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Correlation of olfactory function factors with cardiac sympathetic denervation in Parkinson’s disease

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Abstract

Background

Hyposmia is a common nonmotor symptom of Parkinson’s disease (PD) and reportedly associated with dysautonomia in PD. The smell identification test for measuring olfactory function consists of multiple items to discriminate specific scents. In the present study, factor analysis of the smell identification test was performed, and the correlation of extracted factors with cardiac sympathetic denervation (CSD) in patients with PD was investigated.

Methods

The present study included 183 early PD patients who underwent the Cross-Cultural Smell Identification Test (CC-SIT) and 123I-meta-iodobenzylguanidine (123I-MIBG) myocardial scintigraphy. Factor analysis of 12 items on the CC-SIT was performed using the computed correlation matrix for the binary items, and five smell factors were extracted. Multiple linear regression was performed to determine the correlation of olfactory function with late heart-to-mediastinum (H/M) ratio of 123I-MIBG uptake.

Results

The mean CC-SIT score was 6.1 ± 2.6, and 133 patients (72.7%) had CSD. The CC-SIT score and five smell factors were not associated with dopamine transporter uptake or cognitive functions. However, the CC-SIT score significantly correlated with age (P < 0.001) and late H/M ratio (P < 0.001). Factors 1 and 5 showed an increasing trend with larger H/M ratio, although it was not statistically significant (β = 0.203, P = 0.085 and β = 0.230, P = 0.085, respectively). Factor 5 significantly correlated with the H/M ratio in PD patients with CSD (β = 0.676, P = 0.036).

Discussion

The results showed olfactory dysfunction to be selectively associated with cardiac sympathetic burden in PD. The correlation of certain factors with CSD indicates the possibility of selective hyposmia in PD patients.

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Data availability

The data supporting the findings of this study are available from the corresponding author upon reasonable request.

Abbreviations

CC-SIT:

Cross-cultural smell identification test

CDR:

Clinical dementia rating

CSD:

Cardiac sympathetic denervation

18F-FP-CIT:

18F-N-(3-fluoropropyl)-2beta-carbon ethoxy-3beta-(4-iodophenyl) nortropane

H/M:

Heart-to-mediastinum

H&Y:

Hoehn and Yahr Scale

123I-MIBG:

123I-meta-iodobenzylguanidine

MMSE:

Mini-mental state examination

PET:

Positron emission tomography

PD:

Parkinson’s disease

ROI:

Regions of interest

SNSB:

Seoul neuropsychological screening battery

SUVR:

Standardized uptake value ratio

UPDRS:

Unified Parkinson’s Disease Rating Scale

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Funding

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF-2017R1D1A1B06028086). This research was also supported by the Korea “National Institute of Health” research project (2021-ER1008-02).

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Authors and Affiliations

  1. Department of Neurology, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-gu, Seoul, 06591, Republic of Korea

    Dong-Woo Ryu, Sang-Won Yoo, Ko-Eun Choi, Yoon-Sang Oh & Joong-Seok Kim

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Contributions

Conceptualization: DWR, JSK. Methodology: DWR, JSK. Formal analysis and investigation: DWR, SWY, KEC, YSO, JSK. Writing—original draft preparation: DWR. Writing—review and editing: SWY, KEC, YSO, JSK. Funding acquisition: JSK. Resources: DWR, JSK. Approval of final manuscript: DWR, SWY, KEC, YSO, JSK.

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Correspondence to Joong-Seok Kim.

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Ryu, DW., Yoo, SW., Choi, KE. et al. Correlation of olfactory function factors with cardiac sympathetic denervation in Parkinson’s disease. J Neurol 271, 1397–1407 (2024). https://doi.org/10.1007/s00415-023-12080-8

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