Hyposmia in progressive supranuclear palsy.
Previous studies suggested that olfaction is normal in progressive supranuclear palsy (PSP). We applied the University of Pennsylvania Smell Identification Test (UPSIT) to 36 patients with PSP who scored more than 18 on the Mini Mental State Examination (MMSE), 140 patients with nondemented Parkinson's disease (PD) and 126 controls. Mean UPSIT scores in PSP were lower than in controls (P < 0.001) but higher than in PD (P < 0.001) after adjusting for age, gender, and smoking history. For patients with PSP, UPSIT scores correlated with MMSE (r = 0.44, P = 0.006) but not disease duration (P = 0.6), motor subscale of the Unified Parkinson's Disease Rating Scale (P = 0.2), or Frontal Assessment Battery (P = 0.5). The brains of six of the patients with PSP were examined postmortem and all revealed neurofibrillary tangles and tau accumulation in the rhinencephalon, although only three had hyposmia. Further prospective studies including patients with early PSP and PSP-P with postmortem confirmation might help clarify if smell tests could be useful when the differential diagnosis lies between PD and PSP.
Silveira-Moriyama
Laura
L
Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, United Kingdom.
Hughes
Graham
G
Church
Alistair
A
Ayling
Hilary
H
Williams
David R
DR
Petrie
Aviva
A
Holton
Janice
J
Revesz
Tamas
T
Kingsbury
Ann
A
Morris
Huw R
HR
Burn
David J
DJ
Lees
Andrew J
AJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009410:Nerve Degeneration / Q000209:etiology / Q000473:pathology; D000857:Olfaction Disorders / Q000209:etiology*; D009833:Olfactory Pathways / Q000473:pathology / Q000503:physiopathology; D012372:ROC Curve; D012189:Retrospective Studies; D012903:Smell / Q000502:physiology*; D013494:Supranuclear Palsy, Progressive / Q000150:complications*