Significance of hyposmia in isolated REM sleep behavior disorder.
Dementia with lewy bodies
Hyposmia
Parkinson disease
REM sleep behavior disorder
Synucleinopathy
UPSIT-40
Journal
Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
13
07
2020
accepted:
14
09
2020
revised:
11
09
2020
pubmed:
25
9
2020
medline:
22
6
2021
entrez:
24
9
2020
Statut:
ppublish
Résumé
To determine if hyposmia in isolated REM sleep behavior disorder (IRBD) predicts short-term conversion to any α-synucleinopathy and declines with time. Olfaction was tested using the University of Pennsylvania Smell Identification Test (UPSIT-40) in 140 consecutive patients with polysomnography-confirmed IRBD and in 77 matched controls. Patients were followed-up during 5.6 ± 3.9 (range 0.2-13) years. Twenty-one patients underwent serial UPSIT-40 evaluations at 1-3 and 4-6 years after baseline. UPSIT-40 score was lower in patients than in controls (20.2 ± 6.5 vs. 28.6 ± 5.0; p < 0.001). Hyposmia (UPSIT-40 score < 19 points) occurred in 42.9% patients. Forty-three (30.7%) patients developed Parkinson disease (PD = 27), dementia with Lewy bodies (DLB = 13) and multiple system atrophy (MSA = 3). Kaplan-Meier analysis showed that hyposmics had higher risk than normosmics to develop a synucleinopathy at the short term (p = 0.030). UPSIT-40 score was similar between patients who developed PD and DLB (p = 0.136). Normal smell occurred in all three (100%) IRBD patients who developed MSA, 12 of 27 (44%) who developed PD, and 4 of 13 (31%) that developed DLB. Serial UPSIT-40 evaluations showed no changes with time (p = 0.518). In IRBD, hyposmia is a short-term risk for synucleinopathies but cannot distinguish underlying PD from DLB. Normosmia not only occurs in latent MSA but also in latent PD and DLB. In future IRBD neuroprotective trails, individuals at entry could be enriched for hyposmia, whereas serial evaluation of smell would not be useful to monitor the efficacy of a therapeutic intervention.
Identifiants
pubmed: 32968939
doi: 10.1007/s00415-020-10229-3
pii: 10.1007/s00415-020-10229-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
963-966Références
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