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Prodromal Parkinson disease in patients with idiopathic hyposmia

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Abstract

Background

Idiopathic hyposmia (IH) is a prodromal marker of Parkinson disease (PD). However, IH is common in the general population and only a minority will develop PD. Identification of individuals with IH at prodromal stage of PD would serve to select them to implement neuroprotective agents, when available.

Objective

To identify prodromal PD in IH patients using the Movement Disorders Society (MDS) research criteria for prodromal PD.

Methods

We applied the MDS research criteria for prodromal PD to 25 consecutive patients older than 50 years who were self-referred for smell loss and had IH, and to 18 controls. A number of risk and prodromal PD markers were assessed in all participants including REM sleep behavior disorder (RBD) by video-polysomnography and nigrostriatal dopaminergic dysfunction by DAT-SPECT. After follow-up of 4.7 ± 2.2 years, participants were re-assessed to look for incident PD.

Results

Prodromal PD probability was higher in patients than in controls (19.45 ± 34.9% versus 1.74 ± 4.48%; p = 0.019). Four (16%) patients met the criteria of prodromal PD surpassing 80% probability (99.8%, 99.5%, 88.3%, 86.4%). Three (12%) patients had RBD and four (16%) abnormal DAT-SPECT. At the end of follow-up, one (4%) IH patient who had RBD and baseline prodromal PD probability of 86.4% developed PD, while all controls remained disease free.

Conclusions

Prodromal PD is infrequent among IH patients. MDS research criteria for prodromal PD are useful to identify a subgroup of IH patients at high risk of PD when RBD is assessed by video-polysomnography and nigrostriatal dopamine deficiency with DAT-SPECT.

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Availability of data and material

The data that support the findings of this study are available by request to the corresponding author.

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Funding

This study was not funded.

Author information

Authors and Affiliations

  1. Center for Sleep Disorders, Neurology Service, Hospital Clinic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERNED: CB06/05/0018-ISCIII, Villarroel 170, 08036, Barcelona, Spain

    Paula Marrero-González, Alex Iranzo, Mònica Serradell, Carles Gaig & Joan Santamaría

  2. Rhinology Unit and Smell and Taste Clinic, Otorhinolaryngology Service, Hospital Clinic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERES, Barcelona, Catalonia, Spain

    David Bedoya, Isam Alobid & Joaquim Mullol

  3. Nuclear Medicine Department, Hospital Clínic Barcelona and Biomedical Research Networking Center of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain

    Aida Niñerola-Baizán & Andrés Perissinotti

  4. Otorhinolaryngology Service, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBER Enfermedades Respiratorias, Bunyola, Barcelona, Spain

    Isabel Vilaseca & Isam Alobid

Authors
  1. Paula Marrero-González
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  2. Alex Iranzo
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  3. David Bedoya
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  4. Mònica Serradell
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  5. Aida Niñerola-Baizán
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  7. Carles Gaig
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  8. Isabel Vilaseca
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  9. Isam Alobid
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  10. Joan Santamaría
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  11. Joaquim Mullol
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Corresponding author

Correspondence to Alex Iranzo.

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Conflicts of interest

The authors had no financial disclosures and no conflict of interests concerning the research related to the current study.

Ethical standards

This human study has been approved by our local ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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The study was approved by the local ethics committee of our institution and written informed consent was obtained from all participants.

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Marrero-González, P., Iranzo, A., Bedoya, D. et al. Prodromal Parkinson disease in patients with idiopathic hyposmia. J Neurol 267, 3673–3682 (2020). https://doi.org/10.1007/s00415-020-10048-6

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  • DOI: https://doi.org/10.1007/s00415-020-10048-6

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