Electro-olfactograms are present when odorous stimuli have not been perceived

Smellscape as a healing factor in institutional gardens to enhance health and well-being for older people with dementia: A scoping review

BACKGROUND

There is mounting evidence for the health benefits of aromatic scents for the older people with dementia. However, existing research has focused on indoor aromatherapy using essential oils. It is necessary to explore the health benefits of smellscapes in the outdoor environment for older people with dementia.

AIMS AND OBJECTIVES

This scoping review aims to examine existing evidence for smellscape as a healing factor in institutional garden for older people with dementia, try to bridge the knowledge gaps between outdoor sensory garden scents and aromatherapy to develop green care techniques that incorporate outdoor activities.

METHODS

Seven databases (Scopus, PubMed, PsycINFO, CINAHL, MEDLINE, Embase and Web of Science) were searched with English language articles published between 1990 and 2022. The PRISMA-ScR Checklist was used.

RESULTS

Out of 1013 articles, 11 meet the inclusion criteria. The comprehensive health outcomes include five aspects: mental health; physical health; reduced agitation behaviour; improved cognitive function; and well-being. These aspects are part of the rehabilitation model comprising the person (older people with dementia), environment (garden smellscapes) and outdoor activities (active or passive interventions or a combination).

CONCLUSIONS

The smellscape, as a healing factor in the garden, not only benefits from evidence on indoor aromatherapy but also creates a sensory environment for older people with dementia by compensating for functional impairment, activity support and environmental creation, thereby promoting enhanced health and well-being.

RELEVANCE TO CLINICAL PRACTICE

The research on the healing effects of smellscapes presented in this review offers a novel environmental intervention technique for transferring evidence on essential oils to outdoor sensory gardens. This green care technique is suggested to assist in the creation of healing environments and interventions for people with dementia who cannot be cured.

NO PATIENT OR PUBLIC CONTRIBUTION

This scoping review did not directly involve patient or public contributions to the manuscript.

International consensus statement on allergy and rhinology: Olfaction

BACKGROUND

The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O).

METHODS

Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus.

RESULTS

The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies.

CONCLUSION

This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.

Should Panelists Refrain from Wearing a Personal Fragrance Prior to Sensory Evaluation? The Effect of Using Perfume on Olfactory Performance

It is typically recommended that panelists should refrain from wearing personal fragrances, such as perfume or cologne, prior to sensory evaluation. Interestingly, no study has been reported as to whether panelists’ perceptions of test samples could be affected by personal fragrances worn by themselves. The objective of this study was, therefore, to determine the effect of such a personal fragrance on olfactory performance. Nineteen untrained participants were screened, recruited for, and underwent the Sniffin’ Sticks test designed for measuring olfactory performances that included the odor threshold, discrimination, and identification (TDI). The olfactory performance tasks were conducted under three fragrance level conditions: (1) control (no fragrance), (2) just-about-right (JAR), and (3) excessive, with a preliminary study used to identify both the JAR and excessive fragrance levels. The results showed that the odor discrimination, odor threshold, and combined TDI performances were significantly lowered in the two conditions with the perfume fragrance, while the odor identification performance exhibited no significant differences across all three conditions. These findings provide empirical evidence that even low to moderate levels of personal fragrance can significantly reduce individuals’ olfactory capabilities, possibly subsequently altering the perception of test samples during sensory evaluation.

Electrophysiological Recordings from the Olfactory Epithelium and Human Brain in Response to Stimulation with HLA Related Peptides

In many species, social communication and mate choice are influenced by olfactory cues associated with the major histocompatibility complex (MHC). It has been reported that humans also respond to olfactory signals related to the human MHC-equivalent, the Human Leucocyte Antigen (HLA)-System, and exhibit an olfactory-mediated preference for potential mating partners with a dissimilar, disassortative, HLA-type compared to their own. The aim of this study was to investigate whether HLA-associated peptides, presented as volatile cues, elicit neuronal responses at the receptors in the human olfactory epithelium and can be consciously perceived. To this end the discrimination ability for peptides was tested in a 3-alternative forced choice model. Furthermore electro-olfactograms of the olfactory epithelium and EEG-derived chemosensory event related potentials were recorded using precisely controlled olfactometric stimulation with peptides and control odors. Based on responses from 52 young, healthy participants the peptides could not be discriminated and the electrophysiological signals provided no evidence for a specific response to the peptides which was in contrast to the control odors. In conclusion, within the current setup the results suggest that HLA-associated peptides do not produce specific olfactory activation in humans.

Using Ambient Scent to Enhance Well-Being in the Multisensory Built Environment

The majority of the world's population now lives an urban existence, spending as much as 95% of their lives indoors. The olfactory atmosphere in the built environment has been shown to exert a profound, if often unrecognized, influence over our mood and well-being. While the traditionally malodorous stench to be found indoors (i.e., prior to the invention of modern sanitation) has largely been eliminated in recent centuries, many of the outbreaks of sick-building syndrome that have been reported over the last half century have been linked to the presence of a strange smell in the environment. At the same time, however, there is also growing evidence that consumer behavior can be manipulated by the presence of pleasant ambient odors, while various aromatherapy scents are said to improve our mood and well-being. This Anglophone review focuses primarily on indoor western urban developed spaces. Importantly, the olfactory ambience constitutes but one component of the multisensory atmosphere and ambient odors interact with the visual, auditory, and haptic aspects of the built environment. Surprisingly, the majority of published studies that have deliberately chosen to combine ambient scent with other sensory interventions, such as, for example, music, have failed to increase store sales, or to enhance people's mood and/or well-being, as might have been expected. Such negative findings therefore stress the importance of considering multisensory congruency while, at the same time, also highlighting the potential dangers that may be associated with sensory overload when thinking about the effect of ambient smell on our well-being.

Electrophysiologic assessment of olfactory and gustatory function

This chapter reviews approaches for assessing human and gustatory function using electrophysiologic methods. Its focus is on changes in electrical signals, including summated generator potentials that occur after nasal or oral stimulation. In the first part of the review, we describe tools available to the clinician for assessing olfactory and nasotrigeminal function, including modern electroencephalography (EEG) analysis of brain responses both in the time domain and in the time-frequency (TF) domain. Particular attention is paid to chemosensory event-related potentials (CSERPs) and their potential use in medical-legal cases. Additionally, we focus on the changes of summated generator potentials from the olfactory and respiratory nasal epithelium that could provide new diagnostic insights. In the second part, we describe gustatory event-related potentials (gCSERPs) obtained using a relatively new computer controlled gustometer. A device for presenting different pulses of electrical current to the tongue is also described, with weaker pulses likely reflecting gCSERPs and stronger ones trigeminal CSERPs. Finally, summated generator potentials from the surface of the tongue during gustatory stimulation are described that may prove useful for examining peripheral taste function.

Electro-olfactogram Responses Before and After Aversive Olfactory Conditioning in Humans

The aim of the present study was to investigate whether repetitive aversive odor conditioning induced changes at the level of the peripheral olfactory system in humans. A total of 51 volunteers participated. A pair of indistinguishable odor enantiomers [(+)-rose oxide and (-)-rose oxide] were used as stimuli. During the pre-conditioning, participants' ability to discriminate between the two odors was assessed using a three-alternative, forced-choice discrimination test. In addition, electro-olfactograms (EOG) from the olfactory epithelium were recorded. Participants underwent three conditioning sessions on consecutive days. The experimental group received an electrical stimulus to the forearm only following (+)-rose oxide presentation, whereas its enantiomer sibling was never paired with the aversive stimulus; the control group did not receive any electrical stimulation. During the post-conditioning session, their ability to discriminate the two enantiomers was assessed again using the discrimination test and EOG recordings were obtained similarly to the pre-conditioning session. Results showed significant differences in the peripheral electrophysiological responses between the conditioned and the unconditioned stimulus, demonstrating contextually induced changes at the level of the first neuron in the olfactory system.

Habituation and adaptation to odors in humans

Habituation, or decreased behavioral response, to odors is created by repeated exposure and several detailed characteristics, whereas adaptation relates to the neural processes that constitute this decrease in a behavioral response. As with all senses, the olfactory system continually encounters an enormous variety of odorants which is why mechanisms must exist to segment them and respond to changes. Although most olfactory habitation studies have focused on animal models, this non-systematic review provides an overview of olfactory habituation and adaptation in humans, and techniques that have been used to measure them. Thus far, psychophysics in combination with modern techniques of neural measurement indicate that habituation to odors, or decrease of intensity, is relatively fast with adaptation occurring more quickly at higher cerebral processes than peripheral adaptation. Similarly, it has been demonstrated that many of the characteristics of habitation apply to human olfaction; yet, evidence for some characteristics such as potentiation of habituation or habituation of dishabituation need more support. Additionally, standard experimental designs should be used to minimize variance across studies, and more research is needed to define peripheral-cerebral feedback loops involved in decreased responsiveness to environmental stimuli.

Disrupted Odor Perception

Olfactory loss is frequent. However, in public not many people complain of that, or they are even not (fully) aware of it. This indicates that it is possible to live a life without a sense of smell, albeit it is more dangerous, less pleasant, and food tastes much less interesting. Most common causes for smell loss are sinunasal disease (chronic rhinosinusitis with and without nasal polyps), acute infections of the upper airways, head trauma, and neurodegenerative disorders. In many people smell loss seems to be due to the aging process. Before treatment olfactory disorders are diagnosed according to cause with the medical history being a big portion of the diagnostic process. Olfactory disorders are in principle reversible, with a relatively high degree of spontaneous improvement in olfactory loss following infections of the upper respiratory tract. Medical treatment is according to cause. It also involves surgical approaches as well as conservative treatments including the use of corticosteroids, antibiotics, or smell training. Because today olfactory dysfunction seems to receive more attention than in previous years it can be expected that tomorrow we will have more specific and effective treatment options available.

Olfactory processing: detection of rapid changes

Changes in the olfactory environment have a rather poor chance of being detected. Aim of the present study was to determine, whether the same (cued) or different (uncued) odors can generally be detected at short inter stimulus intervals (ISI) below 2.5 s. Furthermore we investigated, whether inhibition of return, an attentional phenomenon facilitating the detection of new stimuli at longer ISI, is present in the domain of olfaction. Thirteen normosmic people (3 men, 10 women; age range 19-27 years; mean age 23 years) participated. Stimulation was performed using air-dilution olfactometry with 2 odors: phenylethylalcohol and hydrogen disulfide. Reaction time to target stimuli was assessed in cued and uncued conditions at ISIs of 1, 1.5, 2, and 2.5 s. There was a significant main effect of ISI, indicating that odors presented only 1 s apart are missed frequently. Uncued presentation facilitated detection at short ISIs, implying that changes of the olfactory environment are detected better than presentation of the same odor again. Effects in relation to "olfactory inhibition of return," on the other hand, are not supported by our results. This suggests that attention works different for the olfactory system compared with the visual and auditory systems.

From blindsight to blindsmell: a mini review

This mini-review briefly documents the phenomenon of blindsight and investigates evidence for a comparable state in olfaction. Blindsight evokes an appropriate response to a visual stimulus without any conscious visual experience or awareness of that event. For olfaction, we describe many routine aspects of perception that may occur without conscious awareness, arguably paralleling key aspects of blindsight. We then describe the limited neuropsychological evidence suggesting that people can apparently respond appropriately to odours that they cannot subjectively smell - what we would term "blindsmell".

Recording odor-evoked response potentials at the human olfactory epithelium

Electro-olfactogram (EOG) represents the sum of generator potentials of olfactory receptor neurons in response to an olfactory stimulus. Although this measurement technique has been used extensively in animal research, its use in human olfaction research has been relatively limited. To understand the promises and limitations of this technique, this review provides an overview of the olfactory epithelium structure and function, and summarizes EOG characteristics and conventions. It describes methodological pitfalls and their possible solutions, artifacts, and questions of debate in the field. In summary, EOG measurements provide a rare opportunity of recording neuronal input from the peripheral olfactory system, while simultaneously obtaining psychophysical responses in awake humans.

Human olfaction: a constant state of change-blindness

Paradoxically, although humans have a superb sense of smell, they don’t trust their nose. Furthermore, although human odorant detection thresholds are very low, only unusually high odorant concentrations spontaneously shift our attention to olfaction. Here we suggest that this lack of olfactory awareness reflects the nature of olfactory attention that is shaped by the spatial and temporal envelopes of olfaction. Regarding the spatial envelope, selective attention is allocated in space. Humans direct an attentional spotlight within spatial coordinates in both vision and audition. Human olfactory spatial abilities are minimal. Thus, with no olfactory space, there is no arena for olfactory selective attention. Regarding the temporal envelope, whereas vision and audition consist of nearly continuous input, olfactory input is discreet, made of sniffs widely separated in time. If similar temporal breaks are artificially introduced to vision and audition, they induce “change blindness”, a loss of attentional capture that results in a lack of awareness to change. Whereas “change blindness” is an aberration of vision and audition, the long inter-sniff-interval renders “change anosmia” the norm in human olfaction. Therefore, attentional capture in olfaction is minimal, as is human olfactory awareness. All this, however, does not diminish the role of olfaction through sub-attentive mechanisms allowing subliminal smells a profound influence on human behavior and perception.

Odorant concentration dependence in electroolfactograms recorded from the human olfactory epithelium

Electroolfactograms (EOGs) are the summated generator potentials of olfactory receptor neurons measured directly from the olfactory epithelium. To validate the sensory origin of the human EOG, we set out to ask whether EOGs measured in humans were odorant concentration dependent. Each of 22 subjects (12 women, mean age = 23.3 yr) was tested with two odorants, either valeric acid and linalool (n = 12) or isovaleric acid and l-carvone (n = 10), each delivered at four concentrations diluted with warm (37 degrees C) and humidified (80%) odorless air. In behavior, increased odorant concentration was associated with increased perceived intensity (all F > 5, all P < 0.001). In EOG, increased odorant concentration was associated with increased area under the EOG curve (all F > 8, all P < 0.001). These findings substantiate EOG as a tool for probing olfactory coding directly at the level of olfactory receptor neurons in humans.

Olfactory coding with all-or-nothing glomeruli

We present a model for olfactory coding based on spatial representation of glomerular responses. In this model distinct odorants activate specific subsets of glomeruli, dependent on the odorant's chemical identity and concentration. The glomerular response specificities are understood statistically, based on experimentally measured distributions of activation thresholds. A simple version of the model, in which glomerular responses are binary (the all-or-nothing model), allows us to account quantitatively for the following results of human/rodent olfactory psychophysics: 1) just noticeable differences in the perceived concentration of a single odor (Weber ratios) are as low as dC/C approximately 0.04; 2) the number of simultaneously perceived odors can be as high as 12; and 3) extensive lesions of the olfactory bulb do not lead to significant changes in detection or discrimination thresholds. We conclude that a combinatorial code based on a binary glomerular response is sufficient to account for several important features of the discrimination capacity of the mammalian olfactory system.