Lin Chia-Yen, Tsai Yu-Shan, Chang Ming-Hong
Department of Neurology, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Post-Baccalaureate Medicine and Brain and Neuroscience Research Center, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
Front Aging Neurosci. 2024 Mar 4;16:1329551. doi: 10.3389/fnagi.2024.1329551. eCollection 2024.
Olfactory dysfunction in Parkinson's disease (PD) is associated with more severe phenotypes, but trajectories of cognitive function, disease severity, and subdomains of quality-of-life measurements in patients with distinct olfactory profiles remain underexplored.
To analyze the influence of olfaction on trajectories of clinical parameters in patients with PD.
Retrospective cohort study.
From October 2016 to May 2021, the study tracked 58 participants over 3 years. Participants completed follow-up assessments using tools including the Chinese version of the University of Pennsylvania's Smell Identification Test (UPSIT), Montreal Cognitive Assessment (MoCA), Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale, and the Chinese translation of the 39-item Parkinson's Disease Questionnaire (PDQ-39).
Participants were divided into anosmia (UPSIT < 19) and non-anosmia (UPSIT ≥ 19) groups based on initial scores. Generalized estimating equations and repeated measures correlations were used to examine longitudinal associations and correlations between olfaction and clinical parameters.
Divergent cognitive trajectories were observed between groups. The anosmia group exhibited a faster cognitive decline (adjusted B [beta coefficient] = -1.8, = 0.012) according to the interaction effect of olfaction and time on the MoCA score. The anosmia group exhibited no longitudinal correlation between cognition and olfactory function but showed correlations with age ( [coefficient of repeated measures correlation] = -0.464, = 0.004) and disease duration ( = -0.457, = 0.005). The non-anosmia group's UPSIT scores decreased over time ( = -2.3, = 0.005) alongside a significant correlation with motor function ( = -0.479, = 0.006).
The anosmia group's accelerated cognitive decline correlated with age and disease duration, but not olfactory function, suggesting a poor cognitive outcome in this population despite the lack of longitudinal correlation between cognition and olfaction. The non-anosmia group exhibited progressive olfactory degradation and notable correlations between motor function and UPSIT scores, implying pathological accumulation in the olfactory structure and basal ganglia.
帕金森病（PD）中的嗅觉功能障碍与更严重的表型相关，但不同嗅觉特征患者的认知功能轨迹、疾病严重程度以及生活质量测量的子领域仍未得到充分研究。
分析嗅觉对PD患者临床参数轨迹的影响。
回顾性队列研究。
2016年10月至2021年5月，该研究对58名参与者进行了为期3年的跟踪。参与者使用包括中文版宾夕法尼亚大学嗅觉识别测试（UPSIT）、蒙特利尔认知评估（MoCA）、运动障碍协会赞助的统一帕金森病评定量表修订版以及39项帕金森病问卷（PDQ-39）中文译本在内的工具完成随访评估。
根据初始得分将参与者分为嗅觉丧失组（UPSIT<19）和非嗅觉丧失组（UPSIT≥19）。使用广义估计方程和重复测量相关性来检验嗅觉与临床参数之间的纵向关联和相关性。
两组之间观察到不同的认知轨迹。根据嗅觉和时间对MoCA评分的交互作用，嗅觉丧失组表现出更快的认知衰退（调整后的B[β系数]=-1.8，P=0.012）。嗅觉丧失组在认知与嗅觉功能之间未表现出纵向相关性，但与年龄（重复测量相关系数=-0.464，P=0.004）和病程（=-0.457，P=0.005）相关。非嗅觉丧失组 的UPSIT得分随时间下降（=-2.3，P=0.005），同时与运动功能存在显著相关性（=-0.479，P=0.006）。
嗅觉丧失组加速的认知衰退与年龄和病程相关，而非嗅觉功能，这表明尽管认知与嗅觉之间缺乏纵向相关性，但该人群的认知结果较差。非嗅觉丧失组表现出进行性嗅觉退化以及运动功能与UPSIT得分之间的显著相关性，这意味着嗅觉结构和基底神经节存在病理累积。
