Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, 01307, Dresden, Germany.
Section of Physiology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.
J Neurol. 2019 Feb;266(2):339-345. doi: 10.1007/s00415-018-9135-x. Epub 2018 Nov 28.
Patients with idiopathic smell loss constitute an at-risk population for the development of Parkinson's disease (PD). The study aimed to follow up a large number of patients with idiopathic smell and/or taste loss to define the incidence of PD in this population and, further, to assess characteristics of both olfactory and gustatory function and their possible association with PD development.
In this prospective case-control study, 833 patients diagnosed with an idiopathic smell disorder at our Smell and Taste Center during the last 15 years were contacted for a telephone interview. In 474 patients, a complete data set containing of demographic data, clinical information, retrospective smell and taste testing results, and telephone assessment was obtained.
Out of 474 patients with idiopathic smell loss 45 (9.8%) had been diagnosed with PD, since they received the diagnosis of idiopathic smell and/or taste loss (mean 10.9 years after olfactory loss onset). Thus, with respect to the classification into olfactory/gustatory disorders, 28.6% of the patients with a combined olfactory and gustatory disorder developed PD, whereas in 9.9% of those with a pure olfactory disorder and in 3.8% of those with a pure gustatory disorder, PD was diagnosed. No association emerged between qualitative smell or taste loss and PD development.
This large patient cohort study extends the previous literature, indicating that risk stratification might be considerably improved by correct diagnostic allocation and emphasizes the need for an exhaustive olfactory and gustatory assessment in specialized centers.
特发性嗅觉丧失患者构成帕金森病（PD）发展的高危人群。本研究旨在对大量特发性嗅觉和/或味觉丧失患者进行随访，以明确该人群中 PD 的发病率，并进一步评估嗅觉和味觉功能的特征及其与 PD 发展的可能相关性。
在这项前瞻性病例对照研究中，我们的嗅觉味觉中心在过去 15 年中诊断了 833 例特发性嗅觉障碍患者，通过电话对他们进行了随访。在 474 名患者中，获得了包含人口统计学数据、临床信息、回顾性嗅觉和味觉测试结果以及电话评估的完整数据集。
在 474 例特发性嗅觉丧失患者中，有 45 例（9.8%）被诊断为 PD，因为他们在出现嗅觉丧失后 10.9 年（平均）被诊断为特发性嗅觉和/或味觉丧失。因此，根据嗅觉/味觉障碍的分类，45 例嗅觉和味觉均有障碍的患者中有 28.6%发展为 PD，而在单纯嗅觉障碍的患者中有 9.9%，在单纯味觉障碍的患者中有 3.8%。嗅觉或味觉丧失的定性与 PD 发展之间没有关联。
这项大型患者队列研究扩展了以往的文献，表明通过正确的诊断分配可以显著提高风险分层，并且强调了在专门中心进行详尽的嗅觉和味觉评估的必要性。
