Journal of Neurology

, Volume 265, Issue 8, pp 1764–1771 | Cite as

Correlation among olfactory function, motors’ symptoms, cognitive impairment, apathy, and fatigue in patients with Parkinson’s disease

  • Carla MasalaEmail author
  • Paolo SollaEmail author
  • A. Liscia
  • G. Defazio
  • L. Saba
  • A. Cannas
  • A. Cavazzana
  • T. Hummel
  • A. Haehner
Original Communication


Although Parkinson’s disease (PD) is usually considered as a movement disorder, it is strongly associated with non-motor symptoms (NMS), including smell and taste dysfunctions, cognitive impairment, apathy, fatigue, and autonomic dysregulation. Olfactory deficit is considered the most common NMS in PD preceding the motor symptoms for years. The aim of this study was to investigate olfactory function, cognitive impairment, apathy, and fatigue in patients with PD in comparison with healthy controls, and subsequently to analyse the correlations between these NMS and motor symptoms severity in subjects with PD. One hundred and forty-seven participants were enrolled (96 PD patients, mean age in years 67.5, SD 7.2; 51 healthy controls; mean age 65.1, SD 11.8). Olfactory function was evaluated using the Sniffin’ Sticks test (odor detection threshold, discrimination and identification). The Montreal Cognitive Assessment (MoCA) was used to assess cognitive impairment. Apathy was examined by the self-report version of Starkstein Apathy Scale and fatigue was evaluated with the Parkinson’s Disease Fatigue Scale. PD patients showed severe impairment in odor detection threshold, discrimination, and identification compared to healthy controls. Moreover, in PD patients, apathy and fatigue scores were significantly increased, while MoCA scores were decreased in comparison with controls. Multivariate linear regression analyses showed that both apathy and Unified PD Rating Scale (UPDRS) were associated with odor identification, discrimination and Threshold–Discrimination–Identification (TDI) score. In conclusion, our results reported changes in apathy and motor disability as significant predictors in alterations of odor identification, discrimination and TDI score. Furthermore, these data suggest that olfactory dysfunction might progress in tight relation with motor impairment UPDRS but also with non-motor symptoms such as apathy.


Parkinson’s disease Olfaction Cognitive ability Apathy Fatigue 



The authors thank Dr Alan Moat for improving the English text, Dr Raffaella Piras for collecting data and all the participants for their availability. This work was supported by a grant from the University of Cagliari (Progetti di Ricerca di Interesse Dipartimentale, PRID 2017).

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This study was approved by the local Ethics Committee (Prot. NP/2016/4523) and was performed according to the Declaration of Helsinki.

Informed consent

Participants received an explanatory statement and gave their written informed consent to participate in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Biomedical Sciences, Section of PhysiologyUniversity of CagliariCagliariItaly
  2. 2.Movement Disorders Center, Department of Neurology, Institute of NeurologyUniversity of CagliariCagliariItaly
  3. 3.Azienda Ospedaliero Universitaria (A.O.U.)University of CagliariCagliariItaly
  4. 4.Interdisciplinary Center Smell and Taste, Department of Otorhinolaryngology, Medical Faculty Carl Gustav CarusTU DresdenDresdenGermany

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