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Is normosmic Parkinson disease a unique clinical phenotype?

Authors
 Dong H. Lee ; Jungsu S. Oh ; Young H. Sohn ; Jae S. Kim ; Phil H. Lee ; Injoo Lee ; Jae J. Lee ; Jee H. Ham 
Citation
 Neurology, Vol.85(15) : 1270~1275, 2015 
Journal Title
 Neurology 
ISSN
 0028-3878 
Issue Date
2015
Abstract
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.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/141636
DOI
10.1212/WNL.0000000000001999
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Neurology
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Link
 http://www.neurology.org/content/85/15/1270.abstract
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