Type of Article: Original Research

Volume 4; Issue 7: 2017

Page No.: 528-536

DOI: 10.16965/ijims.2017.116

 

ASSESSMENT OF OLFACTORY DYSFUNCTION IN PARKINSON’S DISEASE PATIENTS

Akhilesh Kumar Singh *1, Bal Krishana 2, Meena Gupta 3.

*1 Assistant Professor, Department of Physiology, Andaman & Nicobar Islands Institute of Medical Sciences, Port Blair, India.

Professor, Department of Physiology, Maulana Azad Medical College, New Delhi, India.

3 Professor, Department of Neurology, Govind Ballabh Pant Hospital, New Delhi, India.

Corresponding author: Akhilesh Kumar Singh, Assistant Professor, Department of Physiology, Andaman & Nicobar Islands Institute of Medical Sciences, Port Blair, India.

E-Mail: dr.akhi@yahoo.co.in

Abstract:

Parkinson’s disease (PD) is a progressive neurodegenerative disorder of dopaminergic neurons in the substantia nigra pars compacta, its incidence and prevalence increases with age. Autonomic, cognitive, and sensory symptoms occur frequently in PD along with motor disturbances. The disturbances of olfaction are major, but often overlooked by PD patients. The present study was conducted on 30 patients of PD and 30 age matched controls, of the age group 40-70 years. Besides motors symptoms, history of non-motor symptoms like sleep disturbances, forgetfulness, constipation and urinary problem was taken, though these problems are also associated with old age. 18 patients gave history of forgetfulness. 19 patients had some sort of sleep disturbances. 18 patients had history of constipation and 17 patients gave history of urinary problem. History of olfactory loss or altered olfaction, altered taste sensation was also taken. 11 patients were aware of their olfactory loss or altered olfaction. Out of these 11 patients, 2 patients had complete bilateral anosmia, 2 patients had right sided complete anosmia and 5 patients had history of hyposmia. 21 patients had no history of olfactory loss or altered olfaction. 5 patients had also altered taste sensation. Identification of earlier clinical markers is paramount for success in putative preventive treatments. Besides olfactory dysfunction, the other clinical markers in PD are: upper limb kinematics behavior, cognition impairment, depression, sleep disorders, and micrographia. Identifying subjects with an increased risk of developing PD may contribute to the development of neuroprotective treatment strategies, as a preclinical diagnosis would allow neuroprotective agents to be administered earlier in the disease process.

Key words: Parkinson’s disease (PD), Olfactory dysfunction, Non-motor symptoms.

REFERENCES

  1. Sammi A, Nutt JG, Ransom BR. Parkinson’s disease. Lancet 2004; 363: 1783-93.
  2. Ponsen MM, Stoffers D, Booij J, Berthe LF, Wolters EC, Berendse HW. Idiopathic Hyposmia as a Preclinical Sign of Parkinson’s Disease. Ann Neurol 2004; 56: 173-81.
  3. George JL, Moses D, Wilkins S, Bush AI, Cherny RA Finkelstein DI. Targeting the Progression of Parkinson’s Disease. Curr Neuropharmacol 2009; 7 (1): 9-36.
  4. Stocchi F, Olanow C.W. Neuroprotection in Parkinson’s disease clinical trials. Ann Neurol 2003; 53(suppl 3): S87- S99.
  5. Poirier LJ, Sourkes TL. Influence of the substantia nigra on the catecholamine content of the striatum. Brain 1965; 88: 181-92.
  6. Ansari KA, Johnson A. Olfactory function in patients with Parkinson’s disease. J Chron Dis 1975; 28: 493-7.
  7. Navan P, Findley LJ, Jeffs JAR, Pearce RKB, Bain PG. Randomised, double-blind, 3-month parallel study of the effects of pramipexole, pergolide, and placebo on Parkinsonian tremor. Mov Disord  2003; 18(11): 1324-31.
  8. Dimitrova D, Horak FB, Nutt JG. Postural Muscle Responses to Multidirectional Translations in Patients with Parkinson’s disease. J Neurophysiol 2004; 91: 489-501.
  9. Sobel N, Thomasan ME, Stappen Iris, Tanner MC, Tetrud JW, Bower JM, et al. An impairment in sniffing contributes to the olfactory impairment in Parkinson’s Disease. PNAS 2001; 98 (7): 4154-9.
  10. Ross GW, Abott RD, Petrovitch H, Tanner CM, Davis DG, Nelson J, et al. Association of Olfactory Dysfunction with Incidental Lewy Bodies. Mov Disord 2006; 21 (12): 2062-7.
  11. Double KL, Rowe DB, Hayes M, Chan DKY, Blackie J, Corbett A, et al. Identifying the Pattern of Olfactory deficits in Parkinson Disease Using the Brief Smell Identification Test. Arch Neurol 2003; 60: 545-9.
  12. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992; 55 (3): 181-4.
  13. Ross GW, Petrovitch H, Abbott RD, Tanner CM, Popper J, Masaki K, et al. Association of Olfactory Dysfunction with Risk For Future Parkinson’s Disease. Ann Neurol 2008; 63: 167-73.
  14. Regan, D. Human Brain Electrophysiology. Evoked Potentials and Evoked Magnetic Fields in Science and Medicine. Elsevier, Amsterdam, 1989: 677pp.
  15. Doty RL. The Olfactory system and its Disorders. Semin Neurol 2009; 29 (1): 74-81.
  16. Ansari KA, Johnson A: Olfactory function in patients with Parkinson’s disease. J chronic Dis 1975; 28: 493-97.
  17. Mizuno Y, Hattori N, Kubo S, Sato S, Nishioka K, Hatano T et al. Progress in the pathogenesis and genetics of Parkinson’s disease. Philos Trans R Soc Lond B Biol Sci 2008;363(1500): 2215-27.
  18. DeLong MR, Wichmann T. Circuits and Circuit Disorders of the Basal Ganglia. Arch Neurol 2007;64: 20-4.
  19. Russchen FT, Bakst I, Amaral DG, Price JL. The amygdalostriatal projection in the monkeys. An anterograde tracing study. Brain Res 1985; 329: 241-57.
  20. Parent A. Extrinsic connections of the basal ganglia. Trends Neurosci 1990; 13: 254-8.
  21. Albin RL, Young AB, Penney JB. The functional anatomy of basal ganglia disorders. Trends Neurosci 1989; 12: 366-75.
  22. Parent A, Hazrati LN. Functional anatomy of the basal ganglia. I. The cortico-basal ganglia-thalamo-cortical loop. Brain Res Rev 1995; 20: 91-127.
Download Full Text TOC