年的黑质纹状体多巴胺能功能。在对其余283名亲属的随访中，使用了对帕金森症的存在敏感的有效问卷。距基线两年后，10%的特发性低血症者在基线时也显著降低了[I-123]β-CIT结合，发生了临床帕金森病，而队列中的其他亲属都没有。在其余的非帕金森病患者营养不良亲属中，多巴胺转运体结合的平均下降速度显著高于正常亲属。这些结果表明，特发性嗅觉功能障碍与发生帕金森病的风险增加至少10%相关。
Olfactory dysfunction is an early and common symptom in Parkinson's disease (PD). In an effort to determine whether otherwise unexplained (idiopathic) olfactory dysfunction is associated with an increased risk of developing PD, we designed a prospective study in a cohort of 361 asymptomatic relatives (parents, siblings, or children) of PD patients. A combination of olfactory detection, identification, and discrimination tasks was used to select groups of hyposmic (n = 40) and normosmic (n = 38) individuals for a 2-year clinical follow-up evaluation and sequential single-photon emission computed tomography (SPECT), using [I-123]beta-CIT as a dopamine transporter ligand, to assess nigrostriatal dopaminergic function at baseline and 2 years from baseline. A validated questionnaire, sensitive to the presence of parkinsonism, was used in the follow-up of the remaining 283 relatives. Two years from baseline, 10% of the individuals with idiopathic hyposmia, who also had strongly reduced [I-123]beta-CIT binding at baseline, had developed clinical PD as opposed to none of the other relatives in the cohort. In the remaining nonparkinsonian hyposmic relatives, the average rate of decline in dopamine transporter binding was significantly higher than in the normosmic relatives. These results indicate that idiopathic olfactory dysfunction is associated with an increased risk of developing PD of at least 10%.