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Kawabata K, Bagarinao E, Seppi K, Poewe W. Longitudinal brain changes in Parkinson's disease with severe olfactory deficit. Parkinsonism Relat Disord 2024; 122:106072. [PMID: 38430690 DOI: 10.1016/j.parkreldis.2024.106072] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/20/2024] [Accepted: 02/25/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Olfactory dysfunction and REM sleep behavior disorder (RBD) are associated with distinct cognitive trajectories in the course of Parkinson's disease (PD). The underlying neurobiology for this relationship remains unclear but may involve distinct patterns of neurodegeneration. This study aimed to examine longitudinal cortical atrophy and thinning in early-stage PD with severe olfactory deficit (anosmia) without and with concurrent probable RBD. METHODS Longitudinal MRI data over four years of 134 de novo PD and 49 healthy controls (HC) from the Parkinson Progression Marker Initiative (PPMI) cohort were analyzed using a linear mixed-effects model. Patients were categorized into those with anosmia by the University of Pennsylvania Smell Identification Test (UPSIT) score ≤ 18 (AO+) and those without (UPSIT score > 18, AO-). The AO+ group was further subdivided into AO+ with probable RBD (AO+RBD+) and without (AO+RBD-) for subanalysis. RESULTS Compared to subjects without baseline anosmia, the AO+ group exhibited greater longitudinal declines in both volume and thickness in the bilateral parahippocampal gyri and right transverse temporal gyrus. Patients with concurrent anosmia and RBD showed more extensive longitudinal declines in cortical volume and thickness, involving additional brain regions including the bilateral precuneus, left inferior temporal gyrus, right paracentral gyrus, and right precentral gyrus. CONCLUSIONS The atrophy/thinning patterns in early-stage PD with severe olfactory dysfunction include regions that are critical for cognitive function and could provide a structural basis for previously reported associations between severe olfactory deficit and cognitive decline in PD. Concurrent RBD might enhance the dynamics of cortical changes.
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Affiliation(s)
- Kazuya Kawabata
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria; Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Epifanio Bagarinao
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Japan
| | - Klaus Seppi
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria; Department of Neurology, District Hospital Kufstein, Kufstein, Austria
| | - Werner Poewe
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
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Xie B, Yang S, Hao Y, Sun Y, Li L, Guo C, Yang Y. Impaired olfactory identification in dementia-free individuals is associated with the functional abnormality of the precuneus. Neurobiol Dis 2024; 194:106483. [PMID: 38527709 DOI: 10.1016/j.nbd.2024.106483] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 03/27/2024] Open
Abstract
OBJECTIVE Olfactory dysfunction indicates a higher risk of developing dementia. However, the potential structural and functional changes are still largely unknown. METHODS A total of 236 participants were enrolled, including 45 Alzheimer's disease (AD) individuals and 191dementia-free individuals. Detailed study methods, comprising neuropsychological assessment and olfactory identification test (University of Pennsylvania smell identification test, UPSIT), as well as structural and functional magnetic resonance imaging (MRI) were applied in this research. The dementia-free individuals were divided into two sub-groups based on olfactory score: dementia-free with olfactory dysfunction (DF-OD) sub-group and dementia-free without olfactory dysfunction (DF-NOD) sub-group. The results were analyzed for subsequent intergroup comparisons and correlations. The cognitive assessment was conducted again three years later. RESULTS (i) At dementia-free stage, there was a positive correlation between olfactory score and cognitive function. (ii) In dementia-free group, the volume of crucial brain structures involved in olfactory recognition and processing (such as amygdala, entorhinal cortex and basal forebrain volumes) are positively associated with olfactory score. (iii) Compared to the DF-NOD group, the DF-OD group showed a significant reduction in olfactory network (ON) function. (iv) Compared to DF-NOD group, there were significant functional connectivity (FC) decline between PCun_L(R)_4_1 in the precuneus of posterior default mode network (pDMN) and the salience network (SN) in DF-OD group, and the FC values decreased with falling olfactory scores. Moreover, in DF-OD group, the noteworthy reduction in FC were observed between PCun_L(R)_4_1 and amygdala, which was a crucial component of ON. (v) The AD conversion rate of DF-OD was 29.41%, while the DF-NOD group was 12.50%. The structural and functional changes in the precuneus were also observed in AD and were more severe. CONCLUSIONS In addition to the olfactory circuit, the precuneus is a critical structure in the odor identification process, whose abnormal function underlies the olfactory identification impairment of dementia-free individuals.
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Affiliation(s)
- Bo Xie
- Department of Neurology, The First Hospital of Jilin University, Changchun 130021, China
| | - Simin Yang
- Department of Radiology, The First Hospital of Jilin University, Changchun 130021, China
| | - Yitong Hao
- Department of Neurology, The First Hospital of Jilin University, Changchun 130021, China
| | - Yining Sun
- Department of Neurology, The First Hospital of Jilin University, Changchun 130021, China
| | - Ludi Li
- Department of Neurology, The First Hospital of Jilin University, Changchun 130021, China
| | - Chunjie Guo
- Department of Radiology, The First Hospital of Jilin University, Changchun 130021, China
| | - Yu Yang
- Department of Neurology, The First Hospital of Jilin University, Changchun 130021, China.
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Eckert MA, Benitez A, Soler ZM, Dubno JR, Schlosser RJ. Gray matter and episodic memory associations with olfaction in middle-aged to older adults. Int Forum Allergy Rhinol 2024; 14:961-971. [PMID: 37897207 PMCID: PMC11045322 DOI: 10.1002/alr.23290] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/18/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Age-related declines in olfaction contribute to low quality of life and appear to occur with declines in cognitive function, including diminished episodic memory. We tested the hypothesis that low gray matter volume within cortical regions that support olfaction and episodic memory can explain age-related differences in olfactory and episodic memory functions. METHODS T1-weighted images, Sniffin' Sticks olfactory measures, and the NIH Toolbox-Cognition Battery were administered to 131 middle-aged to older adults (50-86 years; 66% female). Correlation was used to examine the associations between these measures. A network-based image processing approach was then used to examine the degree to which spatial patterns of gray matter variance were related to the olfactory and cognitive measures. Structural equation modeling was used to characterize the relative specificity of olfactory, cognitive, gray matter, and aging associations. RESULTS Olfactory threshold, discrimination, and identification exhibited small to medium effect size associations with episodic memory performance (rs = 0.27-0.42, ps < 0.002). Gray matter volume within medial temporal and orbitofrontal cortex was also related to olfactory (discrimination and identification) and episodic memory function (rs = 0.21-0.36, ps < 0.019). Age and episodic memory explained the same variance in olfaction that was explained by the medial temporal and orbitofrontal pattern of gray matter volume. CONCLUSIONS The results of this cross-sectional study suggest that identifying mechanisms contributing to differences in medial temporal and orbitofrontal cortex will advance our understanding of co-morbid olfactory and cognitive declines.
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Affiliation(s)
- Mark A. Eckert
- Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina
| | | | - Zachary M. Soler
- Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina
| | - Judy R. Dubno
- Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina
| | - Rodney J. Schlosser
- Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina
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Hsieh JW, Lenoir V, Sipione R, Hugentobler M, Daskalou D, Lundstrom JN, Senn P, Rimmer J, Becker M, Landis BN. Can MRI predict olfactory loss and improvement in posttraumatic olfactory dysfunction? Rhinology 2024; 62:172-182. [PMID: 37955246 DOI: 10.4193/rhin23.246] [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: 11/14/2023]
Abstract
BACKGROUND Although most patients with post-traumatic olfactory dysfunction (PTOD) undergo MRI, there is no consensus about its diagnostic or prognostic value. The aims were: 1) to classify the extent of post-traumatic neurodegeneration; 2) to determine its relationship with chemosensory dysfunction (smell, taste, trigeminal); and 3) to establish whether MRI can predict olfactory improvement. METHODOLOGY We conducted a retrospective cohort study based on a series of 56 patients with PTOD. All patients underwent validated psychophysical tests of their smell, taste, and trigeminal functions, otorhinolaryngologic evaluation, and MRI. An experienced radiologist blinded to patient data evaluated 40 chemosensory-relevant brain regions according to a four-point scale (0=no lesion to 3=large lesion). Follow up data after 4 years (on average) were available in 46 patients. RESULTS The cluster analysis showed 4 brain lesion patterns that differed in lesion localization and severity. They are associated with diagnostic categories: anosmia, hyposmia and normosmia. Two clusters were highly specific for anosmia (100% specificity)and could accurately predict this condition (100% positive predictive value). No clusters were associated with trigeminal or taste dysfunction. Regarding improvement, 72.7% of patients in the cluster with mild lesions experienced subjective and measurable olfactory improvement whereas this was only the case in 21.7-37.5% of patients with larger lesions. The odds of subjective smell improvement were 5.9 times higher in patients within the milder cluster compared to larger ones. CONCLUSIONS The analysis of brain lesions in PTOD allows corroboration of smell test results and prediction of subjective and measurable improvement.
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Affiliation(s)
- J W Hsieh
- Rhinology-Olfactory Unit, Department of Otorhinolaryngology - Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland; The Inner Ear and Olfaction Lab, Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - V Lenoir
- Division of Radiology, Department of diagnostics, Geneva University Hospitals, Geneva, Switzerland
| | - R Sipione
- The Inner Ear and Olfaction Lab, Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - M Hugentobler
- Rhinology-Olfactory Unit, Department of Otorhinolaryngology - Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - D Daskalou
- Rhinology-Olfactory Unit, Department of Otorhinolaryngology - Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - J N Lundstrom
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Monell Chemical Senses Center, 3500 Market Street, Philadelphia, PA, USA; Stockholm University Brain Imaging Centre, Stockholm University, Stockholm, Sweden
| | - P Senn
- Rhinology-Olfactory Unit, Department of Otorhinolaryngology - Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland; The Inner Ear and Olfaction Lab, Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - J Rimmer
- Department of Otolaryngology, Head and Neck Surgery, Monash Health, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Australia
| | - M Becker
- Division of Radiology, Department of diagnostics, Geneva University Hospitals, Geneva, Switzerland
| | - B N Landis
- Rhinology-Olfactory Unit, Department of Otorhinolaryngology - Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland; The Inner Ear and Olfaction Lab, Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Georgiopoulos C, Buechner MA, Falkenburger B, Engström M, Hummel T, Haehner A. Differential connectivity of the posterior piriform cortex in Parkinson's disease and postviral olfactory dysfunction: an fMRI study. Sci Rep 2024; 14:6256. [PMID: 38491209 PMCID: PMC10943068 DOI: 10.1038/s41598-024-56996-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/13/2024] [Indexed: 03/18/2024] Open
Abstract
Olfactory dysfunction is a common feature of both postviral upper respiratory tract infections (PV) and idiopathic Parkinson's disease (PD). Our aim was to investigate potential differences in the connectivity of the posterior piriform cortex, a major component of the olfactory cortex, between PV and PD patients. Fifteen healthy controls (median age 66 years, 9 men), 15 PV (median age 63 years, 7 men) and 14 PD patients (median age 70 years, 9 men) were examined with task-based olfactory fMRI, including two odors: peach and fish. fMRI data were analyzed with the co-activation pattern (CAP) toolbox, which allows a dynamic temporal assessment of posterior piriform cortex (PPC) connectivity. CAP analysis revealed 2 distinct brain networks interacting with the PPC. The first network included regions related to emotion recognition and attention, such as the anterior cingulate and the middle frontal gyri. The occurrences of this network were significantly fewer in PD patients compared to healthy controls (p = 0.023), with no significant differences among PV patients and the other groups. The second network revealed a dissociation between the olfactory cortex (piriform and entorhinal cortices), the anterior cingulate gyrus and the middle frontal gyri. This second network was significantly more active during the latter part of the stimulation, across all groups, possibly due to habituation. Our study shows how the PPC interacts with areas that regulate higher order processing and how this network is substantially affected in PD. Our findings also suggest that olfactory habituation is independent of disease.
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Affiliation(s)
- Charalampos Georgiopoulos
- Diagnostic Radiology, Department of Clinical Sciences, Medical Faculty, Lund University, Lund, Sweden.
- Department of Radiology, Section of Neuroradiology and Odontology, Skånes Universitetssjukhus, Entrégatan 7, 221 85, Lund, Sweden.
| | | | | | - Maria Engström
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Parlak AE, Selçuk ÖT, Yilmaz GÖ, Aydenizoz D, Selçuk NT, Öcal R, Seyman D, Yilmaz M, Eyigör H. Olfactory Bulb Volume and Morphology Changes in COVID-19 Patients With Olfactory Disorders Using Magnetic Resonance Imaging. J Comput Assist Tomogr 2024; 48:317-322. [PMID: 37876233 DOI: 10.1097/rct.0000000000001559] [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: 10/26/2023]
Abstract
OBJECTIVES The aims of the study are to explore the morphological changes of olfactory bulb (OB) and olfactory sulcus in COVID-19 patients with associated olfactory dysfunction (OD) by measuring the OB volume (OBV) and olfactory sulcus depth (OSD) and to compare the measurement values with those of healthy individuals. METHODS Between March 2020 and January 2022, 31 consecutive hospitalized patients with a diagnosis of COVID-19 with anosmia and hyposmia who underwent brain magnetic resonance imaging and 35 normosmic control individuals were retrospectively included in the study. Bilateral OBV and OSD were measured and shape of the OB was determined based on the consensus by a neuroradiologist and an otorrhynolaryngologist. RESULTS The mean measurements for the right and the left sides for OBV (38 ± 8.5 and 37.1 ± 8.4, respectively) and OSD (7.4 ± 0.1 and 7.4 ± 1.0 mm, respectively) were significantly lower in COVID-19 patients with OD than those in control group (for the right and the left sides mean OBV 56.3 ± 17.1 and 49.1 ± 13.5, respectively, and mean OSD 9.6 ± 0.8 and 9.4 ± 0.8 mm, respectively). Abnormally shaped OB (lobulated, rectangular, or atrophic) were higher in patient group than those of controls.For the optimal cutoff values, OBV showed sensitivity and specificity values of 90.32% and, 57.14%, for the right, and 87.1% and 62.86% for the left side, respectively (area under the curve, 0.819 and 0.780). Olfactory sulcus depth showed sensitivity and specificity values of 90.32% and 94.29%, for the right, and 96.77% and 85.71%, for the left side, respectively (area under the curve, 0.960 and 0.944). CONCLUSIONS Decrease in OBV and OSD measurements in COVID-19 patients with OD at the early chronic stage of the disease supports direct damage to olfactory neuronal pathways and may be used to monitor olfactory nerve renewal while returning back to normal function.
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Affiliation(s)
| | | | | | | | | | | | - Derya Seyman
- Infectious Diseases, Health Sciences University Antalya Training and Research Hospital, Antalya, Turkey
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Iravani K, Malekpour B, Rasekhi A, Faramarzi A, Soltaniesmaeili A, Golkhar B, Jahanandish F, Babaei A. Functional magnetic resonance imaging in coronavirus disease 2019 induced olfactory dysfunction. J Laryngol Otol 2024; 138:178-183. [PMID: 37795811 DOI: 10.1017/s0022215123001652] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
OBJECTIVE To evaluate the functional magnetic resonance imaging changes in the olfactory structures of coronavirus disease 2019 patients experiencing olfactory dysfunction. METHODS This study included patients aged 25-65 years who presented with a sudden loss of smell, confirmed coronavirus disease 2019 infection, and persistent olfactory dysfunction for a minimum of 2 months without any treatment. RESULTS Irrespective of the side of brain activation, the analysis of the cumulative maximum diameter of the activation zones revealed significantly lower activation in the upper frontal lobe (p = 0.037) and basal ganglia (p = 0.023) in olfactory dysfunction patients. Irrespective of the side of activation, the analysis of the number of activation points demonstrated significantly lower activation in the upper frontal lobe (p = 0.036) and basal ganglia (p = 0.009) in olfactory dysfunction patients. CONCLUSION Patients with coronavirus-triggered olfactory dysfunction exhibited lower activity in their basal ganglia and upper frontal lobe.
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Affiliation(s)
- Kamyar Iravani
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behzad Malekpour
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Rasekhi
- Medical Imaging Research Center ('MIRC'), Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Faramarzi
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Soltaniesmaeili
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behnaz Golkhar
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farimah Jahanandish
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirhossein Babaei
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Thaploo D, Joshi A, Yilmaz E, Yildirim D, Altundag A, Hummel T. Functional connectivity patterns in parosmia. Behav Brain Funct 2023; 19:24. [PMID: 38115149 PMCID: PMC10731743 DOI: 10.1186/s12993-023-00225-8] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE Parosmia is a qualitative olfactory dysfunction presenting as "distorted odor perception" in presence of an odor source. Aim of this study was to use resting state functional connectivity to gain more information on the alteration of olfactory processing at the level of the central nervous system level. METHODS A cross sectional study was performed in 145 patients with parosmia (age range 20-76 years; 90 women). Presence and degree of parosmia was diagnosed on the basis of standardized questionnaires. Participants also received olfactory testing using the "Sniffin' Sticks". Then they underwent resting state scans using a 3 T magnetic resonance imaging scanner while fixating on a cross. RESULTS Whole brain analyses revealed reduced functional connectivity in salience as well as executive control networks. Region of interest-based analyses also supported reduced functional connectivity measures between primary and secondary olfactory eloquent areas (temporal pole, supramarginal gyrus and right orbitofrontal cortex; dorso-lateral pre-frontal cortex and the right piriform cortex). CONCLUSIONS Participants with parosmia exhibited a reduced information flow between memory, decision making centers, and primary and secondary olfactory areas.
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Affiliation(s)
- Divesh Thaploo
- Smell & Taste Clinic, Department of Otorhinolaryngology, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
| | - Akshita Joshi
- Smell & Taste Clinic, Department of Otorhinolaryngology, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Eren Yilmaz
- Faculty of Health Sciences, Istanbul Gelisim University, Istanbul, Turkey
| | - Duzgun Yildirim
- Department of Medical Imaging, Acibadem University, Vocational School of Health Sciences, Istanbul, Turkey
| | - Aytug Altundag
- Faculty of Medicine, Department of Otorhinolaryngology, Biruni University, Istanbul, Turkey
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
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Hosseini SF, Farhadi M, Alizadeh R, Ghanbari H, Maleki S, Zare-Sadeghi A, Kamrava SK. The brain functional connectivity alterations in traumatic patients with olfactory disorder after low-level laser therapy demonstrated by fMRI. Neuroradiol J 2023; 36:716-727. [PMID: 37533379 PMCID: PMC10649526 DOI: 10.1177/19714009231188589] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Low-level laser therapy (LLLT) has been clinically accepted to accelerate the nerve regeneration process after a nerve injury or transection. We aimed to investigate the neuronal basis and the influence of LLLT on brain functional networks in traumatic patients with olfactory dysfunction. METHODS Twenty-four Patients with traumatic anosmia/hyposmia were exposed to pleasant olfactory stimuli during a block-designed fMRI session. After a 10-week period, patients as control group and patients who had completed the sessions of LLLT were invited for follow-up testing using the same fMRI protocol. Two-sample t-tests were conducted to explore group differences in activation responding to odorants (p-FDR-corrected <0.05). Differences of functional connectivity were compared between the two groups and the topological features of the olfactory network were calculated. Correlation analysis was performed between graph parameters and TDI score. RESULTS Compared to controls, laser-treated patients showed increased activation in the cingulate, rectus gyrus, and some parts of the frontal gyrus. Shorter pathlength (p = 0.047) and increased local efficiency (p = 0.043) within the olfactory network, as well as decreased inter-network connectivity within the whole brain were observed in patients after laser surgery. Moreover, higher clustering and local efficiency were related to higher TDI score, as manifested in increased sensitivity to identify odors. CONCLUSIONS The results support that low-level laser induces neural reorganization process and make new connections in the olfactory structures. Furthermore, the connectivity parameters may serve as potential biomarkers for traumatic anosmia or hyposmia by revealing the underlying neural mechanisms of LLLT.
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Affiliation(s)
- Seyedeh Fahimeh Hosseini
- Medical Physics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Farhadi
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Rafieh Alizadeh
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hadi Ghanbari
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shayan Maleki
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Zare-Sadeghi
- Medical Physics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Kamran Kamrava
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Martinez-Nunez AE, Soltanian-Zadeh H, Latack K, Ghazi N, Mahajan A. Hyposmia and apathy in early, de novo Parkinson's disease: Lessons from structural brain connectivity. J Neurol Sci 2023; 452:120767. [PMID: 37619327 DOI: 10.1016/j.jns.2023.120767] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/08/2023] [Accepted: 08/13/2023] [Indexed: 08/26/2023]
Abstract
INTRODUCTION The neuroanatomical structures implicated in olfactory and emotional processing overlap significantly. Our understanding of the relationship between hyposmia and apathy, common manifestations of early Parkinson's disease (PD), is inadequate. MATERIALS AND METHODS We analyzed data on 40 patients with early de-novo idiopathic PD enrolled within 2 years of motor symptom onset in the Parkinson's Progression Markers Initiative (PPMI) study. To be included in the analysis, patients must have smell dysfunction but no apathy at the baseline visit and had completed a diffusion MRI (dMRI) at the baseline visit and at the 48-month follow-up visit. We used the FMRIB Software Library's diffusion tool kit to measure fractional anisotropy (FA) in six regions of interest on dMRI: bilateral anterior corona radiata, left cingulum, left superior corona radiata, genu and body of the corpus callosum. We compared the FA in each region from the dMRI done at the beginning of the study with the follow up studies at 4 years. RESULTS We found a significant decrease of FA at the bilateral anterior corona radiata, and the genu and body of the corpus callosum comparing baseline scans with follow up images at 4-years after starting the study. CONCLUSION Structural connectivity changes associated with apathy can be seen early in PD patients with smell dysfunction.
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Affiliation(s)
| | - Hamid Soltanian-Zadeh
- Departments of Radiology and Research Administration, Henry Ford Health, Detroit, MI, USA; Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
| | - Katie Latack
- Department of Biostatistics, Henry Ford Health, Detroit, MI, USA
| | - Nayereh Ghazi
- Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
| | - Abhimanyu Mahajan
- Rush Parkinson's Disease and Movement Disorders Program, Department of Neurological Sciences, Chicago, IL, United States of America.
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Kocakaya H, Bayar Muluk N, Bekin Sarikaya PZ. Peripheric and central olfactory measurements in patients with bipolar disorder. Acta Radiol 2023; 64:2594-2602. [PMID: 37312533 DOI: 10.1177/02841851231179174] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Bipolar disorder (BD) is a mental health disorder. PURPOSE To investigate the peripheric and central olfactory measurements in patients with BD using magnetic resonance imaging (MRI). MATERIAL AND METHODS This study was conducted retrospectively. Group 1 consisted of 27 euthymic patients with BD (14 men, 13 women) and Group 2 consisted of 27 healthy controls (14 men, 13 women). Olfactory bulb (OB) volume and olfactory sulcus (OS) depth (peripheric), and corpus amygdala and insular gyrus area (central) measurements were performed using cranial MRI. RESULTS OB volume and OS depth value of the bipolar group were lower than the control group, but there were no significant differences between the groups (P > 0.05). The corpus amygdala and left insular gyrus area of the bipolar group were significantly lower than those in the control group (P < 0.05). There were positive correlations between OB volumes and OS depths, the insular gyrus areas, and the corpus amygdala areas (P < 0.05). As the number of depressive episodes and duration of illness increased in bipolar patients, the depth of the sulcus decreased (P < 0.05). CONCLUSION In the present study a correlation was detected between OB volumes and the structures, known as emotional processing (e.g. insular gyrus area, corpus amygdala), and clinical features. Accordingly, new treatment techniques, such as olfactory training, may be considered an option in the treatment of such patients with BD.
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Affiliation(s)
- Hanife Kocakaya
- Psychiatry Department, Faculty of Medicine, Doctor Faculty Member in Kırıkkale University, Kırıkkale, Turkey
| | - Nuray Bayar Muluk
- ENT Department, Faculty of Medicine, Professor in Kırıkkale University, Kırıkkale, Turkey
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12
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Rezaeyan A, Asadi S, Kamrava SK, Zare-Sadeghi A. Brain structural analysis in patients with post-traumatic anosmia: Voxel-based and surface-based morphometry. J Neuroradiol 2023; 50:482-491. [PMID: 36610937 DOI: 10.1016/j.neurad.2022.11.005] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE AND BACKGROUND Voxel-based morphometry (VBM) and surfaced-based morphometry (SBM) investigate the characteristics of gray matter (GM) in various diseases such as post-traumatic anosmia (PTA). This study uses SBM and VBM to examine neuroanatomical measurements of GM and its functional correlates in patients with PTA. METHODS MRI images and olfactory test results were collected from 39 PTA patients and 39 healthy controls. Sniffin' Sticks test was used to assess olfactory function. GM structure was analyzed using CAT12 and FreeSurfer, and olfactory bulb (OB) volume and olfactory sulcus (OS) depth were calculated using 3D-Slicer. RESULTS Anosmic patients showed lower scores in the Sniffin' Sticks olfactory test, as well as reduction of OB volume and OS depth compared to control subjects. In these patients, overlapping changes were found between the VBM and SBM findings in the areas with significant effects, in particular, orbitofrontal cortex, superior and middle frontal gyrus, superior and middle temporal gyrus, anterior cingulate cortex, and insular cortex. Using SBM, decreased cortical thickness clusters were located in inferior and superior parietal gyrus. Further analysis in the region of interest demonstrated correlations between the orbitofrontal cortex and odor threshold score as well as the middle frontal gyrus and smell loss duration. CONCLUSION These findings show that the morphological alterations in the OB, OS, and the central olfactory pathways might contribute to the pathogenic mechanism of olfactory dysfunction after head injury.
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Affiliation(s)
- Abolhasan Rezaeyan
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran; Department of Medical Physics, Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Somayeh Asadi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - S Kamran Kamrava
- ENT and Head and Neck Research Center and Department, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Zare-Sadeghi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; ENT and Head and Neck Research Center and Department, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran; Finetech in Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Yan X, Benkhatar H, Chao YT, Georgiopoulos C, Hummel T. Anterior Skull Base Abnormalities in Congenital Anosmia. ORL J Otorhinolaryngol Relat Spec 2023; 86:1-12. [PMID: 37607521 DOI: 10.1159/000532077] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/11/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION The structures of the skull and the brain are related to each other. Prior work in individuals with isolated congenital anosmia (ICA) showed that these individuals were characterized by olfactory bulb (OB) defects. The aim of this study was to compare the morphological pattern of the anterior skull base surrounding the OB between individuals with ICA and normosmic controls. We meant to investigate whether these features can help distinguish abnormalities from normal variation. METHODS We conducted a retrospective study to acquire T2-weighted magnetic resonance images from individuals diagnosed with ICA (n = 31) and healthy, normosmic controls matched for age and gender (n = 62). Between both groups, we compared the depth and width of the olfactory fossa, the angle of the ethmoidal fovea, as well as the angle of the lateral lamella of the cribriform plate. Within the ICA group, we further performed subgroup analyses based on the presence or absence of the OB, to investigate whether the morphology of the anterior skull base relates to the presence of OBs. The diagnostic performance of these parameters was evaluated using receiver operating characteristic analysis. RESULTS Individuals with ICA exhibited a flattened ethmoid roof and shallower olfactory fossa when compared to controls. Further, the absence of the OB was found to be associated with a higher degree of flattening of the ethmoid roof and a shallow olfactory fossa. We reached the results in the following areas under the receiver operating characteristic curves: 0.80 - angle of fovea ethmoidalis, 0.76 - depth of olfactory fossa, 0.70 - angle of lateral lamella of the cribriform plate for significant differentiation between individuals with ICA and normosmic controls. CONCLUSION Individuals with ICA exhibited an unusual anterior skull base surrounding the OB. This study supports the idea of an integrated development of OB and anterior skull base. Hence, the morphological pattern of the anterior skull base surrounding the OB helps distinguish individuals with ICA from normosmic controls and may therefore be useful for the diagnosis of ICA, although it is certainly not an invariable sign of congenital anosmia.
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Affiliation(s)
- Xiaoguang Yan
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Hakim Benkhatar
- Department of ENT and Head and Neck Surgery, Versailles Hospital, Le Chesnay-Rocquencourt, France
| | - Yun-Ting Chao
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- Division of Rhinology, Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Charalampos Georgiopoulos
- Department of Radiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Muccioli L, Sighinolfi G, Mitolo M, Ferri L, Jane Rochat M, Pensato U, Taruffi L, Testa C, Masullo M, Cortelli P, Lodi R, Liguori R, Tonon C, Bisulli F. Cognitive and functional connectivity impairment in post-COVID-19 olfactory dysfunction. Neuroimage Clin 2023; 38:103410. [PMID: 37104928 PMCID: PMC10165139 DOI: 10.1016/j.nicl.2023.103410] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 04/13/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVES To explore the neuropsychological profile and the integrity of the olfactory network in patients with COVID-19-related persistent olfactory dysfunction (OD). METHODS Patients with persistent COVID-19-related OD underwent olfactory assessment with Sniffin' Sticks and neuropsychological evaluation. Additionally, both patients and a control group underwent brain MRI, including T1-weighted and resting-state functional MRI (rs-fMRI) sequences on a 3 T scanner. Morphometrical properties were evaluated in olfaction-associated regions; the rs-fMRI data were analysed using graph theory at the whole-brain level and within a standard parcellation of the olfactory functional network. All the MR-derived quantities were compared between the two groups and their correlation with clinical scores in patients were explored. RESULTS We included 23 patients (mean age 37 ± 14 years, 12 females) with persistent (mean duration 11 ± 5 months, range 2-19 months) COVID-19-related OD (mean score 23.63 ± 5.32/48, hyposmia cut-off: 30.75) and 26 sex- and age-matched healthy controls. Applying population-derived cut-off values, the two cognitive domains mainly impaired were visuospatial memory and executive functions (17 % and 13 % of patients). Brain MRI did not show gross morphological abnormalities. The lateral orbital cortex, hippocampus, and amygdala volumes exhibited a reduction trend in patients, not significant after the correction for multiple comparisons. The olfactory bulb volumes did not differ between patients and controls. Graph analysis of the functional olfactory network showed altered global and local properties in the patients' group (n = 19, 4 excluded due to artifacts) compared to controls. Specifically, we detected a reduction in the global modularity coefficient, positively correlated with hyposmia severity, and an increase of the degree and strength of the right thalamus functional connections, negatively correlated with short-term verbal memory scores. DISCUSSION Patients with persistent COVID-19-related OD showed an altered olfactory network connectivity correlated with hyposmia severity and neuropsychological performance. No significant morphological alterations were found in patients compared with controls.
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Affiliation(s)
- Lorenzo Muccioli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giovanni Sighinolfi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Micaela Mitolo
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Lorenzo Ferri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | | | - Umberto Pensato
- Department of Neurology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Lisa Taruffi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Claudia Testa
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; Department of Physics and Astronomy, University of Bologna, Bologna, Italy
| | - Marco Masullo
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Pietro Cortelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Raffaele Lodi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Rocco Liguori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Caterina Tonon
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Francesca Bisulli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
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ÇETİN H, ATEŞ AŞ, TAYDAŞ O, ELMAS B, GÜÇLÜ E. Magnetic resonance imaging findings in COVID-19-related anosmia. Turk J Med Sci 2022; 52:1506-1512. [PMID: 36422480 PMCID: PMC10395696 DOI: 10.55730/1300-0144.5490] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 10/19/2022] [Accepted: 10/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) mostly manifests with fever, shortness of breath, and cough, has also been found to cause some neurological symptoms, such as anosmia and ageusia. The aim of the study was to present the magnetic resonance imaging (MRI) findings of patients with anosmia-hyposmia symptoms and to discuss potential mechanisms in light of these findings. METHODS Of the 2412 patients diagnosed with COVID-19-related pneumonia (RT-PCR at least once + clinically confirmed) between March and December 2020, 15 patients underwent olfactory MRI to investigate the cause of ongoing anosmia/ hyposmia symptoms were included in the study. RESULTS Eleven (73.3%) patients were female and four (26.7%) were male. A total of eight patients (53.3%) showed thickening in the olfactory cleft region, where the olfactory epithelium is located. In nine patients (60%), enhancement was observed in the olfactory cleft region. Diffusion-weighted imaging showed restricted diffusion in three patients (20%) (corpus callosum splenium in one patient, thalamus mediodorsal nucleus in one patient, and mesencephalon in one patient). DISCUSSION This study revealed that there is a relationship between anosmia and MRI findings. Larger studies can enlighten the pathophysiological mechanism and shed light on both diagnosis and new treatments.
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Affiliation(s)
- Hüseyin ÇETİN
- Department of Radiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara,
Turkey
| | - Ayşe Şule ATEŞ
- Department of Chest Diseases, Sakarya University Training and Research Hospital, Sakarya,
Turkey
| | - Ogün TAYDAŞ
- Department of Family Medicine, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, İstanbul,
Turkey
| | - Bahri ELMAS
- Department of Pediatrics, Faculty of Medicine, Sakarya University, Sakarya,
Turkey
| | - Ertuğrul GÜÇLÜ
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Sakarya University, Sakarya,
Turkey
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Kulason S, Ratnanather JT, Miller MI, Kamath V, Hua J, Yang K, Ma M, Ishizuka K, Sawa A. A comparative neuroimaging perspective of olfaction and higher-order olfactory processing: on health and disease. Semin Cell Dev Biol 2022; 129:22-30. [PMID: 34462249 PMCID: PMC9900497 DOI: 10.1016/j.semcdb.2021.08.009] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 08/18/2021] [Indexed: 02/08/2023]
Abstract
Olfactory dysfunction is often the earliest indicator of disease in a range of neurological and psychiatric disorders. One tempting working hypothesis is that pathological changes in the peripheral olfactory system where the body is exposed to many adverse environmental stressors may have a causal role for the brain alteration. Whether and how the peripheral pathology spreads to more central brain regions may be effectively studied in rodent models, and there is successful precedence in experimental models for Parkinson's disease. It is of interest to study whether a similar mechanism may underlie the pathology of psychiatric illnesses, such as schizophrenia. However, direct comparison between rodent models and humans includes challenges under light of comparative neuroanatomy and experimental methodologies used in these two distinct species. We believe that neuroimaging modality that has been the main methodology of human brain studies may be a useful viewpoint to address and fill the knowledge gap between rodents and humans in this scientific question. Accordingly, in the present review article, we focus on brain imaging studies associated with olfaction in healthy humans and patients with neurological and psychiatric disorders, and if available those in rodents. We organize this review article at three levels: 1) olfactory bulb (OB) and peripheral structures of the olfactory system, 2) primary olfactory cortical and subcortical regions, and 3) associated higher-order cortical regions. This research area is still underdeveloped, and we acknowledge that further validation with independent cohorts may be needed for many studies presented here, in particular those with human subjects. Nevertheless, whether and how peripheral olfactory disturbance impacts brain function is becoming even a hotter topic in the ongoing COVID-19 pandemic, given the risk of long-term changes of mental status associated with olfactory infection of SARS-CoV-2. Together, in this review article, we introduce this underdeveloped but important research area focusing on its implications in neurological and psychiatric disorders, with several pioneered publications.
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Affiliation(s)
- Sue Kulason
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA; Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - J Tilak Ratnanather
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA; Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Michael I Miller
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA; Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Vidyulata Kamath
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Jun Hua
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Kun Yang
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA; Johns Hopkins Schizophrenia Center, Baltimore, MD, USA
| | - Minghong Ma
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Koko Ishizuka
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA; Johns Hopkins Schizophrenia Center, Baltimore, MD, USA
| | - Akira Sawa
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA; Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA; Johns Hopkins Schizophrenia Center, Baltimore, MD, USA; Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Ammar A, Distinguin L, Chetrit A, Safa D, Hans S, Carlier R, Lechien JR, Edjlali M. Transient modifications of the olfactory bulb on MR follow-up of COVID-19 patients with related olfactory dysfunction. J Neuroradiol 2022; 49:329-332. [PMID: 35306004 PMCID: PMC8926438 DOI: 10.1016/j.neurad.2022.03.003] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/08/2022] [Accepted: 03/08/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Olfactory dysfunction (OD) has been reported with a high prevalence on mild to moderate COVID-19 patients. Previous reports suggest that volume and signal intensity of olfactory bulbs (OB) have been reported as abnormal on acute phase of COVID-19 anosmia, but a prospective MRI and clinical follow-up study of COVID-19 patients presenting with OD was missing, aiming at understanding the modification of OB during patients'follow-up. METHODS A prospective multicenter study was conducted including 11 COVID-19 patients with OD. Patients underwent MRI and psychophysical olfactory assessments at baseline and 6-month post-COVID-19. T2 FLAIR-Signal intensity ratio (SIR) was measured between the average signal of the OB and the average signal of white matter. OB volumes and obstruction of olfactory clefts (OC) were evaluated at both evaluation times. RESULTS The psychophysical evaluations demonstrated a 6-month recovery in 10/11 patients (90.9%). The mean values of OB-SIR significantly decreased from baseline (1.66±0.24) to 6-month follow-up (1.35±0.27), reporting a mean variation of -17.82±15.20 % (p<0.001). The mean values of OB volumes significantly decreased from baseline (49.22±10.46 mm3) to 6-month follow-up (43.70±9.88 mm3), (p=0.006). CONCLUSION Patients with demonstrated anosmia reported abnormalities in OB imaging that may be objectively evaluated with the measurement of SIR and OB volumes. SIR and OB volumes significantly normalized when patient recovered smell. This supports the underlying mechanism of a transient inflammation of the OB as a cause of Olfactory Dysfunction in COVID-19 patients.
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Affiliation(s)
- Amine Ammar
- Department of Radiology, APHP, Hôpitaux Raymond-Poincaré & Ambroise Paré, DMU Smart Imaging, GH Université Paris-Saclay, U 1179 UVSQ/Paris-Saclay, Paris, France.
| | - Lea Distinguin
- Department of Otolaryngology-Head & Neck Surgery, Hôpital Foch, UVSQ/Paris-Saclay, Paris, France
| | - Anaelle Chetrit
- Department of Radiology, APHP, Hôpitaux Raymond-Poincaré & Ambroise Paré, DMU Smart Imaging, GH Université Paris-Saclay, U 1179 UVSQ/Paris-Saclay, Paris, France
| | - Dominique Safa
- Department of Radiology, APHP, Hôpitaux Raymond-Poincaré & Ambroise Paré, DMU Smart Imaging, GH Université Paris-Saclay, U 1179 UVSQ/Paris-Saclay, Paris, France
| | - Stephane Hans
- Department of Otolaryngology-Head & Neck Surgery, Hôpital Foch, UVSQ/Paris-Saclay, Paris, France
| | - Robert Carlier
- Department of Radiology, APHP, Hôpitaux Raymond-Poincaré & Ambroise Paré, DMU Smart Imaging, GH Université Paris-Saclay, U 1179 UVSQ/Paris-Saclay, Paris, France
| | - Jerome R Lechien
- Department of Otolaryngology-Head & Neck Surgery, Hôpital Foch, UVSQ/Paris-Saclay, Paris, France; Department of Otolaryngology-Head & Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium; Department of Human Anatomy and Experimental Oncology, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium
| | - Myriam Edjlali
- Department of Radiology, APHP, Hôpitaux Raymond-Poincaré & Ambroise Paré, DMU Smart Imaging, GH Université Paris-Saclay, U 1179 UVSQ/Paris-Saclay, Paris, France; Laboratoire d'imagerie Biomédicale Multimodale (BioMaps), Université Paris-Saclay, CEA, CNRS, Inserm, Service Hopsitalier Frédéric Joliot, Orsay, France
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18
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Asama Y, Furutani A, Fujioka M, Ozawa H, Takei S, Shibata S, Ogawa K. Analysis of conductive olfactory dysfunction using computational fluid dynamics. PLoS One 2022; 17:e0262579. [PMID: 35020767 PMCID: PMC8754295 DOI: 10.1371/journal.pone.0262579] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 12/30/2021] [Indexed: 11/25/2022] Open
Abstract
Conductive olfactory dysfunction (COD) is caused by an obstruction in the nasal cavity and is characterized by changeable olfaction. COD can occur even when the olfactory cleft is anatomically normal, and therefore, the cause in these cases remains unclear. Herein, we used computational fluid dynamics to examine olfactory cleft airflow with a retrospective cohort study utilizing the cone beam computed tomography scan data of COD patients. By measuring nasal–nasopharynx pressure at maximum flow, we established a cut-off value at which nasal breathing can be differentiated from combined mouth breathing in COD patients. We found that increased nasal resistance led to mouth breathing and that the velocity and flow rate in the olfactory cleft at maximum flow were significantly reduced in COD patients with nasal breathing only compared to healthy olfactory subjects. In addition, we performed a detailed analysis of common morphological abnormalities associated with concha bullosa. Our study provides novel insights into the causes of COD, and therefore, it has important implications for surgical planning of COD, sleep apnea research, assessment of adenoid hyperplasia in children, and sports respiratory physiology.
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Affiliation(s)
- Youji Asama
- Asama Institute, Asama-ENT-Clinic, Koga, Ibaraki, Japan
- Department of Otolaryngology, Head and Neck Surgery School of Medicine, Keio University, Shinjuku, Tokyo, Japan
- Research Organization for Nano and Life Innovation, Waseda University, Shinjyuku-ku, Tokyo, Japan
| | - Akiko Furutani
- Asama Institute, Asama-ENT-Clinic, Koga, Ibaraki, Japan
- Research Organization for Nano and Life Innovation, Waseda University, Shinjyuku-ku, Tokyo, Japan
- * E-mail:
| | - Masato Fujioka
- Department of Otolaryngology, Head and Neck Surgery School of Medicine, Keio University, Shinjuku, Tokyo, Japan
| | - Hiroyuki Ozawa
- Department of Otolaryngology, Head and Neck Surgery School of Medicine, Keio University, Shinjuku, Tokyo, Japan
| | - Satoshi Takei
- Department of Otorhinolaryngology, Saitama City Hospital, Saitama, Japan
| | - Shigenobu Shibata
- Research Organization for Nano and Life Innovation, Waseda University, Shinjyuku-ku, Tokyo, Japan
| | - Kaoru Ogawa
- Department of Otolaryngology, Head and Neck Surgery School of Medicine, Keio University, Shinjuku, Tokyo, Japan
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Manan HA, Yahya N, Han P, Hummel T. A systematic review of olfactory-related brain structural changes in patients with congenital or acquired anosmia. Brain Struct Funct 2022; 227:177-202. [PMID: 34635958 PMCID: PMC8505224 DOI: 10.1007/s00429-021-02397-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/26/2021] [Indexed: 02/08/2023]
Abstract
Brain structural features of healthy individuals are associated with olfactory functions. However, due to the pathophysiological differences, congenital and acquired anosmia may exhibit different structural characteristics. A systematic review was undertaken to compare brain structural features between patients with congenital and acquired anosmia. A systematic search was conducted using PubMed/MEDLINE and Scopus electronic databases to identify eligible reports on anosmia and structural changes and reported according to PRISMA guidelines. Reports were extracted for information on demographics, psychophysical evaluation, and structural changes. Then, the report was systematically reviewed based on various aetiologies of anosmia in relation to (1) olfactory bulb, (2) olfactory sulcus, (3) grey matter (GM), and white matter (WM) changes. Twenty-eight published studies were identified. All studies reported consistent findings with strong associations between olfactory bulb volume and olfactory function across etiologies. However, the association of olfactory function with olfactory sulcus depth was inconsistent. The present study observed morphological variations in GM and WM volume in congenital and acquired anosmia. In acquired anosmia, reduced olfactory function is associated with reduced volumes and thickness involving the gyrus rectus, medial orbitofrontal cortex, anterior cingulate cortex, and cerebellum. These findings contrast to those observed in congenital anosmia, where a reduced olfactory function is associated with a larger volume and higher thickness in parts of the olfactory network, including the piriform cortex, orbitofrontal cortex, and insula. The present review proposes that the structural characteristics in congenital and acquired anosmia are altered differently. The mechanisms behind these changes are likely to be multifactorial and involve the interaction with the environment.
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Affiliation(s)
- Hanani Abdul Manan
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
- Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), Department of Radiology, University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56 000, Kuala Lumpur, Malaysia.
| | - Noorazrul Yahya
- Diagnostic Imaging and Radiotherapy Program, Faculty of Health Sciences, School of Diagnostic and Applied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Pengfei Han
- The Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
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20
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Keshavarz P, Haseli S, Yazdanpanah F, Bagheri F, Raygani N, Karimi-Galougahi M. A Systematic Review of Imaging Studies in Olfactory Dysfunction Secondary to COVID-19. Acad Radiol 2021; 28:1530-1540. [PMID: 34548231 PMCID: PMC8403662 DOI: 10.1016/j.acra.2021.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/31/2021] [Accepted: 08/09/2021] [Indexed: 12/20/2022]
Abstract
RATIONALE AND OBJECTIVES Hyposmia/anosmia is common among patients with coronavirus disease-2019 (COVID-19). Various imaging modalities have been used to assess olfactory dysfunction in COVID-19. In this systematic review, we sought to categorize and summarize the imaging data in COVID-19-induced anosmia. MATERIAL AND METHODS Eligible articles were included after a comprehensive review using online databases including Google scholar, Scopus, PubMed, Web of science and Elsevier. Duplicate results, conference abstracts, reviews, and studies in languages other than English were excluded. RESULTS In total, 305 patients undergoing MRI/functional MRI (177), CT of paranasal sinuses (129), and PET/CT or PET/MRI scans (14) were included. Out of a total of 218 findings reported on MRI, 80 were reported on early (≤ 1 month) and 85 on late (>1 month) imaging in relation to the onset of anosmia. Overall, OB morphology and T2-weighted or FLAIR signal intensity were normal in 68/218 (31.2%), while partial or complete opacification of OC was observed in 60/218 (27.5%). T2 hyperintensity in OB was detected in 11/80 (13.75%) and 18/85 (21.17%) on early and late imaging, respectively. Moreover, OB atrophy was reported in 1/80 (1.25%) on early and in 9/85 (10.58%) on late imaging. Last, among a total of 129 CT scans included, paranasal sinuses were evalualted in 88 (68.21%), which were reported as normal in most cases (77/88, [87.5%]). CONCLUSION In this systematic review, normal morphology and T2/FLAIR signal intensity in OB and OC obstruction were the most common findings in COVID-19-induced anosmia, while paranasal sinuses were normal in most cases. OC obstruction is the likely mechanism for olfactory dysfunction in COVID-19. Abnormalities in OB signal intensity and OB atrophy suggest that central mechanisms may also play a role in late stage in COVID-19-induced anosmia.
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Affiliation(s)
- Pedram Keshavarz
- School of Science and Technology, The University of Georgia, Tbilisi, Georgia; Department of Diagnostic & Interventional Radiology of New Hospitals LTD, Tbilisi, Georgia
| | - Sara Haseli
- Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereshteh Yazdanpanah
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tabriz, Iran
| | - Fateme Bagheri
- Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Negar Raygani
- Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahboobeh Karimi-Galougahi
- Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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21
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Brcina N, Hohenfeld C, Heidbreder A, Mirzazade S, Krahe J, Wojtala J, Binkofski F, Schulz JB, Schiefer J, Reetz K, Dogan I. Increased neural motor activation and functional reorganization in patients with idiopathic rapid eye movement sleep behavior disorder. Parkinsonism Relat Disord 2021; 92:76-82. [PMID: 34715608 DOI: 10.1016/j.parkreldis.2021.10.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/05/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Altered brain activity and functional reorganization patterns during self-initiated movements have been reported in early pre-motor and motor stages of Parkinson's disease. The aim of this study was to investigate whether similar alterations can be observed in patients with idiopathic REM-sleep behavior disorder (RBD). METHODS 13 polysomnography-confirmed male and right-handed RBD patients and 13 healthy controls underwent a bilateral hand-movement fMRI task including internally selected (INT) and externally-guided (EXT) movement conditions for each hand. We examined functional activity and connectivity differences between groups and task-conditions, structural differences using voxel-based morphometry, as well as associations between functional activity and clinical variables. RESULTS No group differences were observed in fMRI-task performance or in voxel-based morphometry. Both groups showed faster reaction times and exhibited greater neural activation when movements were internally selected compared to externally-guided tasks. Compared to controls, RBD patients displayed stronger activation in the dorsolateral prefrontal cortex and primary somatosensory cortex during INT-tasks, and in the right fronto-insular cortex during EXT-tasks performed with the non-dominant hand. Stronger activation in RBD patients was associated with cognitive and olfactory impairment. Connectivity analysis demonstrated overall less interregional coupling in patients compared to controls. In particular, patients showed reduced temporo-cerebellar, occipito-cerebellar and intra-cerebellar connectivity, but stronger connectivity in fronto-cerebellar and fronto-occipital pathways. CONCLUSION The observed stronger activation during hand-movement tasks and connectivity changes in RBD may reflect early compensatory and reorganization patterns in order to preserve motor functioning. Our findings may contribute to a better understanding and prognosis of prodromal stages of α-synucleinopathies.
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Affiliation(s)
- Nikolina Brcina
- RWTH Aachen University, Department of Neurology, Aachen, Germany
| | - Christian Hohenfeld
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Anna Heidbreder
- Department of Neurology with Institute of Sleep Medicine and Neuromuscular Disease, University Hospital Muenster, Muenster, Germany; Medical University Innsbruck, Department of Neurology, Innsbruck, Austria
| | - Shahram Mirzazade
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Janna Krahe
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Jennifer Wojtala
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Ferdinand Binkofski
- Division for Clinical Cognitive Sciences, Department of Neurology, University Hospital RWTH, Aachen, Germany; Institute for Neuroscience and Medicine (INM-4), Research Center Juelich GmbH, Germany
| | - Jörg B Schulz
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | | | - Kathrin Reetz
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany.
| | - Imis Dogan
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
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22
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Rozenkrantz L, Weissgross R, Weiss T, Ravreby I, Frumin I, Shushan S, Gorodisky L, Reshef N, Holzman Y, Pinchover L, Endevelt-Shapira Y, Mishor E, Soroka T, Finkel M, Tagania L, Ravia A, Perl O, Furman-Haran E, Carp H, Sobel N. Unexplained repeated pregnancy loss is associated with altered perceptual and brain responses to men's body-odor. eLife 2020; 9:e55305. [PMID: 32988456 PMCID: PMC7524551 DOI: 10.7554/elife.55305] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 08/18/2020] [Indexed: 01/24/2023] Open
Abstract
Mammalian olfaction and reproduction are tightly linked, a link less explored in humans. Here, we asked whether human unexplained repeated pregnancy loss (uRPL) is associated with altered olfaction, and particularly altered olfactory responses to body-odor. We found that whereas most women with uRPL could identify the body-odor of their spouse, most control women could not. Moreover, women with uRPL rated the perceptual attributes of men's body-odor differently from controls. These pronounced differences were accompanied by an only modest albeit significant advantage in ordinary, non-body-odor-related olfaction in uRPL. Next, using structural and functional brain imaging, we found that in comparison to controls, most women with uRPL had smaller olfactory bulbs, yet increased hypothalamic response in association with men's body-odor. These findings combine to suggest altered olfactory perceptual and brain responses in women experiencing uRPL, particularly in relation to men's body-odor. Whether this link has any causal aspects to it remains to be explored.
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Affiliation(s)
- Liron Rozenkrantz
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Reut Weissgross
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Tali Weiss
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Inbal Ravreby
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Idan Frumin
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Sagit Shushan
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
- Department of Otolaryngology & Head and Neck Surgery, Edith Wolfson Medical Center, Holon, Israel
| | - Lior Gorodisky
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Netta Reshef
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Yael Holzman
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Liron Pinchover
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Yaara Endevelt-Shapira
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Eva Mishor
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Timna Soroka
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Maya Finkel
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Liav Tagania
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Aharon Ravia
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Ofer Perl
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
| | - Edna Furman-Haran
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
- Life Sciences Core Facilities, Weizmann Institute of Science, Rehovot, Israel
| | - Howard Carp
- Department of Obstetrics & Gynecology, Sheba Medical Center, Tel Hashomer, Israel
| | - Noam Sobel
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- The Azrieli National Institute for Human Brain Imaging and Research, Rehovot, Israel
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23
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Aragão MFVV, Leal MC, Cartaxo Filho OQ, Fonseca TM, Valença MM. Anosmia in COVID-19 Associated with Injury to the Olfactory Bulbs Evident on MRI. AJNR Am J Neuroradiol 2020; 41:1703-1706. [PMID: 32586960 PMCID: PMC7583088 DOI: 10.3174/ajnr.a6675] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 06/01/2020] [Indexed: 12/21/2022]
Abstract
Patients with coronavirus disease 2019 (COVID-19) may have symptoms of anosmia or partial loss of the sense of smell, often accompanied by changes in taste. We report 5 cases (3 with anosmia) of adult patients with COVID-19 in whom injury to the olfactory bulbs was interpreted as microbleeding or abnormal enhancement on MR imaging. The patients had persistent headache (n = 4) or motor deficits (n = 1). This olfactory bulb injury may be the mechanism by which the Severe Acute Respiratory Syndrome coronavirus 2 causes olfactory dysfunction.
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Affiliation(s)
- M F V V Aragão
- From the Universidade Federal de Pernambuco (M.F.V.V.A., M.C.L., M.M.V.), Recife, Brazil
- Centro Diagnostico Multimagem (M.F.V.V.A.), Recife, Brazil
| | - M C Leal
- From the Universidade Federal de Pernambuco (M.F.V.V.A., M.C.L., M.M.V.), Recife, Brazil
- Real Hospital de Beneficencia Portuguesa (M.C.L., O.Q.C.F., T.M.F.), Recife, Brazil
| | - O Q Cartaxo Filho
- Real Hospital de Beneficencia Portuguesa (M.C.L., O.Q.C.F., T.M.F.), Recife, Brazil
| | - T M Fonseca
- Real Hospital de Beneficencia Portuguesa (M.C.L., O.Q.C.F., T.M.F.), Recife, Brazil
| | - M M Valença
- From the Universidade Federal de Pernambuco (M.F.V.V.A., M.C.L., M.M.V.), Recife, Brazil
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24
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Galougahi MK, Ghorbani J, Bakhshayeshkaram M, Naeini AS, Haseli S. Olfactory Bulb Magnetic Resonance Imaging in SARS-CoV-2-Induced Anosmia: The First Report. Acad Radiol 2020; 27:892-893. [PMID: 32295727 PMCID: PMC7151240 DOI: 10.1016/j.acra.2020.04.002] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Mahboobeh Karimi Galougahi
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jahangir Ghorbani
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrdad Bakhshayeshkaram
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Safavi Naeini
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Haseli
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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25
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Sobhani S, Rahmani F, Aarabi MH, Sadr AV. Exploring white matter microstructure and olfaction dysfunction in early parkinson disease: diffusion MRI reveals new insight. Brain Imaging Behav 2019; 13:210-219. [PMID: 29134611 DOI: 10.1007/s11682-017-9781-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Olfaction dysfunction is considered as a robust marker of prodromal Parkinson disease (PD). Measurement of olfaction function as a screening test is unsatisfactory due to long lead time interval and low specificity for detection of PD. Use of imaging markers might yield more accurate predictive values and provide bases for combined use of imaging and clinical markers for early PD. Diffusion MRI connectometry was conducted on 85 de novo PD patients in and 36 healthy controls to find: first, white matter tracts with significant difference in quantitative anisotropy between PD groups with various degrees of olfaction dysfunction and second, second fibers with correlation with University of Pennsylvania Smell Identification Test (UPSIT) score in each group using a multiple regression analysis considering age, sex, GDS and MoCA score. Local connectomes were determined in seven of all the possible comparisons, correcting for false discovery rate (FDR). PD patients with anosmia and normal olfaction had the highest number of fibers with decreased connectivity in left inferior longitudinal fasciculus, bilateral fornix, bilateral middle cerebellar peduncle (MCP), bilateral cingulum, bilateral corticospinal tract (CST) and body, genu and splenium of corpus callosum (CC) (FDR = 0.0013). In multiple regression analysis, connectivity in the body, genu and splenium of CC and bilateral fornix had significant negative correlation (FDR between 0.019 and 0.083), and bilateral cingulum and MCP had significant positive correlation (FDR between 0.022 and 0.092) with UPSIT score. White matter connectivity in healthy controls could not be predicted by UPSIT score using the same model. The results of this study provide compelling evidence that microstructural degenerative changes in these areas underlie the clinical phenotype of prodromal olfaction dysfunction in PD and that diffusion parameters of these areas might be able to serve as signature markers for early detection of PD. This is the first report that confirms a discriminative role for UPSIT score in identifying PD specific changes in white matter microstructure. Our results open a window to identify microstructural signatures of prodromal PD in white matter.
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Affiliation(s)
- Soheila Sobhani
- Basir Eye Health Research Center, Tehran, Iran
- Neuroimaging Network (NIN), Universal Scientific Education and Research Network (USERN), Children's Medical Center Hospital, Tehran, 14194, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Rahmani
- Neuroimaging Network (NIN), Universal Scientific Education and Research Network (USERN), Children's Medical Center Hospital, Tehran, 14194, Iran.
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Hadi Aarabi
- Basir Eye Health Research Center, Tehran, Iran
- Neuroimaging Network (NIN), Universal Scientific Education and Research Network (USERN), Children's Medical Center Hospital, Tehran, 14194, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Vafaei Sadr
- Department of Physics, Shahid Beheshti University, G.C., Evin, Tehran, Iran
- Département de Physique Théorique and Center for Astroparticle Physics, Université de Genève, Geneva, Switzerland
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26
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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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27
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Abstract
PURPOSE OF REVIEW Cancer anorexia is a negative prognostic factor and is broadly defined as the loss of the interest in food. However, multiple clinical domains contribute to the phenotype of cancer anorexia. The characterization of the clinical and molecular pathophysiology of cancer anorexia may enhance the efficacy of preventive and therapeutic strategies. RECENT FINDINGS Clinical trials showed that cancer anorexia should be considered as an umbrella encompassing different signs and symptoms contributing to appetite disruption in cancer patients. Loss of appetite, early satiety, changes in taste and smell are determinants of cancer anorexia, whose presence should be assessed in cancer patients. Interestingly, neuronal correlates of cancer anorexia-related symptoms have been revealed by brain imaging techniques. SUMMARY The pathophysiology of cancer anorexia is complex and involves different domains influencing eating behavior. Limiting the assessment of cancer anorexia to questions investigating changes in appetite may impede correct identification of the targets to address.
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Affiliation(s)
- Alessandro Laviano
- aDepartment of Clinical Medicine bDepartment of Clinical and Molecular Medicine, Sapienza University, Rome, Italy cCancer Metabolism Research Group, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
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28
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Woodward MR, Dwyer MG, Bergsland N, Hagemeier J, Zivadinov R, Benedict RH, Szigeti K. Olfactory identification deficit predicts white matter tract impairment in Alzheimer's disease. Psychiatry Res Neuroimaging 2017; 266:90-95. [PMID: 28644998 PMCID: PMC5973809 DOI: 10.1016/j.pscychresns.2017.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/08/2017] [Accepted: 06/02/2017] [Indexed: 12/01/2022]
Abstract
Olfactory identification deficit (OID) has been associated with both aging and Alzheimer's disease (AD). In the context of an amnestic disorders, OID predicts conversion to AD. Neuroanatomical correlates could increase specificity and sensitivity and elucidate the mechanistic differences between OID in AD and aging. Cross-sectional analysis of white matter microstructural changes was performed using diffusion tensor imaging (DTI) and tract-based-spatial-statistics in amnestic mild cognitive impairment (aMCI), AD and normal controls (NC) in 66 subjects (26 AD, 15 aMCI, 25 NC). DTI 3-Tesla MRI scans were analyzed and subject level means for fractional anisotropy (FA), mean diffusivity (MD), radial and axial diffusivity (λ1D and λ2,3D) were calculated. Linear regression models were applied using DTI markers as predictor and OID as outcome. OID was associated with increased λ1D in aMCI and increased MD, λ1D and λ2,3D in AD. Voxel-wise analyses revealed widespread differences in all markers in AD. There were significant differences in λ1D in aMCI, particularly in the olfactory tract. OID is correlated with microstructural white matter changes as early as in aMCI. This study may help elucidate the biological basis for olfactory impairment in Alzheimer's disease. Neuroanatomical correlates could help distinguish OID associated with AD and that associated with aging.
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Affiliation(s)
- Matthew R Woodward
- Alzheimer's Disease and Memory Disorder Center, Department of Neurology, University at Buffalo, SUNY, Buffalo, NY, United States
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, University at Buffalo, SUNY, Buffalo, NY, United States
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, University at Buffalo, SUNY, Buffalo, NY, United States
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, University at Buffalo, SUNY, Buffalo, NY, United States
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, University at Buffalo, SUNY, Buffalo, NY, United States
| | - Ralph Hb Benedict
- Alzheimer's Disease and Memory Disorder Center, Department of Neurology, University at Buffalo, SUNY, Buffalo, NY, United States
| | - Kinga Szigeti
- Alzheimer's Disease and Memory Disorder Center, Department of Neurology, University at Buffalo, SUNY, Buffalo, NY, United States.
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29
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Campabadal A, Uribe C, Segura B, Baggio HC, Abos A, Garcia-Diaz AI, Marti MJ, Valldeoriola F, Compta Y, Bargallo N, Junque C. Brain correlates of progressive olfactory loss in Parkinson's disease. Parkinsonism Relat Disord 2017; 41:44-50. [PMID: 28522171 DOI: 10.1016/j.parkreldis.2017.05.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/04/2017] [Accepted: 05/08/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Olfactory dysfunction is present in a large proportion of patients with Parkinson's disease (PD) upon diagnosis. However, its progression over time has been poorly investigated. The few available longitudinal studies lack control groups or MRI data. OBJECTIVE To investigate the olfactory changes and their structural correlates in non-demented PD over a four-year follow-up. METHODS We assessed olfactory function in a sample of 25 PD patients and 24 normal controls of similar age using the University of Pennsylvania Smell Identification test (UPSIT). Structural magnetic resonance imaging data, obtained with a 3-T Siemens Trio scanner, were analyzed using FreeSurfer software. RESULTS Analysis of variance showed significant group (F = 53.882; P < 0.001) and time (F = 6.203; P = 0.016) effects, but the group-by-time interaction was not statistically significant. UPSIT performance declined ≥1.5 standard deviations in 5 controls and 7 patients. Change in UPSIT scores of patients correlated positively with volume change in the left putamen, right thalamus, and right caudate nucleus. CONCLUSION Olfactory loss over time in PD and controls is similar, but we have observed significant correlation between this loss and basal ganglia volumes only in patients.
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Affiliation(s)
- Anna Campabadal
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
| | - Carme Uribe
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Barbara Segura
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Hugo C Baggio
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Alexandra Abos
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Anna Isabel Garcia-Diaz
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Maria Jose Marti
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain; Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Francesc Valldeoriola
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain; Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Yaroslau Compta
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain; Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Nuria Bargallo
- Centre de Diagnòstic per la Imatge, Hospital Clínic, Barcelona, Catalonia, Spain.
| | - Carme Junque
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain.
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Van de Bittner GC, Riley MM, Cao L, Ehses J, Herrick SP, Ricq EL, Wey HY, O’Neill MJ, Ahmed Z, Murray TK, Smith JE, Wang C, Schroeder FA, Albers MW, Hooker JM. Nasal neuron PET imaging quantifies neuron generation and degeneration. J Clin Invest 2017; 127:681-694. [PMID: 28112682 PMCID: PMC5272198 DOI: 10.1172/jci89162] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 12/01/2016] [Indexed: 01/31/2023] Open
Abstract
Olfactory dysfunction is broadly associated with neurodevelopmental and neurodegenerative diseases and predicts increased mortality rates in healthy individuals. Conventional measurements of olfactory health assess odor processing pathways within the brain and provide a limited understanding of primary odor detection. Quantification of the olfactory sensory neurons (OSNs), which detect odors within the nasal cavity, would provide insight into the etiology of olfactory dysfunction associated with disease and mortality. Notably, OSNs are continually replenished by adult neurogenesis in mammals, including humans, so OSN measurements are primed to provide specialized insights into neurological disease. Here, we have evaluated a PET radiotracer, [11C]GV1-57, that specifically binds mature OSNs and quantifies the mature OSN population in vivo. [11C]GV1-57 monitored native OSN population dynamics in rodents, detecting OSN generation during postnatal development and aging-associated neurodegeneration. [11C]GV1-57 additionally measured rates of neuron regeneration after acute injury and early-stage OSN deficits in a rodent tauopathy model of neurodegenerative disease. Preliminary assessment in nonhuman primates suggested maintained uptake and saturable binding of [18F]GV1-57 in primate nasal epithelium, supporting its translational potential. Future applications for GV1-57 include monitoring additional diseases or conditions associated with olfactory dysregulation, including cognitive decline, as well as monitoring effects of neuroregenerative or neuroprotective therapeutics.
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Affiliation(s)
| | - Misha M. Riley
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, and
| | - Luxiang Cao
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Janina Ehses
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, and
| | - Scott P. Herrick
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Emily L. Ricq
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, and
- Department of Chemistry and Chemical Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Hsiao-Ying Wey
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, and
| | - Michael J. O’Neill
- Eli Lilly and Co. Ltd., Lilly Research Centre, Erl Wood Manor, Windlesham, Surrey, United Kingdom
| | - Zeshan Ahmed
- Eli Lilly and Co. Ltd., Lilly Research Centre, Erl Wood Manor, Windlesham, Surrey, United Kingdom
| | - Tracey K. Murray
- Eli Lilly and Co. Ltd., Lilly Research Centre, Erl Wood Manor, Windlesham, Surrey, United Kingdom
| | - Jaclyn E. Smith
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, and
| | - Changning Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, and
| | | | - Mark W. Albers
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Jacob M. Hooker
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, and
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Vandenhende-Szymanski C, Hochet B, Chevalier D, Mortuaire G. Olfactory cleft opacity and CT score are predictive factors of smell recovery after surgery in nasal polyposis. Rhinology 2015; 53:29-34. [PMID: 25756075 DOI: 10.4193/rhino14.160] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To assess subjective improvement of olfactory function following endoscopic sinus surgery (ESS) in chronic rhinosinusitis associated with nasal polyps (CRSwNP) and to analyse factors of recovery with the European Test of Olfactory Capabilities (ETOC). METHODS We carried out a prospective study of 30 patients with CRSwNP from November 2011 to April 2013. The ETOC was filled the day before surgery and in the short term follow-up. Sixteen suprathreshold odorants with a detection task and a forced choice verbal identification task were tested. RESULTS The mean composite score (MCS) improved at 3 and 6 months. The preoperative MCS was correlated to the Lund-Mackay score and to the olfactory cleft opacification on preoperative computed tomography (CT) scan. Multivariate linear regression modelling of patients with preoperative anosmia showed that the olfactory recovery at 3 months was predicted by the preoperative Lund-Mackay score and the age, and at 6 months by the preoperative Lund-Mackay score. CONCLUSION With a convenient psychophysical test, we showed that olfactory cleft opacification and CT scan score could be predictive factors of olfaction disorder severity and improvement after ESS in CRSwNP. These results need to be strengthened in the long term with a larger panel of patients.
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Doty RL, Beals E, Osman A, Dubroff J, Chung I, Leon-Sarmiento FE, Hurtig H, Ying GS. Suprathreshold odor intensity perception in early-stage Parkinson's disease. Mov Disord 2014; 29:1208-12. [PMID: 24976213 PMCID: PMC4511086 DOI: 10.1002/mds.25946] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 05/15/2014] [Accepted: 05/28/2014] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Whether Parkinson's disease (PD) influences suprathreshold changes in perceived odor intensity is unknown. In patients with Alzheimer's disease, patients with schizophrenia, and the elderly, such perception is reportedly normal. If generally true, this could reflect a core element of the olfactory system insulated to some degree from age- and disease-related pathological conditions. METHODS Odor intensity ratings for pentyl acetate were obtained from 29 early-stage PD patients when on and off dopamine-related medications (DRMs) and from 29 matched controls. RESULTS The ratings were significantly attenuated at the higher odorant concentrations, with the degree of attenuation associated with overall olfactory dysfunction. Ratings were higher on the right than on the left side of the nose of both patients and controls. No associations with DRMs, Unified Parkinson's Disease Rating Scale (UPDRS) scores, or striatal dopamine transporter imaging were found. CONCLUSIONS Parkinson's disease (PD) influences suprathreshold estimates of perceived odor intensity, negating the notion that such perception might be spared in this disease. No association with dopaminergic processes was apparent.
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Affiliation(s)
- Richard L. Doty
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Evan Beals
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Allen Osman
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jacob Dubroff
- Department of Radiology, Division of Nuclear Medicine and Clinical Molecular Imaging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Inna Chung
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Fidias E. Leon-Sarmiento
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Howard Hurtig
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gui-Shuang Ying
- Department of Ophthalmology and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Maione L, Benadjaoud S, Eloit C, Sinisi AA, Colao A, Chanson P, Ducreux D, Benoudiba F, Young J. Computed tomography of the anterior skull base in Kallmann syndrome reveals specific ethmoid bone abnormalities associated with olfactory bulb defects. J Clin Endocrinol Metab 2013; 98:E537-46. [PMID: 23348397 DOI: 10.1210/jc.2012-3553] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT Kallmann syndrome (KS) is characterized by congenital hypogonadotropic hypogonadism (CHH) and an impaired sense of smell related to defective development of the olfactory system. OBJECTIVE The aim of the study was to use high-resolution computed tomography (CT) to detect specific abnormalities in the ethmoid bone region surrounding the olfactory bulbs in patients with KS. PATIENTS Thirty-seven KS patients were compared to normosmic CHH (nCHH) patients (n = 15) and controls (n = 30) of similar age. DESIGN AND METHODS We conducted a prospective study in a single referral center. Subjects underwent CT in bone windows with axial, coronal, and sagittal reconstructions centered on the olfactory fossa (OF) and cribriform plate (CP). We characterized the OF structure by measuring OF height, width, and surface area and a series of angles. The CP foramina were counted bilaterally. Olfactory bulb magnetic resonance imaging, performed in parallel, was compared with CT findings. RESULTS OF height, width, and surface area were all significantly lower in KS patients than in nCHH patients and controls (P < .0001). KS patients also had wider angles than nCHH patients and controls (P < .0001). KS subjects with olfactory bulb agenesis on magnetic resonance imaging or who harbored KAL1 mutations had the most marked changes in OF measurements and angles. Coronal OF height distinguished KS patients from controls with the best sensitivity and specificity. The mean number of CP foramina was similar in KS, nCHH, and control subjects. CONCLUSIONS KS is associated with specific ethmoid bone abnormalities. The preserved number of CP foramina in KS patients suggests that the integrity of olfactory structures is not mandatory for their formation during fetal development or their maintenance in adult life.
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Affiliation(s)
- Luigi Maione
- Université Paris-Sud, Faculté de Médecine Paris-Sud, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Le Kremlin Bicêtre, France
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Sánchez-Pérez M, Recio-Rodríguez M, Jiménez-De la Peña M, Carrascoso-Arranz J, Martínez-De Vega V. [Radiological findings in congenital anosmia: a case report]. Rev Neurol 2011; 53:87-90. [PMID: 21720978] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Hypoplasia of the olfactory tracts and bulbs is a rare cause of anosmia in the paediatric population. In most cases it is usually due to an acquired cause and in only a few is it associated to chromosomal disorders (Kallman's syndrome, among others). CASE REPORT A 10-year-old boy with no chromosomal disorders and a family history of anosmia, who visited because of isolated anosmia; a magnetic resonance scan revealed bilateral hypoplasia of the olfactory tracts and bulbs. CONCLUSIONS Magnetic resonance imaging allows the anatomy of the olfactory tract to be studied in detail and this makes it a valuable tool in the diagnosis of structural abnormalities in cases of olfactory disorders and also in the planning of treatment.
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Miwa T. [Diagnostic sequence for olfactory disorders]. Nihon Jibiinkoka Gakkai Kaiho 2011; 114:94-97. [PMID: 21598757 DOI: 10.3950/jibiinkoka.114.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Gerami H, Nemati S, Abbaspour F, Banan R. Brain single photon emission computed tomography in anosmic subjects after closed head trauma. Acta Med Iran 2011; 49:13-17. [PMID: 21425064] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Anosmia following head trauma is relatively common and in many cases is persistent and irreversible. The ability to objectively measure such a decline in smelling, for both clinical and medicolegal goals, is very important. The aim of this study was to find results of brain Single Photon Emission Computed Tomography (SPECT) in anosmic subjects after closed head trauma. This case-control cross sectional study was conducted in a tertiary referral University Hospital. The brain perfusion state of nineteen anosmic patients and thirteen normal controls was evaluated by means of the SPECT with 99mtc- ECD infusion- before and after olfactory stimulation. The orbitofrontal lobe of the brain was assumed as the region of interest and changes in perfusion of this area before and after the stimulations were compared in two groups. The mean of brain perfusion in controls before and after the stimulation was 8.26% ± 0.19% and 9.89% ± 0.54%, respectively (P < 0.0001). Among patients group, these quantities were 7.97% ± 1.05% and 8.49% ± 1.5%, respectively (P < 0.004). The difference between all the measures in cases and controls were statistically significant (P < 0.0001). There were no differences in age and sex between two groups. The brain SPECT is an objective technique suitable for evaluating anosmia following the head trauma and it may be used with other diagnostic modalities.
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Affiliation(s)
- Hooshang Gerami
- Department of Otolaryngology- Head & Neck Surgery, Guilan University of Medical Sciences, Iran.
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Lee PH, Yeo SH, Yong SW, Kim YJ. Odour identification test and its relation to cardiac 123I-metaiodobenzylguanidine in patients with drug induced parkinsonism. J Neurol Neurosurg Psychiatry 2007; 78:1250-2. [PMID: 17557797 PMCID: PMC2117578 DOI: 10.1136/jnnp.2007.121285] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2007] [Revised: 05/17/2007] [Accepted: 05/22/2007] [Indexed: 11/04/2022]
Abstract
We investigated olfactory function and its relation to cardiac 123I-metaiodobenzylguanidine (MIBG) uptake in 15 patients with drug induced parkinsonism (DIP). The mean Cross Cultural Smell Identification (CCSI) score was significantly greater in patients with DIP than in those with Parkinson's disease (PD: 6.9 (1.6) vs 4.4 (2.2); p<0.001); however, the mean CCSI score in patients with DIP was not significantly different from controls. One patient with DIP, whose CCSI score was significantly reduced, also exhibited decreased cardiac MIBG uptake. DIP patients with CCSI scores within the normal range had normal cardiac MIBG uptake. Our study suggests that an olfactory function test may be a useful tool for detecting DIP unrelated to PD and for identifying patients with DIP who have subclinical PD.
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Affiliation(s)
- Phil Hyu Lee
- Department of Neurology, Ajou University School of Medicine, Woncheon-dong San 5, Paldal-gu, Suwon, Gyeonggi-do, 442-749, Korea.
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Zhao H, Wei Y, Miao X, Zhang C, Zhan X, Wang H, Han D. [Correlation between olfactory disorders and morphology of nasal cavity]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2007; 21:771-774. [PMID: 17993011] [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] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To analyze the correlation between olfactory disorders and the morphology of nasal cavity in chronic rhinosinusitis (CRS). METHOD One hundred and seventy-six patients with chronic rhinosinusitis and/or polyps were included. Olfactory function, the morphology of nasal cavity and nasal sinus, especially the morphology of olfactory cleft, were surveyed by T&T Olfactometer, nasal endoscope and computed tomography (coronal and horizontal position). All patients were divided into 5 groups by different olfaction level. Data was achieved by the scoring endoscopic appearances of Kennedy, and CT staging system of Lund-Mackey and analyzed by SPSS 11.5. RESULT (1) Among all patients, 61.9% accompanied with hyposmia, 21% with anosmia , the other 17.1% with normal olfaction; (2) There was positive correlation between the scores of staging system of Lund-Mackey and the olfactory function level (P < 0.01) (3) There was positive correlation between the scores of endoscopic appearances of Kennedy and the olfactory function level (P < 0.05). CONCLUSION (1) Olfactory function were correlated with the severity of CRS; (2) As the determining methods of CRS, staging system of Lund-Mackey can be used to estimate the olfactory function generally and initially; (3) There was not significant difference between the scores of endoscopic appearances of Kennedy and the olfactory function level.
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Affiliation(s)
- Hong Zhao
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital University of Medical Science, Beijing, 100730, China
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Bohnen NI, Gedela S, Kuwabara H, Constantine GM, Mathis CA, Studenski SA, Moore RY. Selective hyposmia and nigrostriatal dopaminergic denervation in Parkinson’s disease. J Neurol 2007; 254:84-90. [PMID: 17508142 DOI: 10.1007/s00415-006-0284-y] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.6] [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: 11/22/2006] [Accepted: 12/05/2006] [Indexed: 11/28/2022]
Abstract
Olfactory dysfunction is a frequent and early feature of Parkinson's disease (PD), often preceding the motor symptoms by several years. Assessment of olfactory deficits may be used in the diagnostic assessment of PD. In this study we investigated the relationship between selective deficits in smell identification and nigrostriatal dopaminergic denervation in patients with PD. Twenty-seven PD patients (Hoehn and Yahr stages I-III) and 27 healthy controls matched for gender and age underwent olfactory testing using the 40-odor University of Pennsylvania Smell Identification Test (UPSIT). PD patients underwent (11)C-beta-CFT dopamine transporter (DAT) positron emission tomography (PET) imaging and clinical motor examination. We found that total UPSIT scores were significantly lower in the PD than in the control subjects (z=4.7, p<0.0001). Analysis of the individual smell scores identified 3 odors with an accuracy of >0.75 for the diagnosis of PD. These odors were banana, licorice, and dill pickle. A PD-specific smell identification score (UPSIT-3) was calculated for these 3 odors. Analysis of the patient PET data demonstrated significant correlations between dorsal striatal DAT activity and the UPSIT-3 (R(S)=0.53, p=0.0027) and total UPSIT (R(S)=0.44, p=0.023) scores. UPSIT-3 (R(S)=0.43, p=0.027) but not total UPSIT (R(S)=0.20, ns) correlated with nigral DAT activity. We conclude that patients with PD have selective hyposmia. A simplified UPSIT smell identification test consisting of 3 PD-selective odors had more robust correlation with nigral and dorsal striatial dopaminergic activity compared with the full UPSIT scores in patients with PD. Assessment of selective olfactory deficits may be used as a simplified olfactory screening test in the evaluation of subjects with possible PD.
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Abstract
PURPOSE The initial or first clinical presentation of altered sensation of smell is directly linked to the degree of impaired sensitivity. We took the opportunity to examine normal and nonspecific MRI findings in 6 patients with known anosmia after traumatic brain injury with perfusion SPECT brain imaging. MATERIAL AND METHODS Patients included those with primary loss of smell after head injury. All patients underwent standard testing by the Taste & Smell Center. Normal or nonspecific near normal brain MRI studies were subsequently referred for SPECT perfusion neuroimaging. RESULTS MRI studies were negative in 3 cases. In the remaining studies, one case showed nonspecific white matter change, another low signal in the left frontal gyrus, and the sixth case merely some cortical atrophy. All 6 cases demonstrated lesions on SPECT involving the frontal, temporal, and temporoparietal cortex. CONCLUSION This study identified altered blood perfusion pattern in otherwise normal anatomic structures on MRI.
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Affiliation(s)
- Norman M Mann
- Department of Medicine, Taste & Smell Clinic Division, University of Connecticut Health Center, Farmington, Connecticut 06030-1718, USA.
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Mueller C, Temmel AFP, Toth J, Quint C, Herneth A, Hummel T. Computed tomography scans in the evaluation of patients with olfactory dysfunction. Am J Rhinol 2006; 20:109-12. [PMID: 16539305] [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] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND The necessity of computed tomography (CT) scans of the olfactory cleft and the sinuses in patients presenting with olfactory dysfunction is a matter of debate. This study aimed to investigate the significance of CT scans for the diagnosis of olfactory loss and for therapeutic decisions. METHODS This retrospective study included 137 consecutive patients presenting with the main complaint of olfactory loss. Standardized history; ear, nose, and throat examination; and olfactory tests were administered. In addition, a CT scan of the nasal sinuses was obtained. The assumed diagnosis (sinonasal disease [SND] or non-SND) was compared with the diagnosis when additionally considering results from the CT scan. RESULTS CT scans suggested SND in 7/101 patients, without clinical evidence of its presence. In 12/36 patients with suspected SND-related olfactory loss, no signs of SND were detected in CT scans. CONCLUSION CT scans are useful to diagnose conductive/inflammatory olfactory loss in patients suspected of non-SND, which may then justify a course with systemic steroids. Alternatively, considering low costs and rare side effects of a short course with steroids in selected patients, CT scans appear to be of clinical significance only when surgical treatment is contemplated or where the use of systemic corticosteroids is not possible.
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Affiliation(s)
- Christian Mueller
- Department of Otorhinolaryngology, Medical University Vienna, AKH Wien, Waehringer Guertel 18-20, A-1090 Wien, Austria.
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Stiasny-Kolster K, Doerr Y, Möller JC, Höffken H, Behr TM, Oertel WH, Mayer G. Combination of 'idiopathic' REM sleep behaviour disorder and olfactory dysfunction as possible indicator for -synucleinopathy demonstrated by dopamine transporter FP-CIT-SPECT. Brain 2004; 128:126-37. [PMID: 15548552 DOI: 10.1093/brain/awh322] [Citation(s) in RCA: 314] [Impact Index Per Article: 15.7] [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: 11/13/2022] Open
Abstract
REM sleep behaviour disorder (RBD) and olfactory dysfunction are common and very early features of alpha-synucleinopathies, in particular Parkinson's disease. To investigate the hypothesis that these two clinical features in combination are an indicator of evolving alpha-synucleinopathy, olfactory function was assessed in RBD. We studied 30 patients (18 male, 12 female; mean age 48 +/- 14 years, range 19-78 years) with clinical (idiopathic, n = 6; symptomatic, n = 13, mostly associated with narcolepsy) or subclinical (n = 11, associated with narcolepsy) RBD according to standard criteria and 30 age- and gender-matched healthy control subjects using standardized 'Sniffin' Sticks'. RBD patients had a significantly higher olfactory threshold (P = 0.0001), lower discrimination score (P = 0.003), and lower identification score (P = 0.001). Compared with normative data, 97% of the RBD patients had a pathologically increased olfactory threshold, 63% an impaired odour discrimination score, and 63% a decreased identification score. On neurological examination, signs of parkinsonism were newly found in five patients with clinical RBD (not associated with narcolepsy), who usually had a long history of 'idiopathic' RBD. Four of the five patients fulfilled the UK Brain Bank criteria for the clinical diagnosis of Parkinson's disease. The underlying nigrostriatal degeneration of clinical Parkinson's disease was confirmed by I-123-FP-CIT SPECT in one patient and early nigrostriatal degeneration was identified by SPECT in a further two patients with 'idiopathic' clinical RBD out of 11 RBD patients who agreed to undergo SPECT studies. Our study shows that RBD patients have a profound impairment of olfactory function. Five patients with clinical RBD not associated with narcolepsy had clinical or imaging signs of nigrostriatal degeneration. This new clinical finding correlates with the neuropathological staging of Parkinson's disease (stages 1-3) as proposed by Braak. In stage 1, the anterior olfactory nucleus or the olfactory bulb is affected (along with the dorsal motor nucleus of the glossopharyngeal and vagal nerves). In stage 2, additional lesions consistently remain confined to the medulla oblongata and pontine tegmentum, which are critical areas for RBD. Midbrain lesions are found only in stage 3, in particular degeneration of dopaminergic neurons in the substantia nigra pars compacta. Thus, 'idiopathic' RBD patients with olfactory impairment might present with stage 2 preclinical alpha-synucleinopathy. Since narcoleptic patients are not known to have an increased risk of developing parkinsonism, the pathophysiology and clinical relevance of hyposmia in RBD/narcolepsy patients requires further research.
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Affiliation(s)
- K Stiasny-Kolster
- Department of Neurology, Center of Nervous Diseases, Philipps University of Marburg, Germany.
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43
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Abstract
An association between nasal septal mucosal contact points and facial pain has often been quoted, but may be coincidental. CT scans of 100 consecutive rhinology patients were examined for contact points, and the sinuses were scored according to the Lund-Mackay system. The patients' nasal symptoms were recorded using validated questions. Contact of the nasal septum with the lateral nasal structures was identified in 55 patients. The presence of contact was significantly (P < 0.01) associated with nasal blockage and reduction of smell, but there was no association with facial pain. The median Lund-Mackay score for scans with contact was significantly greater than the score for scans without contact. Whereas the results of the study support the hypothesis that nasal contact may impede ventilation and drainage of the paranasal sinuses, the study finds no evidence to support the concept that contact points cause facial pain or headaches.
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44
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Busaba NY. Is imaging necessary in the evaluation of the patient with an isolated complaint of anosmia? Ear Nose Throat J 2001; 80:892-6. [PMID: 11775525] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Imaging studies are often obtained during the evaluation of the patient with an olfactory deficit. The purpose of this article is to describe an investigation that was conducted to assess the effectiveness of imaging studies in determining the etiology of olfactory loss in the patient with an isolated complaint of anosmia and no relevant findings on physical examination, including nasal endoscopy. The author conducted a retrospective review of the records of 20 women and eight men, aged 22 to 71 years (mean: 45), whose duration of anosmia had ranged from 1 month to 2 years (median: 3 mo). Twenty of these patients had undergone contrast-enhanced magnetic resonance imaging of the paranasal sinuses and brain, and the other eight had undergone enhanced computed tomography. The author found that these imaging studies did not add to the information obtained by the clinical history and endoscopic nasal examination and were thus not useful in determining the cause of anosmia. Based on these findings, the author does not recommend that imaging studies be included as part of the evaluation of these patients.
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Affiliation(s)
- N Y Busaba
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Division of Otolaryngology, Boston VA Healthcare System, Department of Otology and Laryngology, Harvard Medical School, Boston, USA.
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45
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Abstract
OBJECTIVE To investigate quantitative positron emission tomography (PET) findings, particularly from orbitofrontal cortex, in patients with posttraumatic anosmia. SETTING Neuropsychology outpatient clinic and university brain imaging center. SUBJECTS Eleven patients with head injury resulting in severe anosmia and 11 controls matched for age. All 11 head-injured patients had their head injuries at least 2 years before involvement in the study. MEASURES Regional cerebral glucose metabolism was measured with PET. RESULTS Quantitative evaluation of PET findings for anosmic patients as a group showed orbitofrontal hypometabolism compared with controls. Decreased activity was also noted in mesial temporal lobe. Activity in subcortical white matter was essentially identical between groups. CONCLUSIONS Findings strongly suggest that posttraumatic anosmia is closely associated with hypometabolism in the orbitofrontal cortex and the medial prefrontal cortex. The results also underscore the importance of posttraumatic anosmia as a clinical sign of orbitofrontal damage, as has been shown previously with neuroSPECT (single photon emission computed tomography).
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Affiliation(s)
- N R Varney
- Psychology Service, VA Medical Center, Iowa City, Iowa 52246-2208, USA
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46
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Abstract
OBJECTIVE To examine the relationship between uninasal anatomy and olfactory ability. DESIGN A stepwise analysis of variance was used to regress the logarithm of the percentage of correct responses on the Odorant Confusion Matrix (a measure of olfactory ability) against the logarithm of nasal volume measurements determined from computed tomographic scans. PARTICIPANTS Nineteen patients with hyposmia whose olfactory losses were thought to be related to conductive disorders. RESULTS After correcting for sex differences, a mathematical model was developed in which the volume of 6 regions of the nasal cavity, 6 first-order interactions, and 3 second-order interactions accounted for 97% of the variation in the measure of olfactory ability. CONCLUSIONS Increases in the size of compartments of the nasal cavity around the olfactory cleft generally increase olfactory ability. Also, anatomical differences in the nasal cavities of men and women may account, in part, for sex differences in olfactory ability.
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Affiliation(s)
- D E Hornung
- Physiology Department, State University of New York-Syracuse Health Science Center, 13210, USA.
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47
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Varney NR, Bushnell D. NeuroSPECT findings in patients with posttraumatic anosmia: a quantitative analysis. J Head Trauma Rehabil 1998; 13:63-72. [PMID: 9582179] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate quantitative neuroSPECT findings, particularly from orbital frontal cortex, in patients rendered totally anosmic from head injury. SETTING Veterans Administration (VA) Medical Center. SUBJECTS Eighteen patients with head injury resulting in severe anosmia and five normal controls. All 18 patients had sustained their head injuries at least 5 years prior to involvement in the study. MEASURES Quantitative neuroSPECT (count density) from sagittal regions of interest (ROIs) ranging circumferentially from orbital frontal cortex to occipital pole. RESULTS Quantitative evaluation of neuroSPECT findings for anosmic patients as a group showed substantial orbital frontal hypoperfusion compared with controls, with 67% of individual anosmic patients showing orbital frontal hypoperfusion at a level two or more standard deviations below that of the worst control subject. By contrast, there were no between-group differences for five other ROIs (inferior frontal pole, superior frontal pole, posterior superior frontal lobe, the parasagittal region, and occipital pole), and individual abnormalities were infrequent in these areas. In addition, orbital frontal count was significantly correlated with ratings of outcome, the only ROI to have such a relationship. CONCLUSIONS Findings strongly suggest that posttraumatic anosmia and the neuropsychological deficits typically associated with posttraumatic anosmia are closely and specifically associated with hypoperfusion in orbital frontal cortex. The results also underscore the importance of posttraumatic anosmia as a clinical sign of orbital frontal damage, which is particularly important in patients with mild head injury who have normal computed tomography and magnetic resonance imaging scans.
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Affiliation(s)
- N R Varney
- Veterans Administration Medical Center, University of Iowa, Iowa City, Iowa 52246-2208, USA
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48
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Goodspeed RB, Gent JF, Leonard G, Catalanotto FA. The prevalence of abnormal paranasal sinus x-rays in patients with olfactory disorders. Conn Med 1987; 51:1-3. [PMID: 3829661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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49
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Schellinger D, Henkin RT, Smirniotopoulos JG. CT of the brain in taste and smell dysfunction. AJNR Am J Neuroradiol 1983; 4:752-4. [PMID: 6410849 PMCID: PMC8334958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Three hundred fifty-four patients with taste and/or smell disorders were evaluated with computed tomography (CT). The largest group was characterized by head trauma (27%), followed by idiopathic causes (26%), postinfluenza-like hyposmia and hypogeusia (15%), and congenital etiologies (14%). Hyposmia and hypogeusia occurred concomitantly in 21%-45%, the percentage varying according to etiologic subgroup. CT abnormalities were found in 108 (31%) of the 354 patients. The most frequent pathologies were frontal encephalomalacia, subfrontal atrophy in the region of the olfactory bulbs, and anterior temporal lobe atrophy. These changes were found alone or in tandem. Some CT findings suggest common cerebral taste and smell centers and common neural pathways and association centers.
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