{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T22:43:08Z","timestamp":1767912188442,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,9,3]],"date-time":"2017-09-03T00:00:00Z","timestamp":1504396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The diagnosis of Parkinson's disease (<jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>) can be challenging early in the disease course, when motor features are subtle. The objective of this study was to explore the diagnostic value of combining acute levodopa challenge and olfactory testing to predict <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from 210 patients with a recent onset of parkinsonism who had at least 2 years of follow\u2010up and underwent acute levodopa challenge for the clinical prediction of long\u2010term dopaminergic response and had olfactory testing with Sniffin\u2019 Sticks Test were evaluated. Single and combined diagnostic measures were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After 2 years of follow\u2010up, a <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> diagnosis was confirmed in 157 patients who fulfilled United Kingdom Parkinson's Disease Society Brain Bank criteria and was ruled out in 53. Sensitivity and specificity of acute levodopa challenge to predict <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> diagnosis were 0.71 and 0.94, respectively. Sensitivity and specificity of olfactory tests were calculated according to the total olfactory score for hyposmia (0.61 and 0.77 respectively), the hyposmia identification subscore (0.63 and 0.74, respectively), and the anosmia score (0.40 and 0.85, respectively). The best combination identified was response to acute levodopa challenge together with hyposmia according to the total olfactory score (sensitivity, 0.90; specificity, 0.74; positive predictive value, 0.91; negative predictive value, 0.72; accuracy, 0.86).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination of response to acute levodopa challenge with hyposmia according to the total olfactory score improved sensitivity for the early diagnosis of <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.12517","type":"journal-article","created":{"date-parts":[[2017,6,16]],"date-time":"2017-06-16T09:17:28Z","timestamp":1497604648000},"page":"824-828","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Diagnostic Value of Combined Acute Levodopa Challenge and Olfactory Testing to Predict Parkinson's Disease"],"prefix":"10.1002","volume":"4","author":[{"given":"Cinthia","family":"Terroba Chambi","sequence":"first","affiliation":[{"name":"Movement Disorders Section Neuroscience Department Raul Carrea Institute for Neurological Research (FLENI) Buenos Aires Argentina"},{"name":"Argentine National Scientific and Technological Research Council (CONICET) Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malco","family":"Rossi","sequence":"additional","affiliation":[{"name":"Movement Disorders Section Neuroscience Department Raul Carrea Institute for Neurological Research (FLENI) Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Bril","sequence":"additional","affiliation":[{"name":"Movement Disorders Section Neuroscience Department Raul Carrea Institute for Neurological Research (FLENI) Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricio 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