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. 1992 Feb;55(2):138–142. doi: 10.1136/jnnp.55.2.138

Bilateral olfactory dysfunction in early stage treated and untreated idiopathic Parkinson's disease.

R L Doty 1, M B Stern 1, C Pfeiffer 1, S M Gollomp 1, H I Hurtig 1
PMCID: PMC488979  PMID: 1538221

Abstract

Decreased olfactory function is among the first signs of idiopathic Parkinson's disease (PD). Whether such dysfunction is present to the same degree on both sides of the nose, however, is unknown. Furthermore, whether the deficit results from or is influenced by anti-Parkinsonian medications has not been definitely established. Odour identification ability was evaluated on the left and right sides of the nose in 20 early-stage untreated PD patients, 20 early-stage treated PD patients, and 20 controls. In all cases, the PD related olfactory dysfunction was bilateral and no difference was observed between the test scores of patients taking or not taking drugs for PD. Although asymmetries of unsystematic direction were present in the test scores of some PD patients, similar asymmetries were observed in the controls and the asymmetries were not related to the side of the major motor dysfunction. As in earlier work, no relation was present between the olfactory test scores and the degree of tremor, rigidity, bradykinesia, or gait disturbance at the time of testing. These findings indicate that the olfactory dysfunction of early stage PD is robust, typically of the same general magnitude on both sides of the nose, and uninfluenced by anti-Parkinsonian medications.

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Selected References

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  1. Ansari K. A., Johnson A. Olfactory function in patients with Parkinson's disease. J Chronic Dis. 1975 Oct;28(9):493–497. doi: 10.1016/0021-9681(75)90058-2. [DOI] [PubMed] [Google Scholar]
  2. Baker H., Spencer R. F. Transneuronal transport of peroxidase-conjugated wheat germ agglutinin (WGA-HRP) from the olfactory epithelium to the brain of the adult rat. Exp Brain Res. 1986;63(3):461–473. doi: 10.1007/BF00237470. [DOI] [PubMed] [Google Scholar]
  3. Barthold S. W. Olfactory neural pathway in mouse hepatitis virus nasoencephalitis. Acta Neuropathol. 1988;76(5):502–506. doi: 10.1007/BF00686390. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bentin S., Silverberg R., Gordon H. W. Asymmetrical cognitive deterioration in demented and Parkinson patients. Cortex. 1981 Dec;17(4):533–543. doi: 10.1016/s0010-9452(81)80060-3. [DOI] [PubMed] [Google Scholar]
  5. Boon A. P., Potter A. E. Extensive extrapontine and central pontine myelinolysis associated with correction of profound hyponatraemia. Neuropathol Appl Neurobiol. 1987 Jan-Feb;13(1):1–9. doi: 10.1111/j.1365-2990.1987.tb00166.x. [DOI] [PubMed] [Google Scholar]
  6. Burdach K. J., Doty R. L. The effects of mouth movements, swallowing, and spitting on retronasal odor perception. Physiol Behav. 1987;41(4):353–356. doi: 10.1016/0031-9384(87)90400-8. [DOI] [PubMed] [Google Scholar]
  7. Cancalon P., Beidler L. M. Distribution along the axon and into various subcellular fractions of molecules labeled with (3H)leucine and rapidly transported in the garfish olfactory nerve. Brain Res. 1975 May 23;89(2):225–244. doi: 10.1016/0006-8993(75)90715-5. [DOI] [PubMed] [Google Scholar]
  8. Deems D. A., Doty R. L., Settle R. G., Moore-Gillon V., Shaman P., Mester A. F., Kimmelman C. P., Brightman V. J., Snow J. B., Jr Smell and taste disorders, a study of 750 patients from the University of Pennsylvania Smell and Taste Center. Arch Otolaryngol Head Neck Surg. 1991 May;117(5):519–528. doi: 10.1001/archotol.1991.01870170065015. [DOI] [PubMed] [Google Scholar]
  9. Direnfeld L. K., Albert M. L., Volicer L., Langlais P. J., Marquis J., Kaplan E. Parkinson's disease. The possible relationship of laterality to dementia and neurochemical findings. Arch Neurol. 1984 Sep;41(9):935–941. doi: 10.1001/archneur.1984.04050200041016. [DOI] [PubMed] [Google Scholar]
  10. Doty R. L., Applebaum S., Zusho H., Settle R. G. Sex differences in odor identification ability: a cross-cultural analysis. Neuropsychologia. 1985;23(5):667–672. doi: 10.1016/0028-3932(85)90067-3. [DOI] [PubMed] [Google Scholar]
  11. Doty R. L., Deems D. A., 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. doi: 10.1212/wnl.38.8.1237. [DOI] [PubMed] [Google Scholar]
  12. Doty R. L., Frye R. E., Agrawal U. Internal consistency reliability of the fractionated and whole University of Pennsylvania Smell Identification Test. Percept Psychophys. 1989 May;45(5):381–384. doi: 10.3758/bf03210709. [DOI] [PubMed] [Google Scholar]
  13. Doty R. L., Perl D. P., Steele J. C., Chen K. M., Pierce J. D., Jr, Reyes P., Kurland L. T. Odor identification deficit of the parkinsonism-dementia complex of Guam: equivalence to that of Alzheimer's and idiopathic Parkinson's disease. Neurology. 1991 May;41(5 Suppl 2):77–81. doi: 10.1212/wnl.41.5_suppl_2.77. [DOI] [PubMed] [Google Scholar]
  14. Doty R. L., Reyes P. F., Gregor T. Presence of both odor identification and detection deficits in Alzheimer's disease. Brain Res Bull. 1987 May;18(5):597–600. doi: 10.1016/0361-9230(87)90129-8. [DOI] [PubMed] [Google Scholar]
  15. Doty R. L., Riklan M., Deems D. A., Reynolds C., Stellar S. The olfactory and cognitive deficits of Parkinson's disease: evidence for independence. Ann Neurol. 1989 Feb;25(2):166–171. doi: 10.1002/ana.410250210. [DOI] [PubMed] [Google Scholar]
  16. Doty R. L., Shaman P., Applebaum S. L., Giberson R., Siksorski L., Rosenberg L. Smell identification ability: changes with age. Science. 1984 Dec 21;226(4681):1441–1443. doi: 10.1126/science.6505700. [DOI] [PubMed] [Google Scholar]
  17. Doty R. L., 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. doi: 10.1016/0031-9384(84)90269-5. [DOI] [PubMed] [Google Scholar]
  18. Esiri M. M., Wilcock G. K. The olfactory bulbs in Alzheimer's disease. J Neurol Neurosurg Psychiatry. 1984 Jan;47(1):56–60. doi: 10.1136/jnnp.47.1.56. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Eskenazi B., Cain W. S., Novelly R. A., Mattson R. Odor perception in temporal lobe epilepsy patients with and without temporal lobectomy. Neuropsychologia. 1986;24(4):553–562. doi: 10.1016/0028-3932(86)90099-0. [DOI] [PubMed] [Google Scholar]
  20. Frye R. E., Schwartz B. S., Doty R. L. Dose-related effects of cigarette smoking on olfactory function. JAMA. 1990 Mar 2;263(9):1233–1236. [PubMed] [Google Scholar]
  21. HIRANO A., ZIMMERMAN H. M. Alzheimer's neurofibrillary changes. A topographic study. Arch Neurol. 1962 Sep;7:227–242. doi: 10.1001/archneur.1962.04210030065009. [DOI] [PubMed] [Google Scholar]
  22. Harrison P. J. Pathogenesis of Alzheimer's disease--beyond the cholinergic hypothesis: discussion paper. J R Soc Med. 1986 Jun;79(6):347–352. doi: 10.1177/014107688607900612. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Hoehn M. M., Yahr M. D. Parkinsonism: onset, progression and mortality. Neurology. 1967 May;17(5):427–442. doi: 10.1212/wnl.17.5.427. [DOI] [PubMed] [Google Scholar]
  24. Hopper M. W., Vogel F. S. The limbic system in Alzheimer's disease. A neuropathologic investigation. Am J Pathol. 1976 Oct;85(1):1–20. [PMC free article] [PubMed] [Google Scholar]
  25. Monath T. P., Cropp C. B., Harrison A. K. Mode of entry of a neurotropic arbovirus into the central nervous system. Reinvestigation of an old controversy. Lab Invest. 1983 Apr;48(4):399–410. [PubMed] [Google Scholar]
  26. Morales J. A., Herzog S., Kompter C., Frese K., Rott R. Axonal transport of Borna disease virus along olfactory pathways in spontaneously and experimentally infected rats. Med Microbiol Immunol. 1988;177(2):51–68. doi: 10.1007/BF00189527. [DOI] [PubMed] [Google Scholar]
  27. Ohm T. G., Braak H. Olfactory bulb changes in Alzheimer's disease. Acta Neuropathol. 1987;73(4):365–369. doi: 10.1007/BF00688261. [DOI] [PubMed] [Google Scholar]
  28. Pearson R. C., Esiri M. M., Hiorns R. W., Wilcock G. K., Powell T. P. Anatomical correlates of the distribution of the pathological changes in the neocortex in Alzheimer disease. Proc Natl Acad Sci U S A. 1985 Jul;82(13):4531–4534. doi: 10.1073/pnas.82.13.4531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Perl D. P., Good P. F. Uptake of aluminium into central nervous system along nasal-olfactory pathways. Lancet. 1987 May 2;1(8540):1028–1028. doi: 10.1016/s0140-6736(87)92288-4. [DOI] [PubMed] [Google Scholar]
  30. Quinn N. P., Rossor M. N., Marsden C. D. Olfactory threshold in Parkinson's disease. J Neurol Neurosurg Psychiatry. 1987 Jan;50(1):88–89. doi: 10.1136/jnnp.50.1.88. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Roberts E. Alzheimer's disease may begin in the nose and may be caused by aluminosilicates. Neurobiol Aging. 1986 Nov-Dec;7(6):561–567. doi: 10.1016/0197-4580(86)90119-3. [DOI] [PubMed] [Google Scholar]
  32. Serby M., Corwin J., Conrad P., Rotrosen J. Olfactory dysfunction in Alzheimer's disease and Parkinson's disease. Am J Psychiatry. 1985 Jun;142(6):781–782. doi: 10.1176/ajp.142.6.aj1426781. [DOI] [PubMed] [Google Scholar]
  33. Shipley M. T. 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. doi: 10.1016/0361-9230(85)90129-7. [DOI] [PubMed] [Google Scholar]
  34. Steventon G. B., Heafield M. T., Waring R. H., Williams A. C. Xenobiotic metabolism in Parkinson's disease. Neurology. 1989 Jul;39(7):883–887. doi: 10.1212/wnl.39.7.883. [DOI] [PubMed] [Google Scholar]
  35. Talamo B. R., Rudel R., Kosik K. S., Lee V. M., Neff S., Adelman L., Kauer J. S. Pathological changes in olfactory neurons in patients with Alzheimer's disease. Nature. 1989 Feb 23;337(6209):736–739. doi: 10.1038/337736a0. [DOI] [PubMed] [Google Scholar]
  36. Tomlinson A. H., Esiri M. M. Herpes simplex encephalitis. Immunohistological demonstration of spread of virus via olfactory pathways in mice. J Neurol Sci. 1983 Aug-Sep;60(3):473–484. doi: 10.1016/0022-510x(83)90158-2. [DOI] [PubMed] [Google Scholar]
  37. Waldton S. Clinical observations of impaired cranial nerve function in senile dementia. Acta Psychiatr Scand. 1974;50(5):539–547. doi: 10.1111/j.1600-0447.1974.tb09714.x. [DOI] [PubMed] [Google Scholar]
  38. Ward C. D., Hess W. A., Calne D. B. Olfactory impairment in Parkinson's disease. Neurology. 1983 Jul;33(7):943–946. doi: 10.1212/wnl.33.7.943. [DOI] [PubMed] [Google Scholar]
  39. Warner M. D., Peabody C. A., Flattery J. J., Tinklenberg J. R. Olfactory deficits and Alzheimer's disease. Biol Psychiatry. 1986 Jan;21(1):116–118. doi: 10.1016/0006-3223(86)90013-2. [DOI] [PubMed] [Google Scholar]

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