Performance of a cost-effective olfactory test to evaluate hyposmia in Parkinson's disease patients

Arruda, Josevânia Fulgêncio de Lima; Silva, Liene Duarte; Brisson, Rodrigo Tavares; Micheli, Gabriel de Castro; Lima, Marco Antônio Sales Dantas de; Rosso, Ana Lucia Zuma de; Fernandes, Rita de Cássia Leite

doi:10.1055/s-0044-1787139

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Original Article • Arq. Neuro-Psiquiatr. 82 (5) • 2024 • https://doi.org/10.1055/s-0044-1787139 linkcopy

Performance of a cost-effective olfactory test to evaluate hyposmia in Parkinson's disease patients

Desempenho de um teste de olfato de bom custo-benefício na avaliação de hiposmia em pacientes com doença de Parkinson

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background Parkinson's disease (PD) causes motor and non-motor symptoms such as hyposmia, which is evaluated through olfactory tests in the clinical practice.

Objective To assess the feasibility of using the modified Connecticut Chemosensory Clinical Research Center (mCCCRC) olfactory test and to compare its performance with the Sniffin' Sticks-12 (SS-12, Burghart Messtechnik GmbH, Wedel, Germany) test.

Methods A transversal case-control study in which the patients were divided into the PD group (PDG) and the control group (CG). The cost and difficulty in handling substances to produce the mCCCRC test kits were evaluated. Sociodemographic characteristics, smoking habits, past coronavirus disease 2019 (COVID-19) infections, self-perception of odor sense, and cognition through the Montreal Cognitive Assessment (MoCA) were also evaluated. The PDG was scored by part III of the Unified Parkinson's Disease Rating Scale (UPDRS-III) and the Hoehn and Yahr Scale (H&Y) scale. Correlations were assessed through the Spearman rank correlation coefficient test (ρ, or rho).

Results The mCCCRC test was easily manufactured and handled at a cost ten times lower compared with the SS-12. The groups (PDG: n = 34; CG: n = 38) were similar in terms of age, sex, level of schooling, smoking habits, and history of COVID-19. The tests results showed moderate correlation (rho = 0.65; p < 0.0001). The CG presented better cognitive performance and scored better in both tests (p < 0.0001). There was a tendency for a negative correlation with age, but good correlation with the MoCA (p = 0.0029). The results of the PDG group showed no correlation with olfactory results and motor performance or disease duration. The self-perception of hyposmia was low in both groups.

Conclusion The mCCCRC is an easy-to-apply and inexpensive method that demonstrated a similar performance to that of the SS-12 in evaluating olfaction in PD patients and healthy controls.

Keywords
Olfaction Disorders; Anosmia; Parkinson Disease

		CG	PDG	p
N		38	34
Age (years): mean(± SD)		65.5(± 6.2)	68.5(± 8.2)	0.5631
Male gender: %		71.0	67.6	0.7541
> 8 years of schooling: %		39.5	38.3	0.2788
Disease duration (years): mean(± SD)		−	7.6(± 5.8)
Smoking: %	Current smoker	5.3	0	< 0.001
Smoking: %	Ex-smoker	60.5	35.3	< 0.001
Past COVID-19: %		3 (8.8)	10 (26.3)	< 0.001
Hoehn&Yahr scale (in stages I-III): %		−	85.2
UPDRS-III points: mean(± SD)		−	28.1(± 13.6)
MoCA points: mean(± SD)		21.3(± 4.0)	17.1(± 6.2)	0.003
SS-12 hits: mean(± SD)		7.76(± 2.0)	4.70(± 2.3)	< 0.0001
mCCCRC hits: mean(± SD)		4.63(± 2.1)	1.17(± 1.6)	< 0.0001

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[TFN1] Abbreviations: CG, control group; COVID-19, coronavirus disease 2019; mCCCRC, modified Connecticut Chemosensory Clinical Research Center olfactory test; MoCA, Montreal Cognitive Assessment; PDG, Parkinson's disease group; SD, standard deviation; SS-12, Sniffin' Sticks-12 test; UPDRS-III, Unified Parkinson's Disease Rating Scale part III.