This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Dementias  • Diagnosis  • Alert me on articles by topic  Social Bookmarking   What's this?

Matteo Pardini, MD; Edward D. Huey, MD; Alyson L. Cavanagh, BS; Jordan Grafman, PhD

Arch Neurol. 2009;66(1):92-96.

Background  Formal olfactory testing may be useful as a bedside tool to help differentiate between conditions such as atypical parkinsonism, dementia, and psychiatric conditions. However, the neural basis of olfactory dysfunction, the effect of concurrent cognitive deficits on olfactory testing results, and the exact prevalence of olfactory deficits in populations with corticobasal syndrome (CBS) and the frontal variant of frontotemporal dementia (FTD-FV) are to date unclear.

Objective  To assess the prevalence and the neural basis of olfactory recognition deficits in patients with a clinical diagnosis of CBS or FTD-FV.

Design  Retrospective study of clinical, neuropsychological, and imaging data.

Setting  National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.

Participants  Twenty-five patients with CBS, 22 with FTD-FV, and 12 age-matched control subjects.

Main Outcome Measures  Results of neuropsychological evaluation, formal olfactory recognition testing (University of Pennsylvania Smell Identification Test [UPSIT]), and voxel-based morphometry analysis of structural magnetic resonance images of the brain.

Results  Mean UPSIT percentile scores were 31.6% for the CBS group and 9.5% for the FTD-FV group. The voxel-based morphometry correlations between local gray matter and UPSIT scores showed a significant volume effect in the right midfrontal gyrus for the FTD-FV patients and in the right insula, right midfrontal gyrus, and bilateral inferior frontal gyrus for the patients with CBS. A linear regression analysis of the UPSIT scores revealed as significant predictors the general memory score of the Wechsler Memory Scale and the Boston Naming Test total score for the patients with FTD-FV and the Mattis Dementia Rating Scale total score for the patients with CBS.

Conclusions  Our data showed a more severe olfactory impairment for CBS patients than previously reported. We also showed a significant relationship between formal olfactory recognition testing scores and specific cognitive domains. These findings could be useful to clinically differentiate FTD-FV and CBS from other dementing illnesses and movement disorders.

Author Affiliations: Cognitive Neuroscience Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland (Drs Pardini, Huey, and Grafman and Ms Cavanagh); and Department of Neurosciences, Ophthalmology, and Genetics, University of Genoa, Genoa, Italy (Dr Pardini).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED ARTICLE

This Month in Archives of Neurology
Arch Neurol. 2009;66(1):17-18.
FULL TEXT