BACKGROUND: The diagnosis of Parkinson's disease (PD) can be challenging early in the disease course, when motor features are subtle. The objective of this study was to explore the diagnostic value of combining acute levodopa challenge and olfactory testing to predict PD. METHODS: Data from 210 patients with a recent onset of parkinsonism who had at least 2 years of follow-up and underwent acute levodopa challenge for the clinical prediction of long-term dopaminergic response and had olfactory testing with Sniffin' Sticks Test were evaluated. Single and combined diagnostic measures were analyzed. RESULTS: After 2 years of follow-up, a PD diagnosis was confirmed in 157 patients who fulfilled United Kingdom Parkinson's Disease Society Brain Bank criteria and was ruled out in 53. Sensitivity and specificity of acute levodopa challenge to predict PD diagnosis were 0.71 and 0.94, respectively. Sensitivity and specificity of olfactory tests were calculated according to the total olfactory score for hyposmia (0.61 and 0.77 respectively), the hyposmia identification subscore (0.63 and 0.74, respectively), and the anosmia score (0.40 and 0.85, respectively). The best combination identified was response to acute levodopa challenge together with hyposmia according to the total olfactory score (sensitivity, 0.90; specificity, 0.74; positive predictive value, 0.91; negative predictive value, 0.72; accuracy, 0.86). CONCLUSION: The combination of response to acute levodopa challenge with hyposmia according to the total olfactory score improved sensitivity for the early diagnosis of PD.
BACKGROUND: The diagnosis of Parkinson's disease (PD) can be challenging early in the disease course, when motor features are subtle. The objective of this study was to explore the diagnostic value of combining acute levodopa challenge and olfactory testing to predict PD. METHODS: Data from 210 patients with a recent onset of parkinsonism who had at least 2 years of follow-up and underwent acute levodopa challenge for the clinical prediction of long-term dopaminergic response and had olfactory testing with Sniffin' Sticks Test were evaluated. Single and combined diagnostic measures were analyzed. RESULTS: After 2 years of follow-up, a PD diagnosis was confirmed in 157 patients who fulfilled United Kingdom Parkinson's Disease Society Brain Bank criteria and was ruled out in 53. Sensitivity and specificity of acute levodopa challenge to predict PD diagnosis were 0.71 and 0.94, respectively. Sensitivity and specificity of olfactory tests were calculated according to the total olfactory score for hyposmia (0.61 and 0.77 respectively), the hyposmia identification subscore (0.63 and 0.74, respectively), and the anosmia score (0.40 and 0.85, respectively). The best combination identified was response to acute levodopa challenge together with hyposmia according to the total olfactory score (sensitivity, 0.90; specificity, 0.74; positive predictive value, 0.91; negative predictive value, 0.72; accuracy, 0.86). CONCLUSION: The combination of response to acute levodopa challenge with hyposmia according to the total olfactory score improved sensitivity for the early diagnosis of PD.
Authors: P Borghammer; K Knudsen; K Østergaard; E H Danielsen; N Pavese; A Arveschoug; H Bluhme; M Bode; A Morsing Journal: Int J Clin Pract Date: 2014-04-22 Impact factor: 2.503
Authors: F Krismer; B Pinter; C Mueller; P Mahlknecht; M Nocker; E Reiter; A Djamshidian-Tehrani; S M Boesch; G K Wenning; C Scherfler; W Poewe; K Seppi Journal: Parkinsonism Relat Disord Date: 2016-11-21 Impact factor: 4.891
Authors: S Gilman; G K Wenning; P A Low; D J Brooks; C J Mathias; J Q Trojanowski; N W Wood; C Colosimo; A Dürr; C J Fowler; H Kaufmann; T Klockgether; A Lees; W Poewe; N Quinn; T Revesz; D Robertson; P Sandroni; K Seppi; M Vidailhet Journal: Neurology Date: 2008-08-26 Impact factor: 9.910
Authors: Mike A Nalls; Cory Y McLean; Jacqueline Rick; Shirley Eberly; Samantha J Hutten; Katrina Gwinn; Margaret Sutherland; Maria Martinez; Peter Heutink; Nigel M Williams; John Hardy; Thomas Gasser; Alexis Brice; T Ryan Price; Aude Nicolas; Margaux F Keller; Cliona Molony; J Raphael Gibbs; Alice Chen-Plotkin; Eunran Suh; Christopher Letson; Massimo S Fiandaca; Mark Mapstone; Howard J Federoff; Alastair J Noyce; Huw Morris; Vivianna M Van Deerlin; Daniel Weintraub; Cyrus Zabetian; Dena G Hernandez; Suzanne Lesage; Meghan Mullins; Emily Drabant Conley; Carrie A M Northover; Mark Frasier; Ken Marek; Aaron G Day-Williams; David J Stone; John P A Ioannidis; Andrew B Singleton Journal: Lancet Neurol Date: 2015-08-10 Impact factor: 44.182
Authors: Usman Saeed; Jordana Compagnone; Richard I Aviv; Antonio P Strafella; Sandra E Black; Anthony E Lang; Mario Masellis Journal: Transl Neurodegener Date: 2017-03-28 Impact factor: 8.014
Authors: Boo-Young Kim; Ju Yeon Park; Eui Jin Kim; Byung Guk Kim; Sung Won Kim; Soo Whan Kim Journal: Int Forum Allergy Rhinol Date: 2019-02-21 Impact factor: 3.858
Authors: Xiuli Dan; Noah Wechter; Samuel Gray; Joy G Mohanty; Deborah L Croteau; Vilhelm A Bohr Journal: Ageing Res Rev Date: 2021-07-27 Impact factor: 11.788