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Abstract：
BACKGROUND General paresis of the insane (GPI) is characterized by cognitive impairment, neuropsychiatric symptoms, and brain structural abnormalities, mimicking many neuropsychiatric diseases. Olfactory dysfunction has been linked to cognitive decline and neuropsychiatric symptoms in numerous neuropsychiatric diseases. Nevertheless, it remains unclear whether patients with GPI experience olfactory dysfunction and whether olfactory dysfunction is associated with their clinical manifestations. MATERIAL AND METHODS Forty patients with GPI and 37 healthy controls (HCs) underwent the \"Sniffin Sticks\" test battery, Mini-Mental State Examination, and Neuropsychiatric Inventory to measure olfactory function, cognitive function, and neuropsychiatric symptoms, respectively. Brain structural abnormalities were evaluated using visual assessment scales including the medial temporal lobe atrophy (MTA) visual rating scale and Fazekas scale. RESULTS Compared with HCs, patients with GPI exhibited significant olfactory dysfunction, as indicated by deficits in the odor threshold (OT) (P=0.001), odor discrimination (OD) (P<0.001), and odor identification (OI) (P<0.001). In patients with GPI, the OI was positively correlated with cognitive function (r=0.57, P<0.001), but no significant correlation was found between olfactory function and neuropsychiatric symptoms, blood, or cerebrospinal fluid biomarkers (rapid plasma reagin circle card test and Treponema pallidum particle agglutination test), or brain structural abnormalities (MTA and Fazekas scale scores). Mediation analysis indicated that the impaired OI in patients with GPI was mediated by cognitive impairment and impaired OT respectively. CONCLUSIONS Patients with GPI exhibited overall olfactory dysfunction. OI is correlated with cognitive function and the impaired OI is mediated by cognitive impairment in patients with GPI. Thus, OI may serve as a marker for reflecting cognitive function in patients with GPI.
摘要：
背景技术精神麻痹(GPI)以认知障碍为特征,神经精神症状,大脑结构异常,模仿许多神经精神疾病。在许多神经精神疾病中，嗅觉功能障碍与认知能力下降和神经精神症状有关。然而，目前尚不清楚GPI患者是否出现嗅觉功能障碍,以及嗅觉功能障碍是否与其临床表现相关.材料和方法40名GPI患者和37名健康对照（HCs）接受了“SniffinSticks”测试电池，迷你精神状态检查，和神经精神量表来测量嗅觉功能，认知功能,和神经精神症状，分别。使用视觉评估量表评估脑结构异常，包括内侧颞叶萎缩（MTA）视觉评定量表和Fazekas量表。结果与HC相比，GPI患者表现出显著的嗅觉功能障碍，如气味阈值（OT）的缺陷（P=0.001）所示，气味辨别（OD）（P<0.001），气味识别(OI)(P<0.001)。在GPI患者中，OI与认知功能呈正相关(r=0.57,P<0.001),但是嗅觉功能和神经精神症状之间没有发现显著的相关性，血,或脑脊液生物标志物（快速血浆反应蛋白环卡试验和梅毒螺旋体颗粒凝集试验），或脑结构异常（MTA和Fazekas量表评分）。中介分析表明，GPI患者的OI受损分别由认知障碍和OT受损介导。结论GPI患者表现出整体嗅觉功能障碍。OI与认知功能相关，OI受损是由GPI患者的认知障碍介导的。因此，OI可以作为反映GPI患者认知功能的标志物。
