Low odor awareness predicts reduced olfactory abilities in women with depressive symptoms, but not with anxiety symptoms

BACKGROUND

Olfactory disorders and affective symptoms are tightly related. However, the factors underlying this association are not yet understood. One candidate factor is "odor awareness": the degree of attention individuals pays to the odors. However, the association between odor awareness and olfactory abilities in individuals with affective symptoms has not been clarified yet.

METHOD

The present study examined whether odor awareness may moderate (a) the relation between olfactory dysfunctions and depressive and anxiety symptoms; (b) the relation between the perceptual ratings of the odors and depressive and anxiety symptoms in a sample of healthy women (n = 214). Self-report measures of depression and anxiety were collected, whereas the Sniffin' Stick test was employed to measure olfactory abilities.

RESULTS

Linear regression analysis revealed that individuals with higher depressive symptoms presented lower olfactory abilities and that odor awareness was a significant moderator of the association between depressive symptoms and olfactory abilities. Anxiety symptoms were not related to any of the olfactory abilities considered, and this relationship did not change according to odor awareness. The familiarity rating of the odor was significantly predicted by odor awareness. These results were confirmed by Bayesian statistics.

LIMITATIONS

The sample was composed only of women.

CONCLUSIONS

In a healthy population of women, only the presence of depressive symptoms is related to reduced olfactory performance. Odor awareness may be implicated in the development and maintenance of olfactory dysfunction; hence it could be used as a useful target for specific treatments in clinical settings.

Odor Hedonic Profile (OHP): a self-rating tool of everyday odors

Odor hedonic estimation (pleasant/unpleasant) is considered the first and one of the most important dimensions in odor perception. Although there are several published scales that rate odor hedonicity, most of them use odorants that induce biases related to stimulus properties or test conditions and make difficult clinical or industrial applications. Thus, this study aimed to propose a model of odor hedonic profile (OHP) based on 14 items related to everyday odors without stimulus. The OHP is a self-rating tool based on the hedonic estimate representation and allows the determination of specific profiles, i.e., "conservative," "neutral," "liberal," "negative olfactory alliesthesia," and "positive olfactory alliesthesia." It can be useful in different contexts (e.g., food studies) and general pathologies (e.g., eating disorders) or pathologies with mood/emotional disturbances (e.g., depression).

Alexithymia modulates the attitudes towards odors but not the olfactory abilities or the affective reactions to odors

Although emotion and olfaction are closely linked, only a few studies have investigated olfactory processing in alexithymia, a condition characterized by altered emotional processing. These results do not allow comprehensive conclusions on whether individuals with alexithymia present lower olfactory abilities or only altered affective reactions and awareness of odors. Three pre-registered experiments were conducted to clarify this relation. We assessed olfactory functions, the affective qualities of odors, the awareness of odors, the attitudes towards them, and the ability to form olfactory images in the mind. Bayesian statistics were used to assess differences between low, medium and high alexithymia groups, and Linear Mixed Models (LMMs) were applied to investigate the modulation of the affective and cognitive components of alexithymia. We observed that individuals with a high level of alexithymia presented the same olfactory abilities, and did not show differences in their rating of odors compared to individuals with low alexithymia levels, while they reported lower levels of social and common odor awareness and a more indifferent attitude towards odors. Olfactory imagery was not affected by alexithymia level, and the affective and cognitive components of alexithymia, when considered separately, modulated olfactory perception differently. Learning more about olfactory perception in individuals with alexithymia leads to a better understanding of how alexithymia impacts the perception of hedonic stimuli coming from different sensory modalities. Our results imply that treatment goals for alexithymia should be the enhancement of the conscious perception of odors, supporting the use of mindfulness-based protocols in the alexithymia treatment.

Sex Differences in Odor Hedonic Perception: An Overview

Odor hedonic evaluation (pleasant/unpleasant) is considered as the first and one of the most prominent dimension in odor perception. While sex differences in human olfaction have been extensively explored, gender effect in hedonic perception appears to be less considered. However, a number of studies have included comparisons between men and women, using different types of measurements (psychophysical, psychophysiological,…). This overview presents experimental works with non-specific and body odors separately presented as well as experimental studies comparing healthy participants vs patients with psychiatric disorders. Contrary to sensitivity, identification or discrimination, the overall literature tends to prove that no so clear differences occur in odor hedonic judgment between men and women. On the whole, gender effect appears more marked for body than non-specific odors and is almost never reported in psychiatric diseases. These findings are discussed in relation to the processes classically implied in pleasantness rating and emotional processes.

Continuous Theta Burst Stimulation Over the Right Orbitofrontal Cortex Impairs Conscious Olfactory Perception

The right orbitofrontal cortex (rOFC) has been proposed as the region where conscious olfactory perception arises; however, evidence supporting this hypothesis has all been collected from neuroimaging and lesion studies in which only correlation and not a temporal pattern can be established. Continuous theta burst stimulation (cTBS) causes a reversible disruption of cortical activity and has been used successfully to disrupt orbitofrontal activity. To overcome intrinsic limitations of current experimental research, a crossover, double-blind, prospective and longitudinal study was carried out in which cTBS was applied over the rOFC to evaluate its effect on odorant stimuli detection. All subjects received real and sham cTBS. Experimental procedures were done in two different sessions with a separation of at least one week between them to avoid carryover and learning effects. A total of 15 subjects completed the experiment, and their data were included in the final analysis (10 women, 5 men, mean age 22.40 ± 3.41). Every session consisted of two different measures of the conscious olfactory perception task: A baseline measure and one 5 min after cTBS/sham. Compared to baseline, marks in the olfactory task during the sham cTBS session increased (p = 0.010), while marks during the real cTBS session decreased (p = 0.017). Our results support the hypothesis that rOFC is an important node of a complex network required for conscious olfactory perception to arise. However, the exact mechanism that explains our results is unclear and could be explained by the disruption of other cognitive functions related to the rOFC.

Decoding of Context-Dependent Olfactory Behavior in Drosophila

Odor information is encoded in the activity of a population of glomeruli in the primary olfactory center. However, how this information is decoded in the brain remains elusive. Here, we address this question in Drosophila by combining neuronal imaging and tracking of innate behavioral responses. We find that the behavior is accurately predicted by a model summing normalized glomerular responses, in which each glomerulus contributes a specific, small amount to odor preference. This model is further supported by targeted manipulations of glomerular input, which biased the behavior. Additionally, we observe that relative odor preference changes and can even switch depending on the context, an effect correctly predicted by our normalization model. Our results indicate that olfactory information is decoded from the pooled activity of a glomerular repertoire and demonstrate the ability of the olfactory system to adapt to the statistics of its environment.