Objective: Our aim was to obtain tremor data of PD and ET patients and the results of their olfactory function, which can help verify our scientific hypothesis on the inverse relation between tremor manifestation and olfactory function decay: lower tremor is accompanied with worse smell perception, and vice versa.

Background: Millions of people suffer from neurological disorders worldwide. Parkinson’s disease (PD) and essential tremor (ET) are among the leading diseases. Expected global PD rate is about 17 million people by 2040. Varying in manifestation, it exhibits some differences for PD and ET: rest tremor for PD and postural-kinetic for ET. Olfactory dysfunction has been reported as the first manifest of PD often preceding the movement disorders, however, it is not specific for ET. Thus, it becomes effective in early differential diagnosis. Tremor records of arms also supports correct diagnosis of the disease at early stage.

Method: We had three groups of patients: suffering from PD, ET and healthy people. An examination procedure of olfactory function was based on extended olfactory Sniffin’ sticks test to determine three parameters: threshold, identification and discrimination. For tremor testing we used wireless device to monitor electrophysiological signals. Four sensors recorded three main characteristics: skin electromyogram (SEMG), gyroscope and accelerations. We used an elastic map technique to cluster and analyze all data.

Results: Combination of tremor data and smell perception provides a clear and apparent distinction of PD patients from ET ones. Proven inverse relation between tremor level and olfactory function decay is the core result of our work. Indeed, ET patients showed better olfactory function results accompanied by stronger tremor, as compared to PD patients. Few ET patients occupy the cluster comprising PD patients, and the reason for that is the lower olfactory function observed on them. This fact forces to continue their observation in dynamics, keeping in mind that such patients have a high chance of PD development in the future.

Conclusion: Combination of olfactory testing and tremor records improves significantly the discrimination of PD patients from those with ET, as well from healthy people. The presented results could be implemented for early differential diagnostics of PD vs. ET, as well as for the improvement of individual therapy course for such patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/correlation-between-olfactory-dysfunction-and-intensity-of-tremor/