Age-related changes in olfactory processing detected with olfactory event-related brain potentials using velopharyngeal closure and natural breathing

Measurement and Analyses of Olfactory Event-Related Potentials

Olfactory event-related potentials (OERPs) are brain electrical activities time-locked to olfactory stimuli, detectable via scalp electrodes. They offer a noninvasive means to study cortical olfactory processing in humans. Previous research suggests that olfactory cortical processing occurring within several seconds after the onset of an odor can be tracked using OERPs. This enables the investigation of the temporal dynamics of neural activity, spanning from those associated with odor properties to subjects' states. Moreover, OERPs are influenced by diseases, including olfactory, neurological, or psychiatric conditions, and have the potential to serve as biomarkers. This chapter describes the measurement and analysis methods required to obtain OERPs, with a particular focus on odor delivery, aiming to provide a primer for those unfamiliar with OERP measurement.

Smell Dysfunction in Patients with Primary Sjögren's Syndrome: Impact on Quality of Life

OBJECTIVES

Patients with primary Sjögren's syndrome (pSS) often report smell and taste disturbances. However, the correlation between smell impairment and mucosal dryness is not well understood. The objectives of this study were to investigate the following: (1) the prevalence of smell hypofunction in patients with SS; (2) the impact of smell hypofunction on their quality of life (QoL); (3) whether the patients' smell is correlated with xerostomia; and (4) whether the patients' smell is affected by taste hypofunction, disease duration, age, smoking or self-reported neuropathy.

METHODOLOGY

An ethically approved cross-sectional study was conducted on 65 female patients with SS and 62 sex-matched healthy controls. Their smell was assessed using the University of Pennsylvania Smell Identification Test. Their taste acuity was assessed using the Taste Strips Test. A visual analogue scale was used for the self-assessment of smell and taste functions. Xerostomia was assessed by the salivary flow rate, clinical oral dryness score and the Xerostomia Inventory. The patients' QoL and mental health well-being were assessed using validated questionnaires.

RESULTS

In the SS group, the patients' smell function was impaired in 27/65 patients compared with the controls (15/62, p < 0.05), and it did not correlate with the severity of xerostomia, taste acuity (r = 0.05, p = 0.6) or self-reported nasal dryness (r = -0.02, p = 0.7). In the patients' group, smell hypofunction was not correlated with disease duration (β = 0.1, 95% CI = -0.07-0.1) or smoking (β = -0.02, 95% CI = -8-7). Age was not correlated with the smell function in the patients' group (β = -0.1, p = 0.5) but was correlated significantly with smell in the healthy participants' group (β = -0.3, p = 0.02). Neuropathy affected 81.2% of the patients' group. Their QoL and mental health well-being were not affected by smell hypofunction.

CONCLUSION

Smell hypofunction appears to be a clinical manifestation in patients with SS, but it does not seem to be associated with the severity of mucosal dryness or with taste disturbance.

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.

Individuals With Autism Spectrum Disorder Show Altered Event-Related Potentials in the Late Stages of Olfactory Processing

Atypical sensory reactivities are pervasive among people with autism spectrum disorder (ASD). With respect to olfaction, most previous studies have used psychophysical or questionnaire-based methodologies; thus, the neural basis of olfactory processing in ASD remains unclear. This study aimed to determine the stages of olfactory processing that are altered in ASD. Fourteen young adults with high-functioning ASD (mean age, 21 years; 3 females) were compared with 19 age-matched typically developing (TD) controls (mean age, 21 years; 4 females). Olfactory event-related potentials (OERPs) for 2-phenylethyl alcohol-a rose-like odor-were measured with 64 scalp electrodes while participants performed a simple odor detection task. Significant group differences in OERPs were found in 3 time windows 542 ms after the stimulus onset. The cortical source activities in these time windows, estimated using standardized low-resolution brain electromagnetic tomography, were significantly higher in ASD than in TD in and around the posterior cingulate cortex, which is known to play a crucial role in modality-general cognitive processing. Supplemental Bayesian analysis provided substantial evidence for an alteration in the later stages of olfactory processing, whereas conclusive evidence was not provided for the earlier stages. These results suggest that olfactory processing in ASD is altered at least at the later, modality-general processing stage.

Somatosensory Response to Trigeminal Stimulation: A Functional Near-Infrared Spectroscopy (fNIRS) Study

Functional near-infrared spectroscopy (fNIRS) is an optical imaging technique measuring relative hemodynamic changes in superficial cortical structures. It has successfully been applied to detect a hemodynamic response in the somatosensory cortex evoked by irritating mechanical, electrical, and heat stimulations of limbs or the face. The aim of the current study was to explore the feasibility of fNIRS to detect respective responses evoked by irritating chemical stimulations of the nasal divisions of the trigeminal nerve. In two experiments, healthy subjects were exposed to acetic acid and ethyl acetate presented using a respiration-synchronized olfactometer. Results demonstrated that fNIRS can detect a signal in both hemispheres after birhinal (experiment 1: n = 14) and monorhinal (experiment 2: n = 12) stimulations using acetic acid but not ethyl acetate. This is a first evidence that fNIRS might be a suitable imaging technique to assess chemosensory neuronal correlates in the somatosensory cortex thereby offering a new, portable method to evaluate the irritating properties of certain volatiles in an objective, nonverbal, easy, and comparably inexpensive manner.

The influences of age on olfaction: a review

Decreased olfactory function is very common in the older population, being present in over half of those between the ages of 65 and 80 years and in over three quarters of those over the age of 80 years. Such dysfunction significantly influences physical well-being and quality of life, nutrition, the enjoyment of food, as well as everyday safety. Indeed a disproportionate number of the elderly die in accident gas poisonings each year. As described in this review, multiple factors contribute to such age-related loss, including altered nasal engorgement, increased propensity for nasal disease, cumulative damage to the olfactory epithelium from viral and other environmental insults, decrements in mucosal metabolizing enzymes, ossification of cribriform plate foramina, loss of selectivity of receptor cells to odorants, changes in neurotransmitter and neuromodulator systems, and neuronal expression of aberrant proteins associated with neurodegenerative disease. It is now well established that decreased smell loss can be an early sign of such neurodegenerative diseases as Alzheimer's disease and sporadic Parkinson's disease. In this review we provide an overview of the anatomy and physiology of the aging olfactory system, how this system is clinically evaluated, and the multiple pathophysiological factors that are associated with its dysfunction.

Studying the effects of smell and taste experience in the pediatric population using functional near infrared spectroscopy: a hypothesis

There are different postnatal sensitive periods throughout the development course of sensory functions. During sensitive periods, there is a biological display of an extreme neural sensitivity to the storage of experience-driven sensory information that is not present outside these developmental stages. This neural property is reflected in subjects' reported preferences for sensory stimuli, such as odors and tastes. The human brain mapping approach (HBA) has demonstrated that disease-free human postnatal and later development of any sensory function parallels morphological and functional development of the CNS and that this development correlates with signal changes that have been acquired by means of neuroimaging techniques. Whether experience with tastes and/or odors has a stronger effect on the perception of gustatory and/or olfactory stimuli the earlier subjects are exposed to certain odors and tastes is still unknown. It is also unknown, whether as well as how this effect is reflected in brain activation patterns and whether we are currently able to identify sensitive periods of gustatory and olfactory development from the imaging signals. To answer these research questions, repeated exposure to tastes and/or odors should be applied in children of different age ranges in order to induce different age-related degrees of olfactory/gustatory preferences as well as different aged-related patterns of oxyhemoglobin (OH) and deoxyhemoglobin (DOH) changes that should be measured by means of the functional near-infrared spectroscopy (fNIRS) technique.

Age and apolipoprotein E ε4 effects on neural correlates of odor memory

Alzheimer's disease (AD) affects 5.4 million Americans. Evidence suggests that individuals who are positive for the apolipoprotein E (ApoE) ε4 allele are at higher risk for developing the disease. Studies have also shown that the ε4 allele is linked to olfactory decline. Olfactory functioning may be investigated using olfactory event-related potentials (OERPs). The high temporal resolution of OERPs enables an understanding of the neural correlates of olfactory processing and functioning. This study investigated the effects of age, ApoE ε4 status, response type, and electrode site on OERP latency and amplitude during encoding and retrieval in an odor recognition memory task. The 60 participants were equally divided into 3 age groups matched on ε4 status: younger, middle, and older. Odors were presented using a computer-controlled olfactometer. Participants were notified during encoding that this was a task of odor memory. Results indicated differences in OERP activity as a function of age, ApoE ε4 status, response type, and electrode site. These findings highlight the potential of OERPs to distinguish ε4- and ε4+ individuals and to contribute to an earlier diagnosis of AD.

Individuals at risk for Alzheimer's disease show differential patterns of ERP brain activation during odor identification

BACKGROUND

Studies suggest that older adults at risk of developing Alzheimer's disease may show olfactory processing deficits before other signs of dementia appear.

METHODS

We studied 60 healthy non-demented individuals, half of whom were positive for the genetic risk factor the Apolipoprotein E ε4 allele, in three different age groups. Event-related potentials to visual and olfactory identification tasks were recorded and analyzed for latency and amplitude differences, and plotted via topographical maps.

RESULTS

Varying patterns of brain activation were observed over the post-stimulus epoch for ε4- versus ε4+ individuals on topographical maps. Individuals with the ε4 allele demonstrated different ERP peak latencies during identification of olfactory but not visual stimuli. High correct ApoE classification rates were obtained utilizing the olfactory ERP.

CONCLUSIONS

Olfactory ERPs demonstrate functional decline in individuals at risk for Alzheimer's disease at much earlier ages than previously observed, suggesting the potential for pre-clinical detection of AD at very early stages.

Adiposity measures predict olfactory processing speed in older adult carriers of the apolipoprotein E ε4 allele

OBJECTIVE

The current study investigated the relationship between adiposity and P3 latency.

METHODS

Fifty-one adults in two age groups (18-25 and 65+) participated. Odor stimuli were delivered via olfactometer as participants focused on a computer screen. Each stimulus was followed by presentation on the screen of four odor identification choices. Participants attempted identification by button press. Olfactory event-related potentials (OERPs) were recorded. BMI and waist circumference were measured as indicators of adiposity.

RESULTS

In bivariate analyses with all participants included, positive correlations for P3 latency with both BMI and waist circumference were observed, indicating that as adiposity increased latencies also increased. When each age group was separately examined, correlations between adiposity measures and latency remained statistically significant for older adults. Furthermore, ApoE ε4 allele status was examined. Latencies remained positively correlated with adiposity in older adult ε4 carriers; but not in non-carriers.

CONCLUSIONS

This study indicates that adiposity predicts olfactory processing speed in older adults, specifically in ε4 carriers.

SIGNIFICANCE

The results suggest that olfactory processing speed may be a useful measure for detecting and following the effects of adiposity on brain integrity and cognitive function in those at genetic risk for AD.

Abnormal event-related potentials in young and middle-aged adults with the ApoE ε4 allele

The largest genetic susceptibility factor for Alzheimer's disease is the Apolipoprotein E (ApoE) ε4 allele. Cognitive decline and olfactory impairment are greater in those positive for the ε4 allele. This study sought to determine if the olfactory event-related potential (OERP), compared to the visual ERP, would be sensitive to these subtle declines. Participants included 40 individuals from two age groups, half of each group were ε4 allele positive and half were ε4 negative. Visual ERPs did not demonstrate significant differences between ApoE groups. OERPs demonstrated robust age by ApoE interactions. P3 latencies were significantly longer in ε4 young and middle age participants. These findings suggest that very early olfactory and cognitive changes related to ApoE status are detectible via the OERP.

Neuronal generator patterns of olfactory event-related brain potentials in schizophrenia

To better characterize neurophysiologic processes underlying olfactory dysfunction in schizophrenia, nose-referenced 30-channel electroencephalogram was recorded from 32 patients and 35 healthy adults (18 and 18 male) during detection of hydrogen sulfide (constant-flow olfactometer, 200 ms unirhinal exposure). Event-related potentials (ERPs) were transformed to reference-free current source density (CSD) waveforms and analyzed by unrestricted Varimax-PCA. Participants indicated when they perceived a high (10 ppm) or low (50% dilution) odor concentration. Patients and controls did not differ in detection of high (23% misses) and low (43%) intensities and also had similar olfactory ERP waveforms. CSDs showed a greater bilateral frontotemporal N1 sink (305 ms) and mid-parietal P2 source (630 ms) for high than low intensities. N1 sink and P2 source were markedly reduced in patients for high intensity stimuli, providing further neurophysiological evidence of olfactory dysfunction in schizophrenia.

Differential effects of active attention and age on event-related potentials to visual and olfactory stimuli

Normal aging impairs olfactory functioning both centrally and peripherally. The P3 peak of the event-related potential (ERP), evoked by active response to a target stimulus, is considered a reflection of central cognitive processing. It can also be evoked in a passive task to both auditory and visual stimuli. Our goal was to investigate whether age influences amplitude and latency of the ERP differentially in active and passive tasks to olfactory stimuli. Olfactory and visual event-related potentials were elicited with a single stimulus paradigm in separate active and passive task response conditions. Participants included 30 healthy individuals from three age groups, young, middle age, and older adults. Results indicated that P3 ERP latency increased with age in both sensory modalities. P3 latencies for active versus passive tasks were similar across age groups for visual ERPs, but in the olfactory modality, older adults demonstrated significantly longer latencies in the passive task compared to the active task. Future directions should include research on specific clinical populations utilizing active versus passive task conditions.

Assessment of olfactory and trigeminal function using chemosensory event-related potentials

GOALS

To give an overview on the theoretical and practical applications of chemosensory event-related potentials.

METHODS

Chemosensory event-related potentials (ERPs) may be elicited by brief and precisely defined odorous stimuli. Based on the principles of air-dilution olfactometry, a stimulator was developed in the late 1970s, which allows stimulation of the olfactory neuroepithelium and the nasal mucosa with no concomitant mechanical stimulation. Chemosensory ERPs were obtained after stimulation of the olfactory nerve (olfactory ERPs) or the trigeminal nerve (somatosensory or trigeminal ERPs). The characteristics of the stimulator for chemosensory research as well as the variables influencing the responses are discussed in this paper.

RESULTS

Implementation and normative data from our department are reported with different clinical examples from otorhinolaryngologic clinic. The bulk of the evoked response consists of a large negative component (often referred to as N1), which occurs between 320 and 450 ms after stimulus onset. This component is followed by a large positive component, often referred to as P2, occurring between 530 and 800 ms after stimulus onset. Absence of olfactory ERPs and presence (even with subtle changes) of somatosensory ERPs is a strong indicator of the presence of an olfactory dysfunction.

CONCLUSIONS

This review examines and discusses the methods of chemosensory stimulation as well as the electrophysiological correlates elicited by such stimuli. The clinical applications of chemosensory ERPs in neurology and otorhinolaryngology are outlined.

Olfactory loss in aging

Olfactory loss is a common age-related complaint that may be caused by changes in the anatomy of the structures required for olfaction (for example, loss of olfactory receptor cells) or in the environment surrounding the receptor cell (for example, altered nasal mucus composition). However, aging, as well as age-related diseases and medications, may also alter the distribution, density, or function of specific receptor proteins, ion channels, or signaling molecules that affect the ability of neural elements throughout the olfactory pathway to signal and process odorant information. Although a great deal has been learned about the prevalence and nature of age-related olfactory loss, we are just beginning to explore avenues to prevent or alleviate this sensory deficit. Some studies suggest that, rather than being a necessary outcome of aging, age-associated factors such as chronic diseases, medications, and dental and sinus problems are the primary culprits in causing olfactory impairment. This idea suggests optimism in that, as we address these other age-related health issues, the prevalence of olfactory loss will lessen as well.

Circadian rhythm and desensitization in chemosensory event-related potentials in response to odorous and painful stimuli

Olfactory (H2S) and trigeminal (CO2) event-related potentials (ERPs) were studied with respect to circadian rhythm and desensitization. ERPs, perceived odor and pain intensity, oral temperature, blood pressure, heart rate, nasal volume, and sleepiness were assessed four times at 04:00, 08:00, 12:00, 16:00, 20:00, and 24:00 hr in five young men. For each of these 24 sessions per participant, H2S and CO2 were each presented in 15 series of five stimuli with a 5-s ISI within and 30-s ISI between series. ERP amplitudes, but not latencies, followed a circadian rhythm (largest at 16:00 and smallest at 04:00) similar to oral temperature and opposite to sleepiness. Amplitudes decreased (most pronounced at 16:00 and 20:00) and latencies increased with repeated stimulation, suggesting desensitization, in accordance with odor and pain intensity. These findings imply that circadian rhythm and desensitization should be considered in chemosensory ERP studies.

The cerebellum and olfaction in the aging brain: a functional magnetic resonance imaging study

The present study investigated activation of distinct cerebellar regions as a result of olfactory stimulation in healthy young and elderly adults using functional magnetic resonance imaging (fMRI). Ten young and 10 elderly adults were imaged using a 1.5-TMR scanner. The odorant amyl acetate was delivered in 12-s on, 40-s off cycles. Throughout the scan participants responded with a button press at first detection of each stimulus interval followed by a second button press upon odorant extinction. Images were processed with AFNI software. Elderly participants showed significantly decreased cerebellar activation in both the superior semilunar lobule (Crus I) and the inferior semilunar lobule (Crus II), two of three previously identified regions of interest for odor processing, compared to young adults. Interestingly, both groups showed similar levels of activation in the third region of interest, the posterior quadrangular lobule (VI), although the elderly showed more variability than the young did. Previous research identifying this area to be involved in attention may reflect the possibility that elderly adults engaged in olfactory tasks may show more variability than young participants in the degree of attentional demands needed for these tasks as a result of decreased olfactory abilities.

A paradigm for measuring the olfactory event-related potential in the clinic

Recent research on the olfactory event-related potential (OERP) using inter-stimulus intervals (ISIs) of 90 s and shorter has revealed a marked decrease in component amplitude after the first trial, with a leveling off for the remaining trials. Studies manipulating the ISI in olfactory and other modalities demonstrate an association between higher amplitudes and longer ISIs, suggesting that habituation occurs at short time intervals between each stimulus presentation. The present study attempted to reduce the effects of habituation by using a 10-min ISI and fewer trials. OERPs were recorded monopolarly at the Fz, Cz and Pz electrode sites in ten subjects (five males, five females), for three trials using a 10-min ISI. Results demonstrated no significant reduction in component amplitudes across trials and no significant difference in latencies over trials, indicating no habituation effect at this ISI. These results indicate that with a 10-min ISI and three trial recordings, a complete reduction in habituation can be achieved. These findings may prove to be clinically useful to physicians who can implement this technique to assess olfactory functioning in cognitively impaired individuals or to assess malingering.