Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishicho, Yonago, 683-8503, Japan.
Neurol Sci. 2018 Feb;39(2):321-328. doi: 10.1007/s10072-017-3187-z. Epub 2017 Nov 11.
Patients with Alzheimer's disease (AD) develop olfactory and gustatory disorders. However, the order of failure and relevance of the pathophysiology are unclear. We compared olfactory identification and whole mouth gustation in patients with AD to those with mild cognitive impairment (MCI) and to healthy controls (HC) and assessed correlations with pathophysiology. Patients with AD (n = 40), MCI (n = 34), and HC (n = 40) were recruited. We performed the Odor Stick Identification Test for Japanese (OSIT-J), gustatory test by the intraoral dropping method using taste solutions, Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognitive subscale Japanese version (ADAS-J cog), Touch Panel-type Dementia Assessment Scale (TDAS), and measurement of amyloid β (Aβ) 42 and phosphorylated tau (p-tau) 181 levels in cerebrospinal fluid (CSF). Patients with AD and MCI had lower OSIT-J scores than did the HC. The OSIT-J score was correlated with the MMSE, ADAS-J cog, TDAS, and Aβ42 results. There were no significant differences in the gustatory test scores among the three groups. The gustatory test score was only correlated with the MMSE, ADAS-J cog, and TDAS results. Olfactory function decreased in AD and MCI patients and was associated with CSF biomarker levels and cognitive disorders. The results suggest that olfactory function is impaired in early stage of AD. Gustatory function was not correlated with CSF biomarkers, which suggests that it may not be impaired in early stage of AD.
阿尔茨海默病（AD）患者会出现嗅觉和味觉障碍。然而，其发病机制的先后顺序和相关性尚不清楚。我们比较了 AD 患者、轻度认知障碍（MCI）患者和健康对照者（HC）的嗅觉识别和全口味觉，并评估了与发病机制的相关性。招募了 40 名 AD 患者、34 名 MCI 患者和 40 名 HC。我们进行了日本嗅觉识别测试（OSIT-J）、使用味觉溶液进行的口腔内滴注味觉测试、简易精神状态检查（MMSE）、阿尔茨海默病评估量表-认知子量表日本版（ADAS-J cog）、触摸面板型痴呆评估量表（TDAS），以及脑脊液（CSF）中淀粉样β（Aβ）42 和磷酸化 tau（p-tau）181 水平的测量。AD 和 MCI 患者的 OSIT-J 评分低于 HC。OSIT-J 评分与 MMSE、ADAS-J cog、TDAS 和 Aβ42 结果相关。三组间味觉测试评分无显著差异。味觉测试评分仅与 MMSE、ADAS-J cog 和 TDAS 结果相关。嗅觉功能在 AD 和 MCI 患者中降低，与 CSF 生物标志物水平和认知障碍相关。结果表明，嗅觉功能在 AD 的早期阶段受损。味觉功能与 CSF 生物标志物无相关性，这表明它在 AD 的早期阶段可能没有受损。
