Parkinson's Disease Research, Education and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, 19104, USA.
Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, 19104, USA.
Neurosci Bull. 2017 Oct;33(5):515-525. doi: 10.1007/s12264-017-0170-x. Epub 2017 Aug 22.
Olfactory dysfunction is common in Parkinson's disease (PD) and often predates the diagnosis by years, reflecting early deposition of Lewy pathology, the histologic hallmark of PD, in the olfactory bulb. Clinical tests are available that allow for the rapid characterization of olfactory dysfunction, including tests of odor identification, discrimination, detection, and recognition thresholds, memory, and tests assessing the build-up of odor intensity across increasing suprathreshold stimulus concentrations. The high prevalence of olfactory impairment, along with the ease and low cost of assessment, has fostered great interest in olfaction as a potential biomarker for PD. Hyposmia may help differentiate PD from other causes of parkinsonism, and may also aid in the identification of "pre-motor" PD due to the early pathologic involvement of olfactory pathways. Olfactory function is also correlated with other non-motor features of PD and may serve as a predictor of cognitive decline. In this article, we summarize the existing literature on olfaction in PD, focusing on the potential for olfaction as a biomarker for early or differential diagnosis and prognosis.
嗅觉功能障碍在帕金森病（PD）中很常见，并且通常在诊断前数年就已经出现，这反映了Lewy 病理学（PD 的组织学标志）在嗅球中的早期沉积。现已有临床测试可用于快速描述嗅觉功能障碍，包括气味识别、辨别、检测和识别阈值、记忆测试，以及评估随着超阈值刺激浓度增加气味强度累积的测试。嗅觉损伤的高患病率，加上评估的简便性和低成本，使得嗅觉作为 PD 潜在生物标志物的可能性引起了极大的关注。嗅觉减退可能有助于将 PD 与其他帕金森病原因区分开来，并且由于嗅觉通路的早期病理参与，也可能有助于识别“运动前”PD。嗅觉功能也与 PD 的其他非运动特征相关，并且可能作为认知能力下降的预测指标。在本文中，我们总结了 PD 中嗅觉的现有文献，重点介绍了嗅觉作为早期或鉴别诊断和预后生物标志物的潜力。
