Mao Cheng-Jie, Wang Fen, Chen Ju-Ping, Yang Ya-Ping, Chen Jing, Huang Juan-Ying, Liu Chun-Feng
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University.
Institute of Neuroscience, Soochow University, Suzhou.
Clin Interv Aging. 2017 Oct 9;12:1637-1644. doi: 10.2147/CIA.S147588. eCollection 2017.
Hyposmia is one of the earliest non-motor features of Parkinson's disease (PD) and can precede the onset of motor symptoms by years. Most of the current olfactory detection tests are targeted at Western populations. The exact relationship between hyposmia and cognitive impairment is unknown. The purpose of the study was to find bromines that can effectively identify olfactory dysfunction and investigate the relationship between hyposmia and cognitive function in early, non-demented, drug-naïve patients with PD in the People's Republic of China.
Sixty-three early, non-demented, drug-naïve patients with PD and 55 healthy controls were enrolled in the study. The T&T olfactometer and a Chinese version of Montreal Cognitive Assessment (MoCA) were applied to assess subjects' olfactory and cognitive functions. Patients with PD also completed the Modified Unified Parkinson's disease-rating scale (UPDRS) and Hoehn and Yahr (H&Y) scale.
Patients with PD had lower scores of visuospatial and executive function (=0.000), attention (=0.03), and delayed recall (=0.001) than controls. β-phenylethyl alcohol (floral smell, smell of rose petals) and isovaleric acid (smell of sweat, stuffy socks) were more sensitive for identifying hyposmia in patients with PD than three other odors. Multivariate logistic regression analysis showed that impaired visuospatial and executive function was associated with hyposmia (=0.013), but was independent of other PD-associated variables.
Hyposmia was common in early, non-demented, drug-naïve PD patients. β-Phenylethyl alcohol and isovaleric acid were more superior for identifying hyposmia in early non-demented Chinese patients with PD. Hyposmia was associated with impaired visuospatial and executive function in patients with PD. Further prospective studies that apply a series of neuropsychological tests and functional magnetic resonance imaging methods in large samples in multicenter studies are needed to confirm our findings and to investigate the relationship between hyposmia and cognitive function with disease progression in patients with PD.
嗅觉减退是帕金森病（PD）最早出现的非运动症状之一，可在运动症状出现前数年出现。目前大多数嗅觉检测测试针对的是西方人群。嗅觉减退与认知障碍的确切关系尚不清楚。本研究的目的是寻找能有效识别嗅觉功能障碍的嗅素，并调查中国早期、未患痴呆、未服用药物的PD患者嗅觉减退与认知功能之间的关系。
本研究纳入了63例早期、未患痴呆、未服用药物的PD患者和55名健康对照者。应用T&T嗅觉计和中文版蒙特利尔认知评估量表（MoCA）评估受试者的嗅觉和认知功能。PD患者还完成了改良的统一帕金森病评定量表（UPDRS）和霍恩及雅尔（H&Y）分级量表。
与对照组相比，PD患者在视觉空间与执行功能（=0.000）、注意力（=0.03）和延迟回忆（=0.001）方面得分较低。β-苯乙醇（花香，玫瑰花瓣气味）和异戊酸（汗臭味，闷袜子味）在识别PD患者嗅觉减退方面比其他三种气味更敏感。多因素逻辑回归分析显示，视觉空间与执行功能受损与嗅觉减退相关（=0.013），但独立于其他与PD相关的变量。
嗅觉减退在早期、未患痴呆、未服用药物的PD患者中很常见。β-苯乙醇和异戊酸在识别早期未患痴呆的中国PD患者嗅觉减退方面更具优势。PD患者的嗅觉减退与视觉空间与执行功能受损有关。需要在多中心研究中对大量样本应用一系列神经心理学测试和功能磁共振成像方法进行进一步的前瞻性研究，以证实我们的发现，并研究PD患者嗅觉减退与认知功能随疾病进展之间的关系。
