Olfactory Testing in Neurological Diseases using Odourized Markers Test

Authors: J. Vodička 1,2;  L. Pecková 1;  A. Kopal 3;  E. Ehler 1,3;  V. Chrobok 1,2
Authors‘ workplace: Fakulta zdravotnických studií, Univerzita Pardubice 1;  Klinika otorinolaryngologie a chirurgie hlavy a krku, Pardubická krajská nemocnice, a. s. 2;  Neurologická klinika, Pardubická krajská nemocnice, a. s. 3
Published in: Cesk Slov Neurol N 2010; 73/106(1): 45-50
Category: Original Paper


Decreased olfactory function has been demonstrated in idiopathic Parkinson’s disease (IPD) by subjective olfactometry. The first goal of the study was to establish whether patients with IPD would score lower in such tests than patients suffering from other neurological diseases. The second goal of this study was establish whether olfactory tests could discriminate IPD from other patients with smell impairment.

Materials and methods:
A total of 218 subjects were included in the study: 64 healthy individuals, 90 with neurological diagnoses (30 of them with idiopathic Parkinson’s disease, 30 with multiple sclerosis and 30 with other neurological diseases), as well as patients with other aetiology of smell impairment (64 patients). The Odourized Markers Test and “Sniffin’ Sticks” (only part identification) were used to evaluate olfactory function in the subjects. Cognitive functions were evaluated in some of the subjects using the mini mental state examination. Rhino‑ endoscopy was performed in subjects with sinonasal disease and smell impairment to evaluate the nasal cavity. Results were statistically evaluated.

Patients suffering from Parkinson’s disease scored a statistically significantly lower score than healthy subjects and patients with other neurological disease (p < 0.05). It was not possible to discriminate subjects with Parkinson’s disease from other patients with olfactory loss (post‑traumatic, postviral and others) using the Odourized Markers Test.

The Odourized Markers Test can be used to measure olfaction in IPD, but results of this test are not specific for this aetiology of olfactory loss.

Key words:
olfactometry – Parkinson’s disease – olfaction disorders – multiple sclerosis


1. Doty RL, Reyes PF, Gregor T. Presence of both odor identification and detection deficits in Alzheimer’s disease. Brain Res Bull 1987; 18(5): 597–600.

2. Doty RL, Bromley SM, Stern MB. Olfactory testing as an aid in the diagnosis of Parkinson’s disease: development of optimal discrimination criteria. Neurodegeneration 1995; 4(1): 93–97.

3. Serby M. Olfaction and Alzheimer’s disease. Prog Neuropsychopharmacol Biol Psychiatry 1986; 10(3–5): 579–586.

4. Doty RL, Deems DA, Stellar S. Olfactory dysfunction in parkinsonism: a general deficit unrelated to neurologic signs, disease stage, or disease duration. Neurology 1988; 38(8): 1237–1244.

5. Ansari KA, Johnson A. Olfactory function in patients with Parkinson’s disease. J Chronic Dis 1975; 28(9): 493–497.

6. Ward CD, Hess WA, Calne DB. Olfactory impairment in Parkinson’s disease. Neurology 1983; 33(7): 943–946.

7. Serby M, Corwin J, Conrad P, Rotrosen J. Olfactory dysfunction in Alzheimer’s disease and Parkinson’s disease. Am J Psychiatry 1985; 142(6): 781–782.

8. Markopoulou K, Larsen KW, Wszolek EK, Denson MA, Lang AE, Pfeiffer RF et al. Olfactory dysfunction in familial parkinsonism. Neurology 1997; 49(5): 1262–1267.

9. Berendse HW, Booij J, Francot CM, Bergmans PL, Hijman R, Stoof JC et al. Subclinical dopaminergic dysfunction in asymptomatic Parkinson’s disease patients’ relatives with a decreased sense of smell. Ann Neurol 2001; 50(1): 34–41.

10. Quinn NP, Rossor MN, Marsden CD. Olfactory threshold in Parkinson‘s disease. J Neurol Neurosurg Psychiatry 1987; 50(1): 88–89.

11. Roth J, Radil T, Růzicka E, Jech R, Tichý J. Apomorphine does not influence olfactory thresholds in Parkinson‘s disease. Funct Neurol 1998; 13(2): 99–103.

12. Busenbark KL, Huber SJ, Greer G, Pahwa R, Koller WC. Olfactory function in essential tremor. Neurology 1992; 42(8): 1631–1632.

13. Doty RL, Singh A, Tetrud J, Langston JW. Lack of major olfactory dysfunction in MPTP‑induced parkinsonism. Ann Neurol 1992; 32(1): 97–100.

14. Doty RL, Golbe LI, McKeown DA, Stern MB, Lehrach CM, Crawford D. Olfactory testing differentiates between progressive supranuclear palsy and idiopathic Parkinson’s disease. Neurology 1993; 43(5): 962–965.

15. Doty RL, Li C, Mannon LJ, Yousem DM. Olfactory dysfunction in multiple sclerosis: relation to longitudinal changes in plaque numbers in central olfactory structures. Neurology 1999; 53(4): 880–882.

16. Zorzon M, Ukmar M, Bragadin LM, Zanier F, Antonello RM, Cazzato G et al. Olfactory dysfunction and extent of white matter abnormalities in multiple sclerosis: a clinical and MR study. Mult Scler 2000; 6(6): 386–390.

17. Magerová H, Vyhnálek M, Laczó J, Bojar J, Hort J.Přínos vyšetření čichu v časné diagnostice demencí neurodegenerativní etiologie. Cesk Slov Neurol N2008; 71/104(3): 298–302.

18. Vodička J, Pellant A, Chrobok V. Screening of olfactory function using odourized markers, Rhinology 2007; 45(2): 164–168.

19. Gelb DJ, Oliver E, Gilman S. Diagnostic criteria for Parkinson disease. Arch Neurol 1999; 56(1): 33–39.

20. Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”. Ann Neurol. 2005; 58(6): 840–846.

21. Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G.“Sniffin’ sticks”: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses 1997; 22(1): 39–52.

22. Müller A, Müngersdorf M, Reichmann H, Strehle G,Hummel T. Olfactory function in Parkinsonian syndromes. J Clin Neurosci 2002; 9(5): 521–524.

23. Doty RL, Stern MB, Pfeiffer C, Gollomp SM, Hurtig HI. Bilateral olfactory dysfunction in early stage treated and untreated idiopathic Parkinson‘s disease. J Neurol Neurosurg Psychiatry 1992; 55(2): 138–142.

24. Hawkes CH, Shephard BC, Daniel SE. Olfactory dysfunction in Parkinson’s disease. J Neurol Neurosurg Psychiatry 1997; 62(5): 436–446.

25. McKinnon JH, Demaerschalk BM, Caviness JN, Wellik KE, Adler CH, Wingerchuk DM. Sniffing out Parkinson disease: can olfactory testing differentiate parkinsonian disorders? Neurologist 2007; 13(6): 382–385.

26. Ponsen MM, Stoffers D, Twisk JW, Wolters ECh, Berendse HW. Hyposmia and executive dysfunction as predictors of future Parkinson‘s disease: a prospective study. Mov Disord 2009; 24(7): 1060–1065.

27. Vodička J, Pellant A. Vliv barev parfémovaných fixů na výsledek čichové zkoušky. II. fakultní konference studentů doktorského studia, Hradec Králové, 24. 10. 2006.

28. Price MJ, Feldman RG, Adelberg D, Kayne H. Abnormalities in color vision and contrast sensitivity in Parkinson’s disease. Neurology 1992; 42(4): 887–890.

29. Postuma RB, Lang AE, Massicotte-Marquez J, Montplaisir J. Potential early markers of Parkinson disease in idiopathic REM sleep behavior disorder. Neurology 2006; 66(6): 845–851.

30. Veselá O, Růzicka E, Jech R, Roth J, Stepánková K, Mecír P et al. Colour discrimination impairment is not a reliable early marker of Parkinson‘s disease. J Neurol 2001; 248(11): 975–978.

31. Landis BN, Burkhard PR. Phantosmias and Parkinson disease. Arch Neurol 2008; 65(9): 1237–1239.

32. Ansari KA. Olfaction in multiple sclerosis. With a note on the discrepancy between optic and olfactory involvement. Eur Neurol 1976; 14(2): 138–145.

33. Kesslak JP, Cotman CW, Chui HC, Van den Noort S,Fang H, Pfeffer R et al. Olfactory tests as possible probes for detecting and monitoring Alzheimer‘s disease. Neurobio­l Aging 1988; 9(4): 399–403.

34. Deems DA, Doty RL, Settle RG, Moore‑Gillon V, Shaman P, Mester AF et al. Smell and taste disorders, a study of 750 patients from the University of Pennsylvania Smell and Taste Center. Arch Otolaryngol Head Neck Surg 1991; 117(5): 519–528.

35. Jafek BW, Murrow B, Linschoten M. Evaluation and treatment of anosmia. Curr Opin Otol Head Neck Surg 2000; 8(1): 63–67.

36. Doty RL, Shaman P, Applebaum SL, Giberson R, Siksorski L, Rosenberg L. Smell identification ability: changes with age. Science 1984; 226(4681): 1441–1443.

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