Objective: The aim of this study was to evaluate motor features in the OFF and ON states and the acute levodopa response in Parkinson’s disease (PD) patients with normosmia compared to those with olfactory impairment.

Background: PD patients with normal olfactory function may have a different clinical phenotype than those patients with olfactory impairment as recently described.

Methods: Data of 169 de novo PD patients (mean age, 64.1±0.7 years; range, 25-84 years; 104 men) that underwent olfactory testing with Sniffin’ Sticks Test and were submitted to acute levodopa challenge for clinical prediction of sustained long-term dopaminergic response, who two years later fulfilled UKPDSBB criteria for PD, were analyzed. MDS-UPDRS-III OFF and ON scores, degree of improvement on acute levodopa challenge were recorded.

Results: The overall frequency of normosmia was 33%. Gender ratio was equal in normosmic patients (50%), whereas it was significantly different among hyposmic patients (73% of males). Normosmic PD patients scored comparably to hyposmic and anosmic PD patients on the MDS-UPDRS-III scale in both OFF (p=0.4) and ON (p=0.3) states, degree of improvement with levodopa (p=0.3) and total tremor (p=0.2) and postural instability/gait disorder subscores (p=0.5), after controlling for age and gender.

Conclusions: Normal olfactory function is common in early PD and was not associated with a better motor performance in comparison to PD patients with olfactory dysfunction.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/motor-features-and-response-to-levodopa-in-parkinsons-disease-with-normal-olfactory-function/