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Identifying the Pattern of Olfactory Deficits in Parkinson Disease Using the Brief Smell Identification Test
Kay L. Double, PhD;
Dominic B. Rowe, PhD;
Michael Hayes, FRACP;
Daniel K. Y. Chan, MD;
Jeff Blackie, FRACP;
Alastair Corbett, FRACP;
Ronald Joffe, FRACP;
Victor S. Fung, PhD;
John Morris, DM;
Glenda M. Halliday, PhD
Arch Neurol. 2003;60:545-549.
Background Selective olfactory deficits occur in 70% to 90% of patients with Parkinson disease, independent of disease severity and duration. Olfactory testing may be a useful diagnostic aid for Parkinson disease, but the types of odors most commonly affected need to be identified.
Objective To determine the pattern and types of odors affected in Parkinson disease by means of the University of Pennsylvania 12-item Brief Smell Identification Test (B-SIT; Sensonics, Inc, Haddon Heights, NJ).
Design Testing patients with Parkinson disease and control subjects in 5 movement disorder clinics.
Participants Forty-nine nondemented patients with Parkinson disease and 52 age- and sex-matched controls.
Main Outcome Measures Normal or abnormal olfactory function was determined in each subject according to predetermined age and sex norms. Predictive statistics and discriminant function analyses were performed to determine the pattern and types of odors best discriminating patients from controls.
Results Abnormal olfactory function was present in 40 (82%) of patients compared with 12 (23%) of controls. The B-SIT score was unaffected by smoking behavior, disease duration, or severity. The sensitivity of the B-SIT for Parkinson disease was 0.82, with a specificity and predictive value of 0.82 and 0.77, respectively. Only 5 of the 12 B-SIT odors (gasoline, banana, pineapple, smoke, and cinnamon) were required to adequately discriminate patients with Parkinson disease from controls.
Conclusions With the use of the B-SIT, 5 specific odors appear primarily affected in patients with Parkinson disease. Significantly, the ability of patients to detect some odors was unimpaired compared with that of controls. Better diagnostic aids could be developed on the basis of the selective pattern of hyposmia observed in Parkinson disease.
From the Prince of Wales Medical Research Institute (Drs Double and Halliday) and Department of Aged Care and Rehabilitation, Bankstown Hospital (Dr Chan), University of New South Wales, Sydney, Australia; Department of Neurology, Royal North Shore Hospital, Sydney (Dr Rowe and Joffe); Department of Neurology, Concord Hospital, Sydney (Drs Hayes and Corbett); Neurology Department, John Hunter Hospital, Newcastle, Australia (Dr Blackie); and Department of Neurology, Westmead Hospital, Sydney (Drs Fung and Morris).
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