Unità Operativa di Neurologia, Ospedale delle Apuane, Azienda USL Toscana Nord Ovest, Massa, Italy.
Istituto di Biorobotica, Scuola Superiore Sant'Anna, Pisa, Italy.
Acta Neurol Scand. 2018 Feb;137(2):204-211. doi: 10.1111/ane.12862. Epub 2017 Oct 29.
Preclinical diagnosis of Parkinson's disease (PD) is nowadays a topic of interest as the neuropathological process could begin years before the appearance of motor symptoms. Several symptoms, among them hyposmia, could precede motor features in PD. In the preclinical phase of PD, a subclinical reduction in motor skills is highly likely. In this pilot study, we investigate a step-by-step method to achieve preclinical PD diagnosis.
We used the IOIT (Italian Olfactory Identification Test) to screen a population of healthy subjects. We identified 20 subjects with idiopathic hyposmia. Hyposmic subjects underwent an evaluation of motor skills, at baseline and after 1 year, using motion analysis sensors previously created by us.
One subject showed significant worsening in motor measurements. In this subject, we further conducted a dopaminergic challenge test monitored with the same sensors and, finally, he underwent [ I]-FP/CIT (DaTscan) SPECT brain imaging. The results show that he is probably affected by preclinical PD.
Our pilot study suggests that the combined use of an olfactory test and motor sensors for motion analysis could be useful for a screening of healthy subjects to identify those at a high risk of developing PD.
目前,临床前帕金森病 (PD) 的诊断是一个研究热点,因为在运动症状出现之前,神经病理学过程可能已经开始多年。一些症状,包括嗅觉减退,可能会先于 PD 的运动特征出现。在 PD 的临床前阶段,运动技能的亚临床下降极有可能发生。在这项初步研究中,我们研究了一种逐步的方法来实现 PD 的临床前诊断。
我们使用 IOIT(意大利嗅觉识别测试)对健康人群进行了筛查。我们确定了 20 名患有特发性嗅觉减退的患者。嗅觉减退的患者在基线和 1 年后使用我们之前创建的运动分析传感器进行了运动技能评估。
一名患者的运动测量结果显著恶化。在这名患者中,我们进一步进行了多巴胺能挑战测试,使用相同的传感器进行监测,最后,他接受了 [I]-FP/CIT (DaTscan) SPECT 脑成像。结果表明,他可能患有临床前 PD。
我们的初步研究表明,嗅觉测试和运动传感器的联合使用可能有助于对健康人群进行筛查,以识别那些有发展 PD 高风险的人群。