Passali G C, Bove F, Vargiu L, Bentivoglio A R, Anzivino R, De Corso E, Galli J, Rigante M, Pandolfini M, Sergi B, Giuliani M, Cianfrone F, Paludetti G, Fasano A
Institute of Otorhinolaryngology, Head and Neck Surgery, Catholic University of Sacred Heart, Rome, Italy.
Department of Neurology, Catholic University of Sacred Heart, Rome, Italy.
Clin Otolaryngol. 2017 Aug;42(4):837-843. doi: 10.1111/coa.12816. Epub 2017 Feb 1.
To investigate in Parkinson's disease-affected patients a correlation between hyposmia and gastrointestinal dysfunction and their possible identical etiopathogenesis.
Retrospective cohort study.
ENT and neurology departments (Gemelli Hospital, Rome, Italy).
A total of 78 patients with diagnosis of PD according to the UK Brain Bank criteria.
informed consent and olfactory testing executed; exclusion criteria: signs of dementia according to the DSM-IV criteria; Mini Mental State Examination score ≤26; head trauma; central neurological disorders, nasal or systemic diseases potentially affecting olfactory function. Motor condition was assessed by means of Hoehn and Yahr staging and by section III of the Unified PD Rating Scale, performed off and on medications.
The patients underwent olfactory evaluation (TDI score), after rhinomanometry with nasal decongestion. A total of 25 non-motor symptoms were evaluated through an interview.
Olfactory dysfunction was objectively found in 91.0% of patients, a percentage higher than the subjective hyposmia reported (55.1%) P = 0.0001. Seven patients (9.0%) were normosmic, 49 (62.8%) hyposmic and 22 (28.2%) anosmic. Subjective hyposmia, constipation, bloating and dyspepsia differed across groups, being higher in anosmic and hyposmic ones than in the normosmic group. P value was ≤0.05 for each symptom. Despite the original results, this study has the limitation of being based on subjective ratings by a relatively limited group of patients.
Hyposmia and gastrointestinal symptoms are correlated, and this would support a possible common origin; the CNS could be reached through two different pathways, both starting in the peripheral nervous system.
研究帕金森病患者嗅觉减退与胃肠功能障碍之间的相关性及其可能相同的病因发病机制。
回顾性队列研究。
耳鼻喉科和神经科（意大利罗马杰梅利医院）。
根据英国脑库标准诊断为帕金森病的78例患者。
签署知情同意书并进行嗅觉测试；排除标准：符合DSM-IV标准的痴呆体征；简易精神状态检查表评分≤26；头部外伤；中枢神经系统疾病、可能影响嗅觉功能的鼻腔或全身性疾病。通过Hoehn和Yahr分期以及统一帕金森病评定量表第三部分对运动状况进行评估，评估在服药和未服药状态下进行。
患者在使用鼻减充血剂进行鼻阻力测量后接受嗅觉评估（TDI评分）。通过访谈评估总共25种非运动症状。
客观发现91.0%的患者存在嗅觉功能障碍，这一百分比高于报告的主观嗅觉减退百分比（55.1%），P = 0.0001。7例患者（9.0%）嗅觉正常，49例（62.8%）嗅觉减退，22例（28.2%）嗅觉丧失。主观嗅觉减退、便秘、腹胀和消化不良在各组之间存在差异，嗅觉丧失和嗅觉减退组高于嗅觉正常组。每种症状的P值均≤0.05。尽管有原始结果，但本研究存在基于相对有限患者群体的主观评分的局限性。
嗅觉减退与胃肠道症状相关，这支持可能存在共同起源；中枢神经系统可能通过两条不同途径受累，这两条途径均始于外周神经系统。
