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- W176238082 abstract "This thesis examines the clinical and pathological involvement of theolfactory system in Parkinson’s Disease (PD). The main aim is toinvestigate the practical use of smell identification tests (SITs) inparkinsonism and tremor. A secondary objective is to investigate thepathological involvement of the rhinencephalon.Commercially available SITs were used to differentiate PD patients fromcontrol subjects in the UK, Brazil and Sri Lanka, showing SITs havecombinations of sensitivity and specificity greater than 80%. Based on thedata obtained a traffic light ruler was devised to determine the likelihood ofa patient having PD at the time of the initial consultation. This was thenused to interpret SITs in 34 patients with possible parkinsonism, showing86.4% sensitivity and 80.0% specificity of SITs when compared todopamine transporter imaging using single photon emission computedtomography (SPECT) as the gold-standard for detecting nigrostriataldopamine denervation. Olfaction was shown to be severely impaired inparkinsonism related to LRRK2 mutations, moderately impaired in subjectswith pure autonomic failure, multiple system atrophy and progressivesupranuclear palsy (PSP) and normal in patients with essential tremor,dystonia and in subjects who had been diagnosed as having PD, but werefound to have normal scans. This indicates that SITs will be more useful indifferentiating PD from non-degenerative tremors than from atypicalparkinsonism.Neuropathological changes were investigated in the rhinencephalon and itwas demonstrated that α-synuclein accumulation in the primary olfactorycortex is heterogeneous, being more severe in the temporal subdivision ofthe piriform cortex. The piriform cortex had Lewy body pathology in all 10PD cases studied, as well as in 7 control cases who presented incidentalLewy body pathology and four cases of LRRK2 related parkinsonism. Thepiriform cortex had abnormal tau accumulation in 6 PSP patients,suggesting tauopathy in the rhinencephalon is a possible substrate forhyposmia in PSP." @default.
- W176238082 created "2016-06-24" @default.
- W176238082 creator A5082158607 @default.
- W176238082 date "2009-10-01" @default.
- W176238082 modified "2023-09-26" @default.
- W176238082 title "Olfaction in Parkinson’s Disease" @default.
- W176238082 hasPublicationYear "2009" @default.
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