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J Neurol Neurosurg Psychiatry. 1997 May; 62(5): 436–446.
PMCID: PMC486843

Olfactory dysfunction in Parkinson's disease.

Abstract

OBJECTIVE: To evaluate olfactory function in Parkinson's disease. METHODS: A standardised odour identification test was used, together with an evoked potential assessment with hydrogen sulphide. In addition, histological analysis was performed on the olfactory bulbs of cadavers who died from Parkinson's disease. RESULTS: Over 70% of patients studied (71 of 96) were outside the 95% limit of normal on the identification test in an age matched sample and there was an unusual pattern of selective loss to certain odours, not hitherto described. The evoked potentials were significantly delayed but of comparable amplitude to a control matched population. Of the 73 patients studied only 37 had a technically satisfactory record containing a clear response to both gases and of these, 12 were delayed. For H2S there was more delay on stimulating the right nostril than the left. Some patients with normal smell identification test scores had delayed evoked potentials. In the pathological examination of olfactory bulbs from eight brains, changes characteristic of Parkinson's disease (Lewy bodies) were seen in every olfactory bulb, particularly in the anterior olfactory nucleus, and were sufficiently distinct to allow a presumptive diagnosis of Parkinson's disease. CONCLUSIONS: Olfactory damage in Parkinson's disease is consistent and severe and may provide an important clue to the aetiology of the disease.

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Selected References

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  • Doty RL, Deems DA, Stellar S. Olfactory dysfunction in parkinsonism: a general deficit unrelated to neurologic signs, disease stage, or disease duration. Neurology. 1988 Aug;38(8):1237–1244. [PubMed]
  • Kobal G, Plattig KH. Methodische Anmerkungen zur Gewinnung olfaktorischer EEG-Antworten des wachen Menschen (objektive Olfaktometrie). EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb. 1978 Sep;9(3):135–145. [PubMed]
  • Chui HC, Mortimer JA, Slager U, Zarow C, Bondareff W, Webster DD. Pathologic correlates of dementia in Parkinson's disease. Arch Neurol. 1986 Oct;43(10):991–995. [PubMed]
  • Doty RL, Shaman P, Dann M. Development of the University of Pennsylvania Smell Identification Test: a standardized microencapsulated test of olfactory function. Physiol Behav. 1984 Mar;32(3):489–502. [PubMed]
  • 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 Mar;55(3):181–184. [PMC free article] [PubMed]
  • Levine HL. The office diagnosis of nasal and sinus disorders using rigid nasal endoscopy. Otolaryngol Head Neck Surg. 1990 Apr;102(4):370–373. [PubMed]
  • Doty RL, Stern MB, Pfeiffer C, Gollomp SM, Hurtig HI. Bilateral olfactory dysfunction in early stage treated and untreated idiopathic Parkinson's disease. J Neurol Neurosurg Psychiatry. 1992 Feb;55(2):138–142. [PMC free article] [PubMed]
  • Quinn NP, Rossor MN, Marsden CD. Olfactory threshold in Parkinson's disease. J Neurol Neurosurg Psychiatry. 1987 Jan;50(1):88–89. [PMC free article] [PubMed]
  • Amsterdam JD, Settle RG, Doty RL, Abelman E, Winokur A. Taste and smell perception in depression. Biol Psychiatry. 1987 Dec;22(12):1481–1485. [PubMed]
  • Kobal G, Hummel C. Cerebral chemosensory evoked potentials elicited by chemical stimulation of the human olfactory and respiratory nasal mucosa. Electroencephalogr Clin Neurophysiol. 1988 Jul-Aug;71(4):241–250. [PubMed]
  • Doty RL, Bromley SM, Stern MB. Olfactory testing as an aid in the diagnosis of Parkinson's disease: development of optimal discrimination criteria. Neurodegeneration. 1995 Mar;4(1):93–97. [PubMed]
  • Pinching AJ, Doving KB. Selective degeneration in the rat olfactory bulb following exposure to different odours. Brain Res. 1974 Dec 27;82(2):195–204. [PubMed]
  • Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967 May;17(5):427–442. [PubMed]
  • Daniel SE, Hawkes CH. Preliminary diagnosis of Parkinson's disease by olfactory bulb pathology. Lancet. 1992 Jul 18;340(8812):186–186. [PubMed]
  • Esiri MM, Wilcock GK. The olfactory bulbs in Alzheimer's disease. J Neurol Neurosurg Psychiatry. 1984 Jan;47(1):56–60. [PMC free article] [PubMed]
  • Mann DM, Tucker CM, Yates PO. Alzheimer's disease: an olfactory connection? Mech Ageing Dev. 1988 Jan;42(1):1–15. [PubMed]
  • Yoshimura N. Olfactory bulb involvement in Pick's disease. Acta Neuropathol. 1988;77(2):202–205. [PubMed]
  • Tomlinson AH, Esiri MM. Herpes simplex encephalitis. Immunohistological demonstration of spread of virus via olfactory pathways in mice. J Neurol Sci. 1983 Aug-Sep;60(3):473–484. [PubMed]
  • Shipley MT. Transport of molecules from nose to brain: transneuronal anterograde and retrograde labeling in the rat olfactory system by wheat germ agglutinin-horseradish peroxidase applied to the nasal epithelium. Brain Res Bull. 1985 Aug;15(2):129–142. [PubMed]
  • Smith CA, Gough AC, Leigh PN, Summers BA, Harding AE, Maraganore DM, Sturman SG, Schapira AH, Williams AC, Maranganore DM, et al. Debrisoquine hydroxylase gene polymorphism and susceptibility to Parkinson's disease. Lancet. 1992 Jun 6;339(8806):1375–1377. [PubMed]
  • Hext PM, Lock EA. The accumulation and metabolism of 3-trifluoromethylpyridine by rat olfactory and hepatic tissues. Toxicology. 1992;72(1):61–75. [PubMed]
  • Ding XX, Coon MJ. Immunochemical characterization of multiple forms of cytochrome P-450 in rabbit nasal microsomes and evidence for tissue-specific expression of P-450s NMa and NMb. Mol Pharmacol. 1990 Apr;37(4):489–496. [PubMed]
  • Schlesinger RB. Comparative deposition of inhaled aerosols in experimental animals and humans: a review. J Toxicol Environ Health. 1985;15(2):197–214. [PubMed]
  • Gillner M, Brittebo EB, Brandt I, Söderkvist P, Appelgren LE, Gustafsson JA. Uptake and specific binding of 2,3,7,8-tetrachlorodibenzo-p-dioxin in the olfactory mucosa of mice and rats. Cancer Res. 1987 Aug 1;47(15):4150–4159. [PubMed]
  • Brittebo EB, Eriksson C, Feil V, Bakke J, Brandt I. Toxicity of 2,6-dichlorothiobenzamide (chlorthiamid) and 2,6-dichlorobenzamide in the olfactory nasal mucosa of mice. Fundam Appl Toxicol. 1991 Jul;17(1):92–102. [PubMed]

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