Self-esteem as an important factor in quality of life and depressive symptoms in anosmia: A pilot study

OBJECTIVES

Previous research has reported a negative impact of olfactory dysfunction on quality of life (QoL) and depressive symptoms. As self-esteem was identified as a contributing factor to depression, this study aimed to investigate QoL, depressive symptoms and self-esteem in patients with smell loss.

DESIGN

Prospective controlled study.

SETTING

Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, in co-operation with the Department of Ear, Nose and Throat Diseases, Medical University of Vienna, Austria.

PARTICIPANTS

Twenty-two anosmic patients (12 females, 10 males) and 25 healthy controls (15 females, 10 males) participated in this study.

MAIN OUTCOME MEASURES

Olfactory performance was assessed using the Sniffin' Sticks battery. In addition, psychological questionnaires that covered the topics quality of life (WHOQOL-BREF), depressive symptoms (BDI-II) and self-esteem (MSWS) were conducted.

RESULTS

The results of this study revealed a decrease in QoL and reduced body-related self-esteem in anosmic patients. Furthermore, QoL and self-esteem were correlated with depressive symptoms.

CONCLUSION

As self-esteem, QoL and depressive symptoms in anosmia interact with each other, we suggest that self-esteem should be considered in the medical history, in order to provide a personalised intervention, adapted to the patient's needs.

Intranasal insulin influences the olfactory performance of patients with smell loss, dependent on the body mass index: A pilot study

BACKGROUND

The application of intranasal insulin in healthy humans has been linked to improved memory function, reduced food intake, and increased olfactory thresholds. There has also been some correlation between the morbidities associated with central nervous system (CNS) insulin resistance, such as type II diabetes mellitus, Alzheimer's disease, obesity, and impaired odour recognition. Given that impaired odour recognition is an important component of olfactory performance, mechanisms that govern these effects may account for impaired olfactory functions in anosmic patients.

METHODOLOGY

Ten patients with post-infectious olfactory loss received intranasal administration of 40 IU insulin or a placebo solution, as well as olfactory performance tests before and after administration.

RESULTS

When administered insulin, patients exhibited an immediate performance improvement with regard to olfactory sensitivity and olfactory intensity ratings. In addition, more odours were correctly identified. Furthermore, an improvement in the odour identification task was detected in patients with higher body mass index.

CONCLUSION

Results of this pilot study shed light on the link between cerebral insulin level and an impaired sense of smell. This research line might provide a better understanding of olfactory loss in relation to eating and dietary behavior, and could offer opportunities to develop faster therapeutic intervention for patients with olfactory dysfunction.

Altered likelihood of brain activation in attention and working memory networks in patients with multiple sclerosis: an ALE meta-analysis

Multiple sclerosis (MS) is a chronic neurological disease, frequently affecting attention and working memory functions. Functional imaging studies investigating those functions in MS patients are hard to compare, as they include heterogeneous patient groups and use different paradigms for cognitive testing. The aim of this study was to investigate alterations in neuronal activation between MS patients and healthy controls performing attention and working memory tasks. Two meta-analyses of previously published fMRI studies investigating attention and working memory were conducted for MS patients and healthy controls, respectively. Resulting maps were contrasted to compare brain activation in patients and healthy controls. Significantly increased brain activation in the inferior parietal lobule and the dorsolateral prefrontal cortex was detected for healthy controls. In contrast, higher neuronal activation in MS patients was obtained in the left ventrolateral prefrontal cortex and the right premotor area. With this meta-analytic approach previous results of investigations examining cognitive function using fMRI are summarized and compared. Therefore a more general view on cognitive dysfunction in this heterogeneous disease is enabled.

A systematic investigation of the invariance of resting-state network patterns: is resting-state fMRI ready for pre-surgical planning?

Objectives: Measurements of resting-state networks (RSNs) have been used to investigate a wide range of diseases, such as dementia or epilepsy. This raises the question whether this method could also serve as a pre-surgical planning tool. Generating reliable functional connectivity patterns is of crucial importance, particularly for pre-surgical planning, as these patterns may directly affect the outcome.

Methods: This study investigated the reproducibility of four commonly used resting-state conditions: fixation of a black crosshair on a white screen; fixation of the center of a black screen; eyes-closed and fixation of the words “Entspann dich!” (Engl., “relax”). Ten healthy, right-handed male subjects (mean age, 25 years; SD 2) participated in the experiment. The spatial overlap for different RSNs across the four conditions was calculated.

Results: The spatial overlap across all four conditions was calculated for each seed region on a single subject and at the group level. Activation maps at the single-subject and group levels were highly stable, especially for the reading network (RNW). The lowest consistency measures were found for the visual network (VIN). At the single-subject level spatial overlap values ranged from 0.31 (VIN) to 0.45 (RNW).

Conclusion: These findings suggest that RSN measurements are a reliable tool to assess language-related networks in clinical settings. Generally, resting-state conditions showed comparable activation patterns, therefore no specific conditions appears to be preferable.