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Martinec Nováková L, Georgi H, Vlčková K, Kopeček M, Babuská A, Havlíček J. Small effects of olfactory identification and discrimination on global cognitive and executive performance over 1 year in aging people without a history of age-related cognitive impairment. Physiol Behav 2024; 282:114579. [PMID: 38710351 DOI: 10.1016/j.physbeh.2024.114579] [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: 01/25/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 05/08/2024]
Abstract
Olfactory and cognitive performance share neural correlates profoundly affected by physiological aging. However, whether odor identification and discrimination scores predict global cognitive status and executive function in healthy older people with intact cognition is unclear. Therefore, in the present study, we set out to elucidate these links in a convenience sample of 204 independently living, cognitively intact healthy Czech adults aged 77.4 ± 8.7 (61-97 years) over two waves of data collection (one-year interval). We used the Czech versions of the Montreal Cognitive Assessment (MoCA) to evaluate global cognition, and the Prague Stroop Test (PST), Trail Making Test (TMT), and several verbal fluency (VF) tests to assess executive function. As a subsidiary aim, we aimed to examine the contribution of olfactory performance towards achieving a MoCA score above vs. below the published cut-off value. We found that the MoCA scores exhibited moderate associations with both odor identification and discrimination. Furthermore, odor identification significantly predicted PST C and C/D scores. Odor discrimination significantly predicted PST C/D, TMT B/A, and standardized composite VF scores. Our findings demonstrate that olfaction, on the one hand, and global cognition and executive function, on the other, are related even in healthy older people.
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Affiliation(s)
- Lenka Martinec Nováková
- Department of Psychology and Life Sciences, Faculty of Humanities, Charles University, Pátkova 2137/5, 182 00 Prague 8 - Libeň, Czech Republic; Department of Chemical Education and Humanities, University of Chemistry and Technology, Prague, Technická 5, 166 28 Prague 6 - Dejvice, Czech Republic.
| | - Hana Georgi
- Prague College of Psychosocial Studies, Hekrova 805, 149 00 Prague 4, Czech Republic
| | - Karolína Vlčková
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague 10 - Vršovice, Czech Republic; Thomayer Teaching Hospital, Vídeňská 800, 140 59 Prague 4 - Krč, Czech Republic
| | - Miloslav Kopeček
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague 10 - Vršovice, Czech Republic; National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic
| | - Anna Babuská
- Department of Zoology, Faculty of Science, Charles University, Viničná 7, 128 00 Prague 2, Czech Republic
| | - Jan Havlíček
- Department of Zoology, Faculty of Science, Charles University, Viničná 7, 128 00 Prague 2, Czech Republic
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Lee HR, Kim KS, Min HJ. Development of a Digital Olfactory Function Test: A Preliminary Study. Life (Basel) 2024; 14:75. [PMID: 38255690 PMCID: PMC10817253 DOI: 10.3390/life14010075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 01/24/2024] Open
Abstract
Olfactory dysfunction is associated with conditions such as neurodegenerative diseases, diabetes, obesity, autoimmune diseases, mental illnesses, and upper-airway-related diseases. The COVID-19 pandemic necessitated the development of an examiner-independent olfactory function test. We recently developed a digital olfactory function test called Digitalscent (DIGITAL SCENT), which is a kiosk-type device with an integrated hardware system. The protocol follows conventional psychophysical olfactory function protocols, including threshold, discrimination, and identification test subsets. Eight healthy participants without olfactory dysfunction volunteered for the suitability test and completed both the YSK olfactory function and Digitalscent tests. Pearson correlations were determined between the YSK olfactory function and Digitalscent tests. Digitalscent could be implemented as a conventional olfactory function test, and all participants followed the Digitalscent test protocols. Limitations in the threshold and identification test subsets included unfamiliarity of the patients to the digital test and incompleteness in the sophisticated release of odorants. A strength of the identification test subset was the dual sensory stimulation of vision and olfaction. Digitalscent could-without facilitating viral transmission-enable early diagnosis of olfactory dysfunction during respiratory viral pandemics. Future studies with larger sample sizes are warranted to facilitate wider use of this digital olfactory function test.
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Affiliation(s)
- Hae Ryong Lee
- Research and Development Center, Digital Scent Co., Ltd., Daejeon 305-700, Republic of Korea;
| | - Kyung Soo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, 224-1 Heukseok-dong, Dongjak-gu, Seoul 06973, Republic of Korea
| | - Hyun Jin Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, 224-1 Heukseok-dong, Dongjak-gu, Seoul 06973, Republic of Korea
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Lundberg M, Maurer R, Tchekmedyian R, Mullur J, Bensko JC, Buchheit KM, Laidlaw TM. Validation of a questionnaire assessing smell loss in an international aspirin-exacerbated respiratory disease population. Allergy Asthma Proc 2024; 45:5-13. [PMID: 38151738 DOI: 10.2500/aap.2024.45.230079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Background: Olfactory dysfunction (OD) and smell loss affects aspects of patients' everyday life and lowers their quality of life. OD questionnaires are considered one of the core-outcome measures in chronic rhinosinusitis, but many existing smell loss questionnaires contained pandemic-prohibitive questions on social gatherings or restaurant visits, were too culture specific or gender specific, or were overly long and cumbersome. Objective: We aimed to develop a new brief questionnaire to assess the impact and consequences of smell loss and its burden on daily life. This study validates this new, short, multicultural, dichotomized questionnaire in an international population that has aspirin-exacerbated disease (AERD). Methods: The Consequences of Smell Loss (COSL) questionnaire was developed and content validity was assessed by experts and patients at Brigham and Women's Hospital. The questionnaire, along with other validated quality-of-life surveys, was answered by 853 patients with AERD. We evaluated the factor structure, reliability, validity, and discriminative ability of the COSL questionnaire. Results: The final version of the COSL questionnaire consisted of 13 items divided into three subdomains (emotional distress, food and safety, and physical health) through factor analysis. The Cronbach α for internal consistency was 0.82. Convergent and discriminant validity with the 22-item Sinonasal Outcome Test (SNOT-22), Healthy Days Core Module-4, Patient Health Questionnaire-4, and a specific question on taste and smell were high (p < 0.0001 for all). The COSL questionnaire score was associated with SNOT-22 categories (p < 0.001) and was categorized as follows: normal, 0-1 points; very few consequences, 2-3 points; few, 4 points; moderate, 5-6 points; and severe, 7-13 points. Conclusion: The COSL questionnaire is a new, brief, valid, reliable tool that can effectively screen for a high burden of OD in patients with AERD and has the potential to be used in other patient populations with OD as well.
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Affiliation(s)
- Marie Lundberg
- From the Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Rie Maurer
- Center for Clinical Investigation, Brigham and Women's Hospital, Boston, Massachusetts
| | - Raffi Tchekmedyian
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jyotsna Mullur
- From the Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jillian C Bensko
- From the Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Kathleen M Buchheit
- From the Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Tanya M Laidlaw
- From the Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
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Jegatheeswaran L, Gokani SA, Luke L, Klyvyte G, Espehana A, Garden EM, Tarantino A, Al Omari B, Philpott CM. Assessment of COVID-19-related olfactory dysfunction and its association with psychological, neuropsychiatric, and cognitive symptoms. Front Neurosci 2023; 17:1165329. [PMID: 37599993 PMCID: PMC10436231 DOI: 10.3389/fnins.2023.1165329] [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: 02/13/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
Purpose of review To provide a detailed overview of the assessment of COVID-19-related olfactory dysfunction and its association with psychological, neuropsychiatric, and cognitive symptoms. Recent findings COVID-19-related olfactory dysfunction can have a detrimental impact to the quality of life of patients. Prior to the COVID-19 pandemic, olfactory and taste disorders were a common but under-rated, under-researched and under-treated sensory loss. The pandemic has exacerbated the current unmet need for accessing good healthcare for patients living with olfactory disorders and other symptoms secondary to COVID-19. This review thus explores the associations that COVID-19 has with psychological, neuropsychiatric, and cognitive symptoms, and provide a framework and rationale for the assessment of patients presenting with COVID-19 olfactory dysfunction. Summary Acute COVID-19 infection and long COVID is not solely a disease of the respiratory and vascular systems. These two conditions have strong associations with psychological, neuropsychiatric, and cognitive symptoms. A systematic approach with history taking and examination particularly with nasal endoscopy can determine the impact that this has on the patient. Specific olfactory disorder questionnaires can demonstrate the impact on quality of life, while psychophysical testing can objectively assess and monitor olfaction over time. The role of cross-sectional imaging is not yet described for COVID-19-related olfactory dysfunction. Management options are limited to conservative adjunctive measures, with some medical therapies described.
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Affiliation(s)
- Lavandan Jegatheeswaran
- Department of Ear, Nose and Throat Surgery, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, United Kingdom
| | - Shyam Ajay Gokani
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Louis Luke
- Department of Ear, Nose and Throat Surgery, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, United Kingdom
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Gabija Klyvyte
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Andreas Espehana
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Elizabeth Mairenn Garden
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Alessia Tarantino
- Department of Ear, Nose and Throat Surgery, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, United Kingdom
| | - Basil Al Omari
- Department of Ear, Nose and Throat Surgery, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, United Kingdom
| | - Carl Martin Philpott
- Department of Ear, Nose and Throat Surgery, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, United Kingdom
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
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Papadatos Z, Phillips NA. Olfactory function reflects episodic memory performance and atrophy in the medial temporal lobe in individuals at risk for Alzheimer's disease. Neurobiol Aging 2023; 128:33-42. [PMID: 37146503 DOI: 10.1016/j.neurobiolaging.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 03/29/2023] [Accepted: 04/02/2023] [Indexed: 05/07/2023]
Abstract
We examined cognitive domains and brain regions associated with olfactory performance in cognitively unimpaired older adults (CU-OAs) and individuals with or at risk for Alzheimer's Disease (AD). We compared CU-OAs (N = 55), individuals with subjective cognitive decline (SCD, N = 55), mild cognitive impairment (MCI, N = 101), and AD (N = 45) on measures of olfactory function (Brief Smell Identification Test), cognition (episodic and semantic memory), and medial temporal lobe thickness and volume. Analyses controlled for age, sex, education, and total intracranial volume. Olfactory function decreased from SCD to MCI to AD. CU-OAs outperformed all groups except SCDs on tests of cognition and olfaction. Although these measures did not differ between the CU-OAs and SCDs, olfactory function correlated with episodic memory tests and with entorhinal cortex atrophy only in the SCD group. Olfactory function also correlated with hippocampal volume and right-hemisphere entorhinal cortex thickness in the MCI group. Olfactory dysfunction reflects medial temporal lobe integrity and memory performance in a group at risk for AD with normal cognition and olfaction.
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Affiliation(s)
- Zoe Papadatos
- Department of Psychology, Concordia University, Montréal, Quebec, Canada
| | - Natalie A Phillips
- Department of Psychology, Concordia University, Montréal, Quebec, Canada; Center for Research in Human Development (CRDH), Concordia University, Montréal, Quebec, Canada; Centre for Research on Brain, Language & Music (CRBLM), McGill University, Montréal, Quebec, Canada; Bloomfield Centre for Research in Aging, Lady Davis Institute for Medical Research/Jewish General Hospital/McGill University, Montréal, Quebec, Canada.
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Mai Y, Klockow M, Haehner A, Hummel T. Self-assessment of olfactory function using the "Sniffin' Sticks". Eur Arch Otorhinolaryngol 2023; 280:3673-3685. [PMID: 36799976 PMCID: PMC10313570 DOI: 10.1007/s00405-023-07872-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/04/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND A precise and reliable test of the olfactory function is indispensable for the diagnosis of the olfactory disorder (OD). Despite of this, in a clinical context, often there is no place in daily routine for time-consuming procedures. This study aimed to examine if the assessment of olfactory function using the "Sniffin' Sticks" is suitable for self-assessment. METHODS Participants comprised 84 healthy control subjects (HC) and 37 OD patients. The "Sniffin' Sticks" test battery consisting of odor threshold (T), discrimination (D) and identification (I) tests was used for self- and assisted assessments. To save time, we applied the 8-item wide step version of the T test and the 8-item D test, whereas the I task remained the same as the original version. The whole test included two sessions, with each session comprising a self-assessment part performed by the participants themselves, and an assisted-assessment part performed by the examiner. RESULTS Sniffin' Sticks self-assessment was efficient in distinguishing between self-reported HC subjects and OD patients (p's < 0.01), and the scores did not differ significantly from the assisted-assessment (p's > 0.05). In the self-administered I and TDI tests, there was a moderate to excellent test-retest reliability (ICC = 0.51-0.93, p's < 0.01), and a strong to excellent correlation with the assisted assessment (r = 0.71-0.92, p's < 0.01). However, the self-administered T and D tests only exhibited low to moderate test-retest reliability (ICC = 0.30-0.72, p's < 0.05) and correlations with the assisted test (r = 0.31-0.62, p's < 0.05). CONCLUSIONS The Identification self-test is appropriate to be solely applied, and is therefore an easy-to-use alternative for olfactory screening in a larger segment of patients. The whole "Sniffin' Sticks" self-test also shows good measurement properties and is therefore a suitable backup in clinical practice, but improvement is needed due to the simplified D and T self-test.
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Affiliation(s)
- Yiling Mai
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
| | - Marie Klockow
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
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Taş BM, Alpaydın T, Akçalı S, Kaygusuz S, Özlük Erol Ö, Şencan Z, Cömert E, Bayar Muluk N, Özel G. Evaluation of Clinical Features and Olfactory Functions in COVID-19: A Multicentre Study. Cureus 2023; 15:e40027. [PMID: 37425551 PMCID: PMC10323863 DOI: 10.7759/cureus.40027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Coronavirus Disease-2019 (COVID-19) causes olfactory loss one of the initial diagnostic criteria. The brief smell identification test (BSIT) is an objective test frequently used in olfactory dysfunction. This study aimed to observe the changes in olfactory functions and clinical features in a short time in COVID-19. Methods In this prospective study involving 64 patients, the BSIT was performed at two different times; at the time of first application and on the 14th day. Demographic features, laboratory findings, body mass index (BMI), blood oxygen saturation values (SpO2), complaints at first admission, fever, follow-up place, and treatment schemes were noted. Results There was a significant difference between the BSIT scores at the first admission and when the polymerase chain reaction (PCR) became negative on the 14th day (p<0.001). Low oxygen saturation values at first admission were associated with low BSIT scores. No relationship was found between olfactory functions and complaints at admission, fever, follow-up place, and treatment schemes. Conclusion As a result, negative effects of COVID-19 on olfactory functions have been demonstrated even in the short follow-up period. In addition, low saturation values at first admission were associated with low BSIT scores.
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Affiliation(s)
- Burak Mustafa Taş
- Otolaryngology, Kirikkale University School of Medicine, Kirikkale, TUR
| | - Turgay Alpaydın
- Anesthesiology Clinic, Manisa Merkezefendi State Hospital, Manisa, TUR
| | - Sinem Akçalı
- Medical Microbiology, Celal Bayar University Faculty of Medicine, Manisa, TUR
| | - Sedat Kaygusuz
- Infectious Diseases and Clinical Microbiology, Kırıkkale University School of Medicine, Kırıkkale, TUR
| | - Özlem Özlük Erol
- Infectious Diseases and Clinical Microbiology, Kırıkkale Yüksek Ihtisas Hospital, Kırıkkale, TUR
| | - Ziya Şencan
- Otolaryngology, Kirikkale University School of Medicine, Kirikkale, TUR
| | - Ela Cömert
- Otorhinolaryngology, Head and Neck Surgery, Kırıkkale University School of Medicine, Kırıkkale, TUR
| | - Nuray Bayar Muluk
- Ear Nose Throat, Kirikkale University School of Medicine, Kırıkkale, TUR
| | - Gökçe Özel
- Otorhinolaryngology, Gökçe ÖZEL Clinic, Ankara, TUR
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Hummel T, Power Guerra N, Gunder N, Hähner A, Menzel S. Olfactory Function and Olfactory Disorders. Laryngorhinootologie 2023; 102:S67-S92. [PMID: 37130532 PMCID: PMC10184680 DOI: 10.1055/a-1957-3267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The sense of smell is important. This became especially clear to patients with infection-related olfactory loss during the SARS-CoV-2 pandemic. We react, for example, to the body odors of other humans. The sense of smell warns us of danger, and it allows us to perceive flavors when eating and drinking. In essence, this means quality of life. Therefore, anosmia must be taken seriously. Although olfactory receptor neurons are characterized by regenerative capacity, anosmia is relatively common with about 5 % of anosmic people in the general population. Olfactory disorders are classified according to their causes (e. g., infections of the upper respiratory tract, traumatic brain injury, chronic rhinosinusitis, age) with the resulting different therapeutic options and prognoses. Thorough history taking is therefore important. A wide variety of tools are available for diagnosis, ranging from short screening tests and detailed multidimensional test procedures to electrophysiological and imaging methods. Thus, quantitative olfactory disorders are easily assessable and traceable. For qualitative olfactory disorders such as parosmia, however, no objectifying diagnostic procedures are currently available. Therapeutic options for olfactory disorders are limited. Nevertheless, there are effective options consisting of olfactory training as well as various additive drug therapies. The consultation and the competent discussion with the patients are of major importance.
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Affiliation(s)
- T Hummel
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
| | - N Power Guerra
- Rudolf-Zenker-Institut für Experimentelle Chirurgie, Medizinische Universität Rostock, Rostock
| | - N Gunder
- Universitäts-HNO Klinik Dresden, Dresden
| | - A Hähner
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
| | - S Menzel
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
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Elliott JE, Lim MM, Keil AT, Postuma RB, Pelletier A, Gagnon J, St. Louis EK, Forsberg LK, Fields JA, Huddleston DE, Bliwise DL, Avidan AY, Howell MJ, Schenck CH, McLeland J, Criswell SR, Videnovic A, During EH, Miglis MG, Shprecher DR, Lee‐Iannotti JK, Boeve BF, Ju YS. Baseline characteristics of the North American prodromal Synucleinopathy cohort. Ann Clin Transl Neurol 2023; 10:520-535. [PMID: 36751940 PMCID: PMC10109527 DOI: 10.1002/acn3.51738] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/10/2023] [Accepted: 01/14/2023] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVE Rapid eye movement (REM) sleep behavior disorder (RBD) is widely considered a prodromal synucleinopathy, as most with RBD develop overt synucleinopathy within ~10 years. Accordingly, RBD offers an opportunity to test potential treatments at the earliest stages of synucleinopathy. The North American Prodromal Synucleinopathy (NAPS) Consortium has created a multisite RBD participant, primarily clinic-based cohort to better understand characteristics at diagnosis, and in future work, identify predictors of phenoconversion, develop synucleinopathy biomarkers, and enable early stage clinical trial enrollment. METHODS Participants ≥18 years of age with overnight polysomnogram-confirmed RBD without Parkinson's disease, dementia, multiple system atrophy, or narcolepsy were enrolled from nine sites across North America (8/2018 to 4/2021). Data collection included family/personal history of RBD and standardized assessments of cognitive, motor, sensory, and autonomic function. RESULTS Outcomes are primarily reported based on sex (361 total: n = 295 male, n = 66 female), and secondarily based on history of antidepressant use (n = 200 with, n = 154 without; with correction for sex differences) and based on extent of synucleinopathy burden (n = 56 defined as isolated RBD, n = 305 defined as RBD+ [i.e., exhibiting ≥1 abnormality]). Overall, these participants commonly demonstrated abnormalities in global cognition (MoCA; 38%), motor function (alternate tap test; 48%), sensory (BSIT; 57%), autonomic function (orthostatic hypotension, 38.8%), and anxiety/depression (BAI and PHQ-9; 39.3% and 31%, respectively). INTERPRETATION These RBD participants, assessed with extensive history, demographic, cognitive, motor, sensory, and autonomic function demonstrated a lack of sex differences and high frequency of concomitant neurological abnormalities. These participants will be valuable for future longitudinal study and neuroprotective clinical trials.
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Affiliation(s)
- Jonathan E. Elliott
- VA Portland Health Care SystemResearch ServicePortlandOregonUSA
- Oregon Health & Science UniversityNeurology, PortlandOregonUSA
| | - Miranda M. Lim
- Oregon Health & Science UniversityNeurology, PortlandOregonUSA
- Behavioral NeuroscienceOregon Health & Science UniversityPortlandOregonUSA
- Department of Pulmonary and Critical Care MedicineOregon Health & Science UniversityPortlandOregonUSA
- Oregon Institute of Occupational Health SciencesOregon Health & Science UniversityPortlandOregonUSA
- NeurologyVA Portland Health Care SystemPortlandOregonUSA
- Mental Illness Research Education and Clinical CenterVA Portland Health Care SystemPortlandOregonUSA
- National Center for Rehabilitative Auditory ResearchVA Portland Health Care SystemPortlandOregonUSA
| | - Allison T. Keil
- VA Portland Health Care SystemResearch ServicePortlandOregonUSA
| | - Ronald B. Postuma
- Montreal Neurological InstituteMcGill UniversityMontrealQuébecCanada
- PsychologyUniversité du Québec à MontréalMontrealQuébecCanada
| | - Amelie Pelletier
- Hôpital du Sacré‐Coeur de MontréalCenter for Advanced Research in Sleep MedicineMontrealQuébecCanada
| | - Jean‐François Gagnon
- PsychologyUniversité du Québec à MontréalMontrealQuébecCanada
- Hôpital du Sacré‐Coeur de MontréalCenter for Advanced Research in Sleep MedicineMontrealQuébecCanada
| | | | | | | | | | | | - Alon Y. Avidan
- Neurology, Sleep Disorders CenterUniversity of California Los AngelesLos AngelesCaliforniaUSA
| | - Michael J. Howell
- NeurologyUniversity of Minnesota Medical CenterMinneapolisMinnesotaUSA
- Hennepin County Medical Center, Minnesota Regional Sleep Disorders CenterMinneapolisMinnesotaUSA
| | - Carlos H. Schenck
- NeurologyUniversity of Minnesota Medical CenterMinneapolisMinnesotaUSA
| | | | | | - Aleksandar Videnovic
- Movement Disorders Unit, Division of Sleep MedicineMassachusetts General HospitalBostonMassachusettsUSA
- Harvard Medical SchoolNeurological Clinical Research InstituteBostonMassachusettsUSA
| | - Emmanuel H. During
- Psychiatry and Behavioral SciencesStanford UniversityRedwood CityCaliforniaUSA
- Neurology & Neurological SciencesStanford UniversityPalo AltoCaliforniaUSA
| | - Mitchell G. Miglis
- Psychiatry and Behavioral SciencesStanford UniversityRedwood CityCaliforniaUSA
- Neurology & Neurological SciencesStanford UniversityPalo AltoCaliforniaUSA
| | | | | | | | - Yo‐El S. Ju
- Washington University School of MedicineSt. LouisMissouriUSA
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10
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Hummel T, T. Liu D, A. Müller C, A. Stuck B, Welge-Lüssen A, Hähner A. Olfactory Dysfunction: Etiology, Diagnosis, and Treatment. DEUTSCHES ARZTEBLATT INTERNATIONAL 2023; 120:146-154. [PMID: 36647581 PMCID: PMC10198165 DOI: 10.3238/arztebl.m2022.0411] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/03/2022] [Accepted: 12/21/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Disorders of the sense of smell have received greater attention because of the frequency with which they occur as a symptom of SARS-CoV-2 infection. Olfactory dysfunction can lead to profound reduction in quality of life and may arise from many different causes. METHODS A selective literature review was conducted with consideration of the current version of the guideline issued by the Association of the Scientific Medical Societies in Germany. RESULTS The cornerstones of diagnosis are the relevant medical history and psychophysical testing of olfactory function using standardized validated tests. Modern treatment strategies are oriented on the cause of the dysfunction. While treatment of the underlying inflammation takes precedence in patients with sinunasal dysosmia, olfactory training is the primary treatment option for other forms of the disorder. The prognosis is determined not only by the cause of the olfactory dysfunction and the patient's age, but also by the olfactory performance as measured at the time of diagnosis. CONCLUSION Options for the treatment of olfactory dysfunction are available but limited, depending on the cause. It is therefore important to carry out a detailed diagnostic work-up and keep the patient informed of the expected course and prognosis.
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Affiliation(s)
- Thomas Hummel
- Interdisciplinary Center for Smell and Taste, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden
| | - David T. Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, Austria
| | - Christian A. Müller
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, Austria
| | - Boris A. Stuck
- Department of Otorhinolaryngology, Head and Neck Surgery, Giessen and Marburg University Hospital Ltd., Marburg
| | - Antje Welge-Lüssen
- Interdisciplinary Center for Smell and Taste, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden
| | - Antje Hähner
- Department of Otorhinolaryngology, Basel University Hospital, Switzerland
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11
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Science interrupted Our attempt to study disgust sensitivity and the development of political attitudes among children and their parents. Politics Life Sci 2023; 41:3-14. [PMID: 36877104 DOI: 10.1017/pls.2022.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Recent research contends that the behavioral immune system, operating largely outside conscious awareness, motivates individuals to exhibit higher levels of prejudice toward unfamiliar out-groups. This research finds that individual variance in disgust sensitivity correlates with support for political policies that facilitate the avoidance of out-groups. We were interested in developing less intrusive indicators of disgust sensitivity via olfactory measures (i.e., ratings of disgusting odors) and behavioral measures (e.g., willingness to touch disgusting objects) and studying the association between measures of disgust sensitivity and in-group bias among children and adults. We submitted a registered report to conduct this research and received an in-principle acceptance. Unfortunately, unforeseen events impaired our data collection, leaving us with a limited sample (nchildren = 32, nadults = 29) and reducing our ability to draw reliable conclusions from our results. In this essay, we describe our motivation and plan of research, the events that made completing the research impossible, and our preliminary results. In doing so, we hope to offer support for studying the effects of the behavioral immune system, even in ways that we did not originally plan. We conclude with a reflection on the value of registered reports for advancing science.
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Sato-Akuhara N, Trimmer C, Keller A, Niimura Y, Shirasu M, Mainland JD, Touhara K. Genetic variation in the human olfactory receptor OR5AN1 associates with the perception of musks. Chem Senses 2023; 48:bjac037. [PMID: 36625229 PMCID: PMC9874024 DOI: 10.1093/chemse/bjac037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Indexed: 01/11/2023] Open
Abstract
Humans have significant individual variations in odor perception, derived from their experience or sometimes from differences in the olfactory receptor (OR) gene repertoire. In several cases, the genetic variation of a single OR affects the perception of its cognate odor ligand. Musks are widely used for fragrance and are known to demonstrate specific anosmia. It, however, remains to be elucidated whether the OR polymorphism contributes to individual variations in musk odor perception. Previous studies reported that responses of the human musk receptor OR5AN1 to a variety of musks in vitro correlated well with perceptual sensitivity to those odors in humans and that the mouse ortholog, Olfr1440 (MOR215-1), plays a critical role in muscone perception. Here, we took advantage of genetic variation in OR5AN1 to examine how changes in receptor sensitivity are associated with human musk perception. We investigated the functional differences between OR5AN1 variants in an in vitro assay and measured both perceived intensity and detection threshold in human subjects with different OR5AN1 genotypes. Human subjects homozygous for the more sensitive L289F allele had a lower detection threshold for muscone and found macrocyclic musks to be more intense than subjects homozygous for the reference allele. These results demonstrate that the genetic variation in OR5AN1 contributes to perceptual differences for some musks. In addition, we found that the more functional variant of OR5A1, a receptor involved in β-ionone perception, is associated with the less functional variant of OR5AN1, suggesting that the perceived intensities of macrocyclic musks and β-ionone are inversely correlated.
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Affiliation(s)
- Narumi Sato-Akuhara
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo 113-8657, Japan
| | - Casey Trimmer
- Monell Chemical Senses Center, Philadelphia, PA 19104, United States
| | - Andreas Keller
- Laboratory of Neurogenetics and Behavior, The Rockefeller University, New York, NY, United States
| | - Yoshihito Niimura
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo 113-8657, Japan
- Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, 1-1, Gakuen Kibanadai Nishi, Miyazaki, Miyazaki 889-2192, Japan
| | - Mika Shirasu
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo 113-8657, Japan
| | - Joel D Mainland
- Monell Chemical Senses Center, Philadelphia, PA 19104, United States
- Department of Neuroscience, University of Pennsylvania School of Medicine, Philadelphia, PA, United States
| | - Kazushige Touhara
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo 113-8657, Japan
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13
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Klarendic M, Zupanic E, Zalaznik M, Georgiev D, Tomazic J, Kojovic M. Olfactory evaluation in hospitalised and self-isolated patients with COVID-19: a single-centre experience on 55 cases. Postgrad Med J 2022; 98:902-905. [PMID: 34772796 PMCID: PMC8594974 DOI: 10.1136/postgradmedj-2021-140315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 10/08/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Smell loss is a common symptom of COVID-19 infection. Majority of the studies that evaluated olfactory impairment in COVID-19 used questionnaires (subjective smell evaluations) and did not compare the results with objective or semiobjective measures of smell. We performed smell testing in hospitalised and self-isolated patients with COVID-19 and control participants. METHODS Fifty-five COVID-19 and 44 control participants underwent smell testing, using Burghart Sniffin' Sticks 'Screening 12 Test'. Participants also rated their smelling capability on the numerical scale. Differences between groups and correlation between smell loss and time from acute onset of symptoms were tested, as well as correlation between results of smell test and subjective assessment of smell. RESULTS Hospitalised patients with COVID-19 correctly determined 6.5/12 odorants compared with 10/12 in the self-isolated and 11/12 in the control group (p<0.001). Hyposmia or anosmia were present in 87.5% of hospitalised and 29.0% of self-isolated patients (p<0.001). The correlation between subjective self-assessment and results of smell testing was non-significant in both groups of patients with COVID-19, while there was a moderate positive correlation (p=0.001, Spearman's correlation coefficient=0.499) in control participants. CONCLUSION Contrary to some previous reports suggesting that the presence of olfactory loss may predict milder course of disease, our study found that a vast majority of hospitalised patients with COVID-19 had prominent olfactory impairment. The absence of correlation between self-rated and objective smell evaluation in patients with COVID-19 indicates that subjective smell assessment is unreliable.
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Affiliation(s)
- Maja Klarendic
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Eva Zupanic
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Mateja Zalaznik
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
- Department for Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Dejan Georgiev
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Janez Tomazic
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
- Department for Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Maja Kojovic
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
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14
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Investigations and Outcomes for Olfactory Disorders. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022; 10:377-384. [PMCID: PMC9707095 DOI: 10.1007/s40136-022-00438-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 12/02/2022]
Abstract
Purpose of Review To provide a detailed overview of the investigations and core outcome measures for olfactory disorders. Recent Findings Olfactory disorders can have a detrimental impact to the quality of life of patients. There are a wide range of causes of olfactory loss including sinonasal conditions, idiopathic, post-head trauma or infection. This review highlights the key investigations and reasoning for their use to clinically assess and research patients with olfactory disorders. In addition, this review outlines the core outcome measures for olfaction that will help inform future research in olfactory disorders. Summary A systematic approach with history taking and examination particularly with nasal endoscopy can determine the cause of the olfactory disorder in most cases. Specific olfactory disorder questionnaires can demonstrate the impact on quality of life, while psychophysical testing can objectively assess and monitor olfaction over time. Olfactory-evoked potentials and functional MRI are reserved for research, whereas CT and MRI imaging are used depending on history and examination. A core outcome set for olfaction has been developed that will help standardise the outcome measures used in olfaction and olfactory disorders research.
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15
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Maharjan A, Khwaounjoo P, Peng M, Cakmak YO. Non-contact neuromodulation of the human autonomic nervous system function via different odors: Sex, menstrual cycle, and odor dose- and duration-specific effects. Front Neurosci 2022; 16:950282. [PMID: 36312014 PMCID: PMC9596915 DOI: 10.3389/fnins.2022.950282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 08/17/2022] [Indexed: 11/24/2022] Open
Abstract
In recent decades, it has been uncovered that the autonomic nervous system (ANS) can be influenced using non-contact neuromodulation via odor stimulation. Increasing parasympathetic-vagal activation of the ANS is integral to improving the sympathovagal balance between the sympathetic- and parasympathetic nervous systems, which is often imbalanced in several chronic inflammatory disorders, such as rheumatoid arthritis and inflammatory bowel diseases. Although research into olfactory stimulation has been observed on the ANS, it is still lacking in the exploration of odor concentration and odor-specific effects. This is particularly the case as research has not utilized specified tools, such as the olfactometer to provide precise odor delivery. Furthermore, no research has compared the results in separate sex cohorts to investigate the role of sex or the menstrual stage on the subsequent interactions. In this study, we investigated the olfactory stimulation effects of four natural odors (mushroom, lavender, jasmine, and rose) in three concentrations (low, moderate, and high) on the ANS. To observe activity from the ANS, we used an electrocardiogram (ECG) based heart rate variability (HRV) and eye-tracker technology (pupil diameter). We found for the first time in literature that there were acute dose- and duration-specific odor effects of odors on the ANS. We also found sex and menstrual cycle effects in this interaction. Furthermore, there were stark distinctions in sympathovagal activity dependent ANS activation (HRV) in comparison to the oculomotor nerve-parasympathetic/cervical sympathetic nerves dependent ANS responses (pupil diameter). Sympathovagal activity dependent HRV showed odor, sex, and menstrual-stage interactions in both divisions of the ANS while the pupil responses only indicated increased sympathetic activation. These results shed light on the use of odor-specific stimulation to modulate the ANS activity in the context of sex and the menstrual stage. Future studies should be performed using a chronic odor delivery design to investigate the long-term effects of odors on the ANS.
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Affiliation(s)
- Ashim Maharjan
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Prashanna Khwaounjoo
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
- Medical Technologies Centre of Research Excellence, Auckland, New Zealand
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Mei Peng
- Sensory Neuroscience Laboratory, Department of Food Science, University of Otago, Dunedin, New Zealand
| | - Yusuf Ozgur Cakmak
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
- Medical Technologies Centre of Research Excellence, Auckland, New Zealand
- Brain Health Research Centre, Dunedin, New Zealand
- Centre for Bioengineering and Nanotechnology, Point of Care Technologies, University of Otago, Dunedin, New Zealand
- *Correspondence: Yusuf Ozgur Cakmak,
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16
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Mastinu M, Melis M, Yousaf NY, Barbarossa IT, Tepper BJ. Emotional responses to taste and smell stimuli: Self-reports, physiological measures, and a potential role for individual and genetic factors. J Food Sci 2022; 88:65-90. [PMID: 36169921 DOI: 10.1111/1750-3841.16300] [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: 03/17/2022] [Revised: 06/24/2022] [Accepted: 07/26/2022] [Indexed: 11/30/2022]
Abstract
Taste and olfaction elicit conscious feelings by direct connection with the neural circuits of emotions that affects physiological responses in the body (e.g., heart rate and skin conductance). While sensory attributes are strong determinants of food liking, other factors such as emotional reactions to foods may be better predictors of consumer choices even for products that are equally-liked. Thus, important insights can be gained for understanding the full spectrum of emotional reactions to foods that inform the activities of product developers and marketers, eating psychologist and nutritionists, and policy makers. Today, self-reported questionnaires and physiological measures are the most common tools applied to study variations in emotional perception. The present review discusses these methodological approaches, underlining their different strengths and weaknesses. We also discuss a small, emerging literature suggesting that individual differences and genetic variations in taste and smell perception, like the genetic ability to perceive the bitter compound PROP, may also play a role in emotional reactions to aromas and foods.
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Affiliation(s)
- Mariano Mastinu
- Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy.,Center for Sensory Sciences & Innovation & Department of Food Science, Rutgers University, New Brunswick, New Jersey, USA
| | - Melania Melis
- Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy
| | - Neeta Y Yousaf
- Center for Sensory Sciences & Innovation & Department of Food Science, Rutgers University, New Brunswick, New Jersey, USA
| | | | - Beverly J Tepper
- Center for Sensory Sciences & Innovation & Department of Food Science, Rutgers University, New Brunswick, New Jersey, USA
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17
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Fahmy M, Whitcroft K. Psychophysical Testing in Chemosensory Disorders. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022; 10:393-404. [PMID: 36120187 PMCID: PMC9468236 DOI: 10.1007/s40136-022-00429-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 12/02/2022]
Abstract
Purpose of Review To provide an overview of psychophysical testing in olfaction and gustation. Recent Findings Subjective patient report correlates poorly with objective assessment of olfaction and gustation. It is therefore important that clinicians and researchers perform psychophysical testing during chemosensory assessment. There are several validated psychophysical tests of olfaction and gustation, with ongoing developments accelerated by the COVID-19 pandemic. These tests have been culturally and linguistically adapted globally. Screening tests have been developed with careful consideration to distinguish normosmics from those with olfactory dysfunction. Summary Validated chemosensory tools are available for use by the clinician to support screening, diagnosis, or monitoring. There are promising advances in self-assessment and screening that provide avenues for the development of a standardised pathway for identification and formal assessment of patients with smell and taste disorders.
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Affiliation(s)
- Miriam Fahmy
- ENT Department, Pinderfields Hospital, Mid Yorkshire Hospital NHS Trust, Wakefield, UK
- Wrexham, UK
| | - Katherine Whitcroft
- ENT Department, Pinderfields Hospital, Mid Yorkshire Hospital NHS Trust, Wakefield, UK
- UCL Ear Institute, London, UK
- Centre for Olfactory Research Applications, Institute of Philosophy, School of Advanced Study, London, UK
- Smell and Taste Clinic, Techniche Universität Dresden, Dresden, Germany
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18
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Sorting of Odor Dilutions Is a Meaningful Addition to Assessments of Olfactory Function as Suggested by Machine-Learning-Based Analyses. J Clin Med 2022; 11:jcm11144012. [PMID: 35887775 PMCID: PMC9317381 DOI: 10.3390/jcm11144012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The categorization of individuals as normosmic, hyposmic, or anosmic from test results of odor threshold, discrimination, and identification may provide a limited view of the sense of smell. The purpose of this study was to expand the clinical diagnostic repertoire by including additional tests. Methods: A random cohort of n = 135 individuals (83 women and 52 men, aged 21 to 94 years) was tested for odor threshold, discrimination, and identification, plus a distance test, in which the odor of peanut butter is perceived, a sorting task of odor dilutions for phenylethyl alcohol and eugenol, a discrimination test for odorant enantiomers, a lateralization test with eucalyptol, a threshold assessment after 10 min of exposure to phenylethyl alcohol, and a questionnaire on the importance of olfaction. Unsupervised methods were used to detect structure in the olfaction-related data, followed by supervised feature selection methods from statistics and machine learning to identify relevant variables. Results: The structure in the olfaction-related data divided the cohort into two distinct clusters with n = 80 and 55 subjects. Odor threshold, discrimination, and identification did not play a relevant role for cluster assignment, which, on the other hand, depended on performance in the two odor dilution sorting tasks, from which cluster assignment was possible with a median 100-fold cross-validated balanced accuracy of 77–88%. Conclusions: The addition of an odor sorting task with the two proposed odor dilutions to the odor test battery expands the phenotype of olfaction and fits seamlessly into the sensory focus of standard test batteries.
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19
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D'Alessandro A, Grigorescu O, Höchenberger R, Ohla K, Hummel T. A Bayesian adaptive algorithm (
QUEST
) to estimate olfactory threshold in hyposmic patients. J SENS STUD 2022. [DOI: 10.1111/joss.12769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Andrea D'Alessandro
- Smell & Taste Clinic, Department of Otorhinolaryngology Technical University of Dresden Dresden Germany
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology University of Trieste Trieste Italy
| | - Oana Grigorescu
- Smell & Taste Clinic, Department of Otorhinolaryngology Technical University of Dresden Dresden Germany
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus Technical University of Dresden Dresden Germany
| | | | | | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology Technical University of Dresden Dresden Germany
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20
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Patel ZM, Holbrook EH, Turner JH, Adappa ND, Albers MW, Altundag A, Appenzeller S, Costanzo RM, Croy I, Davis GE, Dehgani-Mobaraki P, Doty RL, Duffy VB, Goldstein BJ, Gudis DA, Haehner A, Higgins TS, Hopkins C, Huart C, Hummel T, Jitaroon K, Kern RC, Khanwalkar AR, Kobayashi M, Kondo K, Lane AP, Lechner M, Leopold DA, Levy JM, Marmura MJ, Mclelland L, Miwa T, Moberg PJ, Mueller CA, Nigwekar SU, O'Brien EK, Paunescu TG, Pellegrino R, Philpott C, Pinto JM, Reiter ER, Roalf DR, Rowan NR, Schlosser RJ, Schwob J, Seiden AM, Smith TL, Soler ZM, Sowerby L, Tan BK, Thamboo A, Wrobel B, Yan CH. International consensus statement on allergy and rhinology: Olfaction. Int Forum Allergy Rhinol 2022; 12:327-680. [PMID: 35373533 DOI: 10.1002/alr.22929] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/01/2021] [Accepted: 11/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O). METHODS Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus. RESULTS The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies. CONCLUSION This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.
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Affiliation(s)
- Zara M Patel
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Eric H Holbrook
- Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Justin H Turner
- Otolaryngology, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Nithin D Adappa
- Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark W Albers
- Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Aytug Altundag
- Otolaryngology, Biruni University School of Medicine, İstanbul, Turkey
| | - Simone Appenzeller
- Rheumatology, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Richard M Costanzo
- Physiology and Biophysics and Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Ilona Croy
- Psychology and Psychosomatic Medicine, TU Dresden, Dresden, Germany
| | - Greg E Davis
- Otolaryngology, Proliance Surgeons, Seattle and Puyallup, Washington, USA
| | - Puya Dehgani-Mobaraki
- Associazione Naso Sano, Umbria Regional Registry of Volunteer Activities, Corciano, Italy
| | - Richard L Doty
- Smell and Taste Center, Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Valerie B Duffy
- Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | | | - David A Gudis
- Otolaryngology, Columbia University Irving Medical Center, New York, USA
| | - Antje Haehner
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | - Thomas S Higgins
- Otolaryngology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Claire Hopkins
- Otolaryngology, Guy's and St. Thomas' Hospitals, London Bridge Hospital, London, UK
| | - Caroline Huart
- Otorhinolaryngology, Cliniques universitaires Saint-Luc, Institute of Neuroscience, Université catholgique de Louvain, Brussels, Belgium
| | - Thomas Hummel
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | | | - Robert C Kern
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ashoke R Khanwalkar
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Masayoshi Kobayashi
- Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Kenji Kondo
- Otolaryngology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Andrew P Lane
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matt Lechner
- Otolaryngology, Barts Health and University College London, London, UK
| | - Donald A Leopold
- Otolaryngology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Joshua M Levy
- Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael J Marmura
- Neurology Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lisha Mclelland
- Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Takaki Miwa
- Otolaryngology, Kanazawa Medical University, Ishikawa, Japan
| | - Paul J Moberg
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Sagar U Nigwekar
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Erin K O'Brien
- Otolaryngology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Teodor G Paunescu
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Carl Philpott
- Otolaryngology, University of East Anglia, Norwich, UK
| | - Jayant M Pinto
- Otolaryngology, University of Chicago, Chicago, Illinois, USA
| | - Evan R Reiter
- Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - David R Roalf
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nicholas R Rowan
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rodney J Schlosser
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - James Schwob
- Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Allen M Seiden
- Otolaryngology, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - Timothy L Smith
- Otolaryngology, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Zachary M Soler
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - Leigh Sowerby
- Otolaryngology, University of Western Ontario, London, Ontario, Canada
| | - Bruce K Tan
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andrew Thamboo
- Otolaryngology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bozena Wrobel
- Otolaryngology, Keck School of Medicine, USC, Los Angeles, California, USA
| | - Carol H Yan
- Otolaryngology, School of Medicine, UCSD, La Jolla, California, USA
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21
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Nakanishi M, Fornazieri MA, Lança Gomes P, Dias LADM, Freire GSM, Vinha LGDA, Barbosa de Sa LC, Voegels RL, Galvão C, Lima WTA. The digital scent device as a new concept for olfactory assessment. Int Forum Allergy Rhinol 2022; 12:1263-1272. [PMID: 35224885 DOI: 10.1002/alr.22992] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND There are major challenges in olfactory measurements in clinical practice; therefore, a handheld digital scent device (DSD; Noar MultiScent 20) was developed as a tablet with an integrated storage system for odors. The DSD is a self-administered, handheld device that controls the duration of odor release to the nasal cavity through a touchscreen digital interface with automatic database generation. In this study we aimed to determine the feasibility of this DSD as an olfactory assessment test. METHODS We recruited 180 participants (age [mean ± standard deviation], 34.58 ± 9.71 years; 114 women and 66 men) to participate in smell tests using both the DSD and the 40-item Smell Identification Test (SIT-40), which contained the same type and order of odors and the same multiple-choice answers. The scores were compared and evaluated for correlation between the tests, and test-retest reliability was calculated. RESULTS The DSD test scores were higher than the SIT-40 scores (median [interquartile range], 32 [5.0] vs 31 [7.0]; p = 0.005). The completion time was less for the DSD test than for the SIT-40 (12.5 [5.0] vs 16 [6.0] minutes; p < 0.001). The tests were strongly correlated (Spearman rho = 0.74; p < 0.001) and exhibited a high level of agreement (Bland-Altman regression coefficient = 0.672; p = 0.003). The DSD test-retest reliability coefficient was 0.820. CONCLUSION The DSD is feasible as an olfactory assessment test. The digitalization of olfactory assessment combined with data science may enable new research perspectives in the field of olfaction.
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Affiliation(s)
- Marcio Nakanishi
- Department of Otorhinolaryngology, University Hospital of Brasília UnB-EBSERH, Brasilia, Federal District, Brazil.,Department of Ophthalmology and Otorhinolaryngology, Ribeirão Preto Medical School-USP, Ribeirão Preto, São Paulo, Brazil.,Division of Otorhinolaryngology, D'Or Institute of Education and Research, Hospital Santa Luzia, Brasilia, Brazil
| | - Marco Aurélio Fornazieri
- Department of Otorhinolaryngology State University of Londrina, Pontifical Catholic University of Paraná, Londrina, PR, Brazil
| | - Pedro Lança Gomes
- Division of Otorhinolaryngology, D'Or Institute of Education and Research, Hospital Santa Luzia, Brasilia, Brazil
| | | | | | | | | | - Richard Louis Voegels
- Department of Ophthalmology and Otorhinolaryngology, University of São Paulo, São Paulo, Brazil
| | | | - Wilma Terezinha Anselmo Lima
- Department of Ophthalmology and Otorhinolaryngology, Ribeirão Preto Medical School-USP, Ribeirão Preto, São Paulo, Brazil
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22
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Foster E, Bayley M, Langer L, Saverino C, Chandra T, Barnard C, Comper P. The Toronto Concussion Study: Sense of smell is not associated with concussion severity or recovery. Brain Inj 2022; 36:759-767. [PMID: 35171730 DOI: 10.1080/02699052.2022.2037713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To examine sense of smell as a biomarker for both severity and duration of post-concussion symptoms. METHODS Participants were recruited prospectively from an outpatient concussion clinic. Sense of smell was assessed using the University of Pennsylvania Smell Identification Test (UPSIT) within 7 days, and 4, 8 - or 16-weeks post-injury. UPSIT normative data were used as normal controls. The main outcomes were: symptom severity on the Sport Concussion Assessment Tool 3 (SCAT3) symptom inventory and time to physician-declared recovery. RESULTS A total of 167 participants (mean age 32.9 [SD, 12.2] years, 59% female [n = 99]) were classified at 1 week post injury as follows: severe hyposmia in 5 (3%), moderate hyposmia in 10 (6%), mild hyposmia in 48 (29%), and normosmia in 104 (62%) individuals. A convenience sample of 81 individuals with concussion were tested at follow-up. Acute impairment of sense of smell following concussion was not associated with symptom severity on the SCAT3 or time to recovery. Sense of smell was stable from baseline to follow-up in this population. CONCLUSION This study provides evidence that routine testing of sense of smell in individuals with concussion is not warranted as a biomarker for severity of concussion and concussion recovery.
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Affiliation(s)
- Evan Foster
- KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,Translational Research Program, University of Toronto, Toronto, Ontario, Canada
| | - Mark Bayley
- KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,Physiatry, University of Toronto, Toronto, Ontario, Canada
| | - Laura Langer
- KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada
| | | | - Tharshini Chandra
- KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada
| | - Claire Barnard
- KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada
| | - Paul Comper
- KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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23
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Badran BW, Gruber EM, O’Leary GH, Austelle CW, Huffman SM, Kahn AT, McTeague LM, Uhde TW, Cortese BM. Electrical stimulation of the trigeminal nerve improves olfaction in healthy individuals: A randomized, double-blind, sham-controlled trial. Brain Stimul 2022; 15:761-768. [PMID: 35561963 PMCID: PMC9976566 DOI: 10.1016/j.brs.2022.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Both activated by environmental odorants, there is a clear role for the intranasal trigeminal and olfactory nerves in smell function. Unfortunately, our ability to perceive odorants decreases with age or with injury, and limited interventions are available to treat smell loss. OBJECTIVE We investigated whether electrical stimulation of the trigeminal nerve via trigeminal nerve stimulation (TNS) or transcranial direct current stimulation (tDCS) modulates odor sensitivity in healthy individuals. METHODS We recruited 20 healthy adults (12 Female, mean age = 27) to participate in this three-visit, randomized, double-blind, sham-controlled trial. Participants were randomized to receive one of three stimulation modalities (TNS, tDCS, or sham) during each of their visits. Odor detection thresholds were obtained at baseline, immediately post-intervention, and 30-min post-intervention. Furthermore, participants were asked to complete a sustained attention task and mood assessments before odor detection testing. RESULTS Findings reveal a timeXcondition interaction for guaiacol (GUA) odorant detection thresholds (F (3.188, 60.57) = 3.833, P = 0.0125), but not phenyl ethyl alcohol (PEA) odorant thresholds. At 30-min post-stimulation, both active TNS and active tDCS showed significantly increased sensitivity to GUA compared to sham TNS (Sham TNS = -8.30% vs. Active TNS = 9.11%, mean difference 17.43%, 95% CI 5.674 to 29.18, p = 0.0044; Sham TNS = -8.30% vs. Active tDCS = 13.58%, mean difference 21.89%, 95% CI 10.47 to 33.32, p = 0.0004). CONCLUSION TNS is a safe, simple, noninvasive method for boosting olfaction. Future studies should investigate the use of TNS on smell function across different stimulation parameters, odorants, and patient populations.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Bernadette M. Cortese
- Corresponding author. Department of Psychiatry and Behavioral Sciences, The Medical University of South Carolina, 67 President Street, BA 504F, Charleston, South Carolina, 29425, USA. (B.M. Cortese)
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24
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Beutler S, Ladner LR, Hummel T, Croy I. A New Method for a Shorter and Valid Assessment of Olfactory Threshold in Repeated Measurement Designs Based on the Sniffin’ Sticks Test. CHEMOSENS PERCEPT 2021. [DOI: 10.1007/s12078-021-09291-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
Introduction
The Sniffin’ Sticks threshold test is widely used to assess olfactory threshold due to its high reliability and validity. Nevertheless, this test procedure is quite long with an average duration of 10 to 20 min. In study designs that require multiple olfactory threshold tests on short intervals, this could exhaust participants. To counteract this limitation, we developed the informed-four-reversal (INFOUR) short version of the Sniffin’ Sticks threshold test for repeated measurement designs and piloted it in a sample of normosmic participants.
Methods
Forty-two participants performed the original Sniffin’ Sticks version before being assigned either to the control group that repeated the original version or to the test group that conducted the INFOUR short version.
Results
The correlation between the original version at T1 and INFOUR at T2 was r = .75 and did not differ significantly from the retest reliability of the original version. Compared to the original version, the INFOUR took 42% less time to perform.
Conclusion
The INFOUR leads to a significant time saving, while maintaining good validity.
Implications
Therefore, this approach has the potential to be a useful tool for study protocols with repeated olfactory threshold measurements. In particular, when research protocols are time intensive or testing needs to the shortened, because the interventional effects are short or subtle.
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25
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Martinec Nováková L, Kliková M, Miletínová E, Bušková J. Olfaction-Related Factors Affecting Chemosensory Dream Content in a Sleep Laboratory. Brain Sci 2021; 11:1225. [PMID: 34573245 PMCID: PMC8465492 DOI: 10.3390/brainsci11091225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 12/04/2022] Open
Abstract
Mental activity in sleep often involves visual and auditory content. Chemosensory (olfactory and gustatory) experiences are less common and underexplored. The aim of the study was to identify olfaction-related factors that may affect the occurrence of chemosensory dream content. Specifically, we investigated the effects of all-night exposure to an ambient odour, participants' appraisal of their current olfactory environment, their general propensity to notice odours and act on them (i.e., odour awareness), and their olfactory acuity. Sixty pre-screened healthy young adults underwent olfactory assessment, completed a measure of odour awareness, and spent three nights in weekly intervals in a sleep laboratory. The purpose of the first visit was to adapt to the experimental setting. On the second visit, half of them were exposed to the smell of vanillin or thioglycolic acid and the other half to an odourless control condition. On the third visit, they received control or stimulation in a balanced order. On each visit, data were collected twice: once from the first rapid eye movement (REM) stage that occurred after 3 a.m., and then shortly before getting up, usually from a non-REM stage. Participants were asked to report the presence of sensory dream content and to assess their current olfactory environment. Neither exposure, nor participants' assessments of the ambient odour, or olfactory acuity affected reports of chemosensory dream content but they were more frequent in individuals with greater odour awareness. This finding may have implications for treatment when such experiences become unwanted or bothersome.
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Affiliation(s)
- Lenka Martinec Nováková
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (M.K.); (E.M.); (J.B.)
- Department of Psychology and Life Sciences, Faculty of Humanities, Charles University, Pátkova 2137/5, 182 00 Prague 8-Libeň, Czech Republic
| | - Monika Kliková
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (M.K.); (E.M.); (J.B.)
- Third Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague 10-Vinohrady, Czech Republic
| | - Eva Miletínová
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (M.K.); (E.M.); (J.B.)
- Third Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague 10-Vinohrady, Czech Republic
| | - Jitka Bušková
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (M.K.); (E.M.); (J.B.)
- Third Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague 10-Vinohrady, Czech Republic
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26
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Rebholz H, Pfaffeneder-Mantai F, Knoll W, Hassel AW, Frank W, Kleber C. Olfactory dysfunction in SARS-CoV-2 infection: Focus on odorant specificity and chronic persistence. Am J Otolaryngol 2021; 42:103014. [PMID: 33873048 PMCID: PMC8041855 DOI: 10.1016/j.amjoto.2021.103014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 03/28/2021] [Indexed: 01/11/2023]
Abstract
Background Smell dysfunction has been recognized as an early symptom of SARS-CoV-2 infection, often occurring before the onset of core symptoms of the respiratory tract, fever or muscle pain. In most cases, olfactory dysfunction is accompanied by reduced sense of taste, is partial (microsmia) and seems to normalize after several weeks, however, especially in cases of virus-induced complete smell loss (anosmia), there are indications of persisting deficits even 2 months after recovery from the acute disease, pointing towards the possibility of chronic or even permanent smell reduction for a significant part of the patient population. To date, we have no knowledge on the specificity of anosmia towards specific odorants or chemicals and about the longer-term timeline of its persistence or reversal. Methods In this longitudinal study, 70 participants from a community in Lower Austria that had been tested positive for either IgG or IgM SARS-CoV-2 titers in June 2020 and a healthy control cohort (N = 348) underwent smell testing with a 12-item Cross-Cultural Smell Identification Test (CC-SIT), based upon items from the University of Pennsylvania Smell Identification Test (UPSIT). The test was performed in October 2020, i.e. 4 months after initial diagnosis via antibody testing. Results were analyzed using statistical tests for contingency for each smell individually in order to detect whether reacquisition of smell is dependent on specific odorant types. Results For all odorants tested, except the odor “smoke”, even 4 months or more after acute SARS-CoV-2 infection, participants with a positive antibody titer had a reduced sense of smell when compared to the control group. On average, while the control cohort detected a set of 12 different smells with 88.0% accuracy, the antibody-positive group detected 80.0% of tested odorants. A reduction of accuracy of detection by 9.1% in the antibody-positive cohort was detected. Recovery of the ability to smell was particularly delayed for three odorants: strawberry (encoded by the aldehyde ethylmethylphenylglycidate), lemon (encoded by citronellal, a monoterpenoid aldehyde), and soap (alkali metal salts of the fatty acids plus odorous additives) exhibit a sensitivity of detection of an infection with SARS-CoV-2 of 31.0%, 41.0% and 40.0%, respectively. Conclusion Four months or more after acute infection, smell performance of SARS-CoV-2 positive patients with mild or no symptoms is not fully recovered, whereby the ability to detect certain odors (strawberry, lemon and soap) is particularly affected, suggesting the possibility that these sensitivity to these smells may not only be lagging behind but may be more permanently affected.
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Affiliation(s)
- H Rebholz
- Center of Neurodegeneration, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, INSERM, Université de Paris, Paris, France; GHU Psychiatrie et Neurosciences, Paris, France
| | - F Pfaffeneder-Mantai
- Department of Physics and Chemistry of Materials, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria.
| | - W Knoll
- Department of Physics and Chemistry of Materials, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria; AIT Austrian Institute of Technology GmbH, Biosensor Technologies, 3430 Tulln, Austria
| | - A W Hassel
- Department of Physics and Chemistry of Materials, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria; Institute of Chemical Technology of Inorganic Materials, Johannes Kepler University Linz, Linz, Austria
| | - W Frank
- Center of Health Systems Research, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria
| | - C Kleber
- Department of Physics and Chemistry of Materials, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria; Institute of Chemical Technology of Inorganic Materials, Johannes Kepler University Linz, Linz, Austria
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Rhinological manifestations of Sjögren's syndrome: a cohort-matched, prospective, cross-sectional, observational study. The Journal of Laryngology & Otology 2021; 135:932-936. [PMID: 34420533 DOI: 10.1017/s0022215121002255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the prevalence of abnormal rhinological findings in a Sjögren's syndrome population. METHODS A cohort-matched, prospective, cross-sectional, observational study was conducted. Sixty-seven subjects (30 patients and 37 controls) were enrolled. Rhinological assessment including smell threshold was evaluated using a standardised, validated clinical test as part of a larger study. RESULTS Smell thresholds were -4.4 and -5.4 in the Sjögren's syndrome and control groups, respectively (p = 0.001). Hyposmia (threshold values of less than -4.5) was demonstrated in the Sjögren's syndrome group (47 per cent). Smell was negatively correlated with age (p = 0.040). Nasal septal perforation was noted in 3 Sjögren's syndrome patients (10 per cent) and nasal mucosal dryness in 10 patients (33 per cent), but none of the control group were affected. CONCLUSION Hyposmia in Sjögren's syndrome was demonstrated using the Smell Threshold Test. Nasal septal perforation and nasal mucosa dryness were also noted in patients with Sjögren's syndrome. A diagnosis of Sjögren's syndrome should be considered and investigated in smell deprivation and/or nasal septal perforation patients.
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28
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The potential for retronasally delivered olfactory stimuli to assess psychiatric conditions. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-019-00238-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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29
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Singer-Cornelius T, Cornelius J, Oberle M, Metternich FU, Brockmeier SJ. Objective gustatory and olfactory dysfunction in COVID-19 patients: a prospective cross-sectional study. Eur Arch Otorhinolaryngol 2021; 278:3325-3332. [PMID: 33471170 PMCID: PMC7816141 DOI: 10.1007/s00405-020-06590-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/24/2020] [Indexed: 10/30/2022]
Abstract
PURPOSE To determine the prevalence of objective gustatory (GD) and olfactory (OD) dysfunction in COVID-19 patients. METHODS This is a prospective, cross-sectional study of 51 COVID-19 positive patients diagnosed using RT-PCR-based testing. Of these study participants, 41 reported having present GD and OD at the time of enrollment and ten patients were without symptomatic OD and GD. All participants were objectively tested for OD by Brief Smell Identification Test (BSIT) and for GD by Burghart taste strip test, which were mailed to the participants. The subjective presence and severity of COVID-19 symptoms of smell loss, loss of taste, nasal obstruction, rhinorrhea/mucus production, fever, cough and shortness of breath were also assessed. RESULTS Of the 41 patients with GD and OD, only 25.6% (10/39; p ≤ 0.0001) objectively presented GD and 39.1% (16/41; p ≤ 0.0001) OD at the time of their subjective dysfunction. Regarding GD, 23.1% (9/39) suffered from total hypogeusia, 2.6% (1/39) from ageusia. A significant loss of sour (33.3% (13/39)) and salty taste (17.9% (7/39)) could be recognized. Only 10.3% (4/39) showed a reduction in sweet and bitter taste. Concerning OD, 9.8% (4/41) showed a deficit relative to younger age in the BSIT and 29.3% (12/41) results abnormal relative to age. CONCLUSION Subjective and objective findings in GD and OD differ significantly. Most patients suffering from objective dysgeusia present a deficit in sour and salty taste. TRIAL REGISTRATION NUMBER DRKS00021516; 22/04/2020.
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Affiliation(s)
- Thirza Singer-Cornelius
- Klinik für Hals-Nasen-Ohrenheilkunde, Hals- und Gesichtschirurgie, Kantonsspital Aarau, Aarau, Switzerland.
| | - Julian Cornelius
- Departement Chirurgie, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Michael Oberle
- Institut für Labormedizin, Kantonsspital Aarau, Aarau, Switzerland
| | - Frank U Metternich
- Klinik für Hals-Nasen-Ohrenheilkunde, Hals- und Gesichtschirurgie, Kantonsspital Aarau, Aarau, Switzerland
| | - Steffi Johanna Brockmeier
- Klinik für Hals-Nasen-Ohrenheilkunde, Hals- und Gesichtschirurgie, Kantonsspital Aarau, Aarau, Switzerland
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30
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Jraissati Y, Deroy O. Categorizing Smells: A Localist Approach. Cogn Sci 2021; 45:e12930. [PMID: 33389758 DOI: 10.1111/cogs.12930] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 11/30/2022]
Abstract
Humans are poorer at identifying smells and communicating about them, compared to other sensory domains. They also cannot easily organize odor sensations in a general conceptual space, where geometric distance could represent how similar or different all odors are. These two generalities are more or less accepted by psychologists, and they are often seen as connected: If there is no conceptual space for odors, then olfactory identification should indeed be poor. We propose here an important revision to this conclusion: We believe that the claim that there is no odor space is true only if by odor space, one means a conceptual space representing all possible odor sensations, in the paradigmatic sense used for instance for color. However, in a less paradigmatic sense, local conceptual spaces representing a given subset of odors do exist. Thus the absence of a global odor space does not warrant the conclusion that there is no olfactory conceptual map at all. Here we show how a localist account provides a new interpretation of experts and cross-cultural categorization studies: Rather than being exceptions to the poor olfactory identification and communication usually seen elsewhere, experts and cross-cultural categorization are here taken to corroborate the existence of local conceptual spaces.
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Affiliation(s)
- Yasmina Jraissati
- Ronin Institute.,Department of Philosophy, American University of Beirut
| | - Ophelia Deroy
- Faculty of Philosophy, Ludwig Maximilian University.,Munich Centre for Neuroscience, Ludwig Maximilian University.,Institute of Philosophy, School of Advanced Study, University of London
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Abstract
Approximately 5% of the general population is affected by functional anosmia with approximately additional 15% exhibiting decreased olfactory function. Many of these individuals ask for help. Because the subjective rating of olfactory function is biased, assessment of olfactory function is important. Olfactory measurements are needed for patient counseling and the tracking of changes in the sense of smell over time. The present review provides an overview of frequently used psychophysical tests for olfactory function, discusses differences between threshold and suprathreshold aspects of olfactory function, and gives examples on how to apply psychophysical tests.
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Affiliation(s)
- Thomas Hummel
- Department of Otorhinolaryngology, Smell & Taste Clinic, "Technische Universität Dresden", Dresden, Germany
| | - Dino Podlesek
- Department of Neurosurgery, "Technische Universität Dresden", Dresden, Germany
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32
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Mazzatenta A, Neri G, D'Ardes D, De Luca C, Marinari S, Porreca E, Cipollone F, Vecchiet J, Falcicchia C, Panichi V, Origlia N, Di Giulio C. Smell and Taste in Severe CoViD-19: Self-Reported vs. Testing. Front Med (Lausanne) 2020; 7:589409. [PMID: 33344476 PMCID: PMC7745760 DOI: 10.3389/fmed.2020.589409] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/07/2020] [Indexed: 01/05/2023] Open
Abstract
One of the most striking reported symptoms in CoViD-19 is loss of smell and taste. The frequency of these impairments and their specificity as a potential central nervous system function biomarker are of great interest as a diagnostic clue for CoViD-19 infection as opposed to other similar symptomatologic diseases and because of their implication in viral pathogenesis. Here severe CoViD-19 was investigated by comparing self-report vs. testing of smell and taste, thus the objective severity of olfactory impairment and their possible correlation with other symptoms. Because a significant discrepancy between smell and taste testing vs. self-report results (p < 0.001) emerges in our result, we performed a statistical analysis highlighting disagreement among normosmia (p < 0.05), hyposmia, severe hyposmia, and anosmia (p < 0.001) and, in hypogeusia and severe hypogeusia, while no differences are observed in normogeusia and ageusia. Therefore, we analyzed the olfactory threshold by an objective test revealing the distribution of hyposmic (34%), severe hyposmic (48%), and anosmic (13%) patients in severe CoViD-19. In severe CoViD-19 patients, taste is lost in 4.3% of normosmic individuals, 31.9% of hyposmic individuals, 46.8% of severe hyposmic individuals, and 17% of anosmic individuals. Moreover, 95% of 100 CoViD-19 patients objectively tested were affected by smell dysfunction, while 47% were affected by taste dysfunction. Furthermore, analysis by objective testing also highlighted that the severity of smell dysfunction in CoViD-19 subjects did not correlate with age and sex. In conclusion, we report by objective testing that the majority of CoViD-19 patients report severe anosmia, that most of the subjects have olfactory impairment rather than taste impairment, and, finally, that the olfactory impairment correlate with symptom onset and hospitalization (p < 0.05). Patients who exhibit severe olfactory impairment had been hospitalized for about a week from symptom onset; double time has taken place in subjects with normosmia. Our results may be limited by the relatively small number of study participants, but these suggest by objective testing that hyposmia, severe hyposmia, and anosmia may relate directly to infection severity and neurological damage. The smell test assessment could be a potential screening symptom that might contribute to the decision to test suspected cases or guide quarantine instructions, further therapeutic approach, and evaluation of neurological damage.
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Affiliation(s)
- Andrea Mazzatenta
- Neurophysiology, Olfaction and Chemoreception Laboratory, Physiology and Physiopathology Section, Neuroscience, Imaging and Clinical Sciences Department, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Giampiero Neri
- Neurophysiology, Olfaction and Chemoreception Laboratory, Physiology and Physiopathology Section, Neuroscience, Imaging and Clinical Sciences Department, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Damiano D'Ardes
- Medicine and Aging Sciences Department, 'G. d'Annunzio'University of Chieti-Pescara, Chieti, Italy
| | - Carlo De Luca
- Neurophysiology, Olfaction and Chemoreception Laboratory, Physiology and Physiopathology Section, Neuroscience, Imaging and Clinical Sciences Department, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | | | - Ettore Porreca
- Medical, Oral and Biotechnological Sciences, 'G. d'Annunzio'University of Chieti-Pescara, Chieti, Italy
| | - Francesco Cipollone
- Medicine and Aging Sciences Department, 'G. d'Annunzio'University of Chieti-Pescara, Chieti, Italy
| | - Jacopo Vecchiet
- Medicine and Aging Sciences Department, 'G. d'Annunzio'University of Chieti-Pescara, Chieti, Italy
| | | | - Vincenzo Panichi
- Nephrology and Dialysis Unit, Unità Sanitaria Locale Toscana Nord Ovest-Versilia Hospital, Camaiore, Italy
| | - Nicola Origlia
- Neuroscience Institute, National Council of Research, Pisa, Italy
| | - Camillo Di Giulio
- Neurophysiology, Olfaction and Chemoreception Laboratory, Physiology and Physiopathology Section, Neuroscience, Imaging and Clinical Sciences Department, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
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Hwang BY, Mampre D, Penn R, Anderson WS, Kang J, Kamath V. Olfactory Testing in Temporal Lobe Epilepsy: a Systematic Review. Curr Neurol Neurosci Rep 2020; 20:65. [PMID: 33169232 DOI: 10.1007/s11910-020-01083-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Olfactory testing is a potentially safe, cost-effective, bedside evaluation tool for diagnosis, monitoring, and risk assessment for surgery in temporal lobe epilepsy (TLE) patients, but testing methods and relevant olfactory domains are not standardized. We conducted a systematic review to evaluate olfactory tests in TLE and summarize the results of the literature. RECENT FINDINGS Olfactory tests varied significantly in odorant administration tools and devices, target odorants, evaluation timing, and grading scales. The Smell Threshold Test and University of Pennsylvania Smell Identification Test were the most validated single-domain tests for odor detection and odor identification, respectively. For multi-domain tests, Odor Memory/Discrimination Test and the Sniffin' Sticks test were the most validated. Results of olfactory tests in TLE are presented by domain. Rigorous validation, standardization, and comparative analysis of existing olfactory tests by domain is urgently needed to establish the utility and efficacy of olfactory testing in TLE.
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Affiliation(s)
- Brian Y Hwang
- Division of Functional Neurosurgery, Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Meyer 8-181, Baltimore, MD, 21287, USA.
| | - David Mampre
- Division of Functional Neurosurgery, Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Meyer 8-181, Baltimore, MD, 21287, USA
| | - Rachel Penn
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - William S Anderson
- Division of Functional Neurosurgery, Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Meyer 8-181, Baltimore, MD, 21287, USA
| | - Joon Kang
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Colle R, El Asmar K, Verstuyft C, Lledo PM, Lazarini F, Chappell K, Deflesselle E, Ait Tayeb AEK, Falissard B, Duron E, Rotenberg S, Costemale-Lacoste JF, David DJ, Gressier F, Gardier AM, Hummel T, Becquemont L, Corruble E. The olfactory deficits of depressed patients are restored after remission with venlafaxine treatment. Psychol Med 2020; 52:1-9. [PMID: 33087184 DOI: 10.1017/s0033291720003918] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND It is unclear whether olfactory deficits improve after remission in depressed patients. Therefore, we aimed to assess in drug-free patients the olfactory performance of patients with major depressive episodes (MDE) and its change after antidepressant treatment. METHODS In the DEP-ARREST-CLIN study, 69 drug-free patients with a current MDE in the context of major depressive disorder (MDD) were assessed for their olfactory performances and depression severity, before and after 1 (M1) and 3 (M3) months of venlafaxine antidepressant treatment. They were compared to 32 age- and sex-matched healthy controls (HCs). Olfaction was assessed with a psychophysical test, the Sniffin' Sticks test (Threshold: T score; Discrimination: D score; Identification: I score; total score: T + D + I = TDI score) and Pleasantness (pleasantness score: p score; neutral score: N score; unpleasantness score: U score). RESULTS As compared to HCs, depressed patients had lower TDI olfactory scores [mean (s.d.) 30.0(4.5) v. 33.3(4.2), p < 0.001], T scores [5.6(2.6) v. 7.4(2.6), p < 0.01], p scores [7.5(3.0) v. 9.8(2.8), p < 0.001)] and higher N scores [3.5(2.6) v. 2.1(1.8), p < 0.01]. T, p and N scores at baseline were independent from depression and anhedonia severity. After venlafaxine treatment, significant increases of T scores [M1: 7.0(2.6) and M3: 6.8(3.1), p < 0.01] and p scores [M1: 8.1(3.0) and M3: 8.4(3.3), p < 0.05] were evidenced, in remitters only (T: p < 0.01; P: p < 0.01). Olfaction improvement was mediated by depression improvement. CONCLUSIONS The olfactory signature of MDE is restored after venlafaxine treatment. This olfaction improvement is mediated by depression improvement.
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Affiliation(s)
- Romain Colle
- Equipe Moods, INSERM UMR-1178, CESP, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France
- Service Hospitalo-Universitaire de Psychiatrie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Khalil El Asmar
- Equipe Moods, INSERM UMR-1178, CESP, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France
| | - Céline Verstuyft
- Equipe Moods, INSERM UMR-1178, CESP, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France
- Service de Génétique moléculaire, Pharmacogénétique et Hormonologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Pierre-Marie Lledo
- Unité Perception et Mémoire, Institut Pasteur, CNRS UMR3571, Paris, F-75015, France
| | - Françoise Lazarini
- Service de Génétique moléculaire, Pharmacogénétique et Hormonologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Kenneth Chappell
- Equipe Moods, INSERM UMR-1178, CESP, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France
| | - Eric Deflesselle
- Equipe Moods, INSERM UMR-1178, CESP, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France
| | - Abd El Kader Ait Tayeb
- Equipe Moods, INSERM UMR-1178, CESP, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France
- Service Hospitalo-Universitaire de Psychiatrie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Bruno Falissard
- Département de Biostatistiques, Université Paris-Sud, Hôpital Paul Brousse, Assistance Publique Hôpitaux de Paris, Villejuif94400, France
| | - Emmanuelle Duron
- Equipe Moods, INSERM UMR-1178, CESP, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France
| | - Samuel Rotenberg
- Equipe Moods, INSERM UMR-1178, CESP, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France
- Service Hospitalo-Universitaire de Psychiatrie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Jean-Francois Costemale-Lacoste
- Equipe Moods, INSERM UMR-1178, CESP, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France
| | - Denis J David
- Equipe Moods, INSERM UMR-1178, CESP, Univ. Paris-Sud, Fac. Pharmacie, Inserm, Université Paris-Saclay, Chatenay Malabry92290, France
| | - Florence Gressier
- Equipe Moods, INSERM UMR-1178, CESP, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France
- Service Hospitalo-Universitaire de Psychiatrie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Alain M Gardier
- Equipe Moods, INSERM UMR-1178, CESP, Univ. Paris-Sud, Fac. Pharmacie, Inserm, Université Paris-Saclay, Chatenay Malabry92290, France
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, Dresden, TU, Germany
| | - Laurent Becquemont
- Equipe Moods, INSERM UMR-1178, CESP, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France
- Centre de recherche clinique, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Emmanuelle Corruble
- Equipe Moods, INSERM UMR-1178, CESP, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France
- Service Hospitalo-Universitaire de Psychiatrie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
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Devanand DP, Liu X, Cohen H, Budrow J, Schupf N, Manly J, Lee S. Long-Term Test-Retest Reliability of the UPSIT in Cognitively Intact Older Adults. Chem Senses 2020; 44:365-369. [PMID: 31111142 DOI: 10.1093/chemse/bjz025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The objective of this study was to determine the long-term test-retest reliability of the University of Pennsylvania Smell Identification Test (UPSIT), and its individual items, in cognitively intact older adults. A community sample of older adults received a neuropsychological test battery, including the 12-item, 6-trial Selective Reminding Test (SRT). The UPSIT was administered at baseline and follow-up that occurred between 1 and 4 years after baseline. UPSIT scores of participants who were cognitively intact and did not decline cognitively were examined for test-retest reliability. In 92 older adults with mean age 77.6 years followed for 2.79 (standard deviation [SD] 0.69) years, mean UPSIT score declined from 30.29 (SD 5.83) to 27.80 (SD 5.50). In linear mixed models that adjusted for time, age, sex, and education, intraclass correlation coefficients for UPSIT were 0.65, SRT delayed recall 0.59, and SRT total immediate recall 0.49. Among 4 possible response combinations, the largest proportion of participants had correct responses at both visits for 35 out of 40 items. Consistency of item responses ranged from 50% to 90% across the 2 time points. The long-term test-retest reliability of the UPSIT was moderately strong without practice effects over long periods of time in older adults. These results provide indirect support to prior findings on odor identification impairment predicting cognitive decline and dementia, and suggest potential use of olfactory testing as a biomarker in prevention and treatment trials of cognitive enhancers.
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Affiliation(s)
- Davangere P Devanand
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY, USA.,Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Xinhua Liu
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Hannah Cohen
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - John Budrow
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY, USA.,New York Medical College, Valhalla, NY, USA
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Jennifer Manly
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Seonjoo Lee
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.,Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.,Division of Mental Health Data Science, New York State Psychiatric Institute, New York, NY, USA
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36
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Moein ST, Hashemian SM, Tabarsi P, Doty RL. Prevalence and reversibility of smell dysfunction measured psychophysically in a cohort of COVID-19 patients. Int Forum Allergy Rhinol 2020; 10:1127-1135. [PMID: 32761796 PMCID: PMC7436559 DOI: 10.1002/alr.22680] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 01/05/2023]
Abstract
Background Considerable evidence suggests that smell dysfunction is common in coronavirus disease‐2019 (COVID‐19). Unfortunately, extant data on prevalence and reversibility over time are highly variable, coming mainly from self‐report surveys prone to multiple biases. Thus, validated psychophysical olfactory testing is sorely needed to establish such parameters. Methods One hundred severe acute respiratory syndrome‒coronavirus‐2 (SARS‐CoV‐2)‐positive patients were administered the 40‐item University of Pennsylvania Smell Identification Test (UPSIT) in the hospital near the end of the acute phase of the disease. Eighty‐two were retested 1 or 4 weeks later at home. The data were analyzed using analysis of variance and mixed‐effect regression models. Results Initial UPSIT scores were indicative of severe microsmia, with 96% exhibiting measurable dysfunction; 18% were anosmic. The scores improved upon retest (initial test: mean, 21.97; 95% confidence interval [CI], 20.84‐23.09; retest: mean, 31.13; 95% CI, 30.16‐32.10; p < 0.0001); no patient remained anosmic. After 5 weeks from COVID‐19 symptom onset, the test scores of 63% of the retested patients were normal. However, the mean UPSIT score at that time continued to remain below that of age‐ and sex‐matched healthy controls (p < 0.001). Such scores were related to time since symptom onset, sex, and age. Conclusion Smell loss was extremely common in the acute phase of a cohort of 100 COVID‐19 patients when objectively measured. About one third of cases continued to exhibit dysfunction 6 to 8 weeks after symptom onset. These findings have direct implications for the use of olfactory testing in identifying SARS‐CoV‐2 carriers and for counseling such individuals with regard to their smell dysfunction and its reversibility.
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Affiliation(s)
- Shima T Moein
- School of Biological Sciences, Institute for Research in Fundamental Sciences, Tehran, Iran
| | - Seyed MohammadReza Hashemian
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Payam Tabarsi
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Richard L Doty
- Smell & Taste Center, Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Insulin Resistance Is Associated with Reduced Food Odor Sensitivity across a Wide Range of Body Weights. Nutrients 2020; 12:nu12082201. [PMID: 32721994 PMCID: PMC7468861 DOI: 10.3390/nu12082201] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/18/2020] [Accepted: 07/20/2020] [Indexed: 02/06/2023] Open
Abstract
The worldwide obesity epidemic is a major health problem driven by the modern food environment. Recently, it has been shown that smell perception plays a key role in eating behavior and is altered in obesity. However, the underlying mechanisms of this phenomenon are not well understood yet. Since the olfactory system is closely linked to the endocrine system, we hypothesized that hormonal shifts in obesity might explain this relationship. In a within-subject, repeated-measures design, we investigated sensitivity to a food and a non-food odor in the hungry and sated state in 75 young healthy (26 normal weight, 25 overweight, and 24 obese) participants (37 women). To determine metabolic health status and hormonal reactivity in response to food intake, we assessed pre- and postprandial levels of insulin, leptin, glucose, and ghrelin. Odor sensitivity did not directly depend on body weight status/body mass index (BMI) or hunger state. However, we could establish a strong negative mediating effect of insulin resistance on the relationship between BMI/waist-hip ratio and olfactory sensitivity for the food odor. These findings indicate an impact of metabolic health status on sensitivity to food odors. Our results contribute to a better understanding of the mechanisms behind altered smell perception in obesity.
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38
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Liu DT, Besser G, Lang M, Sharma G, Pablik E, Renner B, Mueller CA. Odor Mixtures in Identification Testing Using Sniffin' Sticks: The SSomix Test. Sci Rep 2020; 10:8155. [PMID: 32424128 PMCID: PMC7234997 DOI: 10.1038/s41598-020-65028-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/27/2020] [Indexed: 11/29/2022] Open
Abstract
Clinical tests assessing olfactory performance have become indispensable for diagnosing olfactory dysfunction. As time and personnel resources are limited, it would be advantageous to have shorter protocols focusing on singular aspects of olfactory performance, such as odor identification. However, such a unidimensional approach is often inconclusive and needs further tests (and tools). Hence, new testing methods with high levels of sensitivity, specificity, and reproducibility are required for clinical practice. Here, we developed a Sniffin’ Sticks odor mixture identification test method (SSomix), with emphasis on resource efficiency and simplicity of administration. SSomix consists of mixtures of two and three odors applied onto a piece of paper using 11 out of 16 items from the original Sniffin’ Sticks identification test kit. A total of 66 healthy subjects and 22 patients with olfactory dysfunction were included in the study. SSomix showed good to excellent test-retest reliability and validity. The area under the receiver operating characteristics curves indicated good diagnostic accuracy in identifying patients with reduced and severely impaired olfactory function. SSomix was a suitable downsizing of the original kit, especially regarding resource efficiency.
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Affiliation(s)
- David Tianxiang Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Gerold Besser
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Miriam Lang
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Gunjan Sharma
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Eleonore Pablik
- Section for Medical Statistics, CeMSIIS, Medical University of Vienna, Vienna, Austria
| | - Bertold Renner
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Institute of Clinical Pharmacology, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian Albert Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
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Chowdhury N, Smith TL, Beswick DM. Measuring Success in the Treatment of Patients with Chronic Rhinosinusitis. Immunol Allergy Clin North Am 2020; 40:265-279. [DOI: 10.1016/j.iac.2019.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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40
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Sari H, Atar Y, Mingir T, Kumral TL, Akgun MF, Ahmed EA, Aydogdu I, Salturk Z, Berkiten G, Uyar Y. [Short term olfactory memory and olfactory function after inhalation anesthetic agents: a randomized clinical trial]. Rev Bras Anestesiol 2020; 70:36-41. [PMID: 32173063 DOI: 10.1016/j.bjan.2019.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 11/25/2019] [Accepted: 12/01/2019] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This clinical trial aimed to evaluate the effects of two different inhalation anesthetic agents on postoperative olfactory memory and olfactory function in patients who underwent micro laryngeal surgery. METHODS This randomized prospective controlled study consisted of 102 consecutive patients with a voice disorder. The patients underwent micro laryngeal surgery for voice disorders under general anesthesia. Patients who did not meet inclusion criteria and/or declined to participate (n=34) were excluded from the study. Patients were divided into two groups. Four patients from Group 1 and four patients from Group 2 were lost to follow-up. Group 1 (n=30) received sevoflurane, and Group 2 (n=30) received desflurane during anesthesia. We compared the results by performing the pre-op and post-op Connecticut Chemosensory Clinical Research Center Olfactory test. RESULTS Thirty-three patients (55%) were male and 27 (45%) were female. The mean age was 48.18±13.88 years (range: 19-70 years). Preoperative and postoperative olfactory functions did not show a significant difference within the groups postoperatively (p> 0.05). Preoperative and postoperative olfactory memory showed a significant decrease 3hours after the surgery (p <0.05). CONCLUSIONS Olfactory functions and memory were not affected by desflurane in the early postoperative period. Although sevoflurane did not affect olfactory functions, it had a temporary negative effect on olfactory memory in the early postoperative period.
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Affiliation(s)
- Huseyin Sari
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia.
| | - Yavuz Atar
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
| | - Tarkan Mingir
- Okmeydanı Training and Research Hospital, Department of Anesthesiology, Istambul, Turquia
| | - Tolgar Lutfi Kumral
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
| | - Muhammed Fatih Akgun
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
| | - Esmail Abdulahi Ahmed
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
| | - Imran Aydogdu
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
| | - Ziya Salturk
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
| | - Guler Berkiten
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
| | - Yavuz Uyar
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
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41
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Gaby JM, Tepper BJ. A comparison of hedonic and emotional responses to common odors delivered by qPODs (Portable Olfactive Devices) and traditional sniff jars. Food Qual Prefer 2020. [DOI: 10.1016/j.foodqual.2019.103804] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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42
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Sari H, Atar Y, Mingir T, Kumral TL, Akgun MF, Ahmed EA, Aydogdu I, Salturk Z, Berkiten G, Uyar Y. Short term olfactory memory and olfactory function after inhalation anesthetic agents: a randomized clinical trial. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2020. [PMID: 32173063 PMCID: PMC9373408 DOI: 10.1016/j.bjane.2020.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background and objectives This clinical trial aimed to evaluate the effects of two different inhalation anesthetic agents on postoperative olfactory memory and olfactory function in patients who underwent micro laryngeal surgery. Methods This randomized prospective controlled study consisted of 102 consecutive patients with a voice disorder. The patients underwent micro laryngeal surgery for voice disorders under general anesthesia. Patients who did not meet inclusion criteria and/or declined to participate (n = 34) were excluded from the study. Patients were divided into two groups. Four patients from Group 1 and four patients from Group 2 were lost to follow-up. Group 1 (n = 30) received sevoflurane, and Group 2 (n = 30) received desflurane during anesthesia. We compared the results by performing the pre-op and post-op Connecticut Chemosensory Clinical Research Center Olfactory test. Results Thirty-three patients (55%) were male and 27 (45%) were female. The mean age was 48.18 ± 13.88 years (range: 19‒70 years). Preoperative and postoperative olfactory functions did not show a significant difference within the groups postoperatively (p > 0.05). Preoperative and postoperative olfactory memory showed a significant decrease 3 hours after the surgery (p < 0.05). Conclusions Olfactory functions and memory were not affected by desflurane in the early postoperative period. Although sevoflurane did not affect olfactory functions, it had a temporary negative effect on olfactory memory in the early postoperative period.
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Affiliation(s)
- Huseyin Sari
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia.
| | - Yavuz Atar
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
| | - Tarkan Mingir
- Okmeydanı Training and Research Hospital, Department of Anesthesiology, Istambul, Turquia
| | - Tolgar Lutfi Kumral
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
| | - Muhammed Fatih Akgun
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
| | - Esmail Abdulahi Ahmed
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
| | - Imran Aydogdu
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
| | - Ziya Salturk
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
| | - Guler Berkiten
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
| | - Yavuz Uyar
- Okmeydanı Training and Research Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Istambul, Turquia
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Calvo-Henríquez C, Chiesa-Estomba C, Martinez-Capoccioni G, Lechien JR, Mota-Rojas X, Mayo-Yáñez M, Faraldo-García A. Methods to assess olfaction in pediatric patients: a systematic review from the international YO-IFOS study group. Eur Arch Otorhinolaryngol 2019; 277:313-321. [DOI: 10.1007/s00405-019-05705-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 10/16/2019] [Indexed: 10/25/2022]
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44
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Khurshid K, Crow AJD, Rupert PE, Minniti NL, Carswell MA, Mechanic-Hamilton DJ, Kamath V, Doty RL, Moberg PJ, Roalf DR. A Quantitative Meta-analysis of Olfactory Dysfunction in Epilepsy. Neuropsychol Rev 2019; 29:328-337. [PMID: 31144106 PMCID: PMC6766414 DOI: 10.1007/s11065-019-09406-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 04/11/2019] [Indexed: 11/25/2022]
Abstract
Olfactory dysfunction in epilepsy is well-documented in several olfactory domains. However, the clinical specificity of these deficits remains unknown. The aim of this systematic meta-analysis was to determine which domains of olfactory ability were most impaired in individuals with epilepsy, and to assess moderating factors affecting olfactory ability. Extant peer-reviewed literature on olfaction in epilepsy were identified via a computerized literature search using PubMed, MEDLINE, PsycInfo, and Google Scholar databases. Twenty-one articles met inclusion criteria. These studies included a total of 912 patients with epilepsy and 794 healthy comparison subjects. Included studies measured olfaction using tests of odor identification, discrimination, memory, and detection threshold in patients with different types of epilepsy, including temporal lobe epilepsy (TLE), mixed frontal epilepsy (M-F), and mixed epilepsy (MIX). Olfactory deficits were robust in patients with epilepsy when compared to healthy individuals, with effect sizes in the moderate to large range for several olfactory domains, including odor identification (d = -1.59), memory (d = -1.10), discrimination (d = -1.04), and detection threshold (d = -0.58). Olfactory deficits were most prominent in patients with TLE and M-F epilepsy. Amongst patients with epilepsy, sex, age, smoking status, education, handedness, and age of illness onset were significantly related to olfactory performance. Overall, these meta-analytic findings indicate that the olfactory system is compromised in epilepsy and suggest that detailed neurobiological investigations of the olfactory system may provide further insight into this disorder.
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Affiliation(s)
- Kiran Khurshid
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Andrew J D Crow
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Petra E Rupert
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nancy L Minniti
- Department of Physical Medicine and Rehabilitation, Temple University Hospital, Philadelphia, PA, USA
| | | | - Dawn J Mechanic-Hamilton
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Richard L Doty
- Smell & Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Paul J Moberg
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Smell & Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - David R Roalf
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
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Doty RL, Wylie C, Potter M, Beston R, Cope B, Majam K. Clinical validation of the olfactory detection threshold module of the Snap & Sniff® olfactory test system. Int Forum Allergy Rhinol 2019; 9:986-992. [PMID: 31283113 DOI: 10.1002/alr.22377] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 06/18/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Quantitative olfactory testing is essential to determine the validity and nature of a patient's complaint, accurately monitor changes in function over time (including influences of pharmacological, surgical, or immunological interventions), detect malingering, and establish disability compensation. This work describes the clinical validation of an advanced rapid odor detection threshold test that standardizes odorant delivery and eliminates unsanitary sniff bottles, the need for blindfolds, and the possibility of touching an odorant stimulus to the nose. METHODS Snap & Sniff® single-staircase phenyl ethyl alcohol detection thresholds (S&S-Ts) were assessed bilaterally in 736 patients with chemosensory complaints; 421 received both bilateral and unilateral testing. The results were correlated with scores from the University of Pennsylvania Smell Identification Test (UPSIT) and the Smell Threshold Test (STT), a widely-used standardized threshold test. Test-retest reliability data were obtained for 50 patients. RESULTS S&S-Ts were highly reliable (Spearman r = 0.84), correlated with the other olfactory test measures (rs > 0.65, ps < 0.0001), and required significantly shorter administration times than the STT (<10 minutes). Bilateral thresholds were systematically lower than unilateral thresholds, a phenomenon independent of presentation order but dependent upon the better functioning side of the nose. The S&S-Ts were sensitive to age and sex. No systematic left:right nasal side threshold differences were evident. CONCLUSION The present study validates the use of Snap & Sniff® technology in the clinic setting. High test-retest reliability and brief administration times were evident. The S&S-T test allows for a reliable, valid, inexpensive, and rapid clinical means for quantitatively assessing human olfactory sensitivity.
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Affiliation(s)
- Richard L Doty
- Smell & Taste Center, Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Crystal Wylie
- Smell & Taste Center, Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Mark Potter
- Smell & Taste Center, Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Rachel Beston
- Smell & Taste Center, Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Brooke Cope
- Smell & Taste Center, Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Kelsey Majam
- Smell & Taste Center, Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Maharjan A, Peng M, Cakmak YO. Non-invasive High Frequency Median Nerve Stimulation Effectively Suppresses Olfactory Intensity Perception in Healthy Males. Front Hum Neurosci 2019; 12:533. [PMID: 30719001 PMCID: PMC6348262 DOI: 10.3389/fnhum.2018.00533] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 12/17/2018] [Indexed: 01/27/2023] Open
Abstract
Median nerve stimulation (MNS) had been performed in the existing literature to alleviate symptoms of nausea and vomiting. The observed facilitative effects are thought to be mediated by the vagal pathways, particularly the vagus nerve (VN) brainstem nuclei of the dorsal motor nucleus of vagus and nucleus tractus solitarius (DMV-NTS). Sense of smell is one of the major sensory modalities for inducing vomiting and nausea as a primary defense against potentially harmful intake of material. This study aimed to test effects of non-invasive, high and low frequency MNS on human olfactory functioning, with supplementary exploration of the orbitofrontal cortex (OFC) using near-infrared spectroscopy (NIRS). Twenty healthy, male, adults performed supra-threshold odor intensity tests (labeled magnitude scale, LMS) for four food-related odorant samples (presented in three different concentrations) before and after receiving high-, low frequency MNS and placebo (no stimulation), while cortical activities in the OFC was monitored by the NIRS. Data of the NIRS and LMS test of separate stimulation parameters were statistically analyzed using mixed-model analysis of variance (ANOVA). Only the high frequency MNS showed effects for suppressing the intensity perception of the moderate concentration of Amyl Acetate (p:0.042) and strong concentration of Isovaleric Acid (p:0.004) and 1-Octen-3-ol (p:0.006). These behavioral changes were coupled with significant changes in the NIRS recordings of the left (p:0.000) and right (p:0.003) hemispheric orbitofrontal cortices. This is the first study that applied non-invasive, high frequency MNS to suppress the supra-threshold odor ratings of specific concentrations of odors. The vagal networks are potential relays of MNS to influence OFC. Results from the current article implore further research into non-invasive, high frequency MNS in the investigation of its modulatory effects on olfactory function, given its potential to be used for ameliorating nausea and malnutrition associated with various health conditions.
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Affiliation(s)
- Ashim Maharjan
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Mei Peng
- Department of Food Science, University of Otago, Dunedin, New Zealand
| | - Yusuf O Cakmak
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand.,Brain Health Research Centre, Division of Sciences, University of Otago, Dunedin, New Zealand.,Medical Technologies Centre of Research Excellence, Auckland, New Zealand
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Abstract
How common are smell and taste disorders? How many persons suffer total loss or partial loss? What factors determine such dysfunction? Answers to these questions are not straightforward. Estimates of prevalence are influenced by a multitude of interacting factors, including age, gender, occupation, geography, air and water quality, climate, ethnicity, genetics, education, and health, to name a few. In reality, population estimates of chemosensory disorders vary widely among studies, reflecting not only differential sampling of such variables, but the types of sensory tests that have been employed and the choice of cutoff points to define abnormality. While population-based studies likely provide the most accurate assessments of overall prevalence, even their findings vary dramatically. Nonetheless, there is unanimity among studies that chemosensory disorders are very common in countries where epidemiologic data have been collected, with higher prevalence in men than in women and in older than in younger persons. Moreover, population-based studies have identified, or confirmed observations of case-control and other studies, a wide range of factors that impact the chemical senses. This review describes the major epidemiologic studies that have estimated the prevalence of chemosensory disorders and explores factors involved in producing such disorders within the aging population.
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Affiliation(s)
- Richard L Doty
- Smell and Taste Center and Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
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Abstract
The senses of smell and taste are largely underappreciated by laypersons and medical professionals alike. Unlike vision, hearing, balance, and touch, they are rarely evaluated quantitatively in the clinic, even though hundreds of thousands of persons seek medical help annually for disorders of these senses. Chemosensory disorders impact quality of life, including the flavor of foods and beverages, and compromise the ability to detect such environmental hazards as fires, leaking natural gas, and spoiled foodstuffs. Moreover, olfactory dysfunction can be a harbinger for Alzheimer's and other neurodegenerative diseases, and is known to triple the likelihood of mortality in older persons over the course of 4 or 5 years. Without accurate testing, one cannot establish the veracity of a patient's complaint, the probability of malingering, the impact of treatments, and whether the degree of dysfunction is normal relative to a patient's age and sex. This chapter provides basic information as to how to measure both the senses of smell and taste, as well as normative data for several clinical smell and taste tests.
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Affiliation(s)
- Richard L Doty
- Smell and Taste Center and Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
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Besser G, Jobs L, Liu DT, Mueller CA, Renner B. The Sniffin' Sticks Odor Discrimination Memory Test: A Rapid, Easy-to-Use, Reusable Procedure for Testing Olfactory Memory. Ann Otol Rhinol Laryngol 2018; 128:227-232. [PMID: 30522337 DOI: 10.1177/0003489418818189] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Neurodegenerative diseases can alter odor memory in addition to inducing quantitative impairment, and olfactory memory can be tested using the validated olfactory memory test with encapsulated odors (Odor Discrimination Memory Test [ODMT]). The aim of this study was to investigate the new Sniffin' Sticks ODMT (SSODMT), which is comparable with the ODMT. METHODS The SSODMT was administered to 48 subjects (30 women, 18 men; mean age, 34.6 ± 16.3 years). Olfactory function was assessed using the 16-item Sniffin' Sticks Identification Test. The ODMT was administered to a subgroup of 10 subjects to assess the comparability of the SSODMT and the ODMT. Test-retest reliability was studied in another 20 subjects (10 women, 10 men; mean age, 32.9 ± 16.4 years). RESULTS The mean SSODMT score was 10.7 ± 1.8 (range, 5-12). SSODMT test scores were significantly correlated with Sniffin' Sticks Identification Test scores (r67 = 0.66, P < .001) and were significantly negatively correlated with subject age (r48 = -0.70, P < .001). SSODMT and ODMT scores were highly and significantly correlated, indicating that the test results were comparable (r10 = 0.75, P < .05). Test-retest analysis revealed a significant correlation (r20 = 0.68, P < .001). CONCLUSIONS These results demonstrate the usefulness of the new SSODMT and its comparability with the ODMT. The SSODMT is an easy, rapid, and low-cost tool that is suitable for routine use in evaluating odor memory.
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Affiliation(s)
- Gerold Besser
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Leandra Jobs
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - David Tianxiang Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Christian A Mueller
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Bertold Renner
- Institute of Experimental and Clinical Pharmacology and Toxicology, Erlangen, Erlangen, Germany
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Yan CH, Overdevest JB, Patel ZM. Therapeutic use of steroids in non-chronic rhinosinusitis olfactory dysfunction: a systematic evidence-based review with recommendations. Int Forum Allergy Rhinol 2018; 9:165-176. [DOI: 10.1002/alr.22240] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 10/12/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Carol H. Yan
- Department of Otolaryngology-Head and Neck Surgery; Stanford University; Stanford CA
| | | | - Zara M. Patel
- Department of Otolaryngology-Head and Neck Surgery; Stanford University; Stanford CA
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