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Diffusion tensor imaging and olfactory identification testing in early-stage Parkinson's disease

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Abstract

Evidence from imaging, clinical studies, and pathology suggests that Parkinson’s disease is preceded by a prodromal stage that predates clinical diagnosis by several years but there is no established method for detecting this stage. Olfactory impairment, which is common in Parkinson’s disease and often predates clinical diagnosis, may be a useful biomarker for early Parkinson’s. Evidence is emerging that diffusion imaging parameters might be altered in olfactory tract and substantia nigra in the early stages of clinical Parkinson’s disease, possibly reflecting pathological changes. However, no study has examined olfaction and diffusion imaging in olfactory tract and substantia nigra in the same group of patients. The present study compared newly diagnosed Parkinson’s disease patients with a matched control group using both olfactory testing and diffusion tensor imaging of the substantia nigra and anterior olfactory structures. Fourteen patients with stage 1–2 Hoehn & Yahr Parkinson’s disease were matched to a control group by age and sex. All subjects then completed the University of Pennsylvania Smell Identification Test, as well as a series of MRI scans designed to examine diffusion characteristics of the olfactory tract and the substantia nigra. Olfactory testing revealed significant impairment in the patient group. Diffusion tensor imaging revealed significant group differences in both the substantia nigra and anterior olfactory region, with fractional anisotropy of the olfactory region clearly distinguishing the Parkinson’s subjects from controls. This study suggests that there may be value in combining behavioral (olfaction) and MRI testing to identify early Parkinson’s disease. Since loss of olfaction often precedes the motor symptoms in Parkinson’s disease, the important question raised is “will the combination of olfactory testing and MRI (DTI) testing identify pre-motor Parkinson’s disease?”

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Acknowledgments

TR is grateful to the Faculty of Medicine at Dalhousie University (RAL) for the postdoctoral support grant. We are grateful to Carl Helmick and the staff of the MRI suite, IWK Health Sciences Centre for assistance. Supported by the Dalhousie University Department of Psychiatry Research Fund, Canadian Institutes of Health Research and the Parkinson Society Canada.

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Authors and Affiliations

  1. Department of Pharmacology, Dalhousie University, Halifax, NS, Canada

    Tyler M. Rolheiser & Harold A. Robertson

  2. Department of Psychology, Dalhousie University, Halifax, NS, Canada

    Heather G. Fulton

  3. Department of Psychiatry, Dalhousie University, Halifax, NS, Canada

    Kimberley P. Good & John D. Fisk

  4. Department of Anatomy and Neurobiology, Dalhousie University, Halifax, NS, Canada

    Ronald A. Leslie

  5. Department of Medicine/Neurology, Dalhousie University, Halifax, NS, Canada

    J. Roger McKelvey

  6. Department of Diagnostic Imaging, Dalhousie University, Halifax, NS, Canada

    Naeem M. Khan

  7. Department of Neurology, Innsbruck Medical University, Innsbruck, Austria

    Christophe Scherfler

  8. Brain Repair Centre and Department of Pharmacology, Faculty of Medicine, Dalhousie University, 5850 College Street, Halifax, NS, B3H 1X5, Canada

    Harold A. Robertson

Authors
  1. Tyler M. Rolheiser
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  2. Heather G. Fulton
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  3. Kimberley P. Good
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  4. John D. Fisk
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  5. J. Roger McKelvey
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  6. Christophe Scherfler
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  7. Naeem M. Khan
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  8. Ronald A. Leslie
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  9. Harold A. Robertson
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Correspondence to Harold A. Robertson.

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Rolheiser, T.M., Fulton, H.G., Good, K.P. et al. Diffusion tensor imaging and olfactory identification testing in early-stage Parkinson's disease. J Neurol 258, 1254–1260 (2011). https://doi.org/10.1007/s00415-011-5915-2

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  • DOI: https://doi.org/10.1007/s00415-011-5915-2

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