1Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
2Department of Food Technology, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
3Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
4Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
5The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
Copyright © 2022 The Korean Movement Disorder Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflicts of Interest
The authors have no financial conflicts of interest.
Funding Statement
This study was funded by the Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University, grant number RA57/112, Chulalongkorn Academic Advancement Fund into Its 2nd Century Project of Chulalongkorn University (2300042200), and Centre of Excellence Grant of Chulalongkorn University (GCE6100930004-1).
Author Contributions
Conceptualization: Priya Jagota, Nattida Chotechuang, Chanchai Boonla, Roongroj Bhidayasiri. Formal analysis: Priya Jagota, Nattida Chotechuang. Funding acquisition: Roongroj Bhidayasiri. Investigation: Teeraparp Kitjawijit. Methodology: Priya Jagota, Nattida Chotechuang, Chanchai Boonla, Roongroj Bhidayasiri. Project administration: Priya Jagota, Nattida Chotechuang, Chanawat Anan, Teeraparp Kitjawijit. Resources: Priya Jagota, Nattida Chotechuang, Chanawat Anan, Teeraparp Kitjawijit. Supervision: Chanchai Boonla, Roongroj Bhidayasiri. Writing—original draft: Priya Jagota. Writing—review & editing: all authors.
Demographic data | PD (n = 105) | Control (n = 101) | p-value |
---|---|---|---|
Age (yr) | 63.3 ± 10.5 | 61.07 ± 11.1 | 0.141† |
Sex | |||
Male | 50 (47.6) | 41 (40.6) | 0.310‡ |
Female | 55 (52.4) | 60 (59.4) | |
Weight (kg) | 58.57 ± 12.9 | 60.66 ± 12.5 | 0.279† |
Height (cm) | 160.48 ± 8.8 | 159.01 ± 8.8 | 0.276† |
BMI | 22.62 ± 3.9 | 23.86 ± 4 | 0.028*† |
Smoking | |||
Never | 83 (79) | 82 (81.2) | 0.009*‡ |
Current smokers | 2 (1.9) | 10 (9.9) | |
Past smokers | 20 (19) | 9 (8.9) | |
Alcohol drinking | |||
Never | 73 (69.5) | 86 (85.1) | 0.006*‡ |
Current drinkers | 10 (9.5) | 9 (8.9) | |
Past drinkers | 22 (21) | 6 (5.9) | |
Age at PD onset (yr) | 53.9 ± 12.3 | NA | |
Current symptoms | |||
Tremor | 61 (58.1) | NA | |
Rigidity | 57 (54.3) | NA | |
Bradykinesia | 73 (69.5) | NA | |
Postural instability | 34 (32.4) | NA | |
Gait problem | 50 (47.6) | NA | |
Motor complications | |||
Wearing off | 38 (36.2) | NA | |
Dyskinesia | 24 (22.9) | NA | |
H&Y§ | |||
1 | 1 (1) | NA | |
1.5 | 5 (4.8) | NA | |
2 | 20 (19) | NA | |
2.5 | 61 (58.1) | NA | |
3 | 16 (15.2) | NA | |
4 | 2 (1.9) | NA |
Parameters | PD (n = 105) | Control (n = 101) | p-value |
---|---|---|---|
Mean modified Sniffin’ Stick-16 score (total 14 odors)∥ | 6.4 | 10.7 | < 0.001*† |
Is your smell sensation normal? | |||
Yes | 78 (74.3) | 61 (98.4) (n = 62) | < 0.001*‡ |
No | 27 (25.7) | 1 (1.6) | |
Olfaction abnormality | |||
Decreased | 23 (85.2) | 1 (100) | |
Absent | 2 (7.4) | 0 (0) | |
Altered | 2 (7.4) | 0 (0) | |
Persistence of olfaction abnormality | |||
Present all the time | 12 (44.4) | 1 (100) | |
Present sometimes | 15 (55.6) | 0 (0) | |
Is your taste sensation normal? | |||
Yes | 90 (85.7) | 60 (98.4) (n = 61) | 0.008*‡ |
No | 15 (14.3) | 1 (1.6) | |
Gustatory abnormality | |||
Decreased | 13 (86.7) | 1 (100) | |
Absent | 1 (6.7) | 0 (0) | |
Altered | 1 (6.7) | 0 (0) | |
Persistence of gustatory abnormality | |||
Present all the time | 7 (46.7) | 1 (100) | |
Present sometimes | 8 (53.3) | 0 (0) | |
Preferred taste | |||
Sweet | 54 (51.4) | 29 (28.7) | 0.001*‡ |
Salty | 35 (33.3) | 16 (15.8) | 0.004*‡ |
Sour | 36 (34.3) | 42 (41.6) | 0.280‡ |
Bitter | 1 (1) | 2 (2) | 0.616§ |
Umami | 6 (5.7) | 0 (0) | 0.029*§ |
Dry mouth | 8 (7.6) | 8 (10.8) (n = 74) | 0.461‡ |
Values are presented as n (%) unless otherwise indicated. Some of the controls did not answer some parts of the questionnaires, therefore, the number of controls is different for different parts.
* p < 0.05;
† independent t test;
‡ chi-square test;
§ Fisher’s exact test;
∥ validation of the smell test in the Thai Parkinson’s disease (PD) population shows that only 14 items are useful for the test (turpentine and clove were omitted from the test).
No. | Questions | PD (n = 105) | Control (n = 74) | p-value* |
---|---|---|---|---|
1 | You feel that you eat less than before. | 36.2 | 23 | 0.059 |
2 | Do you feel that you experience the taste of food less than before? | 32.4 | 18.9 | 0.045 |
3 | You feel that your food is not as tasty as before. | 39 | 25.7 | 0.062 |
4 | You have lost your appetite. | 34.3 | 12.2 | 0.001† |
5 | You have lost weight. | 34.3 | 20.3 | 0.041 |
6 | You must add extra seasoning to every food. | 25.7 | 23 | 0.675 |
7 | You feel that your taste sensation has changed. | 26.7 | 13.5 | 0.034 |
8 | When eating food, you must add fish sauce, salt, soy sauce, or other salty ingredients. | 29.5 | 20.3 | 0.163 |
9 | When eating food, you must add lemon, vinegar, or other sour ingredients. | 26.7 | 31.1 | 0.519 |
10 | When eating food, you must add sugar or other sweet ingredients. | 29.5 | 13.5 | 0.012† |
11 | When eating food, you must add monosodium glutamate or other ingredients to make the food taste better. | 13.3 | 16.2 | 0.590 |
12 | When eating food, you must add chili. | 34.3 | 40.5 | 0.393 |
13 | The taste of food is very important to you. | 67.6 | 43.2 | 0.001† |
14 | You can discriminate between different tastes of food, e.g., salty, sweet, sour, and bitter. | 86.7 | 82.4 | 0.436 |
15 | When you start eating, you can determine the taste of the food. | 92.4 | 82.4 | 0.042 |
16 | When you start eating, you can identify what dish it is. | 88.6 | 81.1 | 0.161 |
17 | You can determine how spicy the food is. | 86.7 | 82.4 | 0.436 |
18 | You have oral health problems, such as tooth decay, broken teeth or oral ulcers. | 51.4 | 45.9 | 0.470 |
19 | Your financial difficulties limit your food choices. | 12.4 | 17.6 | 0.332 |
20 | Your depression causes a loss of appetite. | 18.1 | 10.8 | 0.180 |
21 | Your nausea or vomiting causes a loss of appetite. | 9.5 | 5.4 | 0.312 |
22 | You feel that your medication causes nausea and loss of appetite. | 9.5 | 12.2 | 0.573 |
23 | You feel that you want to eat more when you add extra seasoning. | 41.9 | 32.4 | 0.199 |
24 | You cook yourself. | 61.9 | 59.5 | 0.741 |
25 | You like to eat what you or your family cook rather than ready-to-eat food. | 74.3 | 78.4 | 0.528 |
Combination |
PD |
Control |
||
---|---|---|---|---|
p-value* | p† | p-value* | p† | |
Sweet recognition threshold & salt recognition threshold | < 0.001* | 0.38 | 0.023* | 0.31 |
Sweet recognition threshold & bitter recognition threshold | < 0.001* | 0.38 | < 0.001* | 0.70 |
Sweet recognition threshold & sour recognition threshold | 0.011* | 0.28 | < 0.001* | 0.45 |
Sweet recognition threshold & umami recognition threshold | 0.486 | 0.08 | 0.059 | 0.26 |
Salt recognition threshold & bitter recognition threshold | 0.002* | 0.34 | 0.002* | 0.42 |
Salt recognition threshold & sour recognition threshold | < 0.001* | 0.38 | 0.024* | 0.31 |
Salt recognition threshold & umami recognition threshold | 0.007* | 0.30 | 0.016* | 0.33 |
Bitter recognition threshold & sour recognition threshold | < 0.001* | 0.36 | 0.009* | 0.35 |
Bitter recognition threshold & umami recognition threshold | 0.026* | 0.25 | 0.055 | 0.26 |
Sour recognition threshold & umami recognition threshold | < 0.001* | 0.37 | 0.369 | -0.12 |