From: hounddog23x@gmail.com   
      
   Article   
      
   Olfactory dysfunction predicts early transition to a Lewy body disease in   
   idiopathic RBD   
      
      
    Authors   
   Abstract   
      
   Objective: The aim of the present study was to determine the predictive value   
   of olfactory dysfunction for the early development of a synuclein-mediated   
   neurodegenerative disease in subjects with idiopathic REM sleep behavior   
   disorder (iRBD) over an    
   observational period of 5 years.   
   Methods: Thirty-four patients with polysomnography-confirmed iRBD underwent   
   olfactory testing using the entire Sniffin' Sticks test assessing odor   
   identification, odor discrimination, and olfactory threshold. Patients with   
   iRBD were prospectively    
   followed up over a period of 4.9 ± 0.3 years (mean ± SD). The diagnosis of   
   neurodegenerative diseases was based on current clinical diagnostic criteria.   
   Results: After 2.4 ± 1.7 years (mean ± SD), 9 patients (26.5%) with iRBD   
   developed a Lewy body disease (6 Parkinson disease and 3 dementia with Lewy   
   bodies). The entire Sniffin' Sticks test and the identification subtest had   
   the same overall diagnostic    
   accuracy of 82.4% (95% confidence interval: 66.1%-92.0%) in predicting   
   conversion. The relative risk for a Lewy body disease in the lowest tertile of   
   olfactory function was 7.3 (95% confidence interval: 1.8-29.6) compared with   
   the top 2 tertiles.   
   Conclusions: Assessment of olfactory function, particularly odor   
   identification, may help to predict the development of a Lewy body disease in   
   patients with iRBD over a relatively short time period and thus to identify   
   patients suitable for future    
   disease modification trials.   
   Received June 30, 2014.   
   Accepted in final form October 24, 2014.   
   (c) 2015 American Academy of Neurology   
   Published online before print January 21, 2015, doi: 10.1212/WNL   
   0000000000001265 Neurology 10.1212/WNL.0000000000001265   
      
      
      
      
      
   http://m.neurology.org/content/early/2015/01/21/WNL.0000000000001265.abstract   
      
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