Chemosensory event-related potentials change with age

Responses to the activation of different intranasal trigeminal receptors: Evidence from behavioral, peripheral and central levels

AIM

There are various receptors that mediate intranasal trigeminal sensations. However, few studies compare the response patterns across different receptor activations.

METHODS

We recorded negative mucosal potentials (NMPs) in 24 healthy participants and event-related potentials (ERPs) in 17 participants during exposure to five odors that trigger trigeminal sensations and one olfactory stimulus. Additionally, 10 participants completed a continuous odor intensity rating task.

RESULTS

We observed a significant effect of odor type on NMP amplitudes (F=13.51-21.88, p's < 0.01), with cyclohexanone (TRPV1) and CO2 (TRPV1 +A1) inducing greater N1 and/or P1N1 amplitudes than other stimuli (t = 3.28-7.54, p's < 0.05). Similar differences were seen in ERP amplitudes (F=3.69-12.25, p's < 0.05), with cyclohexanone showing greater P2 and/or N1P2 amplitudes than PEA (odorant), carvacrol (TRPV3 +A1), and perillaldehyde (TRPA1) (t = 3.13-4.10, p's < 0.05). CO2 also produced greater amplitudes than carvacrol (t = 3.53-4.42, p's < 0.05). In the odor intensity rating task, cyclohexanone, CO2, and isopulegol (TRPM8 +TRPA1) had higher peak ratings, steeper slopes, and/or shorter latencies (F=6.15-13.86, p's < 0.01; t = 3.14-7.76, p's < 0.05).

CONCLUSIONS

Activation of different intranasal trigeminal receptors yields varied responses. Notably, stimuli involving TRPV1 activation, linked to irritation or pain, elicited stronger behavioral and neural activity compared to stimuli involving other receptors, even when controlling for rated stimulus intensity. This emphasizes TRPV1's significance in survival adaptation. Future studies should test different sets of stimulants to verify the robustness of these findings.

Validation of Korean Olfactory Questionnaire for Perioperative Olfactory Assessment in Endoscopic Endonasal Skull Base Surgery

Objective: To analyze changes in olfactory function after endoscopic endonasal skull base surgery and compare performance of the olfactory questionnaire with those of conventional psychophysical tests. Methods: Patients were classified into 5 categories for olfactory function evaluation (normal, mild hyposmia, moderate hyposmia, severe hyposmia, and anosmia) based on a self-assessment. Patients also underwent the butanol threshold test (BTT), Cross-Cultural Smell Identification Test (CCSIT), and 11-item olfactory questionnaire. Subjects with normosmia preoperatively and who were followed up at least 6 months after surgery were analyzed. Receiver operating characteristic curves and confusion matrix analysis were performed for BTT, CCSIT, and olfactory questionnaire to compare their diagnostic abilities. The effects of age, preoperative olfaction, septal flap, tumor pathology, and tumor size on postoperative olfaction were evaluated using multivariate linear regression analysis. Results: Data from 108 patients were analyzed. Postoperative changes in the olfactory questionnaire were significantly associated with changes in the BTT and CCSIT. The area under the curve for postoperative self-olfactory function classification was highest for olfactory questionnaire (0.894), followed by BTT (0.767) and CCSIT (0.688). Patient age at the time of surgery and preoperative BTT score were significantly related to postoperative olfactory outcomes. Conclusion: The olfactory questionnaire correlated well with conventional psychosomatic olfactory function tests. In combination with clinical parameters and preoperative psychosomatic olfactory function tests, the olfactory questionnaire is suitable for assessing subjective olfactory function after endoscopic endonasal skull base surgery.

Normative data for the Vietnamese smell identification test

Introduction

The 12-item Vietnamese smell identification test (VSIT) has been developed to evaluate the olfactory function of the Vietnamese population. This study aimed to investigate the normative value of the VSIT in different age groups and sexes.

Methods

This cross-sectional study was conducted at Ho Chi Minh University Medical Center, Vietnam. All participants were evaluated for odor identification ability using the VSIT. We included healthy participants aged 18 years or older with no history of olfactory disturbances.

Results

A total of 391 healthy volunteers were recruited with a mean age of 45.80 years (SD: 17.62; range: 18-86; female: 63.4 %). The tenth percentile of scores on the 0-12 VSIT scale was 8.3 in participants aged 18-29 years, 9.0 in 30-39 years, 8.0 in 40-49 years, 7.8 in 50-59 years, 7.9 in 60-69 years and 6.0 in over 70 years. Young adults (18-39 years old) had better olfactory identification ability than older adults (over 50 years), p < 0.001. There was a significant main effect of sex on VSIT score (p = 0.02), suggesting that females outperformed males. Sensitivity to 8 odors were negatively correlated with age: lemon, garlic, banana, coffee, mango, guava, apple and watermelon (p < 0.05 in all cases) whereas four odors were age-independent including orange, fish sauce, soy sauce, and fish.

Conclusion

Normative data provide guidance for assessing individual olfactory function. However, there were significant sex and age effects on olfactory identification scores on the VSIT. Therefore, future studies should be conducted to better adjust for those confounders mentioned above.

Exploratory Study on Chemosensory Event-Related Potentials in Long COVID-19 and Mild Cognitive Impairment: A Common Pathway?

People affected by the Long COVID-19 (LC) syndrome often show clinical manifestations that are similar to those observed in patients with mild cognitive impairments (MCI), such as olfactory dysfunction (OD), brain fog, and cognitive and attentional diseases. This study aimed to investigate the chemosensory-evoked related potentials (CSERP) in LC and MCI to understand if there is a common pathway for the similarity of symptoms associated with these disorders. Eighteen LC patients (mean age 53; s.d. = 7), 12 patients diagnosed with MCI (mean age 67; s.d. = 6), and 10 healthy control subjects (mean age 66; s.d. = 5, 7) were recruited for this exploratory study. All of them performed a chemosensory event-related potentials (CSERP) task with the administration of trigeminal stimulations (e.g., the odorants cinnamaldehyde and eucalyptus). Study results highlighted that MCI and LC showed reduced N1 amplitude, particularly in the left frontoparietal network, involved in working memory and attentional deficits, and a reduction of P3 latency in LC. This study lays the foundations for evaluating aspects of LC as a process that could trigger long-term functional alterations, and CSERPs could be considered valid biomarkers for assessing the progress of OD and an indicator of other impairments (e.g., attentional and cognitive impairments), as they occur in MCI.

Chronic intermittent hypoxia impacts the olfactory nervous system in an age-dependent manner: pilot study

PURPOSE

Obstructive sleep apnea (OSA) is characterized by repetitive upper airway collapse during sleep, which induces chronic intermittent hypoxia (CIH). CIH results in low-grade inflammation, sympathetic overactivity, and oxidative stress. Nevertheless, it remains unclear how exposure to CIH affects olfaction. The purpose of this study was, therefore, to investigate the cytotoxic effects of CIH exposure on mouse olfactory epithelium and the underlying pathophysiology involved.

METHODS

Mice were randomly divided into four groups: Youth mouse (You) + room air (RA), You + intermittent hypoxia (IH), Elderly mouse (Eld) + RA, and Eld + IH (n = 6 mice/group). Mice in the two hypoxia groups were exposed to CIH. The control condition involved exposure to room air (RA) for 4 weeks. Olfactory neuroepithelium was harvested for histologic examination, gene ontology analysis, quantitative real-time polymerase chain reaction (qRT-PCR), and western blotting.

RESULTS

Based on qRT-PCR analysis, olfactory marker protein (OMP), Olfr1507, ADCY3, and GNAL mRNA levels were lower, whereas NGFR, CNPase, NGFRAP1, NeuN, and MAP-2 mRNA levels were higher in the You + IH group than in the You + RA group. Olfactory receptor-regulated genes, neurogenesis-related genes and immunohistochemical results were altered in nasal neuroepithelium under CIH exposure.

CONCLUSIONS

Based on genetic and cytologic analysis, CIH impacted the olfactory neuroepithelium in an age-dependent manner. Our findings suggest that CIH-induced damage to the olfactory neuroepithelium may induce more severe change in the youth than in the elderly.

Do you often sniff yourself or others? Development of the Body Odor Sniffing Questionnaire and a cross-cultural survey in China and the USA

OBJECTIVES

Body odor can convey much information about an individual and thus we frequently engage in sniffing one's own and other people's body odor. However, there is scarce evidence on the within- and cross-cultural variation in body odor sniffing behaviors and no psychometric scale for specifically measuring such behaviors. Hence, our study aimed to develop the Body Odor Sniffing Questionnaire (BOSQ) and used it to make a cross-cultural comparison.

METHODS

In Study 1, 2,026 participants were recruited from our university, with one half used for exploratory factor analysis (EFA) to examine the factor structure of the BOSQ (sample 1) and the other half used for confirmatory factor analysis (CFA) to verify the factor structure (sample 2). In Study 2, 352 Chinese and 254 US participants were recruited to complete the BOSQ through Wenjuanxing and Amazon Mechanical Turk, enabling comparison of body odor sniffing behaviors across two cultures.

RESULTS

The Study 1 results showed that the BOSQ comprises 17 items in three factors: self-private body odor, others' body odor, and self-common body odor. The CFA results further supported that this three-factor model was a good fit. The Study 2 results showed that US participants scored higher overall and on the self-private body odor and others' body odor dimensions, whereas Chinese participants scored higher on the self-common body odor dimension.

CONCLUSIONS

The BOSQ demonstrated good reliability and validity, which is a useful tool for evaluating individuals' body odor sniffing behaviors. Cross-cultural difference existed as the US population reported a higher prevalence of body odor sniffing behavior, compared to the Chinese population.

Ability of dog owners to identify their dogs by smell

Several studies report that olfactory cues play an important role in human life; humans are essentially able to recognize other family members and friends by their odors. Moreover, recent studies report that humans are also able to identify odors of non-conspecifics. The aim of this study was to determine whether dog owners are able to identify their dogs by smell and distinguish the odor of their own dogs from those of other dogs. A total of 53 dog owners (40 females and 13 males of different ages) volunteered to take part in this study. A number of the participants (17) owned 2 dogs; these owners took part in the study twice (i.e., working with only one dog at a time). Sterile gauze pads were used to collect odor samples from the dogs. Each pad was placed in its own sterile glass jar (750 ml) with a twist off lid until the experiment commenced. Participants were asked to identify their own dog´s odor from a line-up of 6 glass containers. This experiment demonstrated that dog owners are capable of identifying their dogs by smell on a significant level. Results of this study additionally suggested that male owners outperformed their female counterparts in the identification process. Moreover, dog owners whose dogs were housed outside had a higher success rate in identification than did participants who kept their dogs indoors with them. The dog owners found it easier to identify dogs that had been neutered, fed dry dog food and bathed less frequently. In general, younger dog owners tended to have more success when attempting to identify their dogs than did their older counterparts.

Olfactory Modulation of the Contingent Negative Variation to Auditory Stimuli

Although pleasantness is intrinsically related to the perception of odors it is difficult to objectively assess odor-induced pleasantness. To evaluate the effects of odors of different valences on the contingent negative variation (CNV) in a younger and an older population. Data from 62 participants (27 men, 35 women) were included. Two age groups with Age group 1 (YOUNG) had 30 subjects within age 18-30 years and age group 2 (OLD) had 32 subjects with age >40 years. Pre-testing was performed to acquaint subjects with the experimental tasks and their environment. Subjects received "Sniffin' Sticks" odor identification tests and a standardized medical history to ascertain normosmia. In addition, they also took questionnaires relating to importance of the sense of smell and personality traits. CNV was elicited with two auditory stimuli, S1 followed by S2 at an interval of 2.4 s. Subjects were asked to push a button as fast as possible after they perceived S2. EEG was recorded from 4 positions of the 10-20 system (Fp2, Fz, Cz, and Pz). Four odors plus odorless air was presented in randomized order. The following main results emerged: (1) Consistent with the literature CNV showed a typical topographical distribution with the largest amplitude over the front-central recording sites. (2) 69% of subjects had consistent CNV for all conditions. (3) for some odor conditions CNV amplitudes exhibit a weak relation to odor pleasantness and associations with calmness. (4) CNV amplitude correlated negatively with reaction times. Overall, the results suggest the usefulness of CNV as an electrophysiological measure of cognition. However, in the present context, concomitantly applied odors of different hedonic tones exerted only minor effects on CNV. Thus, we conclude that odors have little or no effect on CNV.

Odor Sensitivity Versus Odor Identification in Older US Adults: Associations With Cognition, Age, Gender, and Race

The ability to identify odors predicts morbidity, mortality, and quality of life. It varies by age, gender, and race and is used in the vast majority of survey and clinical literature. However, odor identification relies heavily on cognition. Other facets of olfaction, such as odor sensitivity, have a smaller cognitive component. Whether odor sensitivity also varies by these factors has not been definitively answered. We analyzed data from the National Social Life, Health, and Aging Project, a nationally representative study of older US adults (n = 2081). Odor identification was measured using 5 validated odors presented with Sniffin' Stick pens as was odor sensitivity in a 6-dilution n-butanol constant stimuli detection test. Multivariate ordinal logistic regression modeled relationships between olfaction and age, gender, race, cognition, education, socioeconomic status, social network characteristics, and physical and mental health. Odor sensitivity was worse in older adults (P < 0.01), without gender (P = 0.56) or race (P = 0.79) differences. Odor identification was also worse in older adults, particularly men (both P ≤ 0.01), without differences by race. Decreased cognitive function was associated with worse odor identification (P ≤ 0.01) but this relationship was weaker for odor sensitivity (P = 0.02) in analyses that adjusted for other covariates. Odor sensitivity was less strongly correlated with cognitive ability than odor identification, confirming that it may be a more specific measure of peripheral olfactory processing. Investigators interested in associations between olfaction and health should consider both odor sensitivity and identification when attempting to understand underlying neurosensory mechanisms.

Development of the Spanish Version of Sniffin's Sticks Olfactory Identification Test: Normative Data and Validity of Parallel Measures

The Sniffin' Sticks Olfactory Identification Test is a tool for measurement of olfactory performance developed in Germany and validated in several countries. This research aims to develop the Spanish version of the Sniffin' Sticks Olfactory Identification Test and obtain normative values for the Spanish population. The parameters are free recall and subjective intensity of odorants are included. The influence of possible demographic covariates such as sex, age, smoking, or educational level are analyzed, and the items that best discriminate are studied. In addition, the internal structure validity of the blue and purple versions is studied as a parallel measure, and a cultural adaptation of the purple version is carried out. For this, three independent samples of normosmic healthy volunteers were studied. To obtain normative values, the sample was of 417 participants (18-89 years). For the internal structure validity study of both versions, the sample was 226 (18-70 years), and for familiarity of the purple version, the sample was 75 participants (21-79 years). Results indicated that men and women and smokers and non-smokers perform equally. However, differences were found as age progresses, being more pronounced after 60 years old in all three measurements of the identification test. This research also provides the items that best discriminate in the blue version and a cultural adaptation for the purple version. In conclusion, the Sniffin' Sticks Odor Identification Test is a suitable tool for olfactory assessment in the Spanish population. The instrument has been expanded with two new scores, and normative data as a function of age are provided. Its parallel version also seems appropriate for testing, as items have been culturally adapted and evidence of internal structure validity for both versions is reported.

Spanish Validation for Olfactory Function Testing Using the Sniffin' Sticks Olfactory Test: Threshold, Discrimination, and Identification

The assessment of olfactory function is becoming increasingly relevant, especially in cases of cognitive decline (i.e., neurodegenerative diseases), where olfactory alterations may be relevant as potential early biomarkers. The Sniffin' Sticks Olfactory Test, developed in Germany and validated in several countries, is an objective measure of olfactory performance. This study aims to validate this test in a Spanish sample. This study included 209 healthy normosmic volunteers (154 females and 55 males) aged between 20 to 79 years (mean age = 50.11 ± 15.18 years) as the normative sample. From this group, 22 participants were retested in order to obtain test-retest reliability evidence. Odor familiarity for descriptors in the olfactory identification test was also studied on an independent healthy sample (n = 69), and required cultural modifications were applied. Results indicate that men and women, as well as smokers and non-smokers, performed equally in every test. However, significant differences were found between age groups in every score. The general trend is that olfactory function progressively decreases as a function of age, the elderly group (+60 years) being the one with the lowest scores. In conclusion, this normative data, in addition to the test's cultural modifications, allows the Sniffin' Sticks Olfactory Test to be administered on a Spanish population.

No Olfactory Compensation in Food-related Hazard Detection Among Blind and Deaf Adults: A Psychophysical Approach

The exposure-driven olfactory compensation associated with sensory loss is likely to be observed in assessment of food-related dangers. Therefore, in the current study we tested the hypothesis that olfactory compensation occurs in the case of protection from food-related hazards. We compared thresholds for detection of an unpleasant rotten food odor (fermented fish sauce) in four groups of subjects: blind subjects (n = 100), sighted controls (n = 100), deaf subjects (n = 74) and hearing controls (n = 99). Overall, we observed no significant differences in smell acuity between the blind and deaf groups and their matched control samples. However, the sensory deprived subjects assessed their sensitivity as higher than did control groups. The present study is yet another example of research among large samples of sensory deprived individuals that shows no evidence of olfactory compensation. This result is consistent with a growing number of studies suggesting no sensory compensation in simple, absolute sensitivity tasks.

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.

Olfactory perception and blindness: a systematic review and meta-analysis

Anecdotal reports suggest that blind people might develop supra-normal olfactory abilities. However, scientific evidence shows a mixed pattern of findings. Inconsistent observations are reported for both sensory-driven olfactory tasks (e.g., odor threshold) and higher-order olfactory functions (e.g., odor identification). To quantify the evidence systematically, we conducted a review and meta-analysis. Studies were included if they examined olfactory function (i.e., odor threshold, odor discrimination, free odor identification, or cued odor identification) in blind compared with a sighted control group. Articles were identified through computerized literature search. A total of 18 studies focused on olfactory threshold (n = 1227: 590 blind and 637 sighted individuals), 14 studies targeted discrimination (n = 940: 455 blind and 485 sighted), 14 studies measured cued identification (n = 968: 468 blind and 500 sighted), and 7 studies (n = 443: 224 blind and 219 sighted individuals) assessed free identification. Overall, there were no differences in effect sizes between the blind and sighted individuals after correcting the results for publication bias. We additionally conducted an exploratory analysis targeting the role played by three moderators of interests: participants' age, the proportion of women versus men in each of the studies included into meta-analysis and onset of blindness (early blind vs. late-blind). However, none of the moderators affected the observed results. To conclude, blindness seems not to affect cued/free odor identification, odor discrimination or odor thresholds.

Chemosensory Perception: A Review on Electrophysiological Methods in “Cognitive Neuro-Olfactometry”

Various brain imaging techniques are available, but few are specifically designed to visualize chemical sensory and, in particular, olfactory processing. This review describes the results of quantitative and qualitative studies that have used electroencephalography (EEG) and magneto-encephalography (MEG) to evaluate responses to olfactory stimulation (OS). EEG and MEG are able to detect the components of chemosensory event-related potentials (CSERPs) and the cortical rhythms associated with different types of OS. Olfactory studies are filling the gaps in both the developmental field of the life cycle (from newborns to geriatric age) and the clinical and basic research fields, in a way that can be considered the modern “cognitive neuro-olfactometry”.

The olfactory function in patients with common variable immunodeficiency

AIMS

To determine the incidence of olfactory dysfunction in common variable immunodeficiency patients. To evaluate the correlation between olfactory dysfunction and chronic rhinosinusitis in this class of patients.

MATERIALS AND METHODS

Fifty patients, with a diagnosis of common variable immunodeficiency and under immunoglobulin replacement therapy, were submitted to an otolaryngology physical examination and a CT scan of the craniofacial structures in order to show the presence of signs of chronic rhinosinusitis. An olfactory function evaluation was executed using the Sniffin' Sticks Test, with assessment of olfactory threshold, discrimination, identification and overall composite scores (TDI: threshold-discrimination-identification score).

RESULTS

An olfactory dysfunction was found in 23 (46%) common variable immunodeficiency patients, with hyposmia and anosmia respectively present in 65% and 38% of them. The mean TDI score in the study group was 27.7. Common variable immunodeficiency patients with CRS presented a more suggestive increase of the olfactory threshold, discrimination and identification compared to those without chronic rhinosinusitis.

CONCLUSION

In conclusion, patients with common variable immunodeficiency seem to suffer from olfactory disorders more than healthy people. One of the causal factors could be considered the presence of rhinosinusal pathologies.

Olfactory Event-Related Potentials and Exhaled Organic Volatile Compounds: The Slow Link Between Olfactory Perception and Breath Metabolic Response. A Pilot Study on Phenylethyl Alcohol and Vaseline Oil

Olfactory processing starts with the breath and elicits neuronal, metabolic and cortical responses. This process can be investigated centrally via the Olfactory Event-Related Potentials (OERPs) and peripherally via exhaled Volatile Organic Compounds (VOCs). Despite this, the relationship between OERPs (i.e., N1 and Late Positive Component LPC) and exhaled VOCs has not been investigated enough. The aim of this research is to study OERPs and VOCs connection to two different stimuli: phenylethyl alcohol (PEA) and Vaseline Oil (VO). Fifteen healthy subjects performed a perceptual olfactory task with PEA as a smell target stimulus and VO as a neutral stimulus. The results suggest that OERPs and VOCs distributions follow the same amplitude trend and that PEA is highly arousing in both psychophysiological measures. PEA shows ampler and faster N1, a component related to the sensorial aspect of the stimulus. The N1 topographic localization is different between PEA and VO: PEA stimulus evokes greater N1 in the left centroparietal site. LPC, a component elicited by the perceptual characteristic of the stimulus, shows faster latency in the Frontal lobe and decreased amplitude in the Central and Parietal lobe elicited by the PEA smell. Moreover, the delayed time between the onset of N1-LPC and the onset of VOCs seems to be about 3 s. This delay could be identified as the internal metabolic time in which the odorous stimulus, once perceived at the cortical level, is metabolized and subsequently exhaled. Furthermore, the VO stimulus does not allocate the attentive, perceptive and metabolic resource as with PEA.

Influence of Airflow Rate and Stimulus Concentration on Olfactory Event-Related Potentials (OERP) in Humans

Although the association between odor concentration and olfactory event-related potential (OERP) has been studied, less is known about the influence of airflow on OERP. The aim of this study was to investigate the influence of airflow rate and stimulus concentration on OERP in humans. Electroencephalogram data were collected from young healthy volunteers (n = 17) in separate sessions where 2-phenylethanol (PEA) was delivered in the following conditions: 8 L/min 50% v/v, 8 L/min 30% v/v, 4 L/min 100% v/v, and 4 L/min 60%v/v. Odor concentrations are referred to the %v/v achieved with air dilution and was not measured in the nose. Odor intensity ratings were recorded immediately after stimulus presentation. Data recorded at 5 electrodes (Fz, Cz, Pz, C3, and C4) were pooled and analyzed using both time-domain averaging and single-trial time-frequency domain approaches. Higher airflow rate significantly increased intensity ratings (F = 10.98, P < 0.01), and improved the signal-to-noise-ratio (F = 5.42, P = 0.025). Results from time-frequency analysis showed higher concentration versus lower concentration increased brain oscillations in the slow frequency band (1-3 Hz) at 0-600 ms; while higher airflow rates versus lower airflow rate increased theta-band oscillations (300-600 ms and 5-9 Hz) and decreased delta-band oscillations at 900-1500 ms after stimulus onset. In conclusion, compared to stimulus concentration, airflow rate was associated with improved OERP quality and more pronounced responses. The results suggest that intensity ratings and OERP are strongly related to the steepness of stimulus onset. High airflow rates are suggested for odor delivery in order to record OERP.

The intranasal trigeminal system

Many odors activate the intranasal chemosensory trigeminal system where they produce cooling and other somatic sensations such as tingling, burning, or stinging. Specific trigeminal receptors are involved in the mediation of these sensations. Importantly, the trigeminal system also mediates sensitivity to airflow. The intranasal trigeminal and the olfactory system are closely connected. With regard to central nervous processing, it is most interesting that trigeminal stimuli can activate the piriform cortex, which is typically viewed as the primary olfactory cortex. This suggests that interactions between the two systems may form at a relatively early stage of processing. For example, there is evidence showing that acquired olfactory loss leads to reduced trigeminal sensitivity, probably on account of the lack of interaction in the central nervous system. Decreased trigeminal sensitivity may also be responsible for changes in airflow perception, leading to the impression of congested nasal airways.

Systemic diseases and disorders

Alterations in the ability to smell or taste are of considerable consequence, impacting quality of life, safety, nutrition, and dietary activities. These primary senses are influenced by a wide range of systemic diseases and disorders that commonly involve the entire body. These include viral, bacterial, fungal, protozoal, cestode, and nematode infections that can spread throughout the gastric, lymphatic, neural, or circulatory systems as well as classic autoimmune disorders, collagen diseases, diabetes, and hypertension, and others. Although a considerable literature has evolved in which the function of both taste and smell has been assessed in a number of such disorders, quantitative chemosensory testing is still relatively rare with many disorders not receiving empirical assessment. Incongruent findings are not uncommon. This chapter reviews what is known about the influences of a wide spectrum of systemic diseases and disorders on the abilities to taste and smell.

Potential Role of OERP as Early Marker of Mild Cognitive Impairment

Olfactory impairment is present in up to 90% of patients with Alzheimer's disease (AD) and is present in certain cases of mild cognitive impairment (MCI), a transient phase between normal aging and dementia. Subjects affected by MCI have a higher risk of developing dementia compared to the general population, and studies have found that olfactory deficits could be an indicator of whether such a conversion might happen. Following these assumptions, aim of this study was to investigate olfactory perception in MCI patients. We recruited 12 MCI subjects (mean age 70 ± 6.7 years) through the Alzheimer Assessment Unit (UVA Unite) of ASL Lecce (Italy), and 12 healthy geriatric volunteers (HS) as the control group (mean age 64 ± 6.0 years), all of whom were first evaluated via a panel of neuropsychological tests. Subjects were asked to perform an olfactory recognition task involving two scents: rose and eucalyptus, administrated in the context of an oddball task during EEG recordings. Olfactory event-related potential (OERP) components N1 and Late Positive Potential (LPC) were then analyzed as measures of the sensorial and perceptive aspects of the olfactory response, respectively. It was determined that, in the MCI group, both the N1 and LPC components were significantly different compared to those of the HS group during the execution of the oddball task. In particular, the N1 amplitude, was reduced, while the LPC amplitude was increased, indicating that a degree of perceptive compensation can occur when sensorial function is impaired. Further, a correlation analysis, involving OERP components and neuropsychological battery scores, indicated that impairment of olfactory perception may share common pathways with impairments of the spatial system and long-term memory processing.

No Sensory Compensation for Olfactory Memory: Differences between Blind and Sighted People

Blindness can be a driving force behind a variety of changes in sensory systems. When vision is missing, other modalities and higher cognitive functions can become hyper-developed through a mechanism called sensory compensation. Overall, previous studies suggest that olfactory memory in blind people can be better than that of the sighted individuals. Better performance of blind individuals in other-sensory modalities was hypothesized to be a result of, among others, intense perceptual training. At the same time, if the superiority of blind people in olfactory abilities indeed results from training, their scores should not decrease with age to such an extent as among the sighted people. Here, this hypothesis was tested in a large sample of 94 blind individuals. Olfactory memory was assessed using the Test for Olfactory Memory, comprising episodic odor recognition (discriminating previously presented odors from new odors) and two forms of semantic memory (cued and free identification of odors). Regarding episodic olfactory memory, we observed an age-related decline in correct hits in blind participants, but an age-related increase in false alarms in sighted participants. Further, age moderated the between-group differences for correct hits, but the direction of the observed effect was contrary to our expectations. The difference between blind and sighted individuals younger than 40 years old was non-significant, but older sighted individuals outperformed their blind counterparts. In conclusion, we found no positive effect of visual impairment on olfactory memory. We suggest that daily perceptual training is not enough to increase olfactory memory function in blind people.

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.

Different patterns of age-related central olfactory decline in men and women as quantified by olfactory fMRI

Age-related olfactory decline, or presbyosmia, is a prevalent condition with potentially devastating consequences on both quality of life and safety. Despite clear evidence for this decline, it is unknown whether presbyosmia is sex-dependent and also whether it is due to central or peripheral olfactory system deterioration. Therefore, the goals of this study were to investigate the neurofunctional substrate of olfactory decline and examine its relationship to age and sex in thirty-seven (18 women, 19 men) healthy older participants using olfactory functional MRI (fMRI). The olfactory fMRI paradigm utilized unique odor+visual and visual-only conditions to contrast peripheral-to-central and central-to-central olfactory processing, respectively. Age was negatively correlated with fMRI activation in olfactory-related regions. Significant aging effects were identifiable in male participants in all target regions. Female participants, however, showed a different pattern of functional decline. Extended unified structural equation modeling (euSEM) analysis revealed that the effective functional connectivity profile was drastically different between male and female participants, with females manifesting a top-down mechanism to offset age-related olfactory activation decline. Our results support the hypotheses that the central olfactory system is involved in age-related olfactory decline, and that resilience to age-related olfactory decline in women may be due to their profuse olfactory network effective connectivity.

What Makes a Better Smeller?

Olfaction is often viewed as difficult, yet the empirical evidence suggests a different picture. A closer look shows people around the world differ in their ability to detect, discriminate, and name odors. This gives rise to the question of what influences our ability to smell. Instead of focusing on olfactory deficiencies, this review presents a positive perspective by focusing on factors that make someone a better smeller. We consider three driving forces in improving olfactory ability: one’s biological makeup, one’s experience, and the environment. For each factor, we consider aspects proposed to improve odor perception and critically examine the evidence; as well as introducing lesser discussed areas. In terms of biology, there are cases of neurodiversity, such as olfactory synesthesia, that serve to enhance olfactory ability. Our lifetime experience, be it typical development or unique training experience, can also modify the trajectory of olfaction. Finally, our odor environment, in terms of ambient odor or culinary traditions, can influence odor perception too. Rather than highlighting the weaknesses of olfaction, we emphasize routes to harnessing our olfactory potential.

Recovery of Olfactory Function in Postviral Olfactory Dysfunction Patients after Acupuncture Treatment

Introduction. The aims of this study were to assess the impact of traditional Chinese acupuncture (TCA) in postviral olfactory dysfunction (PVOD) patients who were refractory to standardized treatment and to compare the results with the impact observed in an observation group. Methods. Fifty patients who presented to the outpatient clinic with PVOD and were refractory to standardized treatment were included: 25 were treated with TCA and 25 patients were simply observed. A subjective olfactory test was performed using the University of Pennsylvania Smell Identification Test (UPSIT). The effects of TCA were compared with the results obtained in the observation group. Results. Improved olfactory function was observed in eleven patients treated with TCA compared with four patients in the observation group. This study revealed significantly improved olfactory function outcomes in patients who underwent acupuncture compared with the observation group. No significant differences in olfaction recovery were found according to age, gender, or duration of disease between the two groups; however, hyposmic patients recovered at a higher rate than anosmic patients. Conclusion. TCA may aid the treatment of PVOD patients who are refractory to drugs or other therapies.

Changes of olfactory abilities in relation to age: odor identification in more than 1400 people aged 4 to 80 years

The currently presented large dataset (n = 1,422) consists of results that have been assembled over the last 8 years at science fairs using the 16-item odor identification part of the “Sniffin’ Sticks”. In this context, the focus was on olfactory function in children; in addition before testing, we asked participants to rate their olfactory abilities and the patency of the nasal airways. We reinvestigated some simple questions, e.g., differences in olfactory odor identification abilities in relation to age, sex, self-ratings of olfactory function and nasal patency. Three major results evolved: first, consistent with previously published reports, we found that identification scores of the youngest and the oldest participants were lower than the scores obtained by people aged 20–60. Second, we observed an age-related increase in the olfactory abilities of children. Moreover, the self-assessed olfactory abilities were related to actual performance in the smell test, but only in adults, and self-assessed nasal patency was not related to the “Sniffin’ Sticks” identification score.

[Olfactory function in old age]

Olfactory function decreases with age. This is frequent: one in four individuals above 52 years of age exhibits olfactory loss. This decrease in olfactory function can be seen at all levels of olfactory information processing, both on a functional and a morphological level. Recent studies, however, indicate that olfactory loss with age may not be an inevitable fate.

The effect of nasal structure on olfactory function in patients with OSA

The aim of this study was to investigate the relationship between nasal structure and olfactory function in patients with obstructive sleep apnea (OSA). Olfaction and nasal structure of 76 adults with OSA diagnosed by polysomnography were measured using acoustic rhinometry and the Sniffin, Sticks (SS) smell test at Anzhen Hospital, a major academic center in Beijing, China. We tested the hypothesis that nasal structure in these patients would correlate with objectively measured olfactory performance. Minimum cross-sectional area (MCA) of the nose was significantly correlated with SS composite score (r = 0.434, p < 0.001), a result that was driven by two of the test's three components: olfactory threshold (OT) (r = 0.385, p = 0.001) and olfactory discrimination (OD) (r = 0.370, p = 0.001) but not olfactory identification (OI) (p > 0.05). Additionally, nasal volume (NV) was associated with composite SS score (r = 0.350, p = 0.002), a finding driven by OT (r = 0.283, p = 0.014). These data suggest that nasal structure affects parameters of olfactory function, likely via alterations in nasal airflow. Thus, anatomic abnormalities and diseases involving airflow (such as OSA) may cause, in part, olfactory dysfunction that is amenable to treatment. We speculate that surgery that alters nasal volume and MCA may improve olfactory performance.

Is the age-related loss in olfactory sensitivity similar for light and heavy molecules?

The process of aging affects olfaction quite early and can lead to a major handicap. One may ask whether olfactory loss is general or if it affects some odors more specifically? We investigated whether an age-related increase in olfactory threshold could be more or less specific to heavy or light molecules, based on the idea that these odors would bind differently to olfactory receptors. One group of 30 older subjects (50-70 years) and one group of 30 young adults (18-30 years) were tested for their threshold to 4 odors. Two odorants were light molecules (<150 g/mol) and the 2 others were heavy molecules (>150 g/mol). Both sets contained a single molecule and a binary mixture. Older subjects performed worse than young adults in an odor identification task, confirming a decline in the olfactory function. As a major result, young adults were as sensitive to light and heavy molecules; on the contrary, older subjects were less sensitive to heavy molecules (single molecule and binary mixture). The results suggest that older people present a heterogeneous olfactory loss more specific to heavier molecules.

A Study on Olfactory Dysfunction in Turkish Population with using Survey Method and Validated Olfactory Testing

The aim of this study was to evaluate the effect of olfactory dysfunction on quality of life (QOL), and to investigate olfactory dysfunction related self-reported clinical features in Turkish population. The participants were questioned about the presence of any olfactory dysfunction. Participants with a complaint of olfactory dysfunction were asked to fill out a survey and then a validated olfactory test was performed. We asked 2,824 volunteers whether they had olfactory dysfunctions or not. A total of 199 (6.7 %) people mentioned that they had, and filled out the questions in our survey. The mean age of the surveyed population was 44 ± 15 years. The current investigation produced four major findings (1) the feeling of inadequacy due to olfactory dysfunction was more common among females than males (2) there was a significant correlation between subjective olfactory complaints and objective olfactory testing (3) problems in QOL issues are typically reported primarily in the areas of safety and nutrition (4) the possible reasons for the olfactory dysfunction according to the volunteers were upper respiratory infections including rhinosinusitis (46 %), allergic rhinitis (27 %), severe face and head trauma (6.5 %). The effect of subjective olfactory dysfunctions on QOL among the Turkish population was investigated for the first time. Problems in daily life issues are typically reported primarily in the areas of safety and nutrition.

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.

Time to smell: a cascade model of human olfactory perception based on response-time (RT) measurement

The timing of olfactory behavioral decisions may provide an important source of information about how the human olfactory-perceptual system is organized. This review integrates results from olfactory response-time (RT) measurements from a perspective of mental chronometry. Based on these findings, a new cascade model of human olfaction is presented. Results show that main perceptual decisions are executed with high accuracy within about 1~s of sniff onset. The cascade model proposes the existence of distinct processing stages within this brief time-window. According to the cascade model, different perceptual features become accessible to the perceiver at different time-points, and the output of earlier processing stages provides the input for later processing stages. The olfactory cascade starts with detecting the odor, which is followed by establishing an odor object. The odor object, in turn, triggers systems for determining odor valence and edibility. Evidence for the cascade model comes from studies showing that RTs for odor valence and edibility assessment are predicted by the shorter RTs needed to establish the odor object. Challenges for future research include innovative task designs for olfactory RT experiments and the integration of the behavioral processing sequence into the underlying cortical processes using complementary RT measures and neuroimaging methods.

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.

Sex differences in chemosensation: sensory or emotional?

Although the first sex-dependent differences in chemosensory processing were reported in the scientific literature over 60 years ago, the underlying mechanisms are still unknown. Generally, more pronounced sex-dependent differences are noted with increased task difficulty or with increased levels of intranasal irritation produced by the stimulus. Whether differences between the sexes arise from differences in chemosensory sensitivity of the two intranasal sensory systems involved or from differences in cognitive processing associated with emotional evaluation of the stimulants is still not known. We used simultaneous and complementary measures of electrophysiological (EEG), psychophysiological, and psychological responses to stimuli varying in intranasal irritation and odorousness to investigate whether sex differences in the processing of intranasal irritation are mediated by varying sensitivity of the involved sensory systems or by differences in cognitive and/or emotional evaluation of the irritants. Women perceived all stimulants more irritating and they exhibited larger amplitudes of the late positive deflection of the event-related potential than men. No significant differences in sensory sensitivity, anxiety, and arousal responses could be detected. Our findings suggest that men and women process intranasal irritation differently. Importantly, the differences cannot be explained by variation in sensory sensitivity to irritants, differences in anxiety, or differences in physiological arousal. We propose that women allocate more attention to potentially noxious stimuli than men do, which eventually causes differences in cognitive appraisal and subjective perception.

Olfactory Sensitivity and Sexual Desire in Young Adult and Elderly Men: An Introductory Investigation

Background

It has been suggested that olfaction could influence human sexual behavior. Age is negatively associated with many aspects of sexuality and, with increasing age, people tend to show a declining sexual desire. The present pilot study investigated the relationship between sexual desire and olfactory sensitivity in healthy men of two age groups, young adult and elderly (≥65 years old), to ascertain whether their sense of smell could determine sexual desire and whether an age-related weaker olfactory sensitivity could correlate with the decline in sexual appetite in elderly patients.

Methods

Sixty-three volunteers were recruited and divided into two groups, one consisting of 48 healthy young adult men, the other of 15 healthy elderly men. All participants were tested to ascertain their odor threshold for n-butanol (Sniffin’ Sticks) and their sexual desire using the International Index of Erectile Function (IIEF), presenting only the questions relating to frequency (IIEF1) and level (IIEF2) of sexual desire.

Results

Sexual desire and mean olfactory thresholds were higher in the younger adults than in the elderly men (p = 0.001 and p = 0.02, respectively). There was a significant association between butanol threshold and sexual desire for the young adult group (p = 0.02), but not for the elderly group (p = 0.35).

Conclusion

This study found a preliminary association between olfaction and sexual behavior, in young adults at least. More studies are needed to improve our knowledge in this intriguing field, possibly using electrophysiological olfactory methods.

Time-frequency analysis of chemosensory event-related potentials to characterize the cortical representation of odors in humans

Background

The recording of olfactory and trigeminal chemosensory event-related potentials (ERPs) has been proposed as an objective and non-invasive technique to study the cortical processing of odors in humans. Until now, the responses have been characterized mainly using across-trial averaging in the time domain. Unfortunately, chemosensory ERPs, in particular, olfactory ERPs, exhibit a relatively low signal-to-noise ratio. Hence, although the technique is increasingly used in basic research as well as in clinical practice to evaluate people suffering from olfactory disorders, its current clinical relevance remains very limited. Here, we used a time-frequency analysis based on the wavelet transform to reveal EEG responses that are not strictly phase-locked to onset of the chemosensory stimulus. We hypothesized that this approach would significantly enhance the signal-to-noise ratio of the EEG responses to chemosensory stimulation because, as compared to conventional time-domain averaging, (1) it is less sensitive to temporal jitter and (2) it can reveal non phase-locked EEG responses such as event-related synchronization and desynchronization.

Methodology/Principal Findings

EEG responses to selective trigeminal and olfactory stimulation were recorded in 11 normosmic subjects. A Morlet wavelet was used to characterize the elicited responses in the time-frequency domain. We found that this approach markedly improved the signal-to-noise ratio of the obtained EEG responses, in particular, following olfactory stimulation. Furthermore, the approach allowed characterizing non phase-locked components that could not be identified using conventional time-domain averaging.

Conclusion/Significance

By providing a more robust and complete view of how odors are represented in the human brain, our approach could constitute the basis for a robust tool to study olfaction, both for basic research and clinicians.

Chemosensory function assessed with psychophysical testing and event-related potentials in patients with atrophic rhinitis

Atrophic rhinitis (AR) is a chronic inflammation of the nose characterized by an atrophy of the nasal mucosa. This is typically associated with an impaired sense of smell and a subjective sensation of poor nasal breathing. The aim of this study is to assess chemosensory function in patients suffering from AR using psychophysical testings and event-related potentials (ERP) responses. A cohort of nine patients was extensively studied. Eight out of nine had secondary AR sequela of a bilateral total inferior turbinectomy whereas one patient had a primary AR. All the patients had a clinical evaluation using Sniffin' Sticks test and a retro-olfaction test and an electrophysiological evaluation based upon ERPs obtained after both olfactory and trigeminal stimuli. All the patients complained of a poor nasal breathing and presented a distortion of the chemosensory function. Actually, the orthonasal psychophysical testing showed that four patients out of nine had anosmia, three out of nine had hyposmia and two out of nine were normosmic. All the patients demonstrated retro-olfaction scores inferior to the normal values. The chemosensory ERP showed that seven patients had no olfactory response whereas six had no trigeminal response. Four patients had neither olfactory nor trigeminal ERP response. In conclusion, this study demonstrates that most patients with AR secondary to a total bilateral inferior turbinectomy have a reduction of the chemosensory function measured objectively by psychophysical testings and ERP [corrected].