Improved diagnosis of Parkinson's disease from a detailed olfactory phenotype

Richard C. Gerkin, Charles Howard Adler, Joseph G. Hentz, Holly A. Shill, Erika M Driver-Dunckley, Shyamal Mehta, Marwan N. Sabbagh, John Nathaniel Caviness, Brittany N. Dugger, Geidy Serrano, Christine Belden, Brian H. Smith, Lucia Sue, Kathryn J. Davis, Edward Zamrini, Thomas G. Beach

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: To assess the predictive potential of the complete response pattern from the University of Pennsylvania Smell Identification Test for the diagnosis of Parkinson's disease. Methods: We analyzed a large dataset from the Arizona Study of Aging and Neurodegenerative Disorders, a longitudinal clinicopathological study of health and disease in elderly volunteers. Using the complete pattern of responses to all 40 items in each subject's test, we built predictive models of neurodegenerative disease, and we validated these models out of sample by comparing model predictions against postmortem pathological diagnosis. Results: Consistent with anatomical considerations, we found that the specific test response pattern had additional predictive power compared with a conventional measure - total test score - in Parkinson's disease, but not Alzheimer's disease. We also identified specific test questions that carry the greatest predictive power for disease diagnosis. Interpretation: Olfactory ability has typically been assessed with either self-report or total score on a multiple choice test. We showed that a more accurate clinical diagnosis can be made using the pattern of responses to all the test questions, and validated this against the "gold standard" of pathological diagnosis. Information in the response pattern also suggests specific modifications to the standard test that may optimize predictive power under the typical clinical constraint of limited time. We recommend that future studies retain the individual item responses for each subject, and not just the total score, both to enable more accurate diagnosis and to enable additional future insights.

Original languageEnglish (US)
JournalAnnals of Clinical and Translational Neurology
DOIs
StateAccepted/In press - 2017

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Parkinson Disease
Phenotype
Neurodegenerative Diseases
Aptitude
Smell
Self Report
Longitudinal Studies
Volunteers
Alzheimer Disease
Health

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Improved diagnosis of Parkinson's disease from a detailed olfactory phenotype. / Gerkin, Richard C.; Adler, Charles Howard; Hentz, Joseph G.; Shill, Holly A.; Driver-Dunckley, Erika M; Mehta, Shyamal; Sabbagh, Marwan N.; Caviness, John Nathaniel; Dugger, Brittany N.; Serrano, Geidy; Belden, Christine; Smith, Brian H.; Sue, Lucia; Davis, Kathryn J.; Zamrini, Edward; Beach, Thomas G.

In: Annals of Clinical and Translational Neurology, 2017.

Research output: Contribution to journalArticle

Gerkin, RC, Adler, CH, Hentz, JG, Shill, HA, Driver-Dunckley, EM, Mehta, S, Sabbagh, MN, Caviness, JN, Dugger, BN, Serrano, G, Belden, C, Smith, BH, Sue, L, Davis, KJ, Zamrini, E & Beach, TG 2017, 'Improved diagnosis of Parkinson's disease from a detailed olfactory phenotype', Annals of Clinical and Translational Neurology. https://doi.org/10.1002/acn3.447
Gerkin, Richard C. ; Adler, Charles Howard ; Hentz, Joseph G. ; Shill, Holly A. ; Driver-Dunckley, Erika M ; Mehta, Shyamal ; Sabbagh, Marwan N. ; Caviness, John Nathaniel ; Dugger, Brittany N. ; Serrano, Geidy ; Belden, Christine ; Smith, Brian H. ; Sue, Lucia ; Davis, Kathryn J. ; Zamrini, Edward ; Beach, Thomas G. / Improved diagnosis of Parkinson's disease from a detailed olfactory phenotype. In: Annals of Clinical and Translational Neurology. 2017.
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