Tuesday, June 01, 2010

The nose knows: Go (olfactoray abilities) lose as an early indicator or Parkinson's

My educational and school psychology colleagues often question the value and purpose of including general olfactory (Go) abilities in the CHC framework. My response is that CHC framework has relevance in more than just educational psychological assessment, and is relevant to understanding and diagnosing human functioning in a variety of clinical, medical, neuropsychological, etc. settings.

The article below is yet another example of the importance in understanding Go abilities. 

Author(s)        Hisayoshi Oka, Chizuko Toyoda, Makiko Yogo & Soichiro Mochio
DOI        10.1007/s00415-009-5447-1
Olfactory dysfunction and cardiovascular dysautonomia in Parkinson’s disease
Journal    Journal of Neurology
Publisher    Springer Berlin / Heidelberg
ISSN    0340-5354 (Print) 1432-1459 (Online)
Issue    Volume 257, Number 6 / June, 2010
Pages    969-976


Several studies have reported that olfactory dysfunction is an early neuropathological manifestation of Parkinson’s disease (PD). Reduced cardiac meta-iodobenzylguanidine (123I-MIBG) uptake may be one of the earliest signs of PD. We studied the relation of olfactory dysfunction to cardiovascular dysautonomia in patients with PD. The study group comprised 66 patients with PD (70.5 years) and 26 controls (70.3 years) for olfactory assessment, 21 controls (72.1 years) for cardiac 123I-MIBG scintigraphy and heart rate variability (HRV), assessed using the coefficient of variation for RR intervals (HRV), and 23 controls (69.2 years) for orthostatic blood pressure response. Olfactory function was assessed by the odor stick identification test Japan (OSIT-J), and cardiovascular autonomic function was evaluated by 123I-MIBG scintigraphy of the heart, the fall in orthostatic blood pressure, and HRV. Patients with PD had a significantly lower OSIT-J score than did the controls (4.1 ± 3.0 vs. 9.9 ± 1.7, p = 0.001). The OSIT-J score was unrelated to variables other than gender, including age, disease duration, motor score on the unified Parkinson’s disease rating scale, score on the mini-mental state examination, motor phenotype, visual hallucinations, and dopaminergic medication on multiple regression and logistic regression analyses. The OSIT-J score was related to the heart/mediastinum ratio of cardiac 123I-MIBG uptake, the fall in orthostatic blood pressure, and HRV, after adjustment for other clinical variables. Olfactory dysfunction in PD was, thus, significantly related to both cardiac sympathetic and parasympathetic dysfunction, as well as vascular sympathetic dysfunction. As non-motor symptoms of PD, olfactory dysfunction and autonomic network failure appear to be closely related in PD.

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