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Is normosmic Parkinson disease a unique clinical phenotype?

 Dong H. Lee  ;  Jungsu S. Oh  ;  Jee H. Ham  ;  Jae J. Lee  ;  Injoo Lee  ;  Phil H. Lee  ;  Jae S. Kim  ;  Young H. Sohn 
 NEUROLOGY, Vol.85(15) : 1270-1275, 2015 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Corpus Striatum/drug effects* ; Corpus Striatum/metabolism ; Corpus Striatum/pathology ; Dopamine Plasma Membrane Transport Proteins/metabolism ; Female ; Humans ; Levodopa/administration & dosage ; Levodopa/pharmacology* ; Male ; Middle Aged ; Neurogenesis/drug effects ; Neurogenesis/physiology* ; Parkinson Disease/diagnosis ; Parkinson Disease/drug therapy* ; Parkinson Disease/pathology ; Phenotype ; Tomography, Emission-Computed, Single-Photon/methods
OBJECTIVE: Olfactory dysfunction is present in the majority of patients with early-stage Parkinson disease (PD) and can precede the onset of motor symptoms by many years. We performed this study to evaluate whether normosmic patients with PD had different clinical features compared to hyposmic patients. METHODS: We analyzed the data of 208 de novo patients with PD (mean age, 65.4 ± 9.7 years; range, 38-85 years; 104 men) who underwent both olfactory function tests and dopamine transporter (DAT) scans. RESULTS: Normosmic patients were significantly younger and had fewer motor deficits than hyposmic patients with PD. Striatal subregional DAT activities were comparable between the 2 groups, but intersubregional gradients were significantly higher in normosmic than hyposmic PD. A general linear model showed that normosmic patients with PD showed significantly fewer motor deficits after controlling the patient's age, sex, symptom duration, and DAT activity in the posterior putamen (p = 0.016). Levodopa-equivalent dose at approximately 2.5 years follow-up tended to be lower in normosmic than in hyposmic PD (p = 0.055). CONCLUSIONS: These results suggest that normosmic PD is a unique clinical phenotype with a more benign course, compared to hyposmic PD. Either less pathologic involvement in the olfactory system or a greater potential for olfactory neurogenesis in normosmic PD may contribute to this benign process compared to hyposmic PD.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Lee, Phil Hyu(이필휴) ORCID logo https://orcid.org/0000-0001-9931-8462
Ham, Jee Hyun(함지현)
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