Department of Neurology, Tokyo Women's Medical University, Kawada-cho Shinjuku, Tokyo, Japan.
Mov Disord. 2010 Jul 15;25(9):1143-9. doi: 10.1002/mds.23001.
Autonomic and olfactory dysfunctions are considered markers for preclinical diagnosis in Parkinson's disease (PD), because pathological changes in these systems can start before motor symptoms develop. We investigated whether cardiac sympathetic function and olfactory function are associated in PD. Participants comprised 40 nondemented patients with idiopathic PD, and age-matched controls. Cardiac sympathetic function was evaluated by (123) I-metaiodobenzylguanidine (MIBG) uptake, in terms of the heart to mediastinum (H/M) ratio in both early and delayed images, and the washout rate (WR). Olfactory function was evaluated using the Odor Stick Identification Test for Japanese, which evaluates the detection of 12 odorants familiar to Japanese participants. Smell identification scores were significantly lower (P < 0.001) in patients with PD than in controls. Smell identification scores correlated positively with early (P < 0.05) and delayed H/M ratios (P < 0.01), and inversely with the WR (P < 0.005) especially in patients with early PD (below 5 years of the start of motor symptoms), whereas smell identification scores did not correlate with any parameters of MIBG in the advanced PD (above 5 years of the start of motor symptoms). There was no correlation between motor symptom scores and smell identification scores, H/M ratios, or WR. The results suggest that the cardiac sympathetic nervous system might degenerate in parallel with the olfactory system in patients with early PD, and that these two systems might degenerate at a different rate of speed in advanced PD.
自主神经和嗅觉功能障碍被认为是帕金森病（PD）临床前诊断的标志物，因为这些系统的病理变化可能在运动症状出现之前就已经开始了。我们研究了 PD 患者的心脏自主神经功能和嗅觉功能是否相关。参与者包括 40 名非痴呆的特发性 PD 患者和年龄匹配的对照组。心脏自主神经功能通过（123）I-间碘苄胍（MIBG）摄取来评估，以早期和延迟图像中的心脏与纵隔（H/M）比值以及洗脱率（WR）来表示。嗅觉功能使用日本气味棒识别测试进行评估，该测试评估了对 12 种日本参与者熟悉的气味的检测。PD 患者的嗅觉识别评分明显低于对照组（P<0.001）。嗅觉识别评分与早期（P<0.05）和延迟 H/M 比值（P<0.01）呈正相关，与 WR 呈负相关（P<0.005），尤其是在早期 PD（运动症状开始后 5 年内）患者中，而在晚期 PD（运动症状开始后 5 年内）患者中，嗅觉识别评分与 MIBG 的任何参数均无相关性。运动症状评分与嗅觉识别评分、H/M 比值或 WR 之间无相关性。结果表明，在早期 PD 患者中，心脏自主神经系统可能与嗅觉系统平行退化，而在晚期 PD 中，这两个系统可能以不同的速度退化。
