A study of the non-motor symptoms in early Parkinson’s disease with olfactory deficits

L. Wu, N. Mu, F. Yang, J. Zang, J.-P. Zheng

Department of Neurology, People Hospital of Rizhao City, Rizhao, China. llzys_123@163.com

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• Neurology

OBJECTIVE: The aim of this study is to determine characteristics of non-motor symptoms (NMS) in early Parkinson’s disease (PD) with olfactory deficits and to analyze the feasibility of diagnosing PD based on olfactory deficits.

PATIENTS AND METHODS: 62 patients without olfactory deficits in early PD (PD group), 58 patients with olfactory deficits in early PD (olfactory deficits group) and 60 healthy examined people (control group) were selected successively.

RESULTS: It was found that there was no statistical significance in the difference in ages and courses of disease among the three groups (p > 0.05). The percentage of males in the olfactory deficits group markedly increased, the NM-Quest score rose, the rate of cases complicated with a sleep disorder and constipation also increased significantly (p < 0.05). The comparison of depression occurrence rates and other NMS, as well as BUA levels in olfactory deficits group and PD group, showed no significant difference (p > 0.05). According to the relevant analysis, olfactory deficits were positively correlated with the occurrence of cpRBD and constipation (p < 0.05), while they showed no obvious correlation with depression, other NMS or the BUA level (p > 0.05). The degree of olfactory deficits was also positively correlated with the occurrence of cpRBD and constipation (p < 0.05). The prevalence rate of postural instability/gait difficulty (PIGD) in olfactory deficits group was noticeably higher than that in PD group, and olfactory deficits showed a positive correlation with the occurrence of PIGD (p > 0.05). A combination of NMS-Quest and Sniffin’s Sticks was applied to the diagnosis of PD, and it yielded an AUC of 0.795 (sensitivity of 79.3%, specificity of 89.6%, with cutoff scores of 13.5 and 25.5 respectively). The sensitivity, specificity and accuracy all increased markedly.

CONCLUSIONS: The early PD may emerge with olfactory deficits and multiple other non-motor symptoms, and a joint application of NMS-Quest and olfactory rating can serve as a reference for the diagnosis of early PD.

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