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Systematic review and meta-analysis of Sniffin Sticks Test performance in Parkinson’s disease patients in different countries

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Abstract

Introduction

Olfaction impairment occurs in about 90% of patients with Parkinson’s disease. The Sniffin Sticks Test is a widely used instrument to measure olfactory performance and is divided into three subtests that assess olfactory threshold, discrimination and identification. However, cultural and socioeconomic differences can influence test performance.

Objectives

We performed a systematic review and meta-analysis of the existent data about Sniffin Sticks Test performance of Parkinson’s disease patients and healthy controls in different countries and investigated if there are other cofactors which could influence the olfactory test results. A subgroup analysis by country was performed as well as a meta-regression using age, gender and air pollution as covariates.

Results

Four hundred and thirty studies were found and 66 articles were included in the meta-analysis. Parkinson’s disease patients showed significantly lower scores on the Sniffin Sticks Test and all its subtests than healthy controls. Overall, the heterogeneity among studies was moderate to high as well as the intra-country heterogeneity. The subgroup analysis, stratifying by country, maintained a high residual heterogeneity.

Conclusion

The meta-regression showed a significant correlation with age and air pollution in a few subtests. A high heterogeneity was found among studies which was not significantly decreased after subgroup analysis by country. This fact signalizes that maybe cultural influence has a small impact on the Sniffin Sticks Test results. Age and air pollution have influence in a few olfactory subtests.

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Authors and Affiliations

  1. Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, 6690, Ipiranga Avenue, Jardim Botânico, Porto Alegre, 90619-900, Brazil

    Sheila Trentin, Bruno Samuel Fraiman de Oliveira & Yuri Ferreira Felloni Borges

  2. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

    Bruno Samuel Fraiman de Oliveira

  3. Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil

    Carlos Roberto de Mello Rieder

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  1. Sheila Trentin
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Conception and design: ST, BSFO, CRMR. Acquisition of data: ST, BSFO, YFFB. Drafting the article: ST, BSFO. Revising the article for important intellectual content: ST, BSFO, YFFB, CRMR. Approval of article and agreement for submission: ST, BSFO, YFFB, CRMR. All the co-authors listed above gave their final approval of this manuscript version.

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Correspondence to Sheila Trentin.

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Trentin, S., Fraiman de Oliveira, B.S., Ferreira Felloni Borges, Y. et al. Systematic review and meta-analysis of Sniffin Sticks Test performance in Parkinson’s disease patients in different countries. Eur Arch Otorhinolaryngol 279, 1123–1145 (2022). https://doi.org/10.1007/s00405-021-06970-8

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