Hanoğlu Lütfü, Hakyemez Hüsniye Aylin, Özer Feriha, Özben Serkan, Demirci Sema, Oğuz Akarsu Emel
Medipol University Medical Faculty, Department of Neurology, İstanbul, Turkey.
Medilife hospital, Clinic of Neurology, İstanbul, Turkey.
Noro Psikiyatr Ars. 2014 Dec;51(4):389-394. doi: 10.5152/npa.2014.7353. Epub 2014 Dec 1.
Olfactory dysfunction is an early and common symptom in idiopathic Parkinson's disease (IPD). Recently, the relation between olfactory dysfunction and cognitive loss in IPD has been reported. In our study, we aimed to investigate the relation between olfactory dysfunction and cognitive impairments in early IPD related with this theory.
In this study, we included 28 patients with stage 1 and stage 2 IPD according to the Hoehn-Yahr (H-Y) scale and 19 healthy participants. The University of Pennsylvania Smell Identification Test (UPSIT) was performed for evaluating olfactory function. For cognitive investigation in participants, the clock drawing test, Stroop test, verbal fluency test, Benton face recognition test (BFR), Benton line judgment orientation test (BLO), and Auditory Verbal Learning Test (AVLT) were performed.
We found significantly lower UPSIT scores in the patient group compared to controls (p=.018). In the neuropsychological investigation, only Stroop test and BLOT test scores were significantly lower in the patient group compared to controls (p=.003, p=.002, respectively). We found a negative correlation between UPSIT scores and Stroop time (p=.033) and Stroop error (p=.037) and a positive correlation between UPSIT scores and SBST long-term memory scores (p=.016) in patients.
In our study, we found mild cognitive impairment related with visuospatial and executive functions in early-stage IPD compared to controls. But, in the patient group, we detected a different impairment pattern of memory and frontal functions that correlated with hyposmia. This different pattern might be indicating a subgroup of IPD characterized by low performance in episodic verbal memory, with accompanying olfactory dysfunction in the early stage.
嗅觉功能障碍是特发性帕金森病（IPD）早期常见症状。近期，已有关于IPD中嗅觉功能障碍与认知减退之间关系的报道。在我们的研究中，旨在依据该理论探讨早期IPD中嗅觉功能障碍与认知损害之间的关系。
本研究纳入了28例根据霍恩-亚尔（H-Y）分级处于1期和2期的IPD患者以及19名健康参与者。采用宾夕法尼亚大学嗅觉识别测试（UPSIT）评估嗅觉功能。对参与者进行认知调查时，开展了画钟试验、斯特鲁普测试、语言流畅性测试、本顿面部识别测试（BFR）、本顿直线判断定向测试（BLO）以及听觉词语学习测试（AVLT）。
我们发现患者组的UPSIT得分显著低于对照组（p = 0.018）。在神经心理学调查中，与对照组相比，仅患者组的斯特鲁普测试和BLO测试得分显著更低（分别为p = 0.003，p = 0.002）。我们发现患者的UPSIT得分与斯特鲁普测试时间（p = 0.033）和斯特鲁普测试错误（p = 0.037）呈负相关，与语义流畅性测试（SBST）长期记忆得分呈正相关（p = 0.016）。
在我们的研究中，我们发现与对照组相比，早期IPD存在与视觉空间和执行功能相关的轻度认知损害。但是，在患者组中，我们检测到与嗅觉减退相关的记忆和额叶功能的不同损害模式。这种不同模式可能表明存在一个IPD亚组，其特征为情景性言语记忆表现较差，并在早期伴有嗅觉功能障碍。
