Relationship Between Loss Of Sense Of Hyposmia And Mild Cognitive Impairment In Patients With Parkinson’s Disease

Background and Objective:Parkinson’s disease is a degenerative disease of the nervous system, the progress of the disease is slow, common in the elderly. The main clinical manifestations of resting tremor, bradykinesia, rigidity, postural reflex abnormalities. With the development and deepening of the research of PD,more and more researchers have found that in addition to its classic movement symptoms, autonomic nervous system dysfunction, sensory disturbances, sleep disorders, cognitive function and other non-motor symptoms are also important for their clinical performance. There may be some associations between non-motor symptoms. Olfactory dysfunction and cognitive impairment more common in clinical manifestations, they not only increased the other clinical symptoms of PD patients, but also led to a serious decline in the quality of life of patients with PD, but also increased the mortality and mortality rate of PD. Currently on olfactory dysfunction and cognitive impairment in PD pathogenesis and patients link between the two is not clear. Studies have reported cognitive impairment in PD patients sometimes without their knowledge to olfactory dysfunction. Therefore,loss of sense of smell may be associated with cognitive impairment in patients with PD.In recent years, Hely et al. In many years of follow-up study of PD patients, the proportion of cognitive impairment in patients with PD was up to 40%, the impact of cognitive impairment on the daily life of patients is significant,one of the key factors to determine the quality of life of patients. Studies have shown that cognitive impairment in PD patients with olfactory disorders, depression, hallucinations and other symptoms are more common. Olfactory dysfunction, as one of the non motor symptoms, has a certain relationship with cognitive function. From the analysis of neuroanatomy, Olfactory brain structures including some neural and cognitive function related to the frontal temporal lobe cortex, olfactory pathway also thalamus dorsomedial nucleus of the hypothalamus, which are extensive fiber connection. Moreover, the olfactory brain is also involved in human cognitive behavior,olfactory function only reflect part of the brain function. When the olfactory brain pathological changes, olfactory dysfunction and cognitive impairment may exist.The purpose of this study is to investigate the relationship between the degree of cognitive impairment and cognitive status in patients with PD, by evaluating the olfactory function and cognitive function in patients with PD, the relationship between the olfactory function and the presence of mild cognitive impairment in patients with mild cognitive impairment was further explored. to provide a better understanding of the link between PD and non-motor symptoms, early detection, early diagnosis, better management of patients with mild cognitive impairment PD provide a reference and basis for the early diagnosis and management of patients with mild cognitive impairment. Methods:A total of 32 primary PD patients and 24 healthy volunteers matched for gender, age and educational level were included in the study. Collected more than the participants in general information, According to the mini mental state examination scale(MMSE) and Montreal cognitive assessment scale(Mo CA), the cognitive status of all participants were screened and evaluated. OE method(Essence Open) and olfactory self assessment method were used to assess the degree of olfactory dysfunction. Olfactory self evaluation questionnaire score and OE score were used to assess the extent of olfactory loss. H&Y staging and Part UPDRS III were used to assess the severity of the disease in PD patients. Statistical analysis of the scores of all participants in a variety of scale, and statistical analysis. Results1.In 32 patients with PD, 20 patients with PD-CN(62.5%) and 12 patients with PD-MCI(37.5%). PD-MCI group, PD-CN group and HC group were not significantly different(P= 0.32) in gender and years of education. However, there was significant difference in the age difference between the PD-MCI group and the PD-CN group(P < 0.05). The Mo CA score of PD-MCI group was significantly lower than that of group PD-CN(P < 0.001) or HC group(P < 0.001).2. In the olfactory tests, PD-MCI group, PD-CN group and HC group one-way analysis of variance among the three groups was statistically significant(p <0.05). PD-MCI group, one-way analysis of variance among the three groups of OE evaluation between PD-CN group and HC group was statistically significant(p <0.001). 12 PD-MCI patients in seven patients(58.3%) showed olfactory dysfunction, 20 PD-CN patients, 5 patients showed olfactory dysfunction(20.0%). According Scheffe post hoc test, PD-MCI group and PDCA group scored significantly lower than the HC group(p <0.001 and p <0.001). In addition, compared with the PD-CN group(Table 1), PD-MCI group of olfactory self-assessment score was significantly lower(p <0.001).3. In hyposmia mindfulness evaluation, smell between PD-MCI group, PD-CN group and HC group diminished mindfulness-way analysis of variance was statistically significant(p <0.001). Scheffe post hoc test showed, PD-MCI group scored significantly higher than the PD-CN group(p <0.001). The difference between PD-CN group and HC group was not statistically significant(P = 0.36). Conclusion:PD patients with olfactory loss and cognitive impairment correlation exists between the two non-motor symptoms, frontal lobe dysfunction may be associated with olfactory dysfunction,the degree of hyposmia predictable outcome of early PD patients with dementia.For clinical early detection, early diagnosis, better management of PD patients with mild cognitive impairment to provide a reference.