Significance of hyposmia in isolated REM sleep behavior disorder
Objective To determine if hyposmia in isolated REM sleep behavior disorder (IRBD) predicts short-term conversion to any α-synucleinopathy and declines with time. Methods Olfaction was tested using the University of Pennsylvania Smell Identification Test (UPSIT-40) in 140 consecutive patients with po...
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| Veröffentlicht in: | Journal of neurology 2021-03, Vol.268 (3), p.963-966 |
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| creator | Iranzo, Alex Marrero-González, Paula Serradell, Mónica Gaig, Carles Santamaria, Joan Vilaseca, Isabel |
| description | Objective
To determine if hyposmia in isolated REM sleep behavior disorder (IRBD) predicts short-term conversion to any α-synucleinopathy and declines with time.
Methods
Olfaction was tested using the University of Pennsylvania Smell Identification Test (UPSIT-40) in 140 consecutive patients with polysomnography-confirmed IRBD and in 77 matched controls. Patients were followed-up during 5.6 ± 3.9 (range 0.2–13) years. Twenty-one patients underwent serial UPSIT-40 evaluations at 1–3 and 4–6 years after baseline.
Results
UPSIT-40 score was lower in patients than in controls (20.2 ± 6.5 vs. 28.6 ± 5.0;
p
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| doi_str_mv | 10.1007/s00415-020-10229-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2445967125</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2445967125</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-894f8993140634e091caf7fbd1e8a0c6e96a3a68e4b9f180c4caca5c7b94ff563</originalsourceid><addsrcrecordid>eNp9kEtLAzEUhYMotlb_gAsZcONm9OYxM8lOKb6gIvhYh0zmRlOmMzVpBf-9sa0KLlxlcb5zknyEHFI4pQDVWQQQtMiBQU6BMZXzLTKkgrOcikJtkyFwAXnBCzEgezFOAUCmYJcMOFOlVFwNyfmjf-m889Z0FrPeZa8f8z7OvMl8l_nYt2aBTfZweZfFFnGe1fhq3n0fsiaFocGwT3acaSMebM4Reb66fBrf5JP769vxxSS3vCoWuVTCSaU4FVBygaCoNa5ydUNRGrAlqtJwU0oUtXJUghXWWFPYqk5FV5R8RE7Wu_PQvy0xLvTMR4ttazrsl1Ezkb5WVpQVCT3-g077ZejS6xKluJSMrSi2pmzoYwzo9Dz4mQkfmoL-8qvXfnXyq1d-NU-lo830sp5h81P5FpoAvgZiiroXDL93_zP7Cd56hGE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2493882225</pqid></control><display><type>article</type><title>Significance of hyposmia in isolated REM sleep behavior disorder</title><source>SpringerLink Journals - AutoHoldings</source><creator>Iranzo, Alex ; Marrero-González, Paula ; Serradell, Mónica ; Gaig, Carles ; Santamaria, Joan ; Vilaseca, Isabel</creator><creatorcontrib>Iranzo, Alex ; Marrero-González, Paula ; Serradell, Mónica ; Gaig, Carles ; Santamaria, Joan ; Vilaseca, Isabel</creatorcontrib><description>Objective
To determine if hyposmia in isolated REM sleep behavior disorder (IRBD) predicts short-term conversion to any α-synucleinopathy and declines with time.
Methods
Olfaction was tested using the University of Pennsylvania Smell Identification Test (UPSIT-40) in 140 consecutive patients with polysomnography-confirmed IRBD and in 77 matched controls. Patients were followed-up during 5.6 ± 3.9 (range 0.2–13) years. Twenty-one patients underwent serial UPSIT-40 evaluations at 1–3 and 4–6 years after baseline.
Results
UPSIT-40 score was lower in patients than in controls (20.2 ± 6.5 vs. 28.6 ± 5.0;
p
< 0.001). Hyposmia (UPSIT-40 score < 19 points) occurred in 42.9% patients. Forty-three (30.7%) patients developed Parkinson disease (PD = 27), dementia with Lewy bodies (DLB = 13) and multiple system atrophy (MSA = 3). Kaplan–Meier analysis showed that hyposmics had higher risk than normosmics to develop a synucleinopathy at the short term (
p
= 0.030). UPSIT-40 score was similar between patients who developed PD and DLB (
p
= 0.136). Normal smell occurred in all three (100%) IRBD patients who developed MSA, 12 of 27 (44%) who developed PD, and 4 of 13 (31%) that developed DLB. Serial UPSIT-40 evaluations showed no changes with time (
p
= 0.518).
Conclusion
In IRBD, hyposmia is a short-term risk for synucleinopathies but cannot distinguish underlying PD from DLB. Normosmia not only occurs in latent MSA but also in latent PD and DLB. In future IRBD neuroprotective trails, individuals at entry could be enriched for hyposmia, whereas serial evaluation of smell would not be useful to monitor the efficacy of a therapeutic intervention.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-020-10229-3</identifier><identifier>PMID: 32968939</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Atrophy ; Behavior disorders ; Dementia disorders ; Lewy bodies ; Medicine ; Medicine & Public Health ; Movement disorders ; Neurodegenerative diseases ; Neurology ; Neuroprotection ; Neuroradiology ; Neurosciences ; Olfaction ; Olfaction disorders ; Original Communication ; Parkinson's disease ; REM sleep ; Sleep disorders</subject><ispartof>Journal of neurology, 2021-03, Vol.268 (3), p.963-966</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-894f8993140634e091caf7fbd1e8a0c6e96a3a68e4b9f180c4caca5c7b94ff563</citedby><cites>FETCH-LOGICAL-c375t-894f8993140634e091caf7fbd1e8a0c6e96a3a68e4b9f180c4caca5c7b94ff563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-020-10229-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-020-10229-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32968939$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iranzo, Alex</creatorcontrib><creatorcontrib>Marrero-González, Paula</creatorcontrib><creatorcontrib>Serradell, Mónica</creatorcontrib><creatorcontrib>Gaig, Carles</creatorcontrib><creatorcontrib>Santamaria, Joan</creatorcontrib><creatorcontrib>Vilaseca, Isabel</creatorcontrib><title>Significance of hyposmia in isolated REM sleep behavior disorder</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>Objective
To determine if hyposmia in isolated REM sleep behavior disorder (IRBD) predicts short-term conversion to any α-synucleinopathy and declines with time.
Methods
Olfaction was tested using the University of Pennsylvania Smell Identification Test (UPSIT-40) in 140 consecutive patients with polysomnography-confirmed IRBD and in 77 matched controls. Patients were followed-up during 5.6 ± 3.9 (range 0.2–13) years. Twenty-one patients underwent serial UPSIT-40 evaluations at 1–3 and 4–6 years after baseline.
Results
UPSIT-40 score was lower in patients than in controls (20.2 ± 6.5 vs. 28.6 ± 5.0;
p
< 0.001). Hyposmia (UPSIT-40 score < 19 points) occurred in 42.9% patients. Forty-three (30.7%) patients developed Parkinson disease (PD = 27), dementia with Lewy bodies (DLB = 13) and multiple system atrophy (MSA = 3). Kaplan–Meier analysis showed that hyposmics had higher risk than normosmics to develop a synucleinopathy at the short term (
p
= 0.030). UPSIT-40 score was similar between patients who developed PD and DLB (
p
= 0.136). Normal smell occurred in all three (100%) IRBD patients who developed MSA, 12 of 27 (44%) who developed PD, and 4 of 13 (31%) that developed DLB. Serial UPSIT-40 evaluations showed no changes with time (
p
= 0.518).
Conclusion
In IRBD, hyposmia is a short-term risk for synucleinopathies but cannot distinguish underlying PD from DLB. Normosmia not only occurs in latent MSA but also in latent PD and DLB. In future IRBD neuroprotective trails, individuals at entry could be enriched for hyposmia, whereas serial evaluation of smell would not be useful to monitor the efficacy of a therapeutic intervention.</description><subject>Atrophy</subject><subject>Behavior disorders</subject><subject>Dementia disorders</subject><subject>Lewy bodies</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Movement disorders</subject><subject>Neurodegenerative diseases</subject><subject>Neurology</subject><subject>Neuroprotection</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Olfaction</subject><subject>Olfaction disorders</subject><subject>Original Communication</subject><subject>Parkinson's disease</subject><subject>REM sleep</subject><subject>Sleep disorders</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kEtLAzEUhYMotlb_gAsZcONm9OYxM8lOKb6gIvhYh0zmRlOmMzVpBf-9sa0KLlxlcb5zknyEHFI4pQDVWQQQtMiBQU6BMZXzLTKkgrOcikJtkyFwAXnBCzEgezFOAUCmYJcMOFOlVFwNyfmjf-m889Z0FrPeZa8f8z7OvMl8l_nYt2aBTfZweZfFFnGe1fhq3n0fsiaFocGwT3acaSMebM4Reb66fBrf5JP769vxxSS3vCoWuVTCSaU4FVBygaCoNa5ydUNRGrAlqtJwU0oUtXJUghXWWFPYqk5FV5R8RE7Wu_PQvy0xLvTMR4ttazrsl1Ezkb5WVpQVCT3-g077ZejS6xKluJSMrSi2pmzoYwzo9Dz4mQkfmoL-8qvXfnXyq1d-NU-lo830sp5h81P5FpoAvgZiiroXDL93_zP7Cd56hGE</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Iranzo, Alex</creator><creator>Marrero-González, Paula</creator><creator>Serradell, Mónica</creator><creator>Gaig, Carles</creator><creator>Santamaria, Joan</creator><creator>Vilaseca, Isabel</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20210301</creationdate><title>Significance of hyposmia in isolated REM sleep behavior disorder</title><author>Iranzo, Alex ; Marrero-González, Paula ; Serradell, Mónica ; Gaig, Carles ; Santamaria, Joan ; Vilaseca, Isabel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-894f8993140634e091caf7fbd1e8a0c6e96a3a68e4b9f180c4caca5c7b94ff563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Atrophy</topic><topic>Behavior disorders</topic><topic>Dementia disorders</topic><topic>Lewy bodies</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Movement disorders</topic><topic>Neurodegenerative diseases</topic><topic>Neurology</topic><topic>Neuroprotection</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Olfaction</topic><topic>Olfaction disorders</topic><topic>Original Communication</topic><topic>Parkinson's disease</topic><topic>REM sleep</topic><topic>Sleep disorders</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iranzo, Alex</creatorcontrib><creatorcontrib>Marrero-González, Paula</creatorcontrib><creatorcontrib>Serradell, Mónica</creatorcontrib><creatorcontrib>Gaig, Carles</creatorcontrib><creatorcontrib>Santamaria, Joan</creatorcontrib><creatorcontrib>Vilaseca, Isabel</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iranzo, Alex</au><au>Marrero-González, Paula</au><au>Serradell, Mónica</au><au>Gaig, Carles</au><au>Santamaria, Joan</au><au>Vilaseca, Isabel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Significance of hyposmia in isolated REM sleep behavior disorder</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>268</volume><issue>3</issue><spage>963</spage><epage>966</epage><pages>963-966</pages><issn>0340-5354</issn><eissn>1432-1459</eissn><abstract>Objective
To determine if hyposmia in isolated REM sleep behavior disorder (IRBD) predicts short-term conversion to any α-synucleinopathy and declines with time.
Methods
Olfaction was tested using the University of Pennsylvania Smell Identification Test (UPSIT-40) in 140 consecutive patients with polysomnography-confirmed IRBD and in 77 matched controls. Patients were followed-up during 5.6 ± 3.9 (range 0.2–13) years. Twenty-one patients underwent serial UPSIT-40 evaluations at 1–3 and 4–6 years after baseline.
Results
UPSIT-40 score was lower in patients than in controls (20.2 ± 6.5 vs. 28.6 ± 5.0;
p
< 0.001). Hyposmia (UPSIT-40 score < 19 points) occurred in 42.9% patients. Forty-three (30.7%) patients developed Parkinson disease (PD = 27), dementia with Lewy bodies (DLB = 13) and multiple system atrophy (MSA = 3). Kaplan–Meier analysis showed that hyposmics had higher risk than normosmics to develop a synucleinopathy at the short term (
p
= 0.030). UPSIT-40 score was similar between patients who developed PD and DLB (
p
= 0.136). Normal smell occurred in all three (100%) IRBD patients who developed MSA, 12 of 27 (44%) who developed PD, and 4 of 13 (31%) that developed DLB. Serial UPSIT-40 evaluations showed no changes with time (
p
= 0.518).
Conclusion
In IRBD, hyposmia is a short-term risk for synucleinopathies but cannot distinguish underlying PD from DLB. Normosmia not only occurs in latent MSA but also in latent PD and DLB. In future IRBD neuroprotective trails, individuals at entry could be enriched for hyposmia, whereas serial evaluation of smell would not be useful to monitor the efficacy of a therapeutic intervention.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32968939</pmid><doi>10.1007/s00415-020-10229-3</doi><tpages>4</tpages></addata></record> |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Atrophy Behavior disorders Dementia disorders Lewy bodies Medicine Medicine & Public Health Movement disorders Neurodegenerative diseases Neurology Neuroprotection Neuroradiology Neurosciences Olfaction Olfaction disorders Original Communication Parkinson's disease REM sleep Sleep disorders |
| title | Significance of hyposmia in isolated REM sleep behavior disorder |
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