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Olfactory function in atypical parkinsonian syndromes

G K Wenning1, B Shephard, C Hawkes

  • 1University Department of Clinical Neurology, Institute of Neurology, Queen Square, London, England.

Acta Neurologica Scandinavica
|April 1, 1995
PubMed
Summary

Olfactory testing can help differentiate idiopathic Parkinson's disease (IPD) from atypical parkinsonism. Marked smell loss suggests IPD, while preserved or mild impairment indicates other parkinsonian syndromes.

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Area of Science:

  • Neurology
  • Neuroscience

Background:

  • Olfaction is significantly impaired in idiopathic Parkinson's disease (IPD).
  • Olfactory function is generally preserved or mildly reduced in atypical parkinsonism.
  • The diagnostic utility of olfactory testing in differentiating parkinsonian syndromes is not well-established.

Purpose of the Study:

  • To investigate the sensitivity and specificity of olfactory function testing in the differential diagnosis of parkinsonian syndromes.
  • To assess olfactory function in patients with idiopathic Parkinson's disease (IPD), corticobasal degeneration (CBD), and progressive supranuclear palsy (PSP).

Main Methods:

  • Utilized the University of Pennsylvania Smell Identification Test (UPSIT) with scores ranging from 0 to 40.
  • Studied olfactory function in 118 patients with IPD, 29 with multiple system atrophy (MSA), 15 with PSP, and 7 with CBD.

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  • Included 123 healthy control subjects for comparison.

    • Main Results:

    • Marked olfactory impairment was observed in the IPD group.
    • Mild olfactory impairment was noted in MSA patients; olfaction was normal in PSP and CBD patients.
    • An UPSIT score of 25/40 demonstrated 77% sensitivity and 85% specificity in distinguishing IPD from atypical parkinsonism.

    Conclusions:

    • Olfactory function is differentially impaired or preserved across various parkinsonian syndromes.
    • Olfactory testing may serve as a valuable diagnostic tool.
    • Markedly reduced olfaction suggests IPD, whereas preserved or mildly impaired olfaction is more indicative of atypical parkinsonism (MSA, PSP, CBD).