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Kovalová M, Gottfriedová N, Mrázková E, Janout V, Janoutová J. Cognitive impairment, neurodegenerative disorders, and olfactory impairment: A literature review. Otolaryngol Pol 2024; 78:1-17. [PMID: 38623856 DOI: 10.5604/01.3001.0053.6158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
<br><b>Introduction:</b> The early detection and diagnosis of dementia are of key importance in treatment, slowing disease progression, or suppressing symptoms. The possible role of changes in the sense of smell is considered with regard to potential markers for early detection of Alzheimer's disease (AD).</br> <br><b>Materials and methods:</b> A literature search was conducted using the electronic databases PubMed, Scopus, and Web of Science between May 30, 2022 and August 2, 2022. The term "dementia" was searched with keyword combinations related to olfaction.</br> <br><b>Results:</b> A total of 1,288 records were identified through the database search. Of these articles, 49 were ultimately included in the analysis. The results showed the potential role of changes in the sense of smell as potential biomarkers for early detection of AD. Multiple studies have shown that olfactory impairment may be observed in patients with AD, PD, MCI, or other types of dementia. Even though smell tests are able to detect olfactory loss caused by neurodegenerative diseases, they cannot reliably distinguish between certain diseases.</br> <br><b>Conclusions:</b> In individuals with cognitive impairment or neurodegenerative diseases, olfactory assessment has repeatedly been reported to be used for early diagnosis, but not for differential diagnosis.</br>.
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Affiliation(s)
- Martina Kovalová
- Center for Research and Science, Faculty of Health Sciences, Palacký University Olomouc, Czech Republic
| | - Nikol Gottfriedová
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Eva Mrázková
- Center for Research and Science, Faculty of Health Sciences, Palacký University Olomouc, Czech Republic
| | - Vladimír Janout
- Center for Research and Science, Faculty of Health Sciences, Palacký University Olomouc, Czech Republic
| | - Jana Janoutová
- Center for Research and Science, Faculty of Health Sciences, Palacký University Olomouc, Czech Republic
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Oltra J, Habich A, Schwarz CG, Nedelska Z, Przybelski SA, Inguanzo A, Diaz‐Galvan P, Lowe VJ, Oppedal K, Gonzalez MC, Philippi N, Blanc F, Barkhof F, Lemstra AW, Hort J, Padovani A, Rektorova I, Bonanni L, Massa F, Kramberger MG, Taylor J, Snædal JG, Walker Z, Antonini A, Dierks T, Segura B, Junque C, Westman E, Boeve BF, Aarsland D, Kantarci K, Ferreira D. Sex differences in brain atrophy in dementia with Lewy bodies. Alzheimers Dement 2024; 20:1815-1826. [PMID: 38131463 PMCID: PMC10947875 DOI: 10.1002/alz.13571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/13/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Sex influences neurodegeneration, but it has been poorly investigated in dementia with Lewy bodies (DLB). We investigated sex differences in brain atrophy in DLB using magnetic resonance imaging (MRI). METHODS We included 436 patients from the European-DLB consortium and the Mayo Clinic. Sex differences and sex-by-age interactions were assessed through visual atrophy rating scales (n = 327; 73 ± 8 years, 62% males) and automated estimations of regional gray matter volume and cortical thickness (n = 165; 69 ± 9 years, 72% males). RESULTS We found a higher likelihood of frontal atrophy and smaller volumes in six cortical regions in males and thinner olfactory cortices in females. There were significant sex-by-age interactions in volume (six regions) and cortical thickness (seven regions) across the entire cortex. DISCUSSION We demonstrate that males have more widespread cortical atrophy at younger ages, but differences tend to disappear with increasing age, with males and females converging around the age of 75. HIGHLIGHTS Male DLB patients had higher odds for frontal atrophy on radiological visual rating scales. Male DLB patients displayed a widespread pattern of cortical gray matter alterations on automated methods. Sex differences in gray matter measures in DLB tended to disappear with increasing age.
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Affiliation(s)
- Javier Oltra
- Medical Psychology UnitDepartment of MedicineInstitute of NeuroscienceUniversity of BarcelonaBarcelonaCataloniaSpain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)BarcelonaCataloniaSpain
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - Annegret Habich
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
- University Hospital of Psychiatry and Psychotherapy Bern, University of BernBernSwitzerland
| | | | - Zuzana Nedelska
- Memory ClinicDepartment of NeurologyCharles University2nd Faculty of Medicine and Motol University HospitalPragueCzech Republic
| | | | - Anna Inguanzo
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | | | - Val J. Lowe
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
| | - Ketil Oppedal
- Center for Age‐Related MedicineStavanger University HospitalStavangerNorway
- Stavanger Medical Imaging Laboratory (SMIL)Department of RadiologyStavanger University HospitalStavangerNorway
- The Norwegian Centre for Movement DisordersStavanger University HospitalStavangerNorway
| | - Maria C. Gonzalez
- Center for Age‐Related MedicineStavanger University HospitalStavangerNorway
- Stavanger Medical Imaging Laboratory (SMIL)Department of RadiologyStavanger University HospitalStavangerNorway
- The Norwegian Centre for Movement DisordersStavanger University HospitalStavangerNorway
- Department of Quality and Health TechnologyFaculty of Health SciencesUniversity of StavangerStavangerNorway
| | - Nathalie Philippi
- Geriatrics and Neurology UnitsResearch and Resources Memory Center (CM2R)Hôpitaux Universitaires de StrasbourgStrasbourgFrance
- ICube Laboratory (CNRS, UMR 7357)StrasbourgFrance
| | - Frederic Blanc
- Geriatrics and Neurology UnitsResearch and Resources Memory Center (CM2R)Hôpitaux Universitaires de StrasbourgStrasbourgFrance
- ICube Laboratory (CNRS, UMR 7357)StrasbourgFrance
| | - Frederik Barkhof
- Department of Radiology & Nuclear Medicine (AMC)Amsterdam UMC, Vrije UniversiteitAmsterdamthe Netherlands
- Queen Square Institute of Neurology and Centre for Medical Image Computing (CMIC)University College LondonLondonUK
| | - Afina W. Lemstra
- Alzheimer Center AmsterdamNeurologyVrije Universiteit Amsterdam, Amsterdam UMC location VumcAmsterdamThe Netherlands
- Amsterdam NeuroscienceNeurodegeneration, Vrije Universiteit Amsterdam, Amsterdam UMC location VumcAmsterdamThe Netherlands
| | - Jakub Hort
- Memory ClinicDepartment of NeurologyCharles University2nd Faculty of Medicine and Motol University HospitalPragueCzech Republic
| | - Alessandro Padovani
- Neurology UnitDepartment of Clinical and Experimental Sciences (DSCS)University of BresciaBresciaItaly
| | - Irena Rektorova
- Brain and Mind ResearchCentral European Institute of Technology (CEITET)Masaryk UniversityBrnoCzech Republic
| | - Laura Bonanni
- Department of Medicine and Aging Sciences University G. d'Annunzio of Chieti‐Pescara ChietiChietiItaly
| | - Federico Massa
- Department of NeuroscienceRehabilitationOphthalmology, Genetics, Maternal and Child HealthUniversity of GenovaGenovaItaly
| | | | - John‐Paul Taylor
- Translational and Clinical Research InstituteFaculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | | | - Zuzana Walker
- Division of PsychiatryUniversity College LondonLondonUK
- St Margaret's HospitalEssex Partnership University NHS Foundation TrustEssexUK
| | - Angelo Antonini
- Parkinson and Movement Disorders UnitStudy Center on Neurodegeneration (CESNE)PadovaItaly
| | - Thomas Dierks
- University Hospital of Psychiatry and Psychotherapy Bern, University of BernBernSwitzerland
| | - Barbara Segura
- Medical Psychology UnitDepartment of MedicineInstitute of NeuroscienceUniversity of BarcelonaBarcelonaCataloniaSpain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)BarcelonaCataloniaSpain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED: CB06/05/0018‐ISCIII)BarcelonaCataloniaSpain
| | - Carme Junque
- Medical Psychology UnitDepartment of MedicineInstitute of NeuroscienceUniversity of BarcelonaBarcelonaCataloniaSpain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)BarcelonaCataloniaSpain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED: CB06/05/0018‐ISCIII)BarcelonaCataloniaSpain
| | - Eric Westman
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | | | - Dag Aarsland
- Center for Age‐Related MedicineStavanger University HospitalStavangerNorway
- Department of Old Age PsychiatryInstitute of PsychiatryPsychology & Neuroscience (IoPPN)King's College LondonLondonUK
| | | | - Daniel Ferreira
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
- Facultad de Ciencias de la SaludUniversidad Fernando Pessoa CanariasLas PalmasEspaña
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Katanga JA, Hamilton CA, Walker L, Attems J, Thomas AJ. Age-related hearing loss and dementia-related neuropathology: An analysis of the United Kingdom brains for dementia research cohort. Brain Pathol 2023; 33:e13188. [PMID: 37551936 PMCID: PMC10580004 DOI: 10.1111/bpa.13188] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/26/2023] [Indexed: 08/09/2023] Open
Abstract
Age-related hearing loss frequently precedes or coexists with mild cognitive impairment and dementia. The role specific neuropathologies play in this association, as either a cause or a consequence, is unclear. We therefore aimed to investigate whether specific dementia related neuropathologies were associated with hearing impairment in later life. We analysed data on ante-mortem hearing impairment with post-mortem neuropathological data for 442 participants from the Brains for Dementia Research Cohort. Binary logistic regression models were used to estimate the association of hearing impairment with the presence of each dementia-related neuropathology overall, and with specific staged changes. All analyses adjusted for age and sex, and several sensitivity analyses were conducted to test the robustness of findings. Presence and density of neuritic plaques were associated with higher odds of hearing impairment ante-mortem (OR = 3.65, 95% CI 1.78-7.46 for frequent density of plaques). Presence of any LB disease was likewise associated with hearing impairment (OR = 2.10, 95% CI 1.27-3.48), but this did not increase with higher cortical pathology (OR = 1.53, 95% CI 0.75-3.11). Nonspecific amyloid deposition, neurofibrillary tangle staging, overall AD neuropathology level, and cerebrovascular disease were not clearly associated with increased risks of hearing impairment. Our results provide some support for an association between dementia-related neuropathology and hearing loss and suggest that hearing loss may be associated with a high neuritic plaque burden and more common in Lewy body disease.
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Affiliation(s)
- Jessica A. Katanga
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Calum A. Hamilton
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Lauren Walker
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Johannes Attems
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Alan J. Thomas
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
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Palmqvist S, Rossi M, Hall S, Quadalti C, Mattsson-Carlgren N, Dellavalle S, Tideman P, Pereira JB, Nilsson MH, Mammana A, Janelidze S, Baiardi S, Stomrud E, Parchi P, Hansson O. Cognitive effects of Lewy body pathology in clinically unimpaired individuals. Nat Med 2023; 29:1971-1978. [PMID: 37464059 PMCID: PMC10427420 DOI: 10.1038/s41591-023-02450-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 06/08/2023] [Indexed: 07/20/2023]
Abstract
α-Synuclein aggregates constitute the pathology of Lewy body (LB) disease. Little is known about the effects of LB pathology in preclinical (presymptomatic) individuals, either as isolated pathology or coexisting with Alzheimer's disease (AD) pathology (β-amyloid (Aβ) and tau). We examined the effects of LB pathology using a cerebrospinal fluid α-synuclein-seed amplification assay in 1,182 cognitively and neurologically unimpaired participants from the BioFINDER study: 8% were LB positive, 26% Aβ positive (13% of those were LB positive) and 16% tau positive. LB positivity occurred more often in the presence of Aβ positivity but not tau positivity. LB pathology had independently negative effects on cross-sectional and longitudinal global cognition and memory and on longitudinal attention/executive function. Tau had cognitive effects of a similar magnitude, but these were less pronounced for Aβ. Participants with both LB and AD (Aβ and tau) pathology exhibited faster cognitive decline than those with only LB or AD pathology. LB, but not AD, pathology was associated with reduced sense of smell. Only LB-positive participants progressed to clinical LB disease over 10 years. These results are important for individualized prognosis, recruitment and choice of outcome measures in preclinical LB disease trials, but also for the design of early AD trials because >10% of individuals with preclinical AD have coexisting LB pathology.
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Affiliation(s)
- Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Marcello Rossi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Sara Hall
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Corinne Quadalti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Sofia Dellavalle
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Pontus Tideman
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Joana B Pereira
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Maria H Nilsson
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Angela Mammana
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Simone Baiardi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Piero Parchi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden.
- Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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Al-Ezzi MY, Khan KS, Tappuni AR. Smell Dysfunction in Patients with Primary Sjögren’s Syndrome: Impact on Quality of Life. J Clin Med 2023; 12:jcm12072724. [PMID: 37048807 PMCID: PMC10095094 DOI: 10.3390/jcm12072724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/17/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Objectives: Patients with primary Sjögren’s syndrome (pSS) often report smell and taste disturbances. However, the correlation between smell impairment and mucosal dryness is not well understood. The objectives of this study were to investigate the following: (1) the prevalence of smell hypofunction in patients with SS; (2) the impact of smell hypofunction on their quality of life (QoL); (3) whether the patients’ smell is correlated with xerostomia; and (4) whether the patients’ smell is affected by taste hypofunction, disease duration, age, smoking or self-reported neuropathy. Methodology: An ethically approved cross-sectional study was conducted on 65 female patients with SS and 62 sex-matched healthy controls. Their smell was assessed using the University of Pennsylvania Smell Identification Test. Their taste acuity was assessed using the Taste Strips Test. A visual analogue scale was used for the self-assessment of smell and taste functions. Xerostomia was assessed by the salivary flow rate, clinical oral dryness score and the Xerostomia Inventory. The patients’ QoL and mental health well-being were assessed using validated questionnaires. Results: In the SS group, the patients’ smell function was impaired in 27/65 patients compared with the controls (15/62, p < 0.05), and it did not correlate with the severity of xerostomia, taste acuity (r = 0.05, p = 0.6) or self-reported nasal dryness (r = −0.02, p = 0.7). In the patients’ group, smell hypofunction was not correlated with disease duration (β = 0.1, 95% CI = −0.07–0.1) or smoking (β = −0.02, 95% CI = −8–7). Age was not correlated with the smell function in the patients’ group (β = −0.1, p = 0.5) but was correlated significantly with smell in the healthy participants’ group (β = −0.3, p = 0.02). Neuropathy affected 81.2% of the patients’ group. Their QoL and mental health well-being were not affected by smell hypofunction. Conclusion: Smell hypofunction appears to be a clinical manifestation in patients with SS, but it does not seem to be associated with the severity of mucosal dryness or with taste disturbance.
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Affiliation(s)
- Minan Y. Al-Ezzi
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK
- College of Medicine and Dentistry, Ulster University, Birmingham B4 6BN, UK
| | - Khalid S. Khan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
| | - Anwar R. Tappuni
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK
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Sturchio A, Espay AJ. The theoretical problems of "prodrome" and "phenoconversion" in neurodegeneration. Handb Clin Neurol 2023; 192:155-167. [PMID: 36796940 DOI: 10.1016/b978-0-323-85538-9.00002-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The recognition of and approach to prodromal symptoms, those which manifest before a diagnosis can be ascertained at the bedside, are of increasing interest in neurodegenerative research. A prodrome is conceived of as an early window into a disease, a critical time when putative disease-modifying interventions may be best suited for examination. Several challenges affect research in this area. Prodromal symptoms are highly prevalent in the population, can be nonprogressive for years or decades, and exhibit limited specificity in predicting conversion versus nonconversion into a neurodegenerative category within a time window feasible for most longitudinal clinical studies. In addition, there is a large range of biological alterations subsumed within each prodromal syndrome, forced to converge into the unifying nosology of each neurodegenerative disorder. Initial prodromal subtyping efforts have been developed but given the scarcity of prodrome-to-disease longitudinal studies, it is not yet clear whether any prodromal subtype can be predicted to evolve into the corresponding subtype of manifesting disease - a form of construct validity. As current subtypes generated from one clinical population are not faithfully replicated to others, it is likely that, lacking biological or molecular anchors, prodromal subtypes may only be applicable to the cohorts within which they were developed. Furthermore, as clinical subtypes have not aligned with a consistent pattern of pathology or biology, such might also be the fate of prodromal subtypes. Finally, the threshold defining the change from prodrome to disease for most neurodegenerative disorders remains clinical (e.g., a motor change in gait becoming noticeable to a clinician or measurable with portable technologies), not biological. As such, a prodrome can be viewed as a disease state not yet overt to a clinician. Efforts into identifying biological subtypes of disease, regardless of clinical phenotype or disease stage, may best serve future disease-modifying therapeutic strategies deployed not for a prodromal symptom but for a defined biological derangement as soon as it can be determined to lead to clinical changes, prodromal or not.
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Affiliation(s)
- Andrea Sturchio
- James J. and Joan A. Gardner Family Center for Parkinson's disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, United States; Department of Clinical Neuroscience, Neuro Svenningsson, Karolinska Institutet, Stockholm, Sweden.
| | - Alberto J Espay
- James J. and Joan A. Gardner Family Center for Parkinson's disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, United States.
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Oltra J, Habich A, Schwarz CG, Nedelska Z, Przybelski SA, Inguanzo A, Diaz-Galvan P, Lowe VJ, Oppedal K, Blanc F, Lemstra AW, Hort J, Padovani A, Rektorova I, Bonanni L, Massa F, Kramberge MG, Taylor JP, Snædal J, Walker Z, Antonini A, Segura B, Junque C, Westman E, Boeve BF, Aarsland D, Kantarci K, Ferreira D. Sex differences in brain atrophy in dementia with Lewy bodies. Res Sq 2023:rs.3.rs-2516427. [PMID: 36747755 PMCID: PMC9901042 DOI: 10.21203/rs.3.rs-2516427/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background and objectives Sex is an important contributing factor to neuroimaging phenotypes in brain disorders. However, little is known about the contribution of sex differences to the neurodegeneration in dementia with Lewy bodies (DLB). We investigated sex differences in probable DLB patients by using both visual rating scales of lobar atrophy and automated estimations of regional atrophy. Methods We included 442 probable DLB patients from the European-DLB consortium and the Mayo Clinic who have magnetic resonance imaging (MRI) data available. We assessed sex differences and the sex-by-age interaction in two largely independent samples through visual rating scales of lobar atrophy (n = 333; mean age 73 ± 8 years, 62% males) and automated regional estimations of gray matter (GM) volume and mean cortical thickness (CTh) (n = 165; mean age 69 ± 9 years, 72% males). We used binary logistic regression and ANOVA for statistical analysis. Results We found a statistically significantly higher likelihood of frontal atrophy measured by the global cortical atrophy-frontal subscale (GCA-F) in males (40% of males had an abnormal GCA-F score versus 29% of females, P-value = 0.006). Using automated estimations, we found smaller GM volumes in 6 cortical regions in males compared with females, as well as smaller GM volume in the entorhinal cortex and thinner olfactory cortices in females, compared with males. The sex-by-age interaction showed statistically significant results in 6 cortical volumes and 7 mean CTh estimations (P-value ≤ 0.05), accentuated in the right middle frontal gyrus (FDR-adjusted P-value = 0.047). These cross-sectional interactions indicated that while females have statistically significantly less atrophy than males at younger ages, differences become non-significant at older ages, with females showing the same level of atrophy than males around the age of 75. Conclusions This study demonstrates sex differences on brain atrophy in probable DLB. While male DLB patients have a more widespread pattern of cortical atrophy at younger ages, these sex differences tend to disappear with increasing age. Longitudinal studies will help establish these cross-sectional findings and inform on sex and age considerations to the use of MRI in clinical routine, as the field moves towards precision medicine.
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Russo C, Valle MS, Russo A, Malaguarnera L. The Interplay between Ghrelin and Microglia in Neuroinflammation: Implications for Obesity and Neurodegenerative Diseases. Int J Mol Sci 2022; 23:ijms232113432. [PMID: 36362220 PMCID: PMC9654207 DOI: 10.3390/ijms232113432] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/29/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
Numerous studies have shown that microglia are capable of producing a wide range of chemokines to promote inflammatory processes within the central nervous system (CNS). These cells share many phenotypical and functional characteristics with macrophages, suggesting that microglia participate in innate immune responses in the brain. Neuroinflammation induces neurometabolic alterations and increases in energy consumption. Microglia may constitute an important therapeutic target in neuroinflammation. Recent research has attempted to clarify the role of Ghre signaling in microglia on the regulation of energy balance, obesity, neuroinflammation and the occurrence of neurodegenerative diseases. These studies strongly suggest that Ghre modulates microglia activity and thus affects the pathophysiology of neurodegenerative diseases. This review aims to summarize what is known from the current literature on the way in which Ghre modulates microglial activity during neuroinflammation and their impact on neurometabolic alterations in neurodegenerative diseases. Understanding the role of Ghre in microglial activation/inhibition regulation could provide promising strategies for downregulating neuroinflammation and consequently for diminishing negative neurological outcomes.
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Affiliation(s)
- Cristina Russo
- Section of Pathology, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy
| | - Maria Stella Valle
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy
- Section of Physiology, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Antonella Russo
- Section of Physiology, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Lucia Malaguarnera
- Section of Pathology, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, 95123 Catania, Italy
- Correspondence:
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Hasan S, Adler CH, Zhang N, Serrano GE, Sue LI, Shill HA, Mehta SH, Beach TG, Driver-Dunckley ED. Olfactory Dysfunction in Incidental Lewy Body Disease and Parkinson's Disease: An Update. Innov Clin Neurosci 2022; 19:19-23. [PMID: 36591548 PMCID: PMC9776774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective Measuring olfactory dysfunction shows promise as one of a number of nonmotor biomarkers that can be used to detect clinically manifest and prodromal Parkinson's disease (PD) and dementia with Lewy bodies (DLB) and to differentiate these from nonsynucleinopathies. Using a larger sample size than in our previous study, we evaluated the relationship between olfactory dysfunction based on the University of Pennsylvania Smell Identification Test (UPSIT) to the clinicopathological findings in patients with PD (n=41), patients with incidental Lewy body disease (ILBD) (n=47), and controls with no neurodegenerative disease (n=137). Design This study was conducted through the Arizona Study of Aging and Neurodegenerative Disease (AZSAND). We selected individuals who had an UPSIT score completed antemortem and were clinicopathologically diagnosed with PD, ILBD, or control. Various measures included density of Lewy type synucleinopathy (aSyn) in the olfactory bulb and tract, as well as connected mesial temporal lobe structures. Cases and controls were analyzed using one-way analysis of variance (ANOVA) with pairwise contrasts. Results Compared to controls (mean: 27.8, standard deviation [SD]: 6.0), the mean UPSIT scores were lower for PD (15.8, SD: 6.0, p<0.001) and ILBD (24.1, SD: 8.6, p<0.001). The sensitivity for detecting ILBD from controls, based on a cutoff score of less than 23 (23/47), was 48.9 percent. The specificity for detecting a control was 79.6 percent with a cutoff greater than 23 (109/137). Conclusion These findings replicate, with a larger sample size, our previously published findings that individuals with autopsy-confirmed PD and ILBD have significantly lower UPSIT scores compared to controls. These data add to the growing body of evidence supporting early olfactory dysfunction as a prodromal biomarker for the risk of developing PD and ILBD as a prodromal Lewy body disorder.
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Affiliation(s)
- Shemonti Hasan
- Drs. Hasan, Adler, Mehta, and Driver-Dunckley are with the Parkinson's Disease and Movement Disorders Center, Department of Neurology, Mayo Clinic in Scottsdale, Arizona
| | - Charles H Adler
- Drs. Hasan, Adler, Mehta, and Driver-Dunckley are with the Parkinson's Disease and Movement Disorders Center, Department of Neurology, Mayo Clinic in Scottsdale, Arizona
| | - Nan Zhang
- Ms. Zhang is with the Department of Health Science Research, Section of Biostatistics, Mayo Clinic in Scottsdale, Arizona
| | - Geidy E Serrano
- Drs. Serrano and Beach and Ms. Sue are with Civin Laboratory for Neuropathology, Banner Sun Health Research Institute in Sun City, Arizona
| | - Lucia I Sue
- Drs. Serrano and Beach and Ms. Sue are with Civin Laboratory for Neuropathology, Banner Sun Health Research Institute in Sun City, Arizona
| | - Holly A Shill
- Dr. Shill is with Barrow Neurological Institute in Phoenix, Arizona
| | - Shyamal H Mehta
- Drs. Hasan, Adler, Mehta, and Driver-Dunckley are with the Parkinson's Disease and Movement Disorders Center, Department of Neurology, Mayo Clinic in Scottsdale, Arizona
| | - Thomas G Beach
- Drs. Serrano and Beach and Ms. Sue are with Civin Laboratory for Neuropathology, Banner Sun Health Research Institute in Sun City, Arizona
| | - Erika D Driver-Dunckley
- Drs. Hasan, Adler, Mehta, and Driver-Dunckley are with the Parkinson's Disease and Movement Disorders Center, Department of Neurology, Mayo Clinic in Scottsdale, Arizona
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10
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Mullady SSS, Castellanos S, Lopez L, Aguirre G, Weeks J, King S, Valle K, Goode C, Tsoy E, Possin K, Miller B, Kushel M, Lanata S. Neurocognitive health of older adults experiencing homelessness in Oakland, California. Front Neurol 2022; 13:905779. [PMID: 35937073 PMCID: PMC9353024 DOI: 10.3389/fneur.2022.905779] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
Background and objectives The homeless population in the US is aging. Cognitive impairment is prevalent in this population, yet little is known about the neurologic etiologies of such impairment. Addressing this gap in knowledge is important because homeless older adults with cognitive impairment due to neurodegenerative disease may need lifelong tailored support to obtain and maintain housing. In this study, we characterized the neurocognitive health of a sample of adults who experienced homelessness for the first time after age 50 using gold standard behavioral neurology examination practices. Methods We conducted a descriptive cross-sectional study of older adults who first experienced homelessness after age 50. We recruited our sample purposively from an ongoing longitudinal cohort study of adults who were aged 50 and over and homeless when they entered the cohort. For this sub study, we enrolled a convenience sample from those who reported their first episode of homelessness after age 50. We did not exclude individuals based on history of substance use. Neurologists conducted a structured neurocognitive history intake, neurological examination, neuropsychological evaluation, and functional assessment between November 2020 and February 2021. We screened all participants for neurocognitive disorders using gold standard clinical research diagnostic criteria. Results We evaluated 25 participants, most were men (76%) and Black (84%), with a median age of 61 years. The most common neurocognitive complaints included deficits in recent episodic memory (n = 15, 60%), executive functions (n = 13, 52%), and behavior/mood, with apathy being the most common complaint (n = 20, 80%). Neuropsychological testing revealed a high prevalence of socioemotional deficits (n = 20, 80%). Common neurological examination deficits included difficulties with coordination, such as impaired Luria task (n = 16, 64%), signs of distal peripheral neuropathy (n = 8, 32%), anosmia/hyposmia (n = 4, 21%), and signs of mild Parkinsonism (n = 5, 20%). The most common diagnoses were MCI (n = 7, 28%), bvFTD (n = 4, 16%), AD (n = 4, 16%), and DLB (n = 2, 8%). Discussion Our findings suggest that neurocognitive concerns and examination deficits are common among older homeless adults. Specific neurocognitive disorders may be overrepresented in this population, particularly frontotemporal disorders. Longitudinal studies involving brain biomarkers are needed to characterize the neurocognitive health of this vulnerable population more precisely.
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Affiliation(s)
- Sandeepa Satya-Sriram Mullady
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States,*Correspondence: Sandeepa Satya-Sriram Mullady
| | - Stacy Castellanos
- Department of Internal Medicine, UCSF Center for Vulnerable Populations, University of California, San Francisco, San Francisco, CA, United States
| | - Lucia Lopez
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Gloria Aguirre
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - John Weeks
- Department of Internal Medicine, UCSF Center for Vulnerable Populations, University of California, San Francisco, San Francisco, CA, United States
| | - Stephen King
- Department of Internal Medicine, UCSF Center for Vulnerable Populations, University of California, San Francisco, San Francisco, CA, United States
| | - Karen Valle
- Department of Internal Medicine, UCSF Center for Vulnerable Populations, University of California, San Francisco, San Francisco, CA, United States
| | - Collette Goode
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Elena Tsoy
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Katherine Possin
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Bruce Miller
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Margot Kushel
- Department of Internal Medicine, UCSF Center for Vulnerable Populations, University of California, San Francisco, San Francisco, CA, United States
| | - Serggio Lanata
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States,Serggio Lanata
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11
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Miyamoto T, Miyamoto M. Odor identification predicts the transition of patients with isolated RBD: A retrospective study. Ann Clin Transl Neurol 2022; 9:1177-1185. [PMID: 35767550 PMCID: PMC9380141 DOI: 10.1002/acn3.51615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction To determine if the severity of olfactory dysfunction in isolated REM sleep behavior disorder (IRBD) predicts conversion to Parkinson's disease (PD) or dementia with Lewy bodies (DLB). Methods Olfaction was tested using the Japanese version of the University of Pennsylvania Smell Identification Test (UPSIT‐J) in 155 consecutive patients with polysomnography‐confirmed IRBD and 34 healthy controls. IRBD patients were followed up for 5.8 ± 3.2 (range 0.2–11) years. Thirty‐eight patients underwent repeat UPSIT‐J evaluation at 2.7 ± 1.3 years after the baseline test. Results UPSIT‐J score was lower in IRBD patients than in age‐ and sex‐matched controls. The receiver operating characteristic curve analysis showed that the optimal cutoff score of 22.5 in UPSIT‐J discriminated between IRBD patients and controls with a sensitivity of 94.3% and specificity of 81.8%. Anosmia (UPSIT‐J score < 19) was present in 54.2% of IRBD patients. In total, 42 patients developed a neurodegenerative disease, of whom 17 had PD, 22 DLB, and 3 MSA. Kaplan–Meier analysis showed that the short‐term risk of Lewy body disease (LBD) was higher in patients with anosmia than in those without anosmia. At baseline, the UPSIT‐J score was similar between patients who developed PD and DLB (p = 0.136). All three IRBD patients (100%) who developed MSA did not have anosmia. Conclusions In IRBD patients, anosmia predicts a higher short‐term risk of transition to LBD but cannot distinguish between PD and DLB. At baseline, preserved odor identification may occur in latent MSA. Future IRBD neuroprotective trials should evaluate anosmia as a marker of prodromal LBD.
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Affiliation(s)
- Tomoyuki Miyamoto
- Department of Neurology, Dokkyo Medical University Saitama Medical Center, Japan
| | - Masayuki Miyamoto
- Department of Neurology, Center of Sleep Medicine, Dokkyo Medical University, Japan.,Dokkyo Medical University, School of Nursing, Japan
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12
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Tremblay C, Serrano GE, Intorcia AJ, Mariner MR, Sue LI, Arce RA, Atri A, Adler CH, Belden CM, Shill HA, Driver-Dunckley E, Mehta SH, Beach TG. Olfactory Bulb Amyloid-β Correlates With Brain Thal Amyloid Phase and Severity of Cognitive Impairment. J Neuropathol Exp Neurol 2022; 81:643-649. [PMID: 35751438 PMCID: PMC9297096 DOI: 10.1093/jnen/nlac042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Alzheimer disease (AD) neuropathological hallmarks amyloid β (Aβ) and tau neurofibrillary (NF) pathology have been reported in the olfactory bulb (OB) in aging and in different neurodegenerative diseases, which coincides with frequently reported olfactory dysfunction in these conditions. To better understand when the OB is affected in relation to the hierarchical progression of Aβ throughout the brain and whether OB pathology might be an indicator of AD severity, we assessed the presence of OB Aβ and tau NF pathology in an autopsy cohort of 158 non demented control and 173 AD dementia cases. OB Aβ was found in less than 5% of cases in lower Thal phases 0 and 1, in 20% of cases in phase 2, in 60% of cases in phase 3 and in more than 80% of cases in higher Thal phases 4 and 5. OB Aβ and tau pathology significantly predicted a Thal phase greater than 3, a Braak NF stage greater than 4, and an MMSE score lower than 24. While OB tau pathology is almost universal in the elderly and therefore is not a good predictor of AD severity, OB Aβ pathology coincides with clinically-manifest AD and might prove to be a useful biomarker of the extent of brain spread of both amyloid and tau pathology.
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Affiliation(s)
- Cécilia Tremblay
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Geidy E Serrano
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Anthony J Intorcia
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Monica R Mariner
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Lucia I Sue
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Richard A Arce
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Alireza Atri
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA.,Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Charles H Adler
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Christine M Belden
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Holly A Shill
- Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Erika Driver-Dunckley
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Shyamal H Mehta
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Thomas G Beach
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
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13
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Matar E, Lewis SJG. "On the nose" - could olfactory testing be a reliable bedside marker of prodromal DLB? Int Psychogeriatr 2022; 34:523-7. [PMID: 35510296 DOI: 10.1017/S104161022200045X] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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14
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Thomas AJ, Hamilton CA, Barker S, Durcan R, Lawley S, Barnett N, Firbank M, Roberts G, Allan LM, O'Brien J, Taylor JP, Donaghy PC. Olfactory impairment in mild cognitive impairment with Lewy bodies and Alzheimer's disease. Int Psychogeriatr 2022; 34:585-92. [PMID: 34666863 DOI: 10.1017/S1041610221001265] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Impaired olfaction may be a biomarker for early Lewy body disease, but its value in mild cognitive impairment with Lewy bodies (MCI-LB) is unknown. We compared olfaction in MCI-LB with MCI due to Alzheimer's disease (MCI-AD) and healthy older adults. We hypothesized that olfactory function would be worse in probable MCI-LB than in both MCI-AD and healthy comparison subjects (HC). DESIGN Cross-sectional study assessing olfaction using Sniffin' Sticks 16 (SS-16) in MCI-LB, MCI-AD, and HC with longitudinal follow-up. Differences were adjusted for age, and receiver operating characteristic (ROC) curves were used for discriminating MCI-LB from MCI-AD and HC. SETTING Participants were recruited from Memory Services in the North East of England. PARTICIPANTS Thirty-eight probable MCI-LB, 33 MCI-AD, 19 possible MCI-LB, and 32HC. MEASUREMENTS Olfaction was assessed using SS-16 and a questionnaire. RESULTS Participants with probable MCI-LB had worse olfaction than both MCI-AD (age-adjusted mean difference (B) = 2.05, 95% CI: 0.62-3.49, p = 0.005) and HC (B = 3.96, 95% CI: 2.51-5.40, p < 0.001). The previously identified cutoff score for the SS-16 of ≤ 10 had 84% sensitivity for probable MCI-LB (95% CI: 69-94%), but 30% specificity versus MCI-AD. ROC analysis found a lower cutoff of ≤ 7 was better (63% sensitivity for MCI-LB, with 73% specificity vs MCI-AD and 97% vs HC). Asking about olfactory impairments was not useful in identifying them. CONCLUSIONS MCI-LB had worse olfaction than MCI-AD and normal aging. A lower cutoff score of ≤ 7 is required when using SS-16 in such patients. Olfactory testing may have value in identifying early LB disease in memory services.
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15
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Tremblay C, Serrano GE, Intorcia AJ, Sue LI, Wilson JR, Adler CH, Shill HA, Driver-Dunckley E, Mehta SH, Beach TG. Effect of olfactory bulb pathology on olfactory function in normal aging. Brain Pathol 2022; 32:e13075. [PMID: 35485279 PMCID: PMC9424999 DOI: 10.1111/bpa.13075] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/04/2022] [Accepted: 04/05/2022] [Indexed: 01/02/2023] Open
Abstract
Decline of olfactory function is frequently observed in aging and is an early symptom of neurodegenerative diseases. As the olfactory bulb (OB) is one of the first regions involved by pathology and may represent an early disease stage, we specifically aimed to evaluate the contribution of OB pathology to olfactory decline in cognitively normal aged individuals without parkinsonism or dementia. This clinicopathological study correlates OB tau, amyloid β (Aβ) and α‐synuclein (αSyn) pathology densities and whole brain pathology load to olfactory identification function as measured with the University of Pennsylvania Smell Identification Test (UPSIT) and clinical data measured proximate to death in a large autopsy study including 138 cases considered non‐demented controls during life. Tau pathology was frequently observed in the OB (95% of cases), while both Aβ (27% of cases) and αSyn (20% of cases) OB pathologies were less commonly observed. A weak correlation was only observed between OB tau and olfactory performance, but when controlled for age, neither OB tau, Aβ or αSyn significantly predict olfactory performance. Moreover, whole brain tau and αSyn pathology loads predicted olfactory performance; however, only αSyn pathology loads survived age correction. In conclusion, OB tau pathology is frequently observed in normally aging individuals and increases with age but does not appear to independently contribute to age‐related olfactory impairment suggesting that further involvement of the brain seems necessary to contribute to age‐related olfactory decline.
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Affiliation(s)
- Cécilia Tremblay
- Departement of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Geidy E Serrano
- Departement of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Anthony J Intorcia
- Departement of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Lucia I Sue
- Departement of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Jeffrey R Wilson
- Department of Economics, Arizona State University, Tempe, Arizona, USA
| | - Charles H Adler
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Holly A Shill
- Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Erika Driver-Dunckley
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Shyamal H Mehta
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Thomas G Beach
- Departement of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
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16
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Payne M, Manera V, Robert P, Vandersteen C, Beauchet O, Galery K, Sacco G, Fabre R, Gros A. Olfactory identification disorders due to Alzheimer's disease: A new test from France to Quebec. PLoS One 2022; 17:e0265764. [PMID: 35377902 PMCID: PMC8979441 DOI: 10.1371/journal.pone.0265764] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 03/07/2022] [Indexed: 12/14/2022] Open
Abstract
Olfactory identification disorder is regarded as an early marker of Alzheimer’s disease (AD) and of similar diagnostic significance of biological or cognitive markers. Premature damage of the entorhinal olfactory cortex, the hippocampus and the orbitofrontal cortex characterize AD and suggest a specific impairment of olfactory identification. The use of psychophysical olfactory identification tests in clinical diagnostic practice is therefore strongly recommended, but not required. As these widespread tests are rarely used, an innovative test, adapted to this target group has been developed. It has been used and validated in a routine care protocol at different Memory Centers in France and in Quebec, Canada. A total of 157 participants were recruited: including 63 Alzheimer’s patients and 94 healthy controls. The test was composed of 14 odorants diluted into 4 different concentrations. A computer interface generated randomization of 6 odors per participant and the automatic calculation of identification scores, of perceptual thresholds and of composite scores. All participants underwent a Mini Mental Scale Examination within the previous three months or on the same day of the olfactory test. The Alzheimer’s patients had a score between 20 and 30 and healthy controls participants had a score above 28 without any loss of points on recalled items. The results show that our olfactory identification test is able to significantly differentiate Alzheimer’s patients from healthy controls (p < 0.001), and to distinguish the French population tested from the Quebec population (p < 0.001). This study highlights an olfactory identification disorder as a target for early diagnosis of AD. Its cultural qualities make it a potential candidate for differentiated calibration between France and Quebec.
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Affiliation(s)
- Magali Payne
- CoBteK lab (Cognition Behavior and Technology), Université Cote d’Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Centre Mémoire Ressources et Recherche, Université Côte d’Azur, Nice, France
- * E-mail:
| | - Valeria Manera
- CoBteK lab (Cognition Behavior and Technology), Université Cote d’Azur, Nice, France
| | - Philippe Robert
- CoBteK lab (Cognition Behavior and Technology), Université Cote d’Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Centre Mémoire Ressources et Recherche, Université Côte d’Azur, Nice, France
| | - Clair Vandersteen
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France
| | - Olivier Beauchet
- Research Center of the Institut Universitaire en Gériatrie de Montréal, University of Montreal, Montreal, Canada
- Faculty of Medicine, Department of Medicine, University of Montreal, Montreal, Canada
- Division of Geriatric Medicine, Department of Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Kevin Galery
- Research Center of the Institut Universitaire en Gériatrie de Montréal, University of Montreal, Montreal, Canada
| | - Guillaume Sacco
- CoBteK lab (Cognition Behavior and Technology), Université Cote d’Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Centre Mémoire Ressources et Recherche, Université Côte d’Azur, Nice, France
| | - Roxane Fabre
- CoBteK lab (Cognition Behavior and Technology), Université Cote d’Azur, Nice, France
- Département de Santé Publique, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur Département de Santé Publique, Nice, France
| | - Auriane Gros
- CoBteK lab (Cognition Behavior and Technology), Université Cote d’Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Centre Mémoire Ressources et Recherche, Université Côte d’Azur, Nice, France
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17
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Patel ZM, Holbrook EH, Turner JH, Adappa ND, Albers MW, Altundag A, Appenzeller S, Costanzo RM, Croy I, Davis GE, Dehgani-Mobaraki P, Doty RL, Duffy VB, Goldstein BJ, Gudis DA, Haehner A, Higgins TS, Hopkins C, Huart C, Hummel T, Jitaroon K, Kern RC, Khanwalkar AR, Kobayashi M, Kondo K, Lane AP, Lechner M, Leopold DA, Levy JM, Marmura MJ, Mclelland L, Miwa T, Moberg PJ, Mueller CA, Nigwekar SU, O'Brien EK, Paunescu TG, Pellegrino R, Philpott C, Pinto JM, Reiter ER, Roalf DR, Rowan NR, Schlosser RJ, Schwob J, Seiden AM, Smith TL, Soler ZM, Sowerby L, Tan BK, Thamboo A, Wrobel B, Yan CH. International consensus statement on allergy and rhinology: Olfaction. Int Forum Allergy Rhinol 2022; 12:327-680. [PMID: 35373533 DOI: 10.1002/alr.22929] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/01/2021] [Accepted: 11/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O). METHODS Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus. RESULTS The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies. CONCLUSION This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.
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Affiliation(s)
- Zara M Patel
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Eric H Holbrook
- Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Justin H Turner
- Otolaryngology, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Nithin D Adappa
- Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark W Albers
- Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Aytug Altundag
- Otolaryngology, Biruni University School of Medicine, İstanbul, Turkey
| | - Simone Appenzeller
- Rheumatology, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Richard M Costanzo
- Physiology and Biophysics and Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Ilona Croy
- Psychology and Psychosomatic Medicine, TU Dresden, Dresden, Germany
| | - Greg E Davis
- Otolaryngology, Proliance Surgeons, Seattle and Puyallup, Washington, USA
| | - Puya Dehgani-Mobaraki
- Associazione Naso Sano, Umbria Regional Registry of Volunteer Activities, Corciano, Italy
| | - Richard L Doty
- Smell and Taste Center, Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Valerie B Duffy
- Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | | | - David A Gudis
- Otolaryngology, Columbia University Irving Medical Center, New York, USA
| | - Antje Haehner
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | - Thomas S Higgins
- Otolaryngology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Claire Hopkins
- Otolaryngology, Guy's and St. Thomas' Hospitals, London Bridge Hospital, London, UK
| | - Caroline Huart
- Otorhinolaryngology, Cliniques universitaires Saint-Luc, Institute of Neuroscience, Université catholgique de Louvain, Brussels, Belgium
| | - Thomas Hummel
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | | | - Robert C Kern
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ashoke R Khanwalkar
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Masayoshi Kobayashi
- Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Kenji Kondo
- Otolaryngology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Andrew P Lane
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matt Lechner
- Otolaryngology, Barts Health and University College London, London, UK
| | - Donald A Leopold
- Otolaryngology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Joshua M Levy
- Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael J Marmura
- Neurology Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lisha Mclelland
- Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Takaki Miwa
- Otolaryngology, Kanazawa Medical University, Ishikawa, Japan
| | - Paul J Moberg
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Sagar U Nigwekar
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Erin K O'Brien
- Otolaryngology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Teodor G Paunescu
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Carl Philpott
- Otolaryngology, University of East Anglia, Norwich, UK
| | - Jayant M Pinto
- Otolaryngology, University of Chicago, Chicago, Illinois, USA
| | - Evan R Reiter
- Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - David R Roalf
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nicholas R Rowan
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rodney J Schlosser
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - James Schwob
- Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Allen M Seiden
- Otolaryngology, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - Timothy L Smith
- Otolaryngology, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Zachary M Soler
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - Leigh Sowerby
- Otolaryngology, University of Western Ontario, London, Ontario, Canada
| | - Bruce K Tan
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andrew Thamboo
- Otolaryngology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bozena Wrobel
- Otolaryngology, Keck School of Medicine, USC, Los Angeles, California, USA
| | - Carol H Yan
- Otolaryngology, School of Medicine, UCSD, La Jolla, California, USA
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18
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Goodwin GR, Bestwick JP, Noyce AJ. The potential utility of smell testing to screen for neurodegenerative disorders. Expert Rev Mol Diagn 2022; 22:139-148. [PMID: 35129037 DOI: 10.1080/14737159.2022.2037424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Loss of smell is a common early feature of neurodegenerative diseases including Alzheimer's and Parkinson's disease. Identifying these conditions in their early stages is important to understand more about early pathophysiological events and the development of disease modifying therapies. Smell testing may be an effective future tool for screening large populations for early neurodegeneration. AREAS COVERED : In this review, we appraise the evidence for, and discuss the likelihood of, the use of smell testing in large screening programs to detect early neurodegeneration. We evaluate the predictive power of smell tests for neurodegenerative disease, compare performance to other established screening programs, and discuss ethical and practical considerations and limitations. EXPERT OPINION : Even if disease modifying therapies were available for neurodegenerative disease, smell tests alone are unlikely to have high enough predictive power to be used in a future screening program. However, we believe they could be a valuable component of a short battery of tests or part of a stepwise process that together could more accurately identify early neurodegeneration in large populations.
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Affiliation(s)
- Gregory R Goodwin
- Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, E1 4NS, UK
| | - Jonathan P Bestwick
- Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, E1 4NS, UK
| | - Alastair J Noyce
- Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, E1 4NS, UK
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19
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Blesa J, Foffani G, Dehay B, Bezard E, Obeso JA. Motor and non-motor circuit disturbances in early Parkinson disease: which happens first? Nat Rev Neurosci 2022; 23:115-28. [PMID: 34907352 DOI: 10.1038/s41583-021-00542-9] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 12/15/2022]
Abstract
For the last two decades, pathogenic concepts in Parkinson disease (PD) have revolved around the toxicity and spread of α-synuclein. Thus, α-synuclein would follow caudo-rostral propagation from the periphery to the central nervous system, first producing non-motor manifestations (such as constipation, sleep disorders and hyposmia), and subsequently impinging upon the mesencephalon to account for the cardinal motor features before reaching the neocortex as the disease evolves towards dementia. This model is the prevailing theory of the principal neurobiological mechanism of disease. Here, we scrutinize the temporal evolution of motor and non-motor manifestations in PD and suggest that, even though the postulated bottom-up mechanisms are likely to be involved, early involvement of the nigrostriatal system is a key and prominent pathophysiological mechanism. Upcoming studies of detailed clinical manifestations with newer neuroimaging techniques will allow us to more closely define, in vivo, the role of α-synuclein aggregates with respect to neuronal loss during the onset and progression of PD.
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Abstract
The aim of the present review is to summarize literature data on dementia in parkinsonian disorders. Cognitive decline and the gradual development of dementia are considered to be key features in the majority of parkinsonian conditions. The burden of dementia in everyday life of parkinsonian patients and their caregivers is vast and can be even more challenging to handle than the motor component of the disease. Common pathogenetic mechanisms involve the aggregation and spreading of abnormal proteins like alpha-synuclein, tau or amyloid in cortical and subcortical regions with subsequent dysregulation of multiple neurotransmitter systems. The degree of cognitive deterioration in these disorders is variable and ranges from mild cognitive impairment to severe cognitive dysfunction. There is also variation in the number and type of affected cognitive domains which can involve either a single domain like executive or visuospatial function or multiple ones. Novel genetic, biological fluid or imaging biomarkers appear promising in facilitating the diagnosis and staging of dementia in parkinsonian conditions. A significant part of current research in Parkinson's disease and other parkinsonian syndromes is targeted towards the cognitive aspects of these disorders. Stabilization or amelioration of cognitive outcomes represents a primary endpoint in many ongoing clinical trials for novel disease modifying treatments in this field. This article is part of the Special Issue "Parkinsonism across the spectrum of movement disorders and beyond" edited by Joseph Jankovic, Daniel D. Truong and Matteo Bologna.
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Affiliation(s)
- Christos Koros
- 1st Department of Neurology, Aeginition University, Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Aeginition University, Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece; Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aeginition University, Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece; The Gertrude H. Sergievsky Center, Department of Neurology, Taub Institute for Research in Alzheimer's, Disease and the Aging Brain, Columbia University, New York, USA.
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21
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Walker IM, Fullard ME, Morley JF, Duda JE. Olfaction as an early marker of Parkinson's disease and Alzheimer's disease. Handb Clin Neurol 2021; 182:317-329. [PMID: 34266602 DOI: 10.1016/b978-0-12-819973-2.00030-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Olfactory impairment is a common and early sign of Parkinson's disease (PD) and Alzheimer's disease (AD), the two most prevalent neurodegenerative conditions in the elderly. This phenomenon corresponds to pathologic processes emerging in the olfactory system prior to the onset of typical clinical manifestations. Clinically available tests can establish hyposmia through odor identification assessment, discrimination, and odor detection threshold. There are significant efforts to develop preventative or disease-modifying therapies that slow down or halt the progression of PD and AD. Due to the convenience and low cost of its assessment, olfactory impairment could be used in these studies as a screening instrument. In the clinical setting, loss of smell may also help to differentiate PD and AD from alternative causes of Parkinsonism and cognitive impairment, respectively. Here, we discuss the pathophysiology of olfactory dysfunction in PD and AD and how it can be assessed in the clinical setting to aid in the early and differential diagnosis of these disorders.
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Affiliation(s)
- Ian M Walker
- Parkinson's Disease Research, Education and Clinical Center, Michael J. Crescenz, VA Medical Center, Philadelphia, PA, United States; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michelle E Fullard
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
| | - James F Morley
- Parkinson's Disease Research, Education and Clinical Center, Michael J. Crescenz, VA Medical Center, Philadelphia, PA, United States; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - John E Duda
- Parkinson's Disease Research, Education and Clinical Center, Michael J. Crescenz, VA Medical Center, Philadelphia, PA, United States; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
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22
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Shill HA, Zhang N, Driver-Dunckley E, Mehta S, Adler CH, Beach TG. Olfaction in Neuropathologically Defined Progressive Supranuclear Palsy. Mov Disord 2021; 36:1700-1704. [PMID: 33755262 PMCID: PMC9972484 DOI: 10.1002/mds.28568] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Hyposmia is characteristic of idiopathic Parkinson's disease (PD) and dementia with Lewy bodies (DLBs), whereas progressive supranuclear palsy (PSP) typically has normal sense of smell. However, there is a lack of pathologically confirmed data. OBJECTIVE The objective is to study hyposmia in pathologically confirmed PSP patients and compare to PD patients and nondegenerative controls. METHODS We studied autopsied subjects in the Arizona Study of Aging and Neurodegenerative Disorders who had antemortem olfactory testing and a neuropathological diagnosis of either PD, PSP, or control. RESULTS This study included 281 cases. Those with neuropathologically confirmed PSP (N = 24) and controls (N = 174) had significantly better sense of smell than those with PD (N = 76). Although most PSP patients had normal olfaction, there were some with hyposmia, resulting in an overall reduced sense of smell in PSP compared to controls. The sensitivity of having PSP pathologically in those presenting with parkinsonism and normosmia was 93.4% with a specificity of 64.7%. Cases with both PSP and PD pathologically had reduced sense of smell similar to PD alone (N = 7). Hyposmic PSP patients had significantly higher Lewy body burden not meeting criteria for additional PD/DLB diagnosis. CONCLUSIONS Pathologically confirmed PD had reduced olfaction compared with PSP or controls. In the setting of parkinsonism in this sample, the presence of normosmia had high sensitivity for PSP. Hyposmia in PSP suggests the presence of additional Lewy body pathology. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Holly A. Shill
- Barrow Neurological Institute, Phoenix, AZ, USA,University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - Nan Zhang
- Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | | | - Shyamal Mehta
- Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Charles H. Adler
- Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
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Abstract
BACKGROUND Clinicopathological studies have demonstrated that Alzheimer's disease dementia (ADD) is often accompanied by clinically undetectable comorbid neurodegenerative and cerebrovascular disease that alter the rate of cognitive decline. Aside from causing increased variability in clinical response, it is possible that the major ADD comorbidities may not respond to ADD-specific molecular therapeutics. OBJECTIVE As most reports have focused on comorbidity in the oldest-old, its extent in younger age groups that are more likely to be involved in clinical trials is largely unknown; our objective is to provide this information. METHODS We conducted a survey of neuropathological comorbidities in sporadic ADD using data from the US National Alzheimer's Coordinating Center. Subject data was restricted to those with dementia and meeting National Institute on Aging-Alzheimer's Association intermediate or high AD Neuropathological Change levels, excluding those with known autosomal dominant AD-related mutations. RESULTS Highly prevalent ADD comorbidities are not restricted to the oldest-old but are common even in early-onset ADD. The percentage of cases with ADD as the sole major neuropathological diagnosis is highest in the under-60 group, where "pure" ADD cases are still in the minority at 44%. After this AD as a sole major pathology in ADD declines to roughly 20%in the 70s and beyond. Lewy body disease is the most common comorbidity at younger ages but actually is less common at later ages, while for most others, their prevalence increases with age. CONCLUSION Alzheimer's disease neuropathological comorbidities are highly prevalent even in the younger-old.
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Killen A, Olsen K, McKeith IG, Thomas AJ, O'Brien JT, Donaghy P, Taylor J. The challenges of COVID-19 for people with dementia with Lewy bodies and family caregivers. Int J Geriatr Psychiatry 2020; 35:1431-1436. [PMID: 32748560 PMCID: PMC7436139 DOI: 10.1002/gps.5393] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/01/2020] [Accepted: 07/27/2020] [Indexed: 01/12/2023]
Affiliation(s)
- Alison Killen
- Translational and Clinical Research Institute, Biomedical Research BuildingNewcastle UniversityNewcastle upon TyneUK
| | - Kirsty Olsen
- Translational and Clinical Research Institute, Biomedical Research BuildingNewcastle UniversityNewcastle upon TyneUK
| | - Ian G. McKeith
- Translational and Clinical Research Institute, Biomedical Research BuildingNewcastle UniversityNewcastle upon TyneUK
| | - Alan J. Thomas
- Translational and Clinical Research Institute, Biomedical Research BuildingNewcastle UniversityNewcastle upon TyneUK
| | - John T. O'Brien
- Department of Psychiatry, Level E4University of Cambridge School of Clinical MedicineCambridgeUK
| | - Paul Donaghy
- Translational and Clinical Research Institute, Biomedical Research BuildingNewcastle UniversityNewcastle upon TyneUK
| | - John‐Paul Taylor
- Translational and Clinical Research Institute, Biomedical Research BuildingNewcastle UniversityNewcastle upon TyneUK
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Lachén-Montes M, Mendizuri N, Schvartz D, Fernández-Irigoyen J, Sánchez JC, Santamaría E. Proteomic Characterization of the Olfactory Molecular Imbalance in Dementia with Lewy Bodies. Int J Mol Sci 2020; 21:E6371. [PMID: 32887355 DOI: 10.3390/ijms21176371] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/18/2020] [Accepted: 09/01/2020] [Indexed: 02/07/2023] Open
Abstract
Olfactory dysfunction is one of the prodromal symptoms in dementia with Lewy bodies (DLB). However, the molecular pathogenesis associated with decreased smell function remains largely undeciphered. We generated quantitative proteome maps to detect molecular alterations in olfactory bulbs (OB) derived from DLB subjects compared to neurologically intact controls. A total of 3214 olfactory proteins were quantified, and 99 proteins showed significant alterations in DLB cases. Protein interaction networks disrupted in DLB indicated an imbalance in translation and the synaptic vesicle cycle. These alterations were accompanied by alterations in AKT/MAPK/SEK1/p38 MAPK signaling pathways that showed a distinct expression profile across the OB–olfactory tract (OT) axis. Taken together, our data partially reflect the missing links in the biochemical understanding of olfactory dysfunction in DLB.
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