Association Between Autonomic Dysfunctions And Olfactory Dysfunction In Parkinson's Disease

Objective:To investigate the relationship between autonomic dysfunctions and olfactory dysfunction in Parkinson's disease.Methods:Data of demography,disease duration,Hoehn-Yahr stage,Mini-Mental State Examination?MMSE?,Montreal Cognitive Assessment?MoCA?,16-item Sniffin'Sticks odor identification?SS-16?and Scales for Outcomes in Parkinson's Disease–Autonomic Questionnaire?SCOPA-AUT?of 420 PD patients from in-patient and out-patient department of Shanghai Ruijin Hospital was collected during 2014 to 2018.Groups of PD patients with or without olfactory dysfunction were compared in terms of demography,MMSE,MoCA,SS-16,SCOPA-AUT and its subparts.Linear regression was used to assess the correlation between each symptom/item of SCOPA-AUT and SS-16 scores.Binominal logistic regression was performed to determine the relationship between each symptom/item of SCOPA-AUT with olfactory dysfunctions.Results:Scores of SCOPA-AUT and its subparts,including‘gastrointestinal symptoms',‘urinary symptoms',‘cardiovascular symptoms'and‘thermoregulatory symptoms and pupillomotor dysfunction',are statistically different in PD patients with and without olfactory dysfunction with p values of the aforementioned parts as 0.001,0.007,0.007,0.009 and 0.018,respectively.The 1^st item‘choking or difficulty in swallowing'and the 10^th item‘incomplete emptying'was correlated with SS-16 scores,with p value of 0.037 and 0.016,respectively.The 2^nd item‘sialorrhea',the 6^th item‘straining for defecation',the 13^th item‘nocturia'and the 14^th item‘lightheaded when standing up'are associated with olfactory dysfunction in PD patients(p value and OR of the 2^nd item:0.027,1.865;p value and OR of the 6^th item:0.007,2.151;p value and OR of the 14^th item:0.021,1.943;p value and OR of the 14^th item:0.006,2.294).Conclusions:Olfactory dysfunction is the risk factor of‘sialorrhea',‘straining for defecation',‘nocturia'and‘lightheaded when standing up'.Olfactory dysfunction is correlated with autonomic dysfunctions.