Objective: We hypothesis that olfactory dysfunction, could be an independent predictor of gait disturbance in early PD.

Background: The pathophysiology of gait disturbance is not fully understood, but cholinergic dysfunction may be associated with gait as a non-dopaminergic contributor. Recently, central cholinergic activity is closely related with olfaction in PD patients, and it can be estimated with single transmagnetic stimulation (TMS) such as short-latency afferent inhibition (SAI).

Methods: All participants confirmed normal olfactory bulve with flexible fiberoptic laryngoscope and performed Korean version of the Sniffin’ stick (KVSS) test. The gait parameters during 10 m gait consisted of time for walking, number of steps, gait speed, stride length, stride time. SAI was measured by conditioning motor evoked potentials, elicited by TMS of the motor cortex, with electrical stimuli delivered to the contralateral median nerve at intervals ranging from N20 to N20+4ms. Unified Parkinson’s Disease Rating Scale (UPDRS), Hoehn and Yahr (H&Y) stage, Korean version of Mini-Mental Status Examination (K-MMSE), Korean version of Montreal Cognitive Assessment (K-MoCA), Beck depression inventory (BDI) were evaluated.

Results: 40 patients (normosmia:14, hyposmia:14, anosmia:12) data were analyzed. In aforementioned three groups, PD with anosmia group showed difference in age (p=0.01), UPDRS-III (p<0.01), H&Y stage (p=0.05), K-MMSE (p<0.01), and olfactory function tested by KVSS showed hierachial gradient between each group. In gait analysis, time for walking (p=0.01), number of steps (p=0.03), gait speed (p=0.02), and stride length (p=0.03) were significantly reduced in patients with anosmia group than hyposmia and normosmia group. An electrophysiologic parameters using SAI(%) N21ms (p=0.02), N22ms (p=0.05), N23ms (p<0.01), N24ms (p<0.01), and integrated SAI (p=0.01) showed significant difference among three groups. In correlation analysis gait speed showed highly positive association with TDI score (p=0.459, p<0.01).

Conclusions: In this study, olfactory dysfunction and gait disturbance was well related, in addition SAI which reflect the central cholinergic dysfunction showed difference as the degree of olfactory dysfunction. Therefore, central cholinergic dysfunction, especially olfactory dysfunction, could be a kind of non-dopaminergic contributor of gait disturbance in early PD patients.

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/gait-disturbance-and-olfactory-dysfunction-is-associated-with-central-cholinergic-dysfunction-in-early-parkinsons-disease/