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BMC Neurology

, 12:24

First Online: 02 May 2012Received: 07 November 2011Accepted: 02 May 2012


BackgroundThe olfactory bulb OB receives extensive cholinergic input from the basal forebrain and is affected very early in Alzheimer’s disease AD. We speculated that an olfactory ‘stress test’ 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.

MethodsWe 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.

ResultsIn 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 ‘atropine effect’ = AE correlated significantly with demographically scaled episodic memory score r = 0.57, p < 0.001 and left hippocampal volume LHCV r = 0.53, p < 0.001. Among non-demented individuals n = 42, AE correlated with episodic memory r = 0.52, p < 0.001 and LHCV r = 0.49, p < 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 ϵ4 allele was associated with a more negative AE p = 0.014.

ConclusionsThe 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.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2377-12-24 contains supplementary material, which is available to authorized users.

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Autor: Peter W Schofield - Houman Ebrahimi - Alison L Jones - Grant A Bateman - Sonya R Murray


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