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CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(09): 908-913
DOI: 10.1055/s-0042-1755268
Original Article

Evaluation of the complete Sniffin Sticks Test versus its subtests in differentiating Parkinson's disease patients from healthy controls

Avaliação do Sniffin Sticks Test completo versus seus subtestes na diferenciação de pacientes com doença de Parkinson de controles sem a doença
Sheila Trentin 
1   Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Serviço de Neurologia, Porto Alegre RS, Brazil.
,
Bruno Samuel Fraiman de Oliveira 
1   Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Serviço de Neurologia, Porto Alegre RS, Brazil.
2   Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Serviço de Neurologia, Porto Alegre RS, Brazil.
,
Yuri Ferreira Felloni Borges 
1   Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Serviço de Neurologia, Porto Alegre RS, Brazil.
,
Carlos Roberto de Mello Rieder 
3   Universidade Federal de Ciências da Saúde de Porto Alegre, Santa Casa de Misericórdia de Porto Alegre, Faculdade de Medicina, Serviço de Neurologia, Porto Alegre RS, Brazil.
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Abstract

Background Hyposmia is one of the most common, as well as the first nonmotor condition in Parkinson disease (PD). The sniffin sticks test (SST) evaluates three different aspects of olfactory function: threshold (T), discrimination (D), and identification (I). The sum of the scores of these three subtests produce a global score of olfaction, the Threshold-Discrimination-Identification (TDI) score.

Objective The aim of this study was to investigate if the TDI score or one of its subtests is better to discriminate PD patients from controls.

Methods We recruited 27 PD patients and 17 healthy age-matched controls (HC) who were evaluated through a clinical interview, the Montreal Cognitive Assessment and Movement Disorders Society – Unified Parkinson Disease Rating Scale. The olfaction was assessed using the complete SST.

Results The performance of PD patients on the olfactory test was significantly worse when compared with the HC (T: 3.0 vs. 6.5, p < 0.001; D: 8.1 vs. 11.2, p < 0.001; I: 7.3 vs. 11.7, p < 0.001; TDI: 18.8 vs. 29.9, p < 0.001). The prevalence of olfaction impairment in our study (PD: 100%, and HC: 56%) was greater than that found in the literature. Cognition influenced the performance on TDI. The olfactory subtests were impaired proportionally between patients and controls. Furthermore, D and I were correlated, but only in PD patients. The TDI showed a tendency to better discriminate PD patients from HC, when compared with its subtests.

Conclusions Although the complete olfactory evaluation is time consuming, it seems to be a superior tool to identify olfaction impairment in PD patients, when compared with the isolated subtests.

Resumo

Antecendentes Hiposmia é um dos sintomas mais comuns da doença de Parkinson (DP), além de ser um de seus primeiros sintomas não-motores. O Sniffin Sticks Test avalia três diferentes aspectos da função olfatória: limiar (L), discriminação (D) e identificação (I). A soma dos escores desses três subtestes produz um escore global do olfato, o Threshold-Discrimination-Identification (TDI).

Objetivo O objetivo deste estudo foi investigar se o TDI ou um de seus subtestes seria melhor em discriminar pacientes com DP de controles saudáveis.

Métodos Foram recrutados 27 pacientes com DP e 17 controles saudáveis de mesma faixa etária, que foram avaliados através de uma entrevista clínica, a Montreal Cognitive Assessment e Movement Disorders Society – Unified Parkinson Disease Rating Scale. O olfato foi examinado através da bateria completa do Sniffin Sticks Test (SST).

Resultados Os pacientes com DP tiveram pior performance no teste olfatório quando comparados com os controles (L: 3,0 vs. 6,5; p < 0,001; D: 8,1 vs. 11,2; p < 0,001; I: 7,3 vs. 11,7; p < 0,001; TDI: 18,8 vs. 29,9; p < 0,001). A prevalência de comprometimento olfatório no nosso estudo (DP: 100%, e controles: 56%) foi maior do que a reportada na literatura. A cognição influenciou a performance no TDI. Os subtestes olfatórios foram afetados proporcionalmente entre pacientes e controles. Além disso, D e I se correlacionaram, mas apenas em pacientes de DP. O TDI mostrou uma tendência em melhor discriminar pacientes de DP dos controles, quando comparado com os seus subtestes.

Conclusões Embora a avaliação olfatória completa consuma tempo, ela parece ser superior aos subtestes isolados para identificar comprometimento olfatório em pacientes com DP.

Keywords

Parkinson Disease - Anosmia - Smell

Palavras-chave

Doença de Parkinson - Anosmia - Olfato

Authors' Contributions

CRMR: conceptualization; BSFO, ST: data collection and writing; CRMR, YFFB: review and editing.




Publication History

Received: 21 May 2021

Accepted: 22 October 2021

Article published online:
18 October 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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