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Olfactory Impairment Predicts Underlying Dopaminergic Deficit in Presumed Drug‐Induced Parkinsonism
Author(s) -
Morley James F.,
Cheng Gang,
Dubroff Jacob G.,
Wood Stephanie,
Wilkinson Jayne R.,
Duda John E.
Publication year - 2016
Publication title -
movement disorders clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.754
H-Index - 18
ISSN - 2330-1619
DOI - 10.1002/mdc3.12458
Subject(s) - parkinsonism , dopaminergic , neuroscience , parkinson's disease , medicine , psychology , dopamine , disease
Abstract Drug‐induced parkinsonism ( DIP ) is common, and the motor symptoms can be indistinguishable from Parkinson's disease ( PD ). When symptoms persist after drug withdrawal, this may represent “unmasking” of underlying PD . We previously reported that hyposmia, a common nonmotor feature of PD , was associated with persistent DIP . Here, we report on a series of 33 consecutive patients who underwent dopamine transporter imaging to evaluate DIP . We examined the clinical correlates of underlying dopaminergic denervation by comparing subjects with normal and abnormal scans. Imaging was abnormal in 7 of 33 (21%) cases. Motor features were similar in patients with normal and abnormal scans. Olfactory testing was available for 30 subjects and was concordant with imaging in 27 of 30 (odds ratio = 63; 95% confidence interval: 4.8–820; P = 0.002). Olfactory testing may be a simple screen to help identify DIP patients with underlying dopaminergic denervation, consistent with unmasking of incipient PD .