1
|
Li Z, Richter L, Krueger T, Eichwald H, Hähner A, Hummel T. Patients with parosmia respond faster to unpleasant odors than patients with hyposmia: Insights from olfactory event-related potentials. Int Forum Allergy Rhinol 2024. [PMID: 38584570 DOI: 10.1002/alr.23350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/12/2024] [Accepted: 03/22/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Diagnosing parosmia is a challenge. The present study aimed to explore the distinctions between hyposmic patients with and without parosmia utilizing electroencephalography-derived olfactory event-related potentials (ERP). METHODS Forty-four patients with hyposmia were enrolled and divided into a group with parosmia (n = 23, mean age ± standard deviation = 48 ± 14 years, seven men) and a group without parosmia (n = 21, age = 52 ± 12 years, seven men) based on the clinical interview. Additionally, 21 healthy controls (mean age = 45 ± 14 years, six men) were included. Various measurements were obtained, including the Sniffin' Stick test, threshold tests for the odorants furfural mercaptan and 2,6-nonadienal, a modified Sniffin' Stick parosmia test, and well-being ratings. Chemosensory ERPs were recorded separately for each nostril using high-precision, computer-controlled air-dilution olfactometry. RESULTS Patients with parosmia had a decreased olfactory function similar to that observed in patients with hyposmia, although the odor sensitivity of patients with severe parosmia remained relatively unaffected. Patients with parosmia reported a decrease in well-being compared to controls. The severity of parosmia was positively correlated with odor sensitivity. Furthermore, patients with severe parosmia exhibited faster responses to unpleasant odors than patients without parosmia. CONCLUSION Overall, the present findings support the idea that parosmia predominantly occurs during olfactory recovery, significantly disturbing patients and warranting the development of effective treatments. Notably, the relatively faster responses of hyposmic patients with severe parosmia suggest that the generation of distorted olfactory responses may involve early stages of the processing of olfactory information.
Collapse
Affiliation(s)
- Zetian Li
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Luisa Richter
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Tanja Krueger
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Otorhinolaryngology, Bundeswehrkrankenhaus, Berlin, Germany
| | - Herbert Eichwald
- Department of Otorhinolaryngology, Bundeswehrkrankenhaus, Berlin, Germany
| | - Antje Hähner
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
2
|
Song J, Wang M, Wang C, Zhang L. Olfactory dysfunction in chronic rhinosinusitis: insights into the underlying mechanisms and treatments. Expert Rev Clin Immunol 2023; 19:993-1004. [PMID: 37432663 DOI: 10.1080/1744666x.2023.2235891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/07/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION Olfactory dysfunction (OD) is a typical symptom of chronic rhinosinusitis (CRS), which adversely affects the patient's quality of life and results in mood depression. Studies investigating the impairment of olfactory epithelium (OE) have indicated that inflammation-induced cell damage and dysfunction in OE plays a vital role in the development of OD. Consequently, glucocorticoids and biologics are beneficial in the management of OD in CRS patients. However, the mechanisms underlying OE impairment in CRS patients have not been fully elucidated. AREAS COVERED This review focuses on mechanisms underlying inflammation-induced cell impairment in OE of CRS patients. Additionally, the methods used for detection of olfaction and both currently available and potentially new clinical treatments for OD are reviewed. EXPERT OPINION Chronic inflammation in OE impairs not only olfactory sensory neurons but also non-neuronal cells that are responsible for regeneration and support for neurons. The current treatment for OD in CRS is mainly aimed at attenuating and preventing inflammation. Strategies for use of combinations of these therapies may achieve greater efficacy in restoration of the damaged OE and consequently better management of OD.
Collapse
Affiliation(s)
- Jing Song
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Ming Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Laboratory of Allergic Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Chengshuo Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Laboratory of Allergic Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Luo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Laboratory of Allergic Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
3
|
Assessment and Scientific Progresses in the Analysis of Olfactory Evoked Potentials. Bioengineering (Basel) 2022; 9:bioengineering9060252. [PMID: 35735495 PMCID: PMC9219708 DOI: 10.3390/bioengineering9060252] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/27/2022] [Accepted: 06/09/2022] [Indexed: 12/25/2022] Open
Abstract
The human sense of smell is important for many vital functions, but with the current state of the art, there is a lack of objective and non-invasive methods for smell disorder diagnostics. In recent years, increasing attention is being paid to olfactory event-related potentials (OERPs) of the brain, as a viable tool for the objective assessment of olfactory dysfunctions. The aim of this review is to describe the main features of OERPs signals, the most widely used recording and processing techniques, and the scientific progress and relevance in the use of OERPs in many important application fields. In particular, the innovative role of OERPs is exploited in olfactory disorders that can influence emotions and personality or can be potential indicators of the onset or progression of neurological disorders. For all these reasons, this review presents and analyzes the latest scientific results and future challenges in the use of OERPs signals as an attractive solution for the objective monitoring technique of olfactory disorders.
Collapse
|
4
|
Liu J, Pinto JM, Yang L, Yao L, Miao X, Wei Y. Evaluation of idiopathic olfactory loss with chemosensory event-related potentials and magnetic resonance imaging. Int Forum Allergy Rhinol 2018; 8:1315-1322. [PMID: 29782071 PMCID: PMC6282607 DOI: 10.1002/alr.22144] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 04/08/2018] [Accepted: 04/27/2018] [Indexed: 11/08/2022]
Abstract
Background Idiopathic olfactory loss (IOL) accounts for a sizable fraction of olfactory dysfunction, but very little is known about its etiology and electrophysiological changes in the olfactory pathway. Methods We analyzed the physiology of IOL using chemosensory event‐related potentials (ERPs) (olfactory and trigeminal: oERP and tERP) and olfactory pathway magnetic resonance imaging (MRI) measured in adult patients with IOL and healthy controls. Subjective olfactory function was measured by Toyota and Takagi (T&T) olfactometry and Sniffin’ Sticks (SS). Results Olfactory function was worse in patients with IOL compared to controls (T&T, p < 0.001; SS, p < 0.001). oERPs could be evoked in 17 IOL patients. Signals in these patients showed lower amplitude in the N1 and P2 waves than controls (p < 0.05 for both), but there were no difference in latency between the 2 groups (p > 0.05). tERP were detected in all patients and controls; there were no differences in latency and nor amplitude between the 2 groups (p > 0.05). The olfactory bulb (OB) volume was significantly smaller in the IOL group than controls (p < 0.001), but there was no difference in the olfactory sulcus depth between groups (p > 0.05). Better olfactory function was associated with increasing magnitude of N1 amplitude in oERPs (p < 0.05) and increasing OB volume (p < 0.05). Conclusion IOL patients show neurophysiologic deficits and some anatomic differences compared to healthy controls.
Collapse
Affiliation(s)
- Jia Liu
- Department of Otolaryngology-Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jayant M Pinto
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, The University of Chicago, Chicago, IL
| | - Ling Yang
- Central Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Linyin Yao
- Department of Otolaryngology-Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xutao Miao
- Department of Otorhinolaryngology, Beijing United Family Healthcare, Beijing, China
| | - Yongxiang Wei
- Department of Otolaryngology-Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
5
|
Yang L, Wei Y, Zhang W, Yu D, Ren Y, Li K, Guo Y, Zhang J. Examination of chemosensory functions in patients with dysosmia. Med Sci Monit 2012; 18:CR154-9. [PMID: 22367126 PMCID: PMC3560743 DOI: 10.12659/msm.882520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background To examine changes of chemical sensory functions in patients with dysosmia. Material/Methods The 272 study subjects included 98 healthy volunteers, 86 subjects with hyposmia and 88 subjects with functional anosmia. Their chemical sensory functions were examined using olfactory event-related potentials (oERPs), trigeminal event-related potentials (tERPs), T&T olfactometer and triple drop method, respectively. Results The T&T results showed that the difference between patients and healthy subjects had statistical significance. The oERPs and tERPs results showed that patients with functional anosmia had N1 and P2 waves of prolonged latency and reduced amplitude when compared to healthy subjects with the difference of statistical significance. When compared to healthy subjects, patients with functional anosmia had clear hypogeusia and the difference had statistical significance. For the younger group there was significant difference between healthy subjects and patients in T&T, oERPs and tERPs results. Conclusions It is suggested by the apparently concomitant trigeminal nerve dysfunction and hypogeusia in patients with functional anosmia in this study that olfactory and nasal trigeminal function in young patients was clearly decreased. Our study suggests the possible application of oERPs, tERPs and three drops method in clinical diagnosis in Chinese populations and provides scientific evidence for treatment.
Collapse
Affiliation(s)
- Ling Yang
- Center Lab of Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Yang L, Wei Y, Yu D, Zhang J, Liu Y. Olfactory and gustatory function in healthy adult Chinese subjects. Otolaryngol Head Neck Surg 2010; 143:554-60. [PMID: 20869568 DOI: 10.1016/j.otohns.2010.05.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Revised: 04/18/2010] [Accepted: 05/12/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE: To investigate the effect of age and gender on olfactory and gustatory function and to establish test methodology and normative values in Chinese subjects. STUDY DESIGN: Cross-sectional study. SETTING: The center laboratory and the Department of Otolaryngology—Head & Neck Surgery, Beijing Tongren Hospital. SUBJECTS AND METHODS: The T&T olfactometer, the Sniffin' Sticks olfactory test, olfactory event-related potentials (oERPs), trigeminal event-related potentials (tERPs), and the triple drop method for gustatory testing were used to examine the chemosensation in 90 healthy adults (45 men and 45 women). RESULTS: Older subjects (age 51–65 years) showed worse olfaction compared with younger subjects (age 18–35 years) when both T&T (younger —1.71 ± 0.41, older —0.92 ± 0.95; P < 0.01) and Sniffin' Sticks (threshold, discrimination, identification score: younger 33.17 ± 2.83, older 30.89 ± 3.35; P < 0.05) testing were performed. Measurement of oERPs revealed that older patients (N1 471 ± 85 ms, P2 676 ± 93 ms) had longer latencies compared with younger ones (N1 368 ± 57 ms, P2 561 ± 74 ms, P < 0.05) of N1/P2 wave. The results of trigeminal nerve-related potential examination showed that N1/P2 latencies were longer and amplitudes were lower in older people (N1 384 ± 98 ms/—5.01 ± 4.00 uv, P2 568 ± 95 ms/6.53 ± 3.62 uv) compared with younger patients (N1 316 ± 31 ms/—7.20 ± 3.43 uv, P2 472 ± 66 ms/8.72 ± 3.09 uv; P < 0.05). Gustation was normal in all subjects, and there was no significant difference between younger and older groups. CONCLUSION: Age and gender affect olfaction in Chinese adults as measured by standard testing methods used in other human populations. In healthy Chinese subjects, gustation was normal and did not vary with age. Our data provide preliminary normative values for future investigation of chemosensation in the Chinese population.
Collapse
Affiliation(s)
- Ling Yang
- The Center Lab of Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yongxiang Wei
- Department of Otolaryngology—Head & Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Di Yu
- The Center Lab of Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jinfeng Zhang
- Department of Otolaryngology—Head & Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yuehong Liu
- Department of Otolaryngology—Head & Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
7
|
Kassab A, Schaub F, Vent J, Hüttenbrink KB, Damm M. Effects of short inter-stimulus intervals on olfactory and trigeminal event-related potentials. Acta Otolaryngol 2009; 129:1250-6. [PMID: 19863320 DOI: 10.3109/00016480802644605] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Chemosensory event-related potentials (CSERPs) were identified in all measurements using the 20 s and the 10 s inter-stimulus interval (ISI) protocol, reducing the recording time to 75% or 57% compared with the standard protocol. A possible explanation for the rising CSERP amplitudes by shortening the ISI in CO(2) stimulation is due to a phenomenon known as trigeminal sensitization during repeated stimulation. OBJECTIVES CSERPs are influenced by the ISI. The aim of this study was to evaluate the changes in CSERPs by decreasing the ISI from 30 s to 20 s or 10 s, respectively. SUBJECTS AND METHODS Ten normosmic healthy subjects participated this study. Phenyl ethyl alcohol (PEA), hydrogen sulphide (H(2)S) and carbon dioxide (CO(2)) were used in CSERP measurements with different ISI protocols (30 s (standard), 20 s and 10 s). Amplitudes and latencies of ISI protocols were submitted to ANOVA for repeated measurements and t tests for paired samples. RESULTS The amplitudes of CSERPs with PEA and H(2)S stimuli were decreasing with shortening the ISI significantly. In contrast, the highest amplitudes of trigeminal CSERPs were recorded with the 10 s ISI protocol with CO(2). The ANOVA revealed a significantly different effect of shortening the ISI on CSERPs on the right and the left side.
Collapse
Affiliation(s)
- Ahmed Kassab
- National Institute of Laser Enhanced Sciences, Cairo University, Cairo, Egypt.
| | | | | | | | | |
Collapse
|