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Todd LL, Sivakumar R, Lynch SG, Diebolt JH, White J, Villwock JA. Longitudinal Olfactory Patterns in Multiple Sclerosis: A Scoping Review and Implication for Use in Management of Disease. Int J MS Care 2023; 25:131-136. [PMID: 37250191 PMCID: PMC10211351 DOI: 10.7224/1537-2073.2022-019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Although studies regarding multiple sclerosis (MS) and olfactory dysfunction (OD) have been previously described and summarized, there is not a sole review of longitudinal studies regarding the matter. This review examines the existing literature investigating MS and its effect on olfaction. In addition, the role of OD in the diagnosis and prognosis of MS is explored. METHODS A scoping review of the literature was performed covering longitudinal studies investigating MS and OD. Systematic searches of PubMed, Google Scholar, Web of Science, Embase, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, AgeLine, and MEDLINE were performed using terms that encompassed MS and olfaction. The aim of this review was to build on the existing literature by summarizing only findings that were demonstrated longitudinally. RESULTS Of 6938 articles identified from the search, 9 met the inclusion criteria: longitudinal observation of relapsing-remitting or progressive MS. Olfaction was measured and scored using various testing arrays, and these scores were then correlated with a multitude of clinical markers. Across all studies, patients with MS demonstrated increased OD. Longitudinally, 2 contrasting patterns were identified: (1) clinical markers of acute inflammation correlated with an increased odor threshold and (2) clinical markers of neurodegeneration, or progression of disease, correlated with a decreased ability to discriminate and identify odors. CONCLUSIONS These studies suggest that olfaction is a dynamic, dependent variable of neurodegeneration, correlating with inflammation and clinical markers. This opens the door for future exploration of olfaction's relationship with MS diagnosis, characterization, and therapeutic response.
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Affiliation(s)
- Lauren L. Todd
- From the School of Medicine (LLT, RS), University of Kansas Medical Center, Kansas City, KS, USA
| | - Ram Sivakumar
- From the School of Medicine (LLT, RS), University of Kansas Medical Center, Kansas City, KS, USA
| | - Sharon G. Lynch
- From the Department of Neurology (SGL), University of Kansas Medical Center, Kansas City, KS, USA
| | - Jennifer H. Diebolt
- From the Department of Otolaryngology (JHD, JAV), University of Kansas Medical Center, Kansas City, KS, USA
| | - Jacob White
- Welch Medical Library, Johns Hopkins University, Baltimore, MD, USA (JW)
| | - Jennifer A. Villwock
- From the Department of Otolaryngology (JHD, JAV), University of Kansas Medical Center, Kansas City, KS, USA
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Acikgoz M, Piri Cinar B, Aciman Demirel E, Celebi U, Cekic S, Elicora S, Atasoy HT. The effects of cognition, quality of life, and fatigue on olfactory function in patients with multiple sclerosis. Clin Neurol Neurosurg 2023; 229:107739. [PMID: 37146370 DOI: 10.1016/j.clineuro.2023.107739] [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: 03/29/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/07/2023]
Abstract
AIM The frequency of olfactory dysfunction in patients with Multiple Sclerosis (MS) has revealed very different results in studies. Some studies have shown that olfactory dysfunction may be associated with cognitive impairment and poor quality of life. In these studies, different odor tests and cognitive tests were used and different results were obtained. MATERIALS AND METHODS Forty literate patients over the age of 18 and 24 healthy volunteers of similar age and education were included in the study. Sniffin' Sticks Odor Test, California Verbal Learning Test II, Symbol Digit Modalities Test, Revised Brief Visuospatial Memory Test, Trail-Making Test, Quality of Life Short Form-36, Fatigue Impact Scale, Beck Depression Inventory, and Beck Anxiety Inventory were applied to the individuals. RESULTS Olfactory dysfunction was detected in 50 % of the patients. High disability rate, low cognitive functions, low quality of life, and fatigue were identified as the factors affecting olfactory function negatively. Odor discrimination and identification abilities were associated with disability level and cognitive functions, whereas quality of life was linked to odor threshold scores. The olfactory function and cognitive abilities of patients with progressive MS (n = 5) were worse than those of patients with relapsing remitting MS (n = 35). CONCLUSION Olfactory dysfunction is common in patients with MS and is associated with disability and quality of life. Olfactory function can be used in the follow-up of patients and olfactory dysfunction deserves further study as a metric that might emerge as a biomarker.
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Affiliation(s)
- Mustafa Acikgoz
- Department of Neurology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey.
| | - Bilge Piri Cinar
- Department of Neurology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Esra Aciman Demirel
- Department of Neurology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Ulufer Celebi
- Department of Neurology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Sibel Cekic
- Department of Neurology, Bursa Dr. Ayten Bozkaya Spastic Children's Hospital and Rehabilitation Center, Bursa, Turkey
| | - Sultan Elicora
- Department of Otorhinolaryngology, Kocaeli Health and Technology University, Kocaeli, Turkey
| | - Hüseyin Tugrul Atasoy
- Department of Neurology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
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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: 41] [Impact Index Per Article: 20.5] [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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Cavaco S, Ferreira I, Moreira I, Santos E, Samões R, Sousa AP, Pinheiro J, Teixeira-Pinto A, Martins da Silva A. Cognitive dysfunction and mortality in multiple sclerosis: Long-term retrospective review. Mult Scler 2021; 28:1382-1391. [PMID: 34965761 DOI: 10.1177/13524585211066598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cognitive dysfunction as a predictor of clinical progression and mortality in multiple sclerosis (MS) is still a matter of debate. OBJECTIVE The aim of this study was to explore the long-term outcome associated with neuropsychological performance in a cohort of patients with MS. METHODS A series of 408 MS patients had previously undergone a comprehensive neuropsychological assessment and a contemporaneous neurological evaluation (T1). A retrospective review of the clinical records was conducted 102-192 months after T1. Demographic and clinical data regarding the last clinical appointment with EDSS measurement (T2) were collected and the date of the last clinical contact or death (TS) was recorded. RESULTS This review revealed that cognitive dysfunction (T1) was associated with higher odds of transitioning from relapsing-remitting course to a progressive disease course (adjusted odds ratio (OR) = 2.29, p = 0.043) and higher hazard of death in the total sample (adjusted hazard ratio (HR) = 3.07, p = 0.006) and the progressive disease course subgroup (adjusted HR = 3.68, p = 0.007), even when adjusting for other covariates. DISCUSSION The study results demonstrate that cognitive dysfunction in MS is predictive of poorer prognosis and mortality.
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Affiliation(s)
- Sara Cavaco
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal/Neuropsychology Unit, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Inês Ferreira
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal/Neuropsychology Unit, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Inês Moreira
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal/Neuropsychology Unit, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ernestina Santos
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Raquel Samões
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ana Paula Sousa
- Neurophysiology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Joaquim Pinheiro
- Neurology Department, Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal
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