Berendse H W, Booij J, Stoffers D, Ponsen M M, Hijman R, Wolters E Ch
Research Institute Neurosciences Vrije Universiteit, Afdeling neurologie, VU medisch centrum, De Boelelaan 1117, 1081 HV Amsterdam.
Tijdschr Gerontol Geriatr. 2002 Apr;33(2):70-7.
Parkinson's disease (PD) is characterized by a progressive degeneration of mesencephalic dopaminergic neurons. More than half of these neurons are lost in a presymptomatic phase of an estimated 4-6 years duration. It is obvious that any type of treatment aimed at slowing down the disease process should preferably be applied in this presymptomatic phase. Presymptomatic detection of PD has therefore become an important goal. In a recent study in a population of 361 asymptomatic first degree relatives of PD patients, we were able to demonstrate that presymptomatic detection is possible by means of a combination of three olfactory processing tasks and [123l] beta-CIT single photon emission computed tomography (SPECT) scanning of the nigrostriatal dopaminergic system. These results are a first step towards the development of a screening strategy that may be applied in the general population. Impairments of olfactory function, however, are not specific to PD but are also associated with other neurodegenerative disorders (e.g. Alzheimer's disease) and certain lifestyle characteristics (e.g. smoking). In the next few years our research efforts will focus on two different approaches to develop a more specific screening strategy. First, olfactory processing tasks will be combined with tasks aimed at detecting subtle (visuo)motor disturbances and early cognitive impairments. In parallel, an effort will be made to define disease-specific patterns of olfactory dysfunction in neurodegenerative disorders.
帕金森病（PD）的特征是中脑多巴胺能神经元进行性退化。在长达4 - 6年的症状前期，超过一半的这些神经元会丢失。显然，任何旨在减缓疾病进程的治疗方法都最好在这个症状前期应用。因此，帕金森病的症状前检测已成为一个重要目标。在最近一项针对361名帕金森病患者无症状一级亲属的研究中，我们能够证明，通过三项嗅觉处理任务与黑质纹状体多巴胺能系统的[123I]β - CIT单光子发射计算机断层扫描（SPECT）相结合，可以进行症状前检测。这些结果是朝着开发一种可应用于普通人群的筛查策略迈出的第一步。然而，嗅觉功能障碍并非帕金森病所特有，它还与其他神经退行性疾病（如阿尔茨海默病）以及某些生活方式特征（如吸烟）有关。在未来几年，我们的研究工作将集中在两种不同的方法上，以开发一种更具特异性的筛查策略。首先，嗅觉处理任务将与旨在检测细微（视觉）运动障碍和早期认知障碍的任务相结合。同时，将努力确定神经退行性疾病中嗅觉功能障碍的疾病特异性模式。
