Detection of presymptomatic Parkinson's disease: combining smell tests, transcranial sonography, and SPECT.
Olfactory loss is among the early signs of Parkinson's disease (PD). We investigated whether "idiopathic" olfactory dysfunction might relate to signs of nigral degeneration. Olfactory tests were combined with transcranial sonography of the substantia nigra and single photon emission computed tomography (SPECT) imaging. Thirty patients diagnosed with idiopathic olfactory loss participated. Eleven of these patients exhibited an increased echogenicity of the SN in the transcranial sonography. In 10 of these 11 patients, SPECT scans with (123)I-FP-CIT were performed. Median uptake ratios in the basal ganglia were pathological in 5 patients, 2 patients exhibited borderline findings, and 3 patients had normal results. Considering patients with idiopathic olfactory dysfunction, noninvasive transcranial sonography seems to be helpful in identifying patients potentially at risk to develop PD. Longitudinal follow-up studies are necessary to estimate the ratio of patients with dopaminergic cell loss in the basal ganglia who will develop PD in the future.
Sommer
Ulrike
U
Department of Neurology, University of Dresden Medical School, Dresden, Germany. sommer-uli@web.de
Hummel
Thomas
T
Cormann
Katja
K
Mueller
Antje
A
Frasnelli
Johannes
J
Kropp
Joachim
J
Reichmann
Heinz
H
D000328:Adult; D000368:Aged; D004453:Echoencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D000857:Olfaction Disorders / Q000175:diagnosis* / Q000209:etiology*; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon; D014326:Tropanes
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D014326:Tropanes; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane