Lin Chia-Yen, Chen Hsiao-Hui, Lin Ching-Heng, Chang Ming-Hong
Department of Neurology, Neurological Institute, Taichung Veterans General Hospital, No. 1650, Taiwan Boulevard, Section 4, Taichung, 40705, Taiwan.
National Center for Geriatrics and Welfare Research, Yunlin, Taiwan.
Sci Rep. 2025 Jan 9;15(1):1547. doi: 10.1038/s41598-025-85984-2.
This study investigates whether incorporating olfactory dysfunction into motor subtypes of Parkinson's disease (PD) improves associations with clinical outcomes. PD is commonly divided into motor subtypes, such as postural instability and gait disturbance (PIGD) and tremor-dominant PD (TDPD), but non-motor symptoms like olfactory dysfunction remain underexplored. We assessed 157 participants with PD using the University of Pennsylvania Smell Identification Test (UPSIT), Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (M-UPDRS), Montreal Cognitive Assessment (MoCA), 39-item Parkinson's Disease Questionnaire Summary Index (PDQ-39 SI), and 99mTc-TRODAT-1 imaging. Motor subtypes were categorized as PIGD and TDPD, and olfactory subtypes were categorized as total anosmia (TA) and non-anosmia (NA). Significant differences were observed, with the highest disease burden occurring in PIGD TA, while the lowest occurred in TDPD NA. The total M-UPDRS scores (59.0, 47.5, 43.0, 36.0; p < 0.001) and PDQ-39 SI scores (22.4, 22.8, 9.6, and 9.0; p < 0.001) varied significantly across groups, and the highest occurred for PIGD TA, followed by PIGD NA, TDPD TA, and TDPD NA. MoCA scores indicated the best cognitive performance in TDPD NA (p = 0.002). Thus, the results show that integrating olfactory dysfunction with motor subtypes may enhance PD classification, particularly in cognitive assessment in cases of TDPD.
本研究调查将嗅觉功能障碍纳入帕金森病（PD）运动亚型是否能改善与临床结局的关联。PD通常分为运动亚型，如姿势不稳和步态障碍（PIGD）以及震颤为主型PD（TDPD），但嗅觉功能障碍等非运动症状仍未得到充分研究。我们使用宾夕法尼亚大学嗅觉识别测试（UPSIT）、运动障碍协会赞助的统一帕金森病评定量表修订版（M-UPDRS）、蒙特利尔认知评估（MoCA）、39项帕金森病问卷总结指数（PDQ-39 SI）和99mTc-TRODAT-1成像对157名PD患者进行了评估。运动亚型分为PIGD和TDPD，嗅觉亚型分为完全嗅觉丧失（TA）和非嗅觉丧失（NA）。观察到显著差异，疾病负担最高的是PIGD TA，而最低的是TDPD NA。M-UPDRS总分（59.0、47.5、43.0、36.0；p<0.001）和PDQ-39 SI得分（22.4、22.8、9.6和9.0；p<0.001）在各组间差异显著，最高的是PIGD TA，其次是PIGD NA、TDPD TA和TDPD NA。MoCA得分表明TDPD NA的认知表现最佳（p = 0.002）。因此，结果表明将嗅觉功能障碍与运动亚型相结合可能会增强PD的分类，特别是在TDPD病例的认知评估中。
