近日，最新一期的《大腦》（Brain）雜志發(fā)表了日本研究人員的發(fā)現(xiàn),，通過嗅覺檢查，能夠?qū)ε两鹕习Y患者容易出現(xiàn)的認(rèn)知障礙進(jìn)行早期診斷,，今后有望對帕金森氏癥患者的認(rèn)知障礙進(jìn)行早期治療,。
東京大學(xué)副教授武田篤率領(lǐng)的研究小組報告說，研究小組從2009年開始,，對尚未表現(xiàn)出認(rèn)知障礙的44名帕金森氏癥患者,，實施了識別12種氣味的檢查。結(jié)果發(fā)現(xiàn),，有10名存在重度嗅覺障礙的患者此后出現(xiàn)了認(rèn)知障礙,，而沒有嗅覺障礙的人則沒有出現(xiàn)認(rèn)知障礙。
帕金森氏癥是由于腦部多巴胺神經(jīng)細(xì)胞減少,，導(dǎo)致手腳震顫和身體僵硬的難治之癥,，而且并發(fā)認(rèn)知障礙的概率很高。
對于帕金森氏癥的震顫等癥狀,，現(xiàn)在已可用藥物療法改善,，因此他們認(rèn)為：“如果能夠迅速對認(rèn)知障礙進(jìn)行治療，將有助于改善帕金森氏癥患者的癥狀,。”（生物谷Bioon.com）
doi:10.1093/brain/awr321
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Severe olfactory dysfunction is a prodromal symptom of dementia associated with Parkinson's disease: a 3 year longitudinal study
Toru Baba, Akio Kikuchi, Kazumi Hirayama, Yoshiyuki Nishio, Yoshiyuki Hosokai, Shigenori Kanno, Takafumi Hasegawa, Naoto Sugeno, Masatoshi Konno, Kyoko Suzuki, Shoki Takahashi, Hiroshi Fukuda, Masashi Aoki, Yasuto Itoyama, Etsuro Mori and Atsushi Takeda
Dementia is one of the most debilitating symptoms of Parkinson's disease. A recent longitudinal study suggests that up to 80% of patients with Parkinson's disease will eventually develop dementia. Despite its clinical importance, the development of dementia is still difficult to predict at early stages. We previously identified olfactory dysfunction as one of the most important indicators of cortical hypometabolism in Parkinson's disease. In this study, we investigated the possible associations between olfactory dysfunction and the risk of developing dementia within a 3-year observation period. Forty-four patients with Parkinson's disease without dementia underwent the odour stick identification test for Japanese, memory and visuoperceptual assessments, 18F-fluorodeoxyglucose positron emission tomography scans and magnetic resonance imaging scans at baseline and 3 years later. A subgroup of patients with Parkinson's disease who exhibited severe hyposmia at baseline showed more pronounced cognitive decline at the follow-up survey. By the end of the study, 10 of 44 patients with Parkinson's disease had developed dementia, all of whom had severe hyposmia at baseline. The multivariate logistic analysis identified severe hyposmia and visuoperceptual impairment as independent risk factors for subsequent dementia within 3 years. The patients with severe hyposmia had an 18.7-fold increase in their risk of dementia for each 1 SD (2.8) decrease in the score of odour stick identification test for Japanese. We also found an association between severe hyposmia and a characteristic distribution of cerebral metabolic decline, which was identical to that of dementia associated with Parkinson's disease. Furthermore, volumetric magnetic resonance imaging analyses demonstrated close relationships between olfactory dysfunction and the atrophy of focal brain structures, including the amygdala and other limbic structures. Together, our findings suggest that brain regions related to olfactory function are closely associated with cognitive decline and that severe hyposmia is a prominent clinical feature that predicts the subsequent development of Parkinson's disease dementia.
