Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
Department of Neurology, Wonju Seveance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
J Neural Transm (Vienna). 2021 Jun;128(6):763-770. doi: 10.1007/s00702-021-02347-7. Epub 2021 May 20.
To explore the effect of olfactory dysfunction on treatment of motor manifestations in Parkinson's disease (PD). The current longitudinal retrospective cohort study consecutively recruited 108 de novo PD patients. Of whom 29 were normosmia and 79 were hyposmia, respectively, which was determined by the Korean Version of Sniffin' Sticks Test II at the time of diagnosis. All the participants underwent serial clinical examinations including Unified Parkinson's Disease Rating Scale (UPDRS), Mini-Mental State Examination, and Montreal Cognitive Assessment. The normosmic group demonstrated a significantly greater reduction of the UPDRS III score (30.3 ± 5.9 to 21.9 ± 5.1) than that of the hyposmic group (34.5 ± 9.3 to 28.5 ± 8.1) from baseline to 1-year later (p, 0.003; Bonferroni correction for p < 0.0045). Of subdomains in UPDRS III, the axial domain revealed a remarkable decrease in the normosmic group. Further, the hyposmic group exhibited a higher development rate of freezing of gait (FOG) compared to the normosmic group (29/79 (36.7%) vs 2/29 (6.9%); p, 0.002) during 33.9 ± 7.7 months of the mean follow-up period. A Cox proportional hazards model demonstrated the hyposmia to be a significant risk factor for the future development of FOG (HR, 4.23; 95% CI 1.180-17.801; p, 0.05). Our data demonstrated the olfactory dysfunction to be a significant risk factor for the development of the FOG in PD. Hyposmic PD patients should be paid more careful attention to the occurrence of FOG in the clinical practice.
探讨嗅觉功能障碍对帕金森病（PD）运动症状治疗的影响。本研究为当前的纵向回顾性队列研究，连续招募了 108 例初诊 PD 患者。其中 29 例为嗅觉正常，79 例为嗅觉减退，分别采用韩国版 Sniffin' Sticks 测试 II 进行诊断。所有患者均接受了连续的临床检查，包括统一帕金森病评定量表（UPDRS）、简易精神状态检查和蒙特利尔认知评估。嗅觉正常组的 UPDRS III 评分（30.3±5.9 分至 21.9±5.1 分）明显低于嗅觉减退组（34.5±9.3 分至 28.5±8.1 分）（p<0.003；Bonferroni 校正 p<0.0045）。在 UPDRS III 的亚域中，轴性域在嗅觉正常组中显著下降。此外，嗅觉减退组出现冻结步态（FOG）的发展率明显高于嗅觉正常组（29/79（36.7%）比 2/29（6.9%）；p=0.002）。在平均 33.9±7.7 个月的随访期间。Cox 比例风险模型显示，嗅觉减退是 FOG 未来发展的显著危险因素（HR，4.23；95%CI 1.180-17.801；p=0.05）。我们的数据表明，嗅觉功能障碍是 PD 患者发生 FOG 的一个显著危险因素。嗅觉减退的 PD 患者在临床实践中应更加注意 FOG 的发生。
