A comparative study of odor identification and odor discrimination deficits in Parkinson's disease

The aim of this study was to compare the characteristics of odor discrimination and odor identification deficits in a large population of patients with Parkinson's disease (PD) and to determine which of these olfactory tests best distinguishes between patients with PD and control subjects. Olfactory performance was assessed in 404 patients with PD and 150 controls, using the odor identification and discrimination parts of the Sniffin' Sticks battery. Mean identification and discrimination scores in patients with PD were significantly lower than in controls. Linear regression analysis using a 95% confidence interval revealed that, relative to the performance of controls, 65.0% of patients with PD had an impairment in odor identification, whereas 42.1% of patients were impaired on the odor discrimination task. ROC curves revealed a higher sensitivity and specificity for odor identification than for odor discrimination in separating patients from controls. In patients with PD, odor discrimination performance decreased with increasing disease duration, whereas odor identification was not correlated with disease stage or duration. In PD, odor identification is more frequently impaired than odor discrimination and allows a better discrimination between patients and controls. Although an odor identification deficit is generally believed to be independent of disease progression, the impairment in odor discrimination appears to increase with disease duration.