Effect of olfactory impairment and white matter hyperintensities on cognition in Parkinson's disease

Jee Hyun Ham, Jae Jung Lee, Mun Kyung Sunwoo, Jin Yong Hong, Young H. Sohn, Phil Hyu Lee

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)


Introduction: Although white matter hyperintensities (WMH) and olfactory dysfunction are independently associated with the cognitive impairments in Parkinson's disease (PD), the effects of simultaneous presence of these abnormalities remain unknown. Thus, we investigated the different effects of deep WMH and periventricular WMH on olfactory and cognitive performance and evaluated the additive effects of the concurrent presence of WMH and olfactory dysfunction on cognitive performance in PD. Methods: We enrolled 171 patients with non-demented PD whose WMH scores were assessed using a semi-quantitative visual rating system. The olfactory and cognitive performance was assessed using the Cross-Cultural Smell Identification (CCSI) test and the Seoul Neuropsychological Screening Battery. Additionally, the additive effects of concurrent WMH and olfactory dysfunction on cognitive performance were investigated using binary logistic regression. Results: The deep WMH score exhibited a significant negative correlation with the CCSI score (p = 0.026) but the total WMH and periventricular WMH did not. A multiple regression analysis revealed that the total WMH (β = -0.109, p = 0.011) and deep WMH (β = -0.153, p = 0.020) severities had significant negative correlations with semantic fluency. A logistic regression analysis revealed that the simultaneous presence of severe olfactory dysfunction and deep WMH was associated with a greater risk for the semantic fluency impairments (odds ratio = 15.909, p = 0.0005) compared to patients with mild deep WMH or high CCSI scores. Conclusions: These data indicate that deep WMH was closely coupled with olfactory impairments and cognitive decline in PD. Moreover, the concurrent presence of severe deep WMH and olfactory impairments has a greater influence on semantic fluency.

Original languageEnglish
Pages (from-to)95-99
Number of pages5
JournalParkinsonism and Related Disorders
Publication statusPublished - 2016 Mar 1

Bibliographical note

Funding Information:
This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare , Republic of Korea (grant number: HI14C0093 ).

Publisher Copyright:
© 2015 Elsevier Ltd.

All Science Journal Classification (ASJC) codes

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology


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