Document Detail


A cross-sectional study contrasting olfactory function in autonomic disorders.
MedLine Citation:
PMID:  21282592     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare odor identification function in patients with peripheral or central autonomic neurodegeneration and in patients with intact autonomic neurons but undetectable norepinephrine.
METHODS: Olfactory function was evaluated with the University of Pennsylvania Smell Identification Test (UPSIT) in 12 patients with pure autonomic failure, 10 patients with multiple system atrophy, and 4 patients with dopamine β-hydroxylase deficiency. Blood pressure and catecholamine data were also compared.
RESULTS: Odor identification was significantly impaired in patients with pure autonomic failure relative to patients with multiple system atrophy or dopamine β-hydroxylase deficiency. Out of 40 odors, the patients correctly identified mean (95% confidence interval) 19.2 (14.1 to 24.2), 34.4 (32.2 to 36.6), and 31.7 (29.4 to 34.1) (p < 0.001). The difference between patients with pure autonomic failure and those with multiple system atrophy or dopamine β-hydroxylase deficiency persisted after adjustment for age (p = 0.001). Patients with pure autonomic failure also had a greater orthostatic fall in blood pressure and lower plasma norepinephrine levels than patients with multiple system atrophy.
CONCLUSIONS: Olfactory function was relatively intact in patients with dopamine β-hydroxylase deficiency, who have intact noradrenergic neurons but lack norepinephrine. Odor identification was impaired in pure autonomic failure but not in multiple system atrophy, suggesting that 1) peripheral noradrenergic innervation is important for olfactory identification but norepinephrine is not essential and 2) UPSIT may be useful in the differential diagnosis between these disorders.
Authors:
E M Garland; S R Raj; A C Peltier; D Robertson; I Biaggioni
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurology     Volume:  76     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-01     Completed Date:  2011-03-28     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  456-60     Citation Subset:  AIM; IM    
Affiliation:
Autonomic Dysfunction Center, AA3228 Medical Center North, Vanderbilt University, Nashville, TN 37232-2195, USA. emily.garland@vanderbilt.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Autonomic Nervous System Diseases / complications*,  diagnosis,  physiopathology*
Cross-Sectional Studies
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Multiple System Atrophy / complications,  diagnosis,  physiopathology
Neurologic Examination / methods
Olfaction Disorders / complications*,  diagnosis,  physiopathology*
Physical Examination / methods
Predictive Value of Tests
Pure Autonomic Failure / complications,  diagnosis,  physiopathology
Smell / genetics,  physiology*
Grant Support
ID/Acronym/Agency:
P01 HL56693/HL/NHLBI NIH HHS; R01 HL071784/HL/NHLBI NIH HHS; R01 NS055670/NS/NINDS NIH HHS; UL1 RR024975/RR/NCRR NIH HHS
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