科研之友
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摘要
Background: The olfactory bulb (OB) receives extensive cholinergic input from the basal forebrain and is affected very early in Alzheimer%26apos;s disease (AD). We speculated that an olfactory %26apos;stress test%26apos; (OST), targeting the OB, might be used to unmask incipient AD. We investigated if change in olfactory performance following intranasal atropine was associated with several known antecedents or biomarkers of AD. %26lt;br%26gt;Methods: We measured change in performance on the University of Pennsylvania Smell Identification Test (UPSIT) in the left nostril before (20-items) and after (remaining 20-items) intranasal administration of 1 mg of atropine. We administered cognitive tests, measured hippocampal volume from MRI scans and recorded Apolipoprotein E genotype as indices relevant to underlying AD. %26lt;br%26gt;Results: In a convenience sample of 56 elderly individuals (14 probable AD, 13 cognitive impairment no dementia, 29 cognitively intact) the change in UPSIT score after atropine (%26apos;atropine effect%26apos; = AE) correlated significantly with demographically scaled episodic memory score (r = 0.57, p %26lt; 0.001) and left hippocampal volume (LHCV) (r = 0.53, p %26lt; 0.001). Among non-demented individuals (n = 42), AE correlated with episodic memory (r = 0.52, p %26lt; 0.001) and LHCV (r = 0.49, p %26lt; 0.001) and hierarchical linear regression models adjusted for age, gender, education, and baseline UPSIT showed that the AE explained more variance in memory performance (24%) than did LHCV (15%). The presence of any APOE epsilon 4 allele was associated with a more negative AE (p = 0.014). %26lt;br%26gt;Conclusions: The OST using atropine as an olfactory probe holds promise as a simple, inexpensive screen for early and preclinical AD and further work, including longitudinal studies, is needed to explore this possibility.
- 出版日期2012-5-2
