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Dr. Okun

Post of the Week: Smell Issues Associated with other Non-Motor Features in Parkinson

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Dear forum members,


This study below suggests that problems smelling occur frequently in patient with other non-motor issues in PD. The PARS investigators suggest this may be important as we develop better screening methods.


See abstract below:



Mov Disord. 2012 Jan 11. doi: 10.1002/mds.24892. [Epub ahead of print]

Impaired olfaction and other prodromal features in the Parkinson At-Risk Syndrome study.

Siderowf A, Jennings D, Eberly S, Oakes D, Hawkins KA, Ascherio A, Stern MB, Marek K; the PARS Investigators.


Parkinson's Disease and Movement Disorders Center, Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. siderowa@pahosp.com.


To test the association between impaired olfaction and other prodromal features of PD in the Parkinson At-Risk Syndrome Study. The onset of olfactory dysfunction in PD typically precedes motor features, suggesting that olfactory testing could be used as a screening test. A combined strategy that uses other prodromal nonmotor features, along with olfactory testing, may be more efficient than hyposmia alone for detecting the risk of PD. Individuals with no neurological diagnosis completed a mail survey, including the 40-item University of Pennsylvania Smell Identification Test, and questions on prodromal features of PD. The frequency of reported nonmotor features was compared across individuals with and without hyposmia. A total of 4,999 subjects completed and returned the survey and smell test. Of these, 669 were at or below the 15th percentile based on age and gender, indicating hyposmia. Hyposmics were significantly more likely to endorse nonmotor features, including anxiety and depression, constipation, and rapid eye movement sleep behavior disorder symptoms, and to report changes in motor function. Twenty-six percent of subjects with combinations of four or more nonmotor features were hyposmic, compared to 12% for those reporting three or fewer nonmotor features (P < 0.0001). Hyposmia is associated with other nonmotor features of PD in undiagnosed individuals. Further assessment of hyposmic subjects using more specific markers for degeneration, such as dopamine transporter imaging, will evaluate whether combining hyposmia and other nonmotor features is useful in assessing the risk of future neurodegeneration. © 2012 Movement Disorder Society © 2012 Movement Disorder Society.

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