Olfactory impairment in Parkinson's disease and white matter abnormalities in central olfactory areas: A voxel‐based diffusion tensor imaging study
Identifieur interne : 000A97 ( Main/Corpus ); précédent : 000A96; suivant : 000A98Olfactory impairment in Parkinson's disease and white matter abnormalities in central olfactory areas: A voxel‐based diffusion tensor imaging study
Auteurs : Naroa Ibarretxe-Bilbao ; Carme Junque ; Maria-Jose Marti ; Francesc Valldeoriola ; Pere Vendrell ; Nuria Bargallo ; Mojtaba Zarei ; Eduardo TolosaSource :
- Movement Disorders [ 0885-3185 ] ; 2010-09-15.
English descriptors
Abstract
Olfactory dysfunction is known to occur before the appearance of the classical motor signs in Parkinson's disease (PD) and diffusion tensor imaging (DTI) studies in PD have reported fractional anisotropy (FA) reductions in the early disease stages. We aimed to investigate the relationship between olfactory dysfunction and white matter (WM) FA of central olfactory areas in early PD. Twenty‐four patients at Hoehn and Yahr stages I and II and 24 healthy controls matched by age, gender and years of education participated in this study. DTI was acquired at a 3 Tesla scanner and odor identification was assessed using the University of Pennsylvania Smell Identification Test (UPSIT). We performed FA voxelwise group comparisons in the central olfactory structures using tract‐based spatial statistics (TBSS) and correlation analyses between FA values in these central olfactory areas and UPSIT scores. Patients with severe microsmia (UPSIT between 19 and 25) and anosmia (UPSIT lower or equal to 18) had lower FA values than PD patients with mild/moderate or no olfactory dysfunction (UPSIT between 26 and 40) and healthy controls in the WM adjacent to gyrus rectus. In addition, patients with anosmia had reduced FA in the WM surrounding primary olfactory areas in comparison with healthy controls. FA values in the WM adjacent to primary olfactory cortex and right gyrus rectus correlated with UPSIT scores in the PD group. This study demonstrates, for the first time, that microstructural WM reductions are present in the central olfactory system of early stage PD patients and that these reductions are associated with reduced ability to smell. © 2010 Movement Disorder Society
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DOI: 10.1002/mds.23208
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Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</mods:affiliation></affiliation><affiliation><mods:affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</mods:affiliation></affiliation><affiliation><mods:affiliation>Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain</mods:affiliation></affiliation></author><author><name sortKey="Valldeoriola, Francesc" sort="Valldeoriola, Francesc" uniqKey="Valldeoriola F" first="Francesc" last="Valldeoriola">Francesc Valldeoriola</name><affiliation><mods:affiliation>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</mods:affiliation></affiliation><affiliation><mods:affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</mods:affiliation></affiliation><affiliation><mods:affiliation>Movement Disorders Unit, Neurology 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Spain</mods:affiliation></affiliation></author><author><name sortKey="Zarei, Mojtaba" sort="Zarei, Mojtaba" uniqKey="Zarei M" first="Mojtaba" last="Zarei">Mojtaba Zarei</name><affiliation><mods:affiliation>Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Tolosa, Eduardo" sort="Tolosa, Eduardo" uniqKey="Tolosa E" first="Eduardo" last="Tolosa">Eduardo Tolosa</name><affiliation><mods:affiliation>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</mods:affiliation></affiliation><affiliation><mods:affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</mods:affiliation></affiliation><affiliation><mods:affiliation>Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-09-15">2010-09-15</date><biblScope unit="volume">25</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="1888">1888</biblScope><biblScope unit="page" to="1894">1894</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">421DDEB3AF2728CEE05B6CE502124A59B71D8E9E</idno><idno type="DOI">10.1002/mds.23208</idno><idno type="ArticleID">MDS23208</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>DTI</term><term>MRI</term><term>TBSS</term><term>UPSIT</term><term>olfaction</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Olfactory dysfunction is known to occur before the appearance of the classical motor signs in Parkinson's disease (PD) and diffusion tensor imaging (DTI) studies in PD have reported fractional anisotropy (FA) reductions in the early disease stages. We aimed to investigate the relationship between olfactory dysfunction and white matter (WM) FA of central olfactory areas in early PD. Twenty‐four patients at Hoehn and Yahr stages I and II and 24 healthy controls matched by age, gender and years of education participated in this study. DTI was acquired at a 3 Tesla scanner and odor identification was assessed using the University of Pennsylvania Smell Identification Test (UPSIT). We performed FA voxelwise group comparisons in the central olfactory structures using tract‐based spatial statistics (TBSS) and correlation analyses between FA values in these central olfactory areas and UPSIT scores. Patients with severe microsmia (UPSIT between 19 and 25) and anosmia (UPSIT lower or equal to 18) had lower FA values than PD patients with mild/moderate or no olfactory dysfunction (UPSIT between 26 and 40) and healthy controls in the WM adjacent to gyrus rectus. In addition, patients with anosmia had reduced FA in the WM surrounding primary olfactory areas in comparison with healthy controls. FA values in the WM adjacent to primary olfactory cortex and right gyrus rectus correlated with UPSIT scores in the PD group. This study demonstrates, for the first time, that microstructural WM reductions are present in the central olfactory system of early stage PD patients and that these reductions are associated with reduced ability to smell. © 2010 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Naroa Ibarretxe‐Bilbao PhD</name><affiliations><json:string>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</json:string><json:string>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</json:string><json:string>Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain</json:string></affiliations></json:item><json:item><name>Carme Junque PhD</name><affiliations><json:string>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</json:string><json:string>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</json:string><json:string>Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain</json:string></affiliations></json:item><json:item><name>Maria‐Jose Marti MD, PhD</name><affiliations><json:string>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</json:string><json:string>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</json:string><json:string>Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain</json:string></affiliations></json:item><json:item><name>Francesc Valldeoriola MD, PhD</name><affiliations><json:string>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</json:string><json:string>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</json:string><json:string>Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain</json:string></affiliations></json:item><json:item><name>Pere Vendrell PhD</name><affiliations><json:string>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</json:string><json:string>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</json:string></affiliations></json:item><json:item><name>Nuria Bargallo MD, PhD</name><affiliations><json:string>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</json:string><json:string>Centre de Diagnòstic per la Imatge Hospital Clínic de Barcelona (CDIC), Hospital Clínic de Barcelona, Spain</json:string></affiliations></json:item><json:item><name>Mojtaba Zarei MD MRCP</name><affiliations><json:string>Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, United Kingdom</json:string></affiliations></json:item><json:item><name>Eduardo Tolosa MD, PhD</name><affiliations><json:string>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</json:string><json:string>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</json:string><json:string>Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>MRI</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>olfaction</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>DTI</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>UPSIT</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>TBSS</value></json:item></subject><articleId><json:string>MDS23208</json:string></articleId><language><json:string>eng</json:string></language><abstract>Olfactory dysfunction is known to occur before the appearance of the classical motor signs in Parkinson's disease (PD) and diffusion tensor imaging (DTI) studies in PD have reported fractional anisotropy (FA) reductions in the early disease stages. We aimed to investigate the relationship between olfactory dysfunction and white matter (WM) FA of central olfactory areas in early PD. Twenty‐four patients at Hoehn and Yahr stages I and II and 24 healthy controls matched by age, gender and years of education participated in this study. DTI was acquired at a 3 Tesla scanner and odor identification was assessed using the University of Pennsylvania Smell Identification Test (UPSIT). We performed FA voxelwise group comparisons in the central olfactory structures using tract‐based spatial statistics (TBSS) and correlation analyses between FA values in these central olfactory areas and UPSIT scores. Patients with severe microsmia (UPSIT between 19 and 25) and anosmia (UPSIT lower or equal to 18) had lower FA values than PD patients with mild/moderate or no olfactory dysfunction (UPSIT between 26 and 40) and healthy controls in the WM adjacent to gyrus rectus. In addition, patients with anosmia had reduced FA in the WM surrounding primary olfactory areas in comparison with healthy controls. FA values in the WM adjacent to primary olfactory cortex and right gyrus rectus correlated with UPSIT scores in the PD group. 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Universitat de Barcelona, Casanova 143, Barcelona (08036), Spain</p></note><affiliation>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</affiliation><affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</affiliation><affiliation>Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain</affiliation></author><author><persName><forename type="first">Maria‐Jose</forename><surname>Marti</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</affiliation><affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</affiliation><affiliation>Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain</affiliation></author><author><persName><forename type="first">Francesc</forename><surname>Valldeoriola</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</affiliation><affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</affiliation><affiliation>Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain</affiliation></author><author><persName><forename type="first">Pere</forename><surname>Vendrell</surname></persName><roleName type="degree">PhD</roleName><affiliation>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</affiliation><affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</affiliation></author><author><persName><forename type="first">Nuria</forename><surname>Bargallo</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</affiliation><affiliation>Centre de Diagnòstic per la Imatge Hospital Clínic de Barcelona (CDIC), Hospital Clínic de Barcelona, Spain</affiliation></author><author><persName><forename type="first">Mojtaba</forename><surname>Zarei</surname></persName><roleName type="degree">MD MRCP</roleName><affiliation>Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, United Kingdom</affiliation></author><author><persName><forename type="first">Eduardo</forename><surname>Tolosa</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</affiliation><affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</affiliation><affiliation>Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-09-15"></date><biblScope unit="volume">25</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="1888">1888</biblScope><biblScope unit="page" to="1894">1894</biblScope></imprint></monogr><idno type="istex">421DDEB3AF2728CEE05B6CE502124A59B71D8E9E</idno><idno type="DOI">10.1002/mds.23208</idno><idno type="ArticleID">MDS23208</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Olfactory dysfunction is known to occur before the appearance of the classical motor signs in Parkinson's disease (PD) and diffusion tensor imaging (DTI) studies in PD have reported fractional anisotropy (FA) reductions in the early disease stages. We aimed to investigate the relationship between olfactory dysfunction and white matter (WM) FA of central olfactory areas in early PD. Twenty‐four patients at Hoehn and Yahr stages I and II and 24 healthy controls matched by age, gender and years of education participated in this study. DTI was acquired at a 3 Tesla scanner and odor identification was assessed using the University of Pennsylvania Smell Identification Test (UPSIT). We performed FA voxelwise group comparisons in the central olfactory structures using tract‐based spatial statistics (TBSS) and correlation analyses between FA values in these central olfactory areas and UPSIT scores. Patients with severe microsmia (UPSIT between 19 and 25) and anosmia (UPSIT lower or equal to 18) had lower FA values than PD patients with mild/moderate or no olfactory dysfunction (UPSIT between 26 and 40) and healthy controls in the WM adjacent to gyrus rectus. In addition, patients with anosmia had reduced FA in the WM surrounding primary olfactory areas in comparison with healthy controls. FA values in the WM adjacent to primary olfactory cortex and right gyrus rectus correlated with UPSIT scores in the PD group. This study demonstrates, for the first time, that microstructural WM reductions are present in the central olfactory system of early stage PD patients and that these reductions are associated with reduced ability to smell. © 2010 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>MRI</term></item><item><term>olfaction</term></item><item><term>DTI</term></item><item><term>UPSIT</term></item><item><term>TBSS</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-01-26">Received</change><change when="2010-03-29">Registration</change><change when="2010-09-15">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/421DDEB3AF2728CEE05B6CE502124A59B71D8E9E/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. 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Universitat de Barcelona, Casanova 143, Barcelona (08036), Spain</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS23208.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="3"></count><count type="tableTotal" number="4"></count><count type="referenceTotal" number="39"></count><count type="wordTotal" number="5262"></count></countGroup><titleGroup><title type="main" xml:lang="en">Olfactory impairment in Parkinson's disease and white matter abnormalities in central olfactory areas: A voxel‐based diffusion tensor imaging study<link href="#fn1"></link></title><title type="short" xml:lang="en">Olfactory Dysfunction and FA Reductions in PD</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1 #af2 #af3"><personName><givenNames>Naroa</givenNames><familyName>Ibarretxe‐Bilbao</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1 #af2 #af3" corresponding="yes"><personName><givenNames>Carme</givenNames><familyName>Junque</familyName><degrees>PhD</degrees></personName><contactDetails><email>cjunque@ub.edu</email></contactDetails></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1 #af2 #af4"><personName><givenNames>Maria‐Jose</givenNames><familyName>Marti</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1 #af2 #af4"><personName><givenNames>Francesc</givenNames><familyName>Valldeoriola</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Pere</givenNames><familyName>Vendrell</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af2 #af5"><personName><givenNames>Nuria</givenNames><familyName>Bargallo</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af6"><personName><givenNames>Mojtaba</givenNames><familyName>Zarei</familyName><degrees>MD MRCP</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1 #af2 #af4"><personName><givenNames>Eduardo</givenNames><familyName>Tolosa</familyName><degrees>MD, PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="ES" type="organization"><unparsedAffiliation>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="ES" type="organization"><unparsedAffiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="ES" type="organization"><unparsedAffiliation>Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="ES" type="organization"><unparsedAffiliation>Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="ES" type="organization"><unparsedAffiliation>Centre de Diagnòstic per la Imatge Hospital Clínic de Barcelona (CDIC), Hospital Clínic de Barcelona, Spain</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="GB" type="organization"><unparsedAffiliation>Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, United Kingdom</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">MRI</keyword><keyword xml:id="kwd2">olfaction</keyword><keyword xml:id="kwd3">DTI</keyword><keyword xml:id="kwd4">UPSIT</keyword><keyword xml:id="kwd5">TBSS</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Olfactory dysfunction is known to occur before the appearance of the classical motor signs in Parkinson's disease (PD) and diffusion tensor imaging (DTI) studies in PD have reported fractional anisotropy (FA) reductions in the early disease stages. We aimed to investigate the relationship between olfactory dysfunction and white matter (WM) FA of central olfactory areas in early PD. Twenty‐four patients at Hoehn and Yahr stages I and II and 24 healthy controls matched by age, gender and years of education participated in this study. DTI was acquired at a 3 Tesla scanner and odor identification was assessed using the University of Pennsylvania Smell Identification Test (UPSIT). We performed FA voxelwise group comparisons in the central olfactory structures using tract‐based spatial statistics (TBSS) and correlation analyses between FA values in these central olfactory areas and UPSIT scores. Patients with severe microsmia (UPSIT between 19 and 25) and anosmia (UPSIT lower or equal to 18) had lower FA values than PD patients with mild/moderate or no olfactory dysfunction (UPSIT between 26 and 40) and healthy controls in the WM adjacent to gyrus rectus. In addition, patients with anosmia had reduced FA in the WM surrounding primary olfactory areas in comparison with healthy controls. FA values in the WM adjacent to primary olfactory cortex and right gyrus rectus correlated with UPSIT scores in the PD group. This study demonstrates, for the first time, that microstructural WM reductions are present in the central olfactory system of early stage PD patients and that these reductions are associated with reduced ability to smell. © 2010 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Potential conflict of interest: Nothing to report.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Olfactory impairment in Parkinson's disease and white matter abnormalities in central olfactory areas: A voxel‐based diffusion tensor imaging study</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Olfactory Dysfunction and FA Reductions in PD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Olfactory impairment in Parkinson's disease and white matter abnormalities in central olfactory areas: A voxel‐based diffusion tensor imaging study</title></titleInfo><name type="personal"><namePart type="given">Naroa</namePart><namePart type="family">Ibarretxe‐Bilbao</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</affiliation><affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</affiliation><affiliation>Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Carme</namePart><namePart type="family">Junque</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</affiliation><affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</affiliation><affiliation>Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain</affiliation><description>Correspondence: Departament de Psiquiatria i Psicobiologia Clínica. Universitat de Barcelona, Casanova 143, Barcelona (08036), Spain</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Maria‐Jose</namePart><namePart type="family">Marti</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</affiliation><affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</affiliation><affiliation>Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Francesc</namePart><namePart type="family">Valldeoriola</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</affiliation><affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</affiliation><affiliation>Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Pere</namePart><namePart type="family">Vendrell</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</affiliation><affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nuria</namePart><namePart type="family">Bargallo</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</affiliation><affiliation>Centre de Diagnòstic per la Imatge Hospital Clínic de Barcelona (CDIC), Hospital Clínic de Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mojtaba</namePart><namePart type="family">Zarei</namePart><namePart type="termsOfAddress">MD MRCP</namePart><affiliation>Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Eduardo</namePart><namePart type="family">Tolosa</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Spain</affiliation><affiliation>Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain</affiliation><affiliation>Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2010-09-15</dateIssued><dateCaptured encoding="w3cdtf">2010-01-26</dateCaptured><dateValid encoding="w3cdtf">2010-03-29</dateValid><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">3</extent><extent unit="tables">4</extent><extent unit="references">39</extent><extent unit="words">5262</extent></physicalDescription><abstract lang="en">Olfactory dysfunction is known to occur before the appearance of the classical motor signs in Parkinson's disease (PD) and diffusion tensor imaging (DTI) studies in PD have reported fractional anisotropy (FA) reductions in the early disease stages. We aimed to investigate the relationship between olfactory dysfunction and white matter (WM) FA of central olfactory areas in early PD. Twenty‐four patients at Hoehn and Yahr stages I and II and 24 healthy controls matched by age, gender and years of education participated in this study. DTI was acquired at a 3 Tesla scanner and odor identification was assessed using the University of Pennsylvania Smell Identification Test (UPSIT). We performed FA voxelwise group comparisons in the central olfactory structures using tract‐based spatial statistics (TBSS) and correlation analyses between FA values in these central olfactory areas and UPSIT scores. Patients with severe microsmia (UPSIT between 19 and 25) and anosmia (UPSIT lower or equal to 18) had lower FA values than PD patients with mild/moderate or no olfactory dysfunction (UPSIT between 26 and 40) and healthy controls in the WM adjacent to gyrus rectus. In addition, patients with anosmia had reduced FA in the WM surrounding primary olfactory areas in comparison with healthy controls. FA values in the WM adjacent to primary olfactory cortex and right gyrus rectus correlated with UPSIT scores in the PD group. This study demonstrates, for the first time, that microstructural WM reductions are present in the central olfactory system of early stage PD patients and that these reductions are associated with reduced ability to smell. © 2010 Movement Disorder Society</abstract><note type="content">*Potential conflict of interest: Nothing to report.</note><subject lang="en"><genre>Keywords</genre><topic>MRI</topic><topic>olfaction</topic><topic>DTI</topic><topic>UPSIT</topic><topic>TBSS</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. 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