RESUMEN
Olfactory dysfunction seems to be one of the most frequent symptoms in idiopathic parkinsonian syndrome (IPS). In contrast to the increasing number of studies providing evidence of the usefulness of olfactory tests in the diagnosis of IPS, clinical assessment of olfactory function is rarely performed. This may be due to the lack of an easy-to-use, inexpensive, standardized, and reliable test. In this study, we administered the newly developed "sniffin' sticks" test to a group of 40 nondemented IPS patients and compared the results with 40 healthy controls matched for age, gender, and smoking habits. In all three subtests including odor identification, odor detection threshold, and odor discrimination, the control group scored significantly better than the IPS group, yielding a specificity and sensitivity of 90% each. Our results indicate that olfactory disturbances in IPS can be found at early stages of the disease, appear bilaterally, and do not correlate with the dominant side of parkinsonism. Therefore, we emphasize that olfactory testing may be a useful tool in the diagnosis of IPS.
Asunto(s)
Trastornos del Olfato/diagnóstico , Enfermedad de Parkinson/diagnóstico , Olfato , Factores de Edad , Anciano , Estudios de Casos y Controles , Técnicas y Procedimientos Diagnósticos , Femenino , Lateralidad Funcional , Humanos , Masculino , Pruebas Neuropsicológicas , Trastornos del Olfato/etiología , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/psicología , Valores de Referencia , Sensibilidad y Especificidad , Umbral SensorialRESUMEN
'Sniffin' Sticks' is a new test of nasal chemosensory performance based on pen-like odor dispensing devices. It comprises three tests of olfactory function, namely tests for odor threshold (n-butanol, testing by means of a single staircase), odor discrimination (16 pairs of odorants, triple forced choice) and odor identification (16 common odorants, multiple forced choice from four verbal items per test odorant). After extensive preliminary investigations the tests were applied to a group of 104 healthy volunteers (52 female, 52 male, mean age 49.5 years, range 18-84 years) in order to establish test-retest reliability and to compare them with an established measure of olfactory performance (the Connecticut Chemosensory Clinical Research Center Test, CCCRC). Performance decreased with increasing age of the subjects (P < 0.001). Coefficients of correlation between sessions 1 and 2 were 0.61 for thresholds, 0.54 for discrimination and 0.73 for identification. Butanol thresholds as obtained with the CCCRC increased as a function of age; this relation to the subjects' age was not found for the CCCRC odor identification task. The test-retest reliability for CCCRC thresholds was 0.36, for odor identification it was 0.60. It is concluded that 'Sniffin' Sticks' may be suited for the routine clinical assessment of olfactory performance.
Asunto(s)
Odorantes , Olfato/fisiología , Adulto , Factores de Edad , Anciano , Análisis Factorial , Femenino , Frutas , Humanos , Masculino , Persona de Mediana Edad , Estadística como AsuntoRESUMEN
"Sniffin' Sticks" is a new test of nasal chemosensory performance based on pen-like odour-dispensing devices. This portable test is suited for repetitive, inexpensive screening of odour identification. The test includes a forced odour-identification task for seven odours performed by means of a list of four items (multiple-choice). In 146 subjects the basic screening test was compared to a down-scaled version of the UPSIT (CC-SIT). Sniffin' Sticks exhibited a relatively higher coefficient of correlation with the subjects' age; they also demonstrated the women's superior olfactory sensitivity more pronounced when compared to men. In addition, the coefficient of correlation between age and olfactory performance was slightly higher when the sticks were used. Preliminary investigations in nine patients with impaired olfactory function (i.e., anosmic or hyposmic patients) revealed significantly lower scores in patients compared to healthy controls matched for age and sex (p < 0.001). It is concluded that Sniffin' Sticks may be useful in the routine clinical assessment of olfactory performance where both time and costs matter.