title: [Olfactory dysfunction in Parkinson's disease: its role as a new cardinal sign in early and differential diagnosis].
abstract: Olfactory dysfunction is a prominent symptom in Parkinson's disease (PD) and found in about 70-100% of patients. In earlier studies significant loss of olfactory function seemed to be unrelated to disease duration, did not correlate with motor function, and was uninfluenced by antiparkinsonian medication. We suggest that the increase of dopaminergic cells in the olfactory bulb is responsible for the hyposmia in PD patients. Interestingly, this olfactory dysfunction is not found in progressive supranuclear palsy or corticobasal degeneration. In multiple system atrophy, the deficit is mild and indistinguishable from cerebellar syndromes of other aetiologies. Intact olfaction has also been reported recently in Parkin disease (PARK 2) and vascular parkinsonism. Olfactory tests may significantly enhance the diagnostic armamentarium in the differential diagnosis of parkinsonian syndromes and indeterminate tremors. Furthermore, olfactory testing may also prove to be a useful aid in the early or "preclinical" detection of PD, once effective disease-modifying therapies are found. Braak and coworkers have confirmed the widespread, extranigral pathology in PD and suggested that pathology in the anterior olfactory region may be one of the earliest appearances of neurodegeneration in PD.
authors: Klinik für Neurologie, Diakonie-Klinikum Schwäbisch Hall gGmbH, Diakoniestrasse 10, Schwäbisch Hall, Germany. birgit.herting@diaksha.de
authors: B
authors: B
authors: Herting
authors: S
authors: S
authors: Bietenbeck
authors: K
authors: K
authors: Scholz
authors: A
authors: A
authors: Hähner
authors: T
authors: T
authors: Hummel
authors: H
authors: H
authors: Reichmann
mesh_terms: D003937:Diagnosis, Differential; D042241:Early Diagnosis; D006801:Humans; D000857:Olfaction Disorders / Q000175:diagnosis / Q000209:etiology*; D010300:Parkinson Disease / Q000175:diagnosis*; D011237:Predictive Value of Tests
references: Curr Opin Neurol. 2004 Aug;17(4):417-23
references: 15247536
references: Neurosci Res. 2005 Jan;51(1):111-5
references: 15596247
references: Neurology. 1988 Aug;38(8):1237-44
references: 3399075
references: Eur Arch Otorhinolaryngol. 2000;257(4):205-11
references: 10867835
references: Neurology. 1994 Feb;44(2):266-8
references: 8309571
references: J Neural Transm (Vienna). 2005 Oct;112(10):1363-70
references: 15711853
references: J Neurol Neurosurg Psychiatry. 1992 Feb;55(2):138-42
references: 1538221
references: Exp Neurol. 2006 Jan;197(1):113-21
references: 16246330
references: Nervenarzt. 2000 Aug;71(8):643-50
references: 10996914
references: Brain. 2005 Jan;128(Pt 1):126-37
references: 15548552
references: Chem Senses. 2003 Jul;28(6):537-43
references: 12907591
references: Neurology. 2006 Mar 28;66(6):845-51
references: 16567700
references: J Chronic Dis. 1975 Oct;28(9):493-7
references: 1176578
references: Neuropathol Appl Neurobiol. 2003 Oct;29(5):503-10
references: 14507342
references: Neurology. 1997 Nov;49(5):1424-31
references: 9371933
references: Neurology. 1991 May;41(5 Suppl 2):77-80; discussion 80-1
references: 2041598
references: Ann Neurol. 2001 Jul;50(1):34-41
references: 11456307
references: J Neurol Neurosurg Psychiatry. 1997 May;62(5):436-46
references: 9153598
references: Mov Disord. 2004 Oct;19(10):1196-202
references: 15390014
references: Funct Neurol. 1998 Apr-Jun;13(2):99-103
references: 9626594
references: Proc Natl Acad Sci U S A. 2001 Mar 27;98(7):4154-9
references: 11259673
references: J Neurol Neurosurg Psychiatry. 2004 Dec;75(12):1749-52
references: 15548497
references: Cell Tissue Res. 2004 Oct;318(1):121-34
references: 15338272
references: Mov Disord. 2003 Aug;18(8):938-42
references: 12889086
references: J Clin Neurosci. 2002 Sep;9(5):521-4
references: 12383407
references: Mov Disord. 1995 May;10(3):283-7
references: 7651444
references: Neurology. 2004 Apr 13;62(7):1224-6
references: 15079034
references: Ann Neurol. 1992 Jul;32(1):97-100
references: 1642478
references: Ann Neurol. 2004 Aug;56(2):169-71
references: 15293267
references: Mov Disord. 2003 Apr;18(4):364-72
references: 12671941
references: Mov Disord. 2004 Jun;19(6):687-92
references: 15197709
references: Mov Disord. 2005 Apr;20(4):471-5
references: 15597336
references: J Neural Transm (Vienna). 2002 May;109(5-6):805-11
references: 12111470
references: Ann Neurol. 2004 Aug;56(2):173-81
references: 15293269
references: J Neural Transm (Vienna). 2005 May;112(5):669-76
references: 15517435
references: Geriatrics. 1991 Aug;46 Suppl 1:47-51
references: 1894145
references: Brain. 2002 Nov;125(Pt 11):2431-45
references: 12390970
references: Chem Senses. 1997 Feb;22(1):39-52
references: 9056084