Donald A. McKeown

Tests of human olfactory function: Principal components analysis suggests that most measure a common source of variance

It is not known whether nominally different olfactory tests actually measure dissimilar perceptual attributes. In this study, we administered nine olfactory tests, including tests of odor identification, discrimination, detection, memory, and suprathreshold intensity and pleasantness perception, to 97 healthy subjects. Aprincipal components analysis performed on the intercorrelation matrix revealed four meaningful components. The first was comprised of strong primary loadings from most of the olfactory test measures, whereas the second was comprised of primary loadings from intensity ratings given to a set of suprathreshold odorant concentrations. The third and fourth components had primary loadings that reflected, respectively, mean suprathreshold pleasantness ratings and a response bias measure derived from a yes/no odor identification signal detection task. In an effort to adjust for potential confounding influences of age, gender, smoking, and years of schooling on the component structure, a matrix of residuals from a multiple regression analysis, which included these variables, was also analyzed. A similar component pattern emerged. Overall, these findings suggest, in healthy subjects spanning a wide age range, that (1) a number of nominally distinct tests of olfactory function are measuring a common source of variance, and (2) some suprathreshold odor intensity and pleasantness rating tests may be measuring sources of variance different from this common source.

Olfactory testing differentiates between progressive supranuclear palsy and idiopathic Parkinson's disease.

Olfactory dysfunction occurs in most patients with idiopathic Parkinsons disease (PD). In this study, we sought to determine whether such dysfunction is also present in progressive supranuclear palsy (PSP), a condition which shares a number of motor symptoms with PD and is commonly misdiagnosed as PD. We administered the University of Pennsylvania Smell Identification Test, a standardized test of odor identification ability, to 21 PSP patients; 17 also received a forced-choice odor detection threshold test. We compared the olfactory test scores to those obtained from PD patients and normal controls matched to the PSP patients on the basis of age, sex, and smoking habits. Overall, the olfactory function of the PSP patients was markedly superior to that of the PD patients and did not differ significantly from that of the normal controls. There was no association in either the PSP or PD patient groups between (1) the olfactory test scores and (2) measures of motor symptom severity, disease stage, and medication usage. These findings demonstrate that patients with PSP and PD differ markedly in their ability to smell and suggest that olfactory testing may be useful in their differential diagnosis.

Olfactory function in Parkinson's disease subtypes

Decreased olfactory function commonly occurs in idiopathic Parkinsons disease (PD), regardless of stage, treatment, or duration of disease. In the present study, we sought to determine whether different subtypes of PD, categorized according to well-defined clinical criteria, evidence different degrees of olfactory dysfunction. Significantly different scores on the University of Pennsylvania Smell Identification Test (UPSIT) were present between patients with benign PD and malignant PD (respective means [SD] = 22.51 [8.50] and 17.38 [6.29]) and between tremor-predominant PD and postural instability-gait disorder (PIGD)-predominant PD (23.43 [8.18] versus 17.35 [6.00]). No statistically significant differences in UPSIT scores were observed between young-onset and older-onset PD patients. Women outperformed men in most subtypes examined.

Smell and taste function in the visually impaired

Surprisingly few quantitative studies have addressed the question of whether visually impaired individuals evidence, perhaps in compensation for their loss of vision, increased acuteness in their other senses. In this experiment we sought to determine whether blind subjects outperform sighted subjects on a number of basic tests of chemosensory function. Over 50 blind and 75 sighted subjects were administered the following olfactory and gustatory tests: the University of Pennsylvania Smell Identification Test (UPSIT); a 16-item odor discrimination test; and a suprathreshold taste test in which measures of taste-quality identification and ratings of the perceived intensity and pleasantness of sucrose, citric acid, sodium chloride, and caffeine were obtained. In addition, 39 blind subjects and 77 sighted subjects were administered a single staircase phenyl ethyl alcohol (PEA) odor detection threshold test. Twenty-three of the sighted subjects were employed by the Philadelphia Water Department and trained to serve on its water quality evaluation panel. The primary findings of the study were that (a) the blind subjects did not outperform sighted subjects on any test of chemosensory function and (b) the trained subjects significantly outperformed the other two groups on the odor detection, odor discrimination, and taste identification tests, and nearly outperformed the blind subjects on the UPSIT. The citric acid concentrations received larger pleasantness ratings from the trained panel members than from the blind subjects, whose ratings did not differ significantly from those of the untrained sighted subjects. Overall, the data imply that blindness, per se, has little influence on chemosensory function and add further support to the notion that specialized training enhances performance on a number of chemosensory tasks.

Olfactory function in young adolescents with Down's syndrome.

Decreased ability to smell is present in adults with Downs syndrome, many of whom are known to have brain pathology analogous to that seen in Alzheimers disease. Because olfactory loss is well documented in Alzheimers disease, the question arises whether young adolescents with Downs syndrome, who have no clear Alzheimers disease-like neuropathology, also exhibit olfactory dysfunction. To consider this issue, standardised tests of odour discrimination and identification were administered to 20 young adolescents with Downs syndrome (mean age (SD) 13.89 (1.98) years) and their test scores were compared with 20 mentally retarded and 20 non-mentally retarded control subjects matched to the patients with Downs syndrome on the basis of cognitive ability. No significant differences in olfactory function were found among the three study groups. These findings, along with those from studies of olfactory function in older patients with Downs syndrome, suggest that Downs syndrome related olfactory dysfunction occurs only at ages when Alzheimers disease-like pathology is present.