Department of Neurology, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany.
Department of Otorhinolaryngology, TU Dresden, Dresden, Germany.
J Neural Transm (Vienna). 2020 Mar;127(3):347-354. doi: 10.1007/s00702-020-02156-4. Epub 2020 Feb 15.
The pathophysiology of cervical dystonia is not completely understood. Current concepts of the pathophysiology propose that it is a network disorder involving the basal ganglia, cerebellum and sensorimotor cortex. These structures are primarily concerned with sensorimotor control but are also involved in non-motor functioning such as the processing of information related to the chemical senses. This overlap lets us hypothesize a link between cervical dystonia and altered sense of smell and taste. To prove this hypothesis and to contribute to the better understanding of cervical dystonia, we assessed olfactory and gustatory functioning in 40 adults with idiopathic cervical dystonia and 40 healthy controls. The Sniffin Sticks were used to assess odor threshold, discrimination and identification. Furthermore, the Taste Strips were applied to assess the combined taste score. Motor and non-motor deficits of cervical dystonia including neuropsychological and psychiatric alterations were assessed as cofactors for regression analyses. We found that cervical dystonia subjects had lower scores than healthy controls for odor threshold (5.8 ± 2.4 versus 8.0 ± 3.2; p = 0.001), odor identification (11.7 ± 2.3 versus 13.1 ± 1.3; p = 0.001) and the combined taste score (9.5 ± 2.2 versus 11.7 ± 2.7; p < 0.001), while no difference was found in odor discrimination (12.0 ± 2.5 versus 12.9 ± 1.8; p = 0.097). Regression analysis suggests that age is the main predictor for olfactory decline in subjects with cervical dystonia. Moreover, performance in the Montreal Cognitive Assessment is a predictor for gustatory decline in cervical dystonia subjects. Findings propose that cervical dystonia is associated with diminished olfactory and gustatory functioning.
颈肌张力障碍的病理生理学尚不完全清楚。目前的病理生理学概念提出，它是一种涉及基底节、小脑和感觉运动皮层的网络障碍。这些结构主要与感觉运动控制有关，但也与非运动功能有关，如与化学感觉相关信息的处理。这种重叠让我们假设颈肌张力障碍与嗅觉和味觉改变之间存在联系。为了证明这一假设，并有助于更好地理解颈肌张力障碍，我们评估了 40 名特发性颈肌张力障碍患者和 40 名健康对照者的嗅觉和味觉功能。使用 Sniffin' Sticks 评估嗅觉阈值、辨别力和识别力。此外，还应用 Taste Strips 评估综合味觉评分。颈肌张力障碍的运动和非运动缺陷，包括神经心理学和精神改变，作为回归分析的协变量进行评估。我们发现，颈肌张力障碍患者的嗅觉阈值（5.8 ± 2.4 与 8.0 ± 3.2；p = 0.001）、嗅觉识别力（11.7 ± 2.3 与 13.1 ± 1.3；p = 0.001）和综合味觉评分（9.5 ± 2.2 与 11.7 ± 2.7；p < 0.001）均低于健康对照组，而嗅觉辨别力（12.0 ± 2.5 与 12.9 ± 1.8；p = 0.097）无差异。回归分析表明，年龄是颈肌张力障碍患者嗅觉下降的主要预测因素。此外，蒙特利尔认知评估的表现是颈肌张力障碍患者味觉下降的预测因素。研究结果表明，颈肌张力障碍与嗅觉和味觉功能下降有关。
