Laura Fadda (Italy)
Azienda Ospedaliero Universitaria di Cagliari Emergency Department, Institute of NeurologyAuthor Of 1 Presentation
OLFACTION IMPAIRMENT IN PARKINSON’S DISEASE PATIENTS WITH TREMOR DOMINANT SUBTYPE COMPARED TO THOSE WITH AKINETIC RIGID DOMINANT SUBTYPE.
- Paolo Solla (Italy)
Abstract
Background and Aims:
Parkinson's disease (PD) may present with different motor subtypes depending on the predominant symptoms (tremor or rigidity/bradykinesia). Slower disease progression and cognitive decline have been observed in tremor-dominant (TD) patients compared to those with akinetic-rigid dominant (ARD) subtype. Olfactory disorders have been described in parkinsonian patients, although the definite correlations with different subtypes of PD are not clear. Thus, we investigated the possible olfactory impairment in PD patients with TD subtype in comparison to ARD subtype.
Methods:
Sixty-Two PD patients, 20 with TD subtype and 42 with ARD subtype, were enrolled. Patients with cognitive impairment were excluded. PD patients were divided into ARD and TD subgroups using tremor/rigidity ratio, calculated using UPDRS-III subscores. Olfactory function was assessed with the Sniffin’ Sticks Extended Test (SSET). SSET parameters [Olfactory Threshold (OT), Discrimination (OD), Identification (OI) and Threshold-Discrimination-Identification (TDI) scores were calculated.
Results:
OT, OD and TDI scores were significantly lower in the ARD subtype than in the TD group [respectively 1.9±1,4 vs 3.3±2.7 (p=0.008); 7.0±3.1 vs 8.6±2.2 (p=0.042); 16.0±6.5 vs 20.3±6.1 (p=0.017)], while OI scores were not significantly different. On multivariate linear regression analysis the tremor/rigidity ratio was a significant predictor of OT (p=0.01) and TDI (p=0.02).
Conclusions:
Our findings show a more evident olfactory disfunction in PD patients with ARD subtype. Such evidence supports the biological relevance of clinical subtypes in PD patients suggesting the idea of a different pathophysiological process between these different clinical forms.