Optimizing odor identification testing as quick and accurate diagnostic tool for Parkinson's disease

作者：Philipp Mahlknecht, Raimund Pechlaner, Sanne Boesveldt, Dieter Volc, Bernardette Pinter, Eva Reiter, Christoph Felix Müller, Florian Krismer, Henk W. Berendse, Jacobus Johannes van Hilten, Albert Wuschitz, Wolfgang Schimetta, Birgit Högl, Atbin Djamshidian, Michael Nocker, Georg Göbel, Arno Gasperi, Stefan Julia Kiechl, Johann Willeit, Werner H Poewe, Klaus Seppi · 发表于：Movement Disorders · 年份：2016 · DOI：10.1002/mds.26637 · 被引用次数：70 · 研究领域：Olfactory and Sensory Function Studies、Parkinson's Disease Mechanisms and Treatments、Advanced Chemical Sensor Technologies

INTRODUCTION: The aim of this study was to evaluate odor identification testing as a quick, cheap, and reliable tool to identify PD. METHODS: Odor identification with the 16-item Sniffin' Sticks test (SS-16) was assessed in a total of 646 PD patients and 606 controls from three European centers (A, B, and C), as well as 75 patients with atypical parkinsonism or essential tremor and in a prospective cohort of 24 patients with idiopathic rapid eye movement sleep behavior disorder (center A). Reduced odor sets most discriminative for PD were determined in a discovery cohort derived from a random split of PD patients and controls from center A using L1-regularized logistic regression. Diagnostic accuracy was assessed in the rest of the patients/controls as validation cohorts. RESULTS: Olfactory performance was lower in PD patients compared with controls and non-PD patients in all cohorts (each P < 0.001). Both the full SS-16 and a subscore of the top eight discriminating odors (SS-8) were associated with an excellent discrimination of PD from controls (areas under the curve ≥0.90; sensitivities ≥83.3%; specificities ≥82.0%) and from non-PD patients (areas under the curve ≥0.91; sensitivities ≥84.1%; specificities ≥84.0%) in all cohorts. This remained unchanged when patients with >3 years of disease duration were excluded from analysis. All 8 incident PD cases among patients with idiopathic rapid eye movement sleep behavior disorder were predicted with the SS-16 and the SS-8 (sens...