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Olfaction in Neuropathologically Defined Progressive Supranuclear Palsy.

Holly A Shill1,2, Nan Zhang3, Erika Driver-Dunckley3

  • 1Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona, USA.

Movement Disorders : Official Journal of the Movement Disorder Society
|March 23, 2021
PubMed
Summary
This summary is machine-generated.

Idiopathic Parkinson's disease (PD) patients show reduced smell, unlike most progressive supranuclear palsy (PSP) patients. Hyposmia in PSP may indicate additional Lewy body pathology, differentiating it from PD.

Keywords:
Parkinson's diseaseUniversity of Pennsylvania Smell Identification Testbrain bankpathology

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Area of Science:

  • Neuroscience
  • Neuropathology
  • Olfactory dysfunction

Background:

  • Hyposmia is a known characteristic of idiopathic Parkinson's disease (PD) and dementia with Lewy bodies (DLBs).
  • Progressive supranuclear palsy (PSP) typically presents with a normal sense of smell.
  • There is a scarcity of pathologically confirmed data regarding olfactory function in PSP.

Purpose of the Study:

  • To investigate hyposmia in pathologically confirmed PSP patients.
  • To compare olfactory function in PSP patients with those diagnosed with PD and non-degenerative controls.
  • To explore the relationship between hyposmia and Lewy body burden in PSP.

Main Methods:

  • Utilized autopsied subjects from the Arizona Study of Aging and Neurodegenerative Disorders.
  • Included subjects with antemortem olfactory testing and confirmed neuropathological diagnoses (PD, PSP, or control).
  • Analyzed data from 281 cases: 24 PSP, 76 PD, and 174 controls.

Main Results:

  • Pathologically confirmed PD patients exhibited significantly reduced sense of smell compared to PSP and controls.
  • Most PSP patients had normal olfaction, but a subset showed hyposmia, leading to overall reduced smell in PSP versus controls.
  • Normosmia in parkinsonism cases demonstrated high sensitivity (93.4%) for pathologically confirmed PSP.

Conclusions:

  • Pathologically confirmed PD is associated with reduced olfaction, distinct from PSP and controls.
  • Normosmia in patients with parkinsonism is a strong indicator for PSP in this cohort.
  • Hyposmia in PSP cases suggests the presence of concomitant Lewy body pathology.