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Roguski A, Rolinski M, Jones MW, Whone A. Inaccurate self-report of olfactory dysfunction in REM Sleep Behaviour Disorder and implications for prognosis. Clin Park Relat Disord 2022; 8:100176. [PMID: 36594073 PMCID: PMC9804136 DOI: 10.1016/j.prdoa.2022.100176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/31/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction The earliest stages of alpha-synucleinopathies are accompanied by non-specific prodromal symptoms such as diminished sense of smell, constipation and depression, as well as more specific prodromal conditions including REM Sleep Behaviour Disorder (RBD). While the majority of RBD patients will develop an alpha-synucleinopathy, one of the greatest clinical challenges is determining whether and when individual patients will phenoconvert. Clinical evaluation of a patient presenting with RBD should therefore include robust and objective assessments of known alpha-synucleinopathy prodromes. Methods This study compared olfactory function self-report measures with psychophysical 'Sniffin' Stick 16-item Identification' test scores in Control (n = 19), RBD (n = 16) and PD (n = 17) participants. Results We confirm that olfactory test scores are significantly diminished in RBD and PD groups compared to Controls (p < 0.001, One-Way ANOVA with Tukey-Kramer Post-Hoc, effect size = 0.401). However, RBD participants were only 56 % accurate when self-reporting olfactory dysfunction, hence markedly less likely to perceive or acknowledge their own hyposmia compared to Controls (p = 0.045, Fisher's Exact Test, effect-size = 0.35). Conclusion When isolated RBD presents with hyposmia, there is an increased likelihood of phenoconversion to Parkinson's Disease (PD) or Dementia with Lewy Bodies (DLB); unawareness of olfactory dysfunction in an individual with isolated RBD may therefore confound differential diagnosis and prognosis. Our results evidence the fallibility of olfactory function self-report in the context of RBD prognosis, indicating that clinical assessments of RBD patients should include more reliable measures of olfactory status.
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Affiliation(s)
- Amber Roguski
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom,Corresponding author.
| | - Michal Rolinski
- Department of Neurology, Torbay Hospital, Torquay, United Kingdom
| | - Matt W. Jones
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Alan Whone
- Department of Neurology, Southmead Hospital, Bristol, United Kingdom,Translational Health Sciences, University of Bristol, Bristol, United Kingdom
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Chen A, Chen X, Deng J, Wei J, Qian H, Huang Y, Wu S, Gao F, Gong C, Liao Y, Zheng X. Dexmedetomidine alleviates olfactory cognitive dysfunction by promoting neurogenesis in the subventricular zone of hypoxic-ischemic neonatal rats. Front Pharmacol 2022; 13:983920. [PMID: 36059991 PMCID: PMC9437207 DOI: 10.3389/fphar.2022.983920] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/25/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Hypoxic-ischemic brain damage (HIBD) is the main cause of neurological dysfunction in neonates. Olfactory cognitive function is important for feeding, the ability to detect hazardous situations and social relationships. However, only a few studies have investigated olfactory cognitive dysfunction in neonates with HIBD; furthermore, the specific mechanisms involved are yet to be elucidated. It has been reported that neurogenesis in the subventricular zone (SVZ) is linked to olfactory cognitive function. Recently, dexmedetomidine (DEX) has been shown to provide neuroprotection in neonates following HIBD. In the present study, we investigated whether DEX could improve olfactory cognitive dysfunction in neonatal rats following HIBD and attempted to determine the underlying mechanisms. Methods: We induced HIBD in rats using the Rice–Vannucci model, and DEX (25 μg/kg, i.p.) was administered immediately after the induction of HIBD. Next, we used triphenyl tetrazolium chloride (TTC) staining and the Zea-longa score to assess the success of modelling. The levels of BDNF, TNF-α, IL-1β and IL-6 were determined by western blotting. Immunofluorescence staining was used to detect microglial activation and microglial M1/M2 polarization as well as to evaluate the extent of neurogenesis in the SVZ. To evaluate the olfactory cognitive function, the rats in each group were raised until post-natal days 28–35; then, we performed the buried food test and the olfactory memory test. Results: Analysis showed that HIBD induced significant brain infarction, neurological deficits, and olfactory cognitive dysfunction. Furthermore, we found that DEX treatment significantly improved olfactory cognitive dysfunction in rat pups with HIBD. DEX treatment also increased the number of newly formed neuroblasts (BrdU/DCX) and neurons (BrdU/NeuN) in the SVZ by increasing the expression of BDNF in rat pups with HIBD. Furthermore, analysis showed that the neurogenic effects of DEX were possibly related to the inhibition of inflammation and the promotion of M1 to M2 conversion in the microglia. Conclusion: Based on the present findings, DEX treatment could improve olfactory cognitive dysfunction in neonatal rats with HIBD by promoting neurogenesis in the SVZ and enhancing the expression of BDNF in the microglia. It was possible associated that DEX inhibited neuroinflammation and promoted M1 to M2 conversion in the microglia.
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Affiliation(s)
- Andi Chen
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xiaohui Chen
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Jianhui Deng
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Jianjie Wei
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Haitao Qian
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yongxin Huang
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Shuyan Wu
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Fei Gao
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Cansheng Gong
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yanling Liao
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xiaochun Zheng
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Fujian Provincial Key Laboratory of Emergency Medicine, Fujian Provincial Key Laboratory of Critical care Medicine, Fujian Provincial Co-Constructed Laboratory of “Belt and Road”, Fujian Emergency Medical Center, Fuzhou, China
- *Correspondence: Xiaochun Zheng,
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Zigrand C, Jobin B, Lecuyer Giguère F, Giguère JF, Boller B, Frasnelli J. Olfactory perception in patients with a mild traumatic brain injury: a longitudinal study. Brain Inj 2022; 36:985-990. [PMID: 35946141 DOI: 10.1080/02699052.2022.2109734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE This longitudinal study aimed to evaluate olfactory perception in patients with first time mild traumatic brain injury (mTBI) 2-4 weeks (baseline) and 6 months (follow-up) following their trauma. METHODS At baseline, we enrolled 107 participants (54 healthy controls; 53 patients with mTBI). Thirty-nine healthy controls and 32 patients with mTBI returned for follow-up. We assessed odor detection (yes/no paradigm) and odor perception with a self-reported evaluation of intensity and pleasantness of four common odorants, by using an olfactometer, i.e., a computer controlled automated odor presentation device. RESULTS At baseline, patients with mTBI showed significantly more difficulty detecting odors; however, they perceived them as more intense and less pleasant. These effects vanished at follow-up. CONCLUSION These results suggest that patients with mTBI suffer from altered olfactory detection and perception in the first weeks following their trauma. This may have an impact on eating behavior and quality of life. Further, our data suggest recovery of olfactory function within the first six months following a head trauma.
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Affiliation(s)
- Coline Zigrand
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivieres, QC, Canada.,Research Center of the Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.,Research Center of the Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada
| | - Benoit Jobin
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivieres, QC, Canada.,Research Center of the Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.,Research Center of the Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada
| | - Fanny Lecuyer Giguère
- Research Center of the Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada.,Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | | | - Benjamin Boller
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivieres, QC, Canada.,Research Center of the Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
| | - Johannes Frasnelli
- Research Center of the Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada.,Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivieres, QC, Canada
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Rothman DJ, McDonald SD, Walker WC, Feldman G. Olfactory Changes After Military Deployment Are Associated With Emotional Distress but Not With Mild Traumatic Brain Injury History. Am J Phys Med Rehabil 2022; 101:423-428. [PMID: 35444152 DOI: 10.1097/phm.0000000000001839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of the study was to identify the impact of mild traumatic brain injury history and current emotional status on olfactory functioning. DESIGN This was a cross-sectional study of 49 predominantly male, military veterans, reservists, and active duty service members with Operations Enduring Freedom, Iraqi Freedom, and New Dawn deployments and varying mild traumatic brain injury histories. RESULTS Those with a positive history of mild traumatic brain injury (n = 32) endorsed significantly higher rates of self-reported olfactory disturbance. However, there were no differences between the mild traumatic brain injury and no mild traumatic brain injury groups for rates of objective odor identification dysfunction (none vs. microsmia or more severe) or overall accuracy of odor identification. In keeping with this, self-reported olfactory disturbance also failed to associate with odor identification dysfunction. In both groups, those self-reporting olfactory disturbance reported significantly greater emotional distress, severity of posttraumatic stress symptoms, and attentional impulsivity. However, self-reported olfactory disturbance was not associated with other behavioral factors frequently attributed to TBI, such as aggression, motor impulsiveness, poor planning, and cognitive flexibility. CONCLUSIONS These findings indicate mild traumatic brain injury is not a risk factor for postacute microsomia among Operations Enduring Freedom, Iraqi Freedom, and New Dawn military veterans. Higher observed rates of self-reported olfactory disturbance in patients with mild traumatic brain injury may be a function of emotional distress rather than organic brain injury.
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Affiliation(s)
- David J Rothman
- From the Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia (DJR, SDM, WCW); Hunter Holmes McGuire Veterans Affairs Medical, Richmond, Virginia (DJR, SDM, GF); Sheltering Arms Institute: A Collaboration with VCU Health, Richmond, Virginia (DJR); Department of Psychology, Virginia Commonwealth University, Richmond, Virginia (SDM); and Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia (GF)
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Yoon Y, Kim S, Seol Y, Im H, Park U, Han HB, Choi JH, Ryu H. Increases of Phosphorylated Tau (Ser202/Thr205) in the Olfactory Regions Are Associated with Impaired EEG and Olfactory Behavior in Traumatic Brain Injury Mice. Biomedicines 2022; 10:865. [PMID: 35453615 PMCID: PMC9031269 DOI: 10.3390/biomedicines10040865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/30/2022] [Accepted: 04/03/2022] [Indexed: 02/04/2023] Open
Abstract
Traumatic brain injury (TBI) leads to long-term cognitive impairments, with an increased risk for neurodegenerative and psychiatric disorders. Among these various impairments, olfactory dysfunction is one of the most common symptoms in TBI patients. However, there are very few studies that show the association between olfactory dysfunction and repetitive TBI. To investigate the effects of repetitive TBI on olfactory functioning and the related pathological neuronal injuries in mice, we applied a weight-drop model of TBI and performed neuropathological examinations and electroencephalography (EEG) in olfactory-bulb-associated areas. Through neuropathological examinations, we found significant increases of amyloid precursor protein (APP) and phosphorylated Tau (p-Tau) (S202/T205) in olfactory-bulb-associated areas. Neuronal atrophy in the lateral anterior olfactory nucleus (AOL), granule layer olfactory bulb (GrO), and dorsal tenia tecta (DTT) was also found to be correlated with p-Tau levels. However, there was no difference in the total Tau levels in the olfactory-bulb-associated areas of TBI mice. Electroencephalography (EEG) of repetitive TBI mouse models showed impaired spontaneous delta oscillation, as well as altered cross-frequency coupling between delta phase and amplitudes of the fast oscillations in the resting-state olfactory bulb. Furthermore, abnormal alterations in EEG band powers were observed during the olfactory oddball paradigm test. TBI also led to impairments of the olfactory-function-associated behaviors. This study provides evidence of behavioral, neuropathological, and physiological alterations in the mouse olfactory system caused by repetitive TBI. Together, p-Tau alterations and EEG impairments may serve as important biomarkers of olfactory-track-associated dysfunctions in repetitive TBI.
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Affiliation(s)
- Younghyun Yoon
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN 37235, USA;
- Center for Neuroscience, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea; (S.K.); (Y.S.); (H.I.); (U.P.); (H.-B.H.)
| | - SuHyun Kim
- Center for Neuroscience, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea; (S.K.); (Y.S.); (H.I.); (U.P.); (H.-B.H.)
| | - YunHee Seol
- Center for Neuroscience, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea; (S.K.); (Y.S.); (H.I.); (U.P.); (H.-B.H.)
| | - Hyoenjoo Im
- Center for Neuroscience, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea; (S.K.); (Y.S.); (H.I.); (U.P.); (H.-B.H.)
| | - Uiyeol Park
- Center for Neuroscience, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea; (S.K.); (Y.S.); (H.I.); (U.P.); (H.-B.H.)
| | - Hio-Been Han
- Center for Neuroscience, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea; (S.K.); (Y.S.); (H.I.); (U.P.); (H.-B.H.)
- Program of Brain and Cognitive Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Korea
| | - Jee Hyun Choi
- Center for Neuroscience, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea; (S.K.); (Y.S.); (H.I.); (U.P.); (H.-B.H.)
- Neuroscience Program, Division of Bio-Medical Science & Technology, KIST School, University of Science and Technology, Seoul 02792, Korea
| | - Hoon Ryu
- Center for Neuroscience, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea; (S.K.); (Y.S.); (H.I.); (U.P.); (H.-B.H.)
- Neuroscience Program, Division of Bio-Medical Science & Technology, KIST School, University of Science and Technology, Seoul 02792, Korea
- Boston University Alzheimer’s Disease Research Center, Department of Neurology, Boston University School of Medicine, Boston, MA 02130, USA
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6
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Marin C, Fuentes M, Alobid I, Tubita V, Rojas-Lechuga MJ, Mullol J. Olfactory Bulb Excitotoxicity as a Gap-Filling Mechanism Underlying the Link Between Traumatic Brain Injury-Induced Secondary Neuronal Degeneration and Parkinson's Disease-Like Pathology. Neurochem Res 2022; 47:1025-1036. [PMID: 35067829 DOI: 10.1007/s11064-021-03503-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/02/2021] [Accepted: 12/04/2021] [Indexed: 10/19/2022]
Abstract
There is increasing preclinical and clinical data supporting a potential association between Traumatic Brain Injury (TBI) and Parkinson's disease (PD). It has been suggested that the glutamate-induced excitotoxicity underlying TBI secondary neuronal degeneration (SND) might be associated with further development of PD. Interestingly, an accumulation of extracellular glutamate and olfactory dysfunction are both sharing pathological conditions in TBI and PD. The possible involvement of glutamate excitotoxicity in olfactory dysfunction has been recently described, however, the role of olfactory bulbs (OB) glutamate excitotoxicity as a possible mechanism involved in the association between TBI and PD-related neurodegeneration has not been investigated yet. We examined the number of nigral dopaminergic neurons (TH +), nigral α-synuclein expression, the striatal dopamine transporter (DAT) expression, and motor performance after bilateral OB N-Methyl-D-Aspartate (NMDA)-induced excitotoxic lesions in rodents. Bulbar NMDA administration induced a decrease in the number of correct choices in the discrimination tests one week after lesions (p < 0.01) and a significant decrease in the number of nigral DAergic neurons (p < 0.01) associated with an increase in α-synuclein expression (p < 0.01). No significant striatal changes in DAT expression or motor alterations were observed. Our results show an association between TBI-induced SND and PD-related neurodegeneration suggesting that the OB excitotoxicity occurring in TBI SND may be a filling gap mechanism underlying the link between TBI and PD-like pathology.
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Affiliation(s)
- Concepció Marin
- INGENIO, IRCE, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), IDIBAPS-CELLEX, Department 2B, Rosselló 149-153, 08036, Barcelona, Catalonia, Spain. .,Centre for Biomedical Investigation in Respiratory Diseases (CIBERES), Barcelona, Spain.
| | - Mireya Fuentes
- INGENIO, IRCE, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), IDIBAPS-CELLEX, Department 2B, Rosselló 149-153, 08036, Barcelona, Catalonia, Spain.,Centre for Biomedical Investigation in Respiratory Diseases (CIBERES), Barcelona, Spain
| | - Isam Alobid
- INGENIO, IRCE, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), IDIBAPS-CELLEX, Department 2B, Rosselló 149-153, 08036, Barcelona, Catalonia, Spain.,Centre for Biomedical Investigation in Respiratory Diseases (CIBERES), Barcelona, Spain.,Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, Villarroel 170, 08036, Barcelona, Catalonia, Spain
| | - Valeria Tubita
- INGENIO, IRCE, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), IDIBAPS-CELLEX, Department 2B, Rosselló 149-153, 08036, Barcelona, Catalonia, Spain.,Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - María Jesús Rojas-Lechuga
- INGENIO, IRCE, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), IDIBAPS-CELLEX, Department 2B, Rosselló 149-153, 08036, Barcelona, Catalonia, Spain.,Centre for Biomedical Investigation in Respiratory Diseases (CIBERES), Barcelona, Spain.,Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, Villarroel 170, 08036, Barcelona, Catalonia, Spain
| | - Joaquim Mullol
- INGENIO, IRCE, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), IDIBAPS-CELLEX, Department 2B, Rosselló 149-153, 08036, Barcelona, Catalonia, Spain. .,Centre for Biomedical Investigation in Respiratory Diseases (CIBERES), Barcelona, Spain. .,Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, Villarroel 170, 08036, Barcelona, Catalonia, Spain.
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8
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Pellegrino R, Farruggia MC, Small DM, Veldhuizen MG. Post-traumatic olfactory loss and brain response beyond olfactory cortex. Sci Rep 2021; 11:4043. [PMID: 33597627 DOI: 10.1038/s41598-021-83621-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 01/29/2021] [Indexed: 01/31/2023] Open
Abstract
Olfactory impairment after a traumatic impact to the head is associated with changes in olfactory cortex, including decreased gray matter density and decreased BOLD response to odors. Much less is known about the role of other cortical areas in olfactory impairment. We used fMRI in a sample of 63 participants, consisting of 25 with post-traumatic functional anosmia, 16 with post-traumatic hyposmia, and 22 healthy controls with normosmia to investigate whole brain response to odors. Similar neural responses were observed across the groups to odor versus odorless stimuli in the primary olfactory areas in piriform cortex, whereas response in the frontal operculum and anterior insula (fO/aI) increased with olfactory function (normosmia > hyposmia > functional anosmia). Unexpectedly, a negative association was observed between response and olfactory perceptual function in the mediodorsal thalamus (mdT), ventromedial prefrontal cortex (vmPFC) and posterior cingulate cortex (pCC). Finally, connectivity within a network consisting of vmPFC, fO, and pCC could be used to successfully classify participants as having functional anosmia or normosmia. We conclude that, at the neural level, olfactory impairment due to head trauma is best characterized by heightened responses and differential connectivity in higher-order areas beyond olfactory cortex.
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Heslot C, Cogné M, Guillouët E, Perdrieau V, Lefevre-Dognin C, Glize B, Bonan I, Azouvi P. Management of unfavorable outcome after mild traumatic brain injury: Review of physical and cognitive rehabilitation and of psychological care in post-concussive syndrome. Neurochirurgie 2020; 67:283-289. [PMID: 33049290 DOI: 10.1016/j.neuchi.2020.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 08/26/2020] [Accepted: 09/13/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Mild Traumatic Brain Injury (mTBI) is a public health issue with approximately 42 million people worldwide affected yearly. Most patients have a favorable short-term recovery but 10-20% are likely to develop post-concussive syndrome (association of physical, cognitive, and psychological difficulties after injury). Post-concussive syndrome can be associated with Post-Traumatic Stress Disorder (PTSD). There is to date no recommendation on the interventions that could be done to reduce post-concussive syndrome. The present review aims at summarizing the effect of therapeutic education, physical and cognitive rehabilitation and of psychological care in mTBI patients with post-concussive syndrome. METHODS In the current international literature, we investigated the effects of therapeutic education, physical and cognitive rehabilitation and of psychological care in this population using the Medline database and we discussed the results of these studies. RESULTS The application of a therapeutic education intervention within 3 months after mTBI has been found appropriate and effective to prevent post-concussion syndrome in several studies but the timeline of this intervention differs among the existing studies. Concerning physical disabilities, several pharmacological, rehabilitative and non-pharmacological techniques have shown some efficacy in reducing headache and vertigo; rTMS seems also promising in this context. The management of fatigue is also crucial and requires a multidisciplinary approach. We did not find any intervention in mTBI patients with post-concussive syndrome suffering from dysosmia and/or dysgueusia. No pharmacological treatment is currently recommended to reduce the cognitive symptoms of post-concussive syndrome after mTBI. Rehabilitation and brain-stimulation techniques have already proven their efficacy to reduce the cognitive impairment in this population. Even if the use of Virtual Reality software seems well tolerated in this population, its efficacy and additional value needs to be demonstrated in larger studies. Concerning the psychological care after mTBI, Cognitive and Behavioral Therapy interventions are the most frequently reported in this population, followed by psychoeducational interventions. PTSD management seems crucial in overall recovery of patients with post-concussive syndrome. CONCLUSION Many studies have sought to demonstrate the effectiveness of various rehabilitation techniques, including different cognitive rehabilitation programs, technology-assisted rehabilitation, different types of brain stimulation and some pharmacological treatments. However, most of these studies are of a low level of scientific evidence and it would be necessary to carry out well-conducted prospective randomized trials in order to offer an appropriate and effective multidisciplinary management for patients with post-concussive syndrome after mTBI.
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Affiliation(s)
- C Heslot
- Rehabilitation Medicine Unit, Rennes University Hospital, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - M Cogné
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
| | - E Guillouët
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - V Perdrieau
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - C Lefevre-Dognin
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - B Glize
- Rehabilitation Medicine Unit, Bordeaux University Hospital, place Amélie-Raba-Léon, 33000 Bordeaux, France; EA4136, Bordeaux University, 146, rue Léo-Saignat, 33000 Bordeaux, France
| | - I Bonan
- Rehabilitation Medicine Unit, Rennes University Hospital, 2, rue Henri-le-Guilloux, 35000 Rennes, France; Unit Empenn-U1228, INSERM, INRIA, University of Rennes 1, Rennes, France
| | - P Azouvi
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; EA 4047 HANDIReSP, Versailles-Saint Quentin University, France
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10
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Abstract
Childhood traumatic brain injury (TBI) commonly occurs during brain development and can have direct, immediately observable neurologic, cognitive, and behavioral consequences. However, it can also disrupt subsequent brain development, and long-term outcomes are a combination of preinjury development and abilities, consequences of brain injury, as well as delayed impaired development of skills that were immature at the time of injury. There is a growing number of studies on mild TBI/sport-related concussions, describing initial symptoms and their evolution over time and providing guidelines for effective management of symptoms and return to activity/school/sports. Mild TBI usually does not lead to long-term cognitive or academic consequences, despite reports of behavioral/psychologic issues postinjury. Regarding moderate to severe TBI, injury to the brain is more severe, with evidence of a number of detrimental consequences in various domains. Patients can display neurologic impairments (e.g., motor deficits, signs of cerebellar disorder, posttraumatic epilepsy), medical problems (e.g., endocrine pituitary deficits, sleep-wake abnormalities), or sensory deficits (e.g., visual, olfactory deficits). The most commonly reported deficits are in the cognitive-behavioral field, which tend to be significantly disabling in the long-term, impacting the development of autonomy, socialization and academic achievement, participation, quality of life, and later, independence and ability to enter the workforce (e.g., intellectual deficits, slow processing speed, attention, memory, executive functions deficits, impulsivity, intolerance to frustration). A number of factors influence outcomes following pediatric TBI, including preinjury stage of development and abilities, brain injury severity, age at injury (with younger age at injury most often associated with worse outcomes), and a number of family/environment factors (e.g., parental education and occupation, family functioning, parenting style, warmth and responsiveness, access to rehabilitation and care). Interventions should identify and target these specific factors, given their major role in postinjury outcomes. Abusive head trauma (AHT) occurs in very young children (most often <6 months) and is a form of severe TBI, usually associated with delay before appropriate care is sought. Outcomes are systematically worse following AHT than following accidental TBI, even when controlling for age at injury and injury severity. Children with moderate to severe TBI and AHT usually require specific, coordinated, multidisciplinary, and long-term rehabilitation interventions and school adaptations, until transition to adult services. Interventions should be patient- and family-centered, focusing on specific goals, comprising education about TBI, and promoting optimal parenting, communication, and collaborative problem-solving.
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Affiliation(s)
- Mathilde Chevignard
- Rehabilitation Department for Children with Acquired Neurological Injury and Outreach Team for Children and Adolescents with Acquired Brain Injury, Saint Maurice Hospitals, Saint Maurice, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, Paris, France; GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France.
| | - Hugo Câmara-Costa
- GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France; Centre d'Etudes en Santé des Populations, INSERM U1018, Paris, France
| | - Georges Dellatolas
- GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France
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11
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Abstract
PURPOSE OF REVIEW Olfactory functioning disturbances are common following traumatic brain injury (TBI) having a significant impact on quality of life. A spontaneous recovery of the olfactory function over time may occur in TBI patients. Although there is no standard treatment for patients with posttraumatic olfactory loss, olfactory training (OT) has shown some promise beneficial effects. However, the mechanisms underlying spontaneous recovery and olfactory improvement induced by OT are not completely known. RECENT FINDINGS The spontaneous recovery of the olfactory function and the improvement of olfactory function after OT have recently been associated with an increase in subventricular (SVZ) neurogenesis and an increase in olfactory bulb (OB) glomerular dopaminergic (DAergic) interneurons. In addition, after OT, an increase in electrophysiological responses at the olfactory epithelium (OE) level has been reported, indicating that recovery of olfactory function not only affects olfactory processing at the central level, but also at peripheral level. However, the role of OE stem cells in the spontaneous recovery and in the improvement of olfactory function after OT in TBI is still unknown. In this review, we describe the physiology of the olfactory system, and the olfactory dysfunction after TBI. We highlight the possible role for the SVZ neurogenesis and DAergic OB interneurons in the recovery of the olfactory function. In addition, we point out the relevance of the OE neurogenesis process as a future target for the research in the pathophysiological mechanisms involved in the olfactory dysfunction in TBI. The potential of basal stem cells as a promising candidate for replacement therapies is also described.
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Affiliation(s)
- Concepció Marin
- INGENIO, IRCE, Department 2B, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036, Barcelona, Catalonia, Spain. .,Centre for Biomedical Investigation in Respiratory Diseases (CIBERES), Barcelona, Spain.
| | - Cristóbal Langdon
- INGENIO, IRCE, Department 2B, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036, Barcelona, Catalonia, Spain.,Centre for Biomedical Investigation in Respiratory Diseases (CIBERES), Barcelona, Spain.,Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Isam Alobid
- INGENIO, IRCE, Department 2B, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036, Barcelona, Catalonia, Spain.,Centre for Biomedical Investigation in Respiratory Diseases (CIBERES), Barcelona, Spain.,Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Joaquim Mullol
- INGENIO, IRCE, Department 2B, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036, Barcelona, Catalonia, Spain. .,Centre for Biomedical Investigation in Respiratory Diseases (CIBERES), Barcelona, Spain. .,Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.
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12
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Lecuyer Giguere F, Jobin B, Robert J, Bastien L, Giguère JF, De Beaumont L, de Guise E, Frasnelli J. Early parosmia signs and affective states predicts depression and anxiety symptoms six months after a mild Traumatic Brain Injury. Chem Senses 2020; 45:bjaa037. [PMID: 32516412 DOI: 10.1093/chemse/bjaa037] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Indexed: 02/28/2024] Open
Abstract
This longitudinal study aimed to evaluate qualitative (parosmia) and quantitative (hyposmia/anosmia) olfaction 2-4 weeks (baseline) and six months (follow-up) after a mild traumatic brain injury (mTBI). We further evaluated the predictive value of baseline depression, anxiety and olfaction scores on depression and anxiety at follow-up. At baseline, olfactory function and affective state were assessed in 107 participants (53 patients with mild TBI; 54 healthy controls). At follow-up, data were collected on 71 participants (32 patients, 39 controls). Both at baseline and follow-up, patients with mild TBI showed more signs of parosmia, depression and anxiety, compared to controls. However, patients did not, neither at baseline nor follow-up, show quantitative olfactory impairment. Moreover, while baseline scores of depression and anxiety helped predict the development of symptoms of depression and anxiety at follow up, adding parosmia scores to the prediction model significantly increased the amount of explained variances. Clinicians should implement affective and olfactory evaluation to predict patients' affective outcome.
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Affiliation(s)
- Fanny Lecuyer Giguere
- Department of Psychology, University of Montréal, Montréal, Québec, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, Québec, Canada
- Research Center, (CIUSSS-NIM), Montréal, Québec, Canada
| | - Benoit Jobin
- Department of Psychology, University of Montréal, Montréal, Québec, Canada
- Research Center, (CIUSSS-NIM), Montréal, Québec, Canada
| | - Joëlle Robert
- Department of Psychology, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Laurianne Bastien
- Department of Psychology, University of Montréal, Montréal, Québec, Canada
- Research Center, (CIUSSS-NIM), Montréal, Québec, Canada
| | | | - Louis De Beaumont
- Research Center, (CIUSSS-NIM), Montréal, Québec, Canada
- Department of Surgery, University of Montréal, Montréal, Québec, Canada
| | - Elaine de Guise
- Department of Psychology, University of Montréal, Montréal, Québec, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, Québec, Canada
- Research Institute-McGill University Health Centre, Montreal, Quebec, Canada
| | - Johannes Frasnelli
- Department of Psychology, University of Montréal, Montréal, Québec, Canada
- Research Center, (CIUSSS-NIM), Montréal, Québec, Canada
- Department of Anatomy, University of Québec in Trois-Rivières (UQTR), Trois-Rivières, Québec, Canada
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13
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Lecuyer Giguère F, Frasnelli A, De Guise É, Frasnelli J. Olfactory, cognitive and affective dysfunction assessed 24 hours and one year after a mild Traumatic Brain Injury (mTBI). Brain Inj 2019; 33:1184-1193. [DOI: 10.1080/02699052.2019.1631486] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Fanny Lecuyer Giguère
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Quebec, Canada
- CEAMS, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | | | - Élaine De Guise
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Quebec, Canada
- Research Institute-McGill University Health Centre, Montreal, Quebec, Canada
| | - Johannes Frasnelli
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
- CEAMS, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
- Department of Anatomy, Université du Québec à Trois-Rivières (UQTR), Trois-Rivières, Quebec, Canada
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14
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Moon WJ, Park M, Hwang M, Kim JK. Functional MRI as an Objective Measure of Olfaction Deficit in Patients with Traumatic Anosmia. AJNR Am J Neuroradiol 2018; 39:2320-2325. [PMID: 30409849 DOI: 10.3174/ajnr.a5873] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 09/24/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE While posttraumatic anosmia is not uncommon, the olfactory function evaluation has strongly relied on subjective responses given by patients. We aimed to examine the utility of fMRI as an objective tool for diagnosing traumatic anosmia. MATERIALS AND METHODS Sixteen patients (11 men and 5 women; mean age, 42.2 ± 10.4 years) with clinically diagnosed traumatic anosmia and 19 healthy control subjects (11 men and 8 women; mean age, 29.3 ± 8.5 years) underwent fMRI during olfactory stimulation with citral (a pleasant odor) or β-mercaptoethanol (an unpleasant odor). All patients were subjected to a clinical olfactory functional assessment and nasal endoscopic exploration. Two-sample t tests were conducted with age as a covariate to examine group differences in brain activation responses to olfactory stimulation (false discovery rate-corrected P < .05). RESULTS Compared with healthy control subjects, patients with traumatic anosmia had reduced activation in the bilateral primary and secondary olfactory cortices and the limbic system in response to β-mercaptoethanol stimulation, whereas reduced activation was observed only in the left frontal subgyral region in response to citral stimulation. CONCLUSIONS Brain activation was decreased in the bilateral primary and secondary olfactory cortices as well as the limbic system in response to olfactory stimulation in patients with traumatic anosmia compared with healthy control subjects. These preliminary results may shed light on the potential of fMRI for the diagnosis of traumatic anosmia.
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Affiliation(s)
- W-J Moon
- Department of Radiology (W.-J.M., M.P.), Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - M Park
- Department of Radiology (W.-J.M., M.P.), Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - M Hwang
- GE Healthcare (M.H.), Seoul, Korea
| | - J K Kim
- Department of Otorhinolaryngology-Head and Neck Surgery (J.K.K.), Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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