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Oka N, Iwai K, Sakai H. The neural substrates responsible for food odor processing: an activation likelihood estimation meta-analysis. Front Neurosci 2023; 17:1191617. [PMID: 37424999 PMCID: PMC10326844 DOI: 10.3389/fnins.2023.1191617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
In many species including humans, food odors appear to play a distinct role when compared with other odors. Despite their functional distinction, the neural substrates responsible for food odor processing remain unclear in humans. This study aimed to identify brain regions involved in food odor processing using activation likelihood estimation (ALE) meta-analysis. We selected olfactory neuroimaging studies conducted with sufficient methodological validity using pleasant odors. We then divided the studies into food and non-food odor conditions. Finally, we performed an ALE meta-analysis for each category and compared the ALE maps of the two categories to identify the neural substrates responsible for food odor processing after minimizing the confounding factor of odor pleasantness. The resultant ALE maps revealed that early olfactory areas are more extensively activated by food than non-food odors. Subsequent contrast analysis identified a cluster in the left putamen as the most likely neural substrate underlying food odor processing. In conclusion, food odor processing is characterized by the functional network involved in olfactory sensorimotor transformation for approaching behaviors to edible odors, such as active sniffing.
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Imai N, Osanai A, Moriya A, Katsuki M, Kitamura E. Classification of odors associated with migraine attacks: a cross-sectional study. Sci Rep 2023; 13:8469. [PMID: 37230996 DOI: 10.1038/s41598-023-35211-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 05/15/2023] [Indexed: 05/27/2023] Open
Abstract
Migraine, a common primary headache disorder, is associated with various factors such as stress, hormones in women, fasting, weather, and sleep disturbance as well as odors. We aimed to categorize odors associated with migraine and explore their relationships with clinical characteristics. A total of 101 migraineurs answered a questionnaire to determine the odors associated with migraine attacks. We performed factor analysis to explore the common factors of the odors and the relationship between these factors and the clinical characteristics. The factor analysis estimated six common factors: factor 1, fetid odor; factor 2, cooking products; factor 3, oil derivatives and others; factor 4, shampoo and conditioner; factor 5, cleaning products; factor 6, perfumes, insecticides, and rose. Factor 5 also included hair styling preparations, laundry detergent, and fabric softener, usually those with floral fragrances, and factor 5 was more likely to be associated with migraine attacks in patients with chronic migraine than in those with episodic migraine (P = 0.037). Our study showed that odors associated with migraine attacks could be categorized into six groups and suggested that some chemicals were more likely associated with migraine attacks in patients with chronic migraine than in those with episodic migraine.
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Affiliation(s)
- Noboru Imai
- Department of Neurology, Japanese Red Cross Shizuoka Hospital, 8-2 Ohtemachi, Aoi-Ku, Shizuoka, Shizuoka, 420-0853, Japan.
| | - Ayako Osanai
- Department of Neurology, Japanese Red Cross Shizuoka Hospital, 8-2 Ohtemachi, Aoi-Ku, Shizuoka, Shizuoka, 420-0853, Japan
| | - Asami Moriya
- Department of Neurology, Japanese Red Cross Shizuoka Hospital, 8-2 Ohtemachi, Aoi-Ku, Shizuoka, Shizuoka, 420-0853, Japan
| | - Masahito Katsuki
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, Niigata, Japan
| | - Eiji Kitamura
- Department of Neurology, Kitasato University, Sagamihara, Kanagawa, Japan
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3
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Molot J, Sears M, Anisman H. Multiple Chemical Sensitivity: It's time to catch up to the science. Neurosci Biobehav Rev 2023; 151:105227. [PMID: 37172924 DOI: 10.1016/j.neubiorev.2023.105227] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 05/06/2023] [Indexed: 05/15/2023]
Abstract
Multiple chemical sensitivity (MCS) is a complex medical condition associated with low dose chemical exposures. MCS is characterized by diverse features and common comorbidities, including fibromyalgia, cough hypersensitivity, asthma, and migraine, and stress/anxiety, with which the syndrome shares numerous neurobiological processes and altered functioning within diverse brain regions. Predictive factors linked to MCS comprise genetic influences, gene-environment interactions, oxidative stress, systemic inflammation, cell dysfunction, and psychosocial influences. The development of MCS may be attributed to the sensitization of transient receptor potential (TRP) receptors, notably TRPV1 and TRPA1. Capsaicin inhalation challenge studies demonstrated that TRPV1 sensitization is manifested in MCS, and functional brain imaging studies revealed that TRPV1 and TRPA1 agonists promote brain-region specific neuronal variations. Unfortunately, MCS has often been inappropriately viewed as stemming exclusively from psychological disturbances, which has fostered patients being stigmatized and ostracized, and often being denied accommodation for their disability. Evidence-based education is essential to provide appropriate support and advocacy. Greater recognition of receptor-mediated biological mechanisms should be incorporated in laws, and regulation of environmental exposures.
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Affiliation(s)
- John Molot
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
| | - Margaret Sears
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
| | - Hymie Anisman
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
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4
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Molot J, Sears M, Marshall LM, Bray RI. Neurological susceptibility to environmental exposures: pathophysiological mechanisms in neurodegeneration and multiple chemical sensitivity. REVIEWS ON ENVIRONMENTAL HEALTH 2022; 37:509-530. [PMID: 34529912 DOI: 10.1515/reveh-2021-0043] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/13/2021] [Indexed: 05/23/2023]
Abstract
The World Health Organization lists air pollution as one of the top five risks for developing chronic non-communicable disease, joining tobacco use, harmful use of alcohol, unhealthy diets and physical inactivity. This review focuses on how host defense mechanisms against adverse airborne exposures relate to the probable interacting and overlapping pathophysiological features of neurodegeneration and multiple chemical sensitivity. Significant long-term airborne exposures can contribute to oxidative stress, systemic inflammation, transient receptor subfamily vanilloid 1 (TRPV1) and subfamily ankyrin 1 (TRPA1) upregulation and sensitization, with impacts on olfactory and trigeminal nerve function, and eventual loss of brain mass. The potential for neurologic dysfunction, including decreased cognition, chronic pain and central sensitization related to airborne contaminants, can be magnified by genetic polymorphisms that result in less effective detoxification. Onset of neurodegenerative disorders is subtle, with early loss of brain mass and loss of sense of smell. Onset of MCS may be gradual following long-term low dose airborne exposures, or acute following a recognizable exposure. Upregulation of chemosensitive TRPV1 and TRPA1 polymodal receptors has been observed in patients with neurodegeneration, and chemically sensitive individuals with asthma, migraine and MCS. In people with chemical sensitivity, these receptors are also sensitized, which is defined as a reduction in the threshold and an increase in the magnitude of a response to noxious stimulation. There is likely damage to the olfactory system in neurodegeneration and trigeminal nerve hypersensitivity in MCS, with different effects on olfactory processing. The associations of low vitamin D levels and protein kinase activity seen in neurodegeneration have not been studied in MCS. Table 2 presents a summary of neurodegeneration and MCS, comparing 16 distinctive genetic, pathophysiological and clinical features associated with air pollution exposures. There is significant overlap, suggesting potential comorbidity. Canadian Health Measures Survey data indicates an overlap between neurodegeneration and MCS (p < 0.05) that suggests comorbidity, but the extent of increased susceptibility to the other condition is not established. Nevertheless, the pathways to the development of these conditions likely involve TRPV1 and TRPA1 receptors, and so it is hypothesized that manifestation of neurodegeneration and/or MCS and possibly why there is divergence may be influenced by polymorphisms of these receptors, among other factors.
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Affiliation(s)
- John Molot
- Family Medicine, University of Ottawa Faculty of Medicine, North York, ON, Canada
| | | | | | - Riina I Bray
- Family and Community Medicine, University of Toronto, Toronto, ON, Canada
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5
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Villar-Martinez MD, Goadsby PJ. Pathophysiology and Therapy of Associated Features of Migraine. Cells 2022; 11:cells11172767. [PMID: 36078174 PMCID: PMC9455236 DOI: 10.3390/cells11172767] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
Migraine is a complex and debilitating disorder that is broadly recognised by its characteristic headache. However, given the wide array of clinical presentations in migraineurs, the headache might not represent the main troublesome symptom and it can even go unnoticed. Understanding migraines exclusively as a pain process is simplistic and certainly hinders management. We describe the mechanisms behind some of the most disabling associated symptoms of migraine, including the relationship between the central and peripheral processes that take part in nausea, osmophobia, phonophobia, vertigo and allodynia. The rationale for the efficacy of the current therapeutic arsenal is also depicted in this article. The associated symptoms to migraine, apart from the painful component, are frequent, under-recognised and can be more deleterious than the headache itself. The clinical anamnesis of a headache patient should enquire about the associated symptoms, and treatment should be considered and individualised. Acknowledging the associated symptoms as a fundamental part of migraine has permitted a deeper and more coherent comprehension of the pathophysiology of migraine.
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Affiliation(s)
- Maria Dolores Villar-Martinez
- Headache Group, Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK
- NIHR King’s Clinical Research Facility, SLaM Biomedical Research Centre, King’s College Hospital, London SE5 9RS, UK
| | - Peter J. Goadsby
- Headache Group, Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK
- NIHR King’s Clinical Research Facility, SLaM Biomedical Research Centre, King’s College Hospital, London SE5 9RS, UK
- Department of Neurology, University of California, Los Angeles, CA 90095, USA
- Correspondence:
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Reichherzer A, Wargocki P, Mayer F, Norrefeldt V, Herbig B. Increased self-reported sensitivity to environmental stimuli and its effects on perception of air quality and well-being. Int J Hyg Environ Health 2022; 246:114045. [DOI: 10.1016/j.ijheh.2022.114045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 11/06/2022]
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7
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Infortuna C, Gualano F, Freedberg D, Patel SP, Sheikh AM, Muscatello MRA, Bruno A, Mento C, Chusid E, Han Z, Thomas FP, Battaglia F. Motor Cortex Response to Pleasant Odor Perception and Imagery: The Differential Role of Personality Dimensions and Imagery Ability. Front Hum Neurosci 2022; 16:943469. [PMID: 35903786 PMCID: PMC9314567 DOI: 10.3389/fnhum.2022.943469] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/17/2022] [Indexed: 12/03/2022] Open
Abstract
Background Neuroimaging studies have shown a complex pattern of brain activation during perception of a pleasant odor and during its olfactory imagery. To date, little is known regarding changes in motor cortex excitability during these tasks. Bergamot essential oil (BEO) is extensively used in perfumes and cosmetics for its pleasantness. Therefore, to further our understanding of the human sense of smell, this study aimed to investigate the effect of perception and imagery of a pleasant odor (BEO) on motor cortex using Transcranial magnetic stimulation (TMS). Materials and Methods We examined the primary motor cortex (M1) excitability during perception of a pleasant odor (BEO) or perception of odorless saline (experiment 1). Furthermore, we tested the effect of olfactory imagery (OI) of BEO on corticospinal excitability (experiment 2). The increase in motor evoked potential (MEP) amplitude was correlated with personality dimensions scores, pleasantness, vividness, and general imagery ability. Results The results indicate that the corticospinal excitability changed after both perception and imagery of a pleasant odor (BEO). The correlation analysis shows an association with neuroticism personality trait (experiment 1) and with general olfactory imagery ability (experiment 2). Conclusion Both perception of a pleasant odor and its olfactory imagery modulate motor cortex excitability. The enhanced brain activation is affected by specific individual characteristics. Overall, our findings provide physiological evidence for a complex interaction between the olfactory and motor systems.
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Affiliation(s)
- Carmenrita Infortuna
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario “G. Martino”, University of Messina, Messina, Italy
| | - Francesca Gualano
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, NJ, United States
- Department of Neurology, Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | - David Freedberg
- Department of Art History and Archeology, Italian Academy for Advanced Studies, Columbia University, New York, NY, United States
| | - Sapan P. Patel
- Department of Art History and Archeology, Italian Academy for Advanced Studies, Columbia University, New York, NY, United States
| | - Asad M. Sheikh
- Department of Pre-Clinical Sciences, New York College of Podiatric Medicine, New York, NY, United States
| | - Maria Rosaria Anna Muscatello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario “G. Martino”, University of Messina, Messina, Italy
| | - Antonio Bruno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario “G. Martino”, University of Messina, Messina, Italy
| | - Carmela Mento
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario “G. Martino”, University of Messina, Messina, Italy
| | - Eileen Chusid
- Department of Pre-Clinical Sciences, New York College of Podiatric Medicine, New York, NY, United States
| | - Zhiyong Han
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | - Florian P. Thomas
- Department of Neurology, Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | - Fortunato Battaglia
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, NJ, United States
- Department of Neurology, Hackensack Meridian School of Medicine, Nutley, NJ, United States
- *Correspondence: Fortunato Battaglia,
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8
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Torske A, Koch K, Eickhoff S, Freiherr J. Localizing the human brain response to olfactory stimulation: A meta-analytic approach. Neurosci Biobehav Rev 2021; 134:104512. [PMID: 34968523 DOI: 10.1016/j.neubiorev.2021.12.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/18/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
The human sense of smell and the ability to detect and distinguish odors allows for the extraction of valuable information from the environment, thereby driving human behavior. Not only can the sense of smell help to monitor the safety of inhaled air, but it can also help to evaluate the edibility of food. Therefore, in an effort to further our understanding of the human sense of smell, the aim of this meta-analysis was to provide the scientific community with activation probability maps of the functional anatomy of the olfactory system, in addition to separate activation maps for specific odor categories (pleasant, food, and aversive odors). The activation likelihood estimation (ALE) method was utilized to quantify all relevant and available data to perform a formal statistical analysis on the inter-study concordance of various odor categories. A total of 81 studies (108 contrasts, 1053 foci) fulfilled our inclusion criteria. Significant ALE peaks were observed in all odor categories in brain areas typically associated with the functional neuroanatomy of olfaction including the piriform cortex, amygdala, insula, and orbitofrontal cortex, amongst others. Additional contrast analyses indicate clear differences in neural activation patterns between odor categories.
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Affiliation(s)
- A Torske
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Germany; Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; Graduate School of Systemic Neurosciences, Ludwig Maximilians Universität München, Martinsried, Germany
| | - K Koch
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Germany; Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; Graduate School of Systemic Neurosciences, Ludwig Maximilians Universität München, Martinsried, Germany
| | - S Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - J Freiherr
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Institute for Process Engineering and Packaging IVV, Sensory Analytics and Technologies, Fraunhofer Freising, Germany.
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9
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Azuma K, Uchiyama I, Kunugita N. Potential factors affecting chronic chemical intolerance associated with constitutional predisposition or lifestyle and environment during childhood: From a six-year follow-up study. J Psychosom Res 2021; 151:110665. [PMID: 34763204 DOI: 10.1016/j.jpsychores.2021.110665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/31/2021] [Accepted: 10/31/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The Japanese chemical intolerance (JCI) study was conducted in January 2012 with a cohort of 7245 adults from population-based sampling. This study aimed to investigate the childhood constitutional and environmental factors involved in the development of chronic CI from the prospective cohort study. METHODS In the cohort, 4683 persons were identified after six years. Self-reported questionnaires were administered to the subjects to obtain information on CI status; medical history; constitution, lifestyle, and housing environment during childhood; and recent psychosomatic states. We assessed the differences between individuals with persisting CI status during the follow-up (defined as chronic CI) and controls not having CI status during the follow-up. RESULTS A total of 2500 individuals responded. Multiple logistic regression analyses revealed significant associations between chronic CI and motion sickness to car or bus and allergic conjunctivitis during childhood. Significant associations between a possible increased risk of CI and the existence of high-voltage power lines close to housing, the use of vinyl covering in wall material, the use of strong perfume by a family member, and the experience of stinky odor of paint or wax at elementary school were observed. However, the use of carpet in floor material and plaster coating in wall material was associated with a possible decreased risk of CI. CONCLUSIONS Some potential constitutional predisposition from childhood, including inherent susceptibility in the autonomic nervous system may be involved in the development of CI.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama 589-8511, Japan; Department of Environmental Health, National Institute of Public Health, Wako 351-0197, Japan.
| | - Iwao Uchiyama
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto 606-8225, Japan.
| | - Naoki Kunugita
- Occupational and Community Health Nursing Division, Department of Nursing, School of Health Sciences, University of Occupational and Environmental Health, Japan; Department of Environmental Health, National Institute of Public Health, Wako 351-0197, Japan.
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10
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Damiani G, Alessandrini M, Caccamo D, Cormano A, Guzzi G, Mazzatenta A, Micarelli A, Migliore A, Piroli A, Bianca M, Tapparo O, Pigatto PDM. Italian Expert Consensus on Clinical and Therapeutic Management of Multiple Chemical Sensitivity (MCS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111294. [PMID: 34769816 PMCID: PMC8582949 DOI: 10.3390/ijerph182111294] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 12/29/2022]
Abstract
Multiple chemical sensitivity (MCS) is a multisystem, recurrent, environmental disorder that flares in response to different exposures (i.e., pesticides, solvents, toxic metals and molds) under the threshold limit value (TLV) calculated for age and gender in the general population. MCS is a syndrome characterized by cutaneous, allergic, gastrointestinal, rheumatological, endocrinological, cardiological and neurological signs and symptoms. We performed a systematic review of the literature to summarize the current clinical and therapeutic evidence and then oriented an eDelphi consensus. Four main research domains were identified (diagnosis, treatment, hospitalization and emergency) and discussed by 10 experts and an MCS patient. Thus, the first Italian MCS consensus had the double aim: (a) to improve MCS knowledge among healthcare workers and patients by standardizing the clinical and therapeutic management to MCS patients; and (b) to improve and shed light on MCS misconceptions not supported by evidence-based medicine (EBM).
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Affiliation(s)
- Giovanni Damiani
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy;
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- PhD Degree Program in Pharmacological Sciences, Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padua, Italy
| | - Marco Alessandrini
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Daniela Caccamo
- Department of Biomedical Sciences, Dental Sciences, & Morpho-Functional Imaging, Polyclinic Hospital University, 98124 Messina, Italy;
| | - Andrea Cormano
- International Society of Doctors for Environment, 82100 Benevento, Italy;
| | - Gianpaolo Guzzi
- Italian Association for Metals and Biocompatibility Research—A.I.R.M.E.B., 20122 Milan, Italy;
| | - Andrea Mazzatenta
- Department of Neuroscience, Imaging and Clinical Science, ‘G. d’Annunzio’ University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Alessandro Micarelli
- Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy;
- ITER Center for Balance and Rehabilitation Research (ICBRR), 02032 Rome, Italy
| | - Alberto Migliore
- Department of Internal Medicine, Unit of Rheumatology, San Pietro Fatebenefratelli Hospital, 00189 Rome, Italy;
| | - Alba Piroli
- Department of MeSVA, University of L’Aquila, 67100 L’Aquila, Italy;
| | | | | | - Paolo Daniele Maria Pigatto
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy;
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Correspondence: ; Tel.: +39-02-5031-9971
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Mosca A, Del Casale A, Borro M, Gentile G, Pomes LM, Padovano A, Fiaschè F, Pinzone V, Rapinesi C, Zoppi T, Brugnoli R, Sani G, Kotzalidis GD, Girardi P, Ferracuti S, Simmaco M, Pompili M. PON1 polymorphisms can predict generalized anxiety and depressed mood in patients with multiple chemical sensitivity. Per Med 2021; 18:255-267. [PMID: 33728967 DOI: 10.2217/pme-2019-0141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background: Multiple chemical sensitivity (MCS) is a chronic condition with somatic, cognitive and affective symptoms that follow contact with chemical agents at usually non toxic concentrations. We aimed to assess the role of genetic polymorphisms involved in oxidative stress on anxiety and depression in MCS. Materials & methods: Our study investigated the CAT rs1001179, MPO rs2333227, PON1 rs662 and PON1 rs705379 polymorphisms in MCS. Results: The AG genotype of the PON1 rs662 and the TT and CT genotypes of the PON1 rs705379 were involved in anxiety and depression. Discussion: These results are in line with existing evidence of PON1 involvement in MCS and suggest a further role of this gene in the exhibition of anxiety and depression in this disease.
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Affiliation(s)
- Alessio Mosca
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy
| | - Antonio Del Casale
- Department of Dynamic & Clinical Psychology, & Health Studies, Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Marina Borro
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Laboratory & Advanced Molecular Diagnostics, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Giovanna Gentile
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Laboratory & Advanced Molecular Diagnostics, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Leda Marina Pomes
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Laboratory & Advanced Molecular Diagnostics, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Alessio Padovano
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Federica Fiaschè
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Vito Pinzone
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Chiara Rapinesi
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy
| | - Teodolinda Zoppi
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Roberto Brugnoli
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Gabriele Sani
- Institute of Psychiatry & Psychology, Department of Geriatrics, Neuroscience & Orthopedics, Fondazione Policlinico Universitario IRCCS "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Georgios Demetrios Kotzalidis
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy
| | - Paolo Girardi
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Stefano Ferracuti
- Department of Human Neuroscience, Sapienza University; Unit of Risk Management, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Maurizio Simmaco
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Laboratory & Advanced Molecular Diagnostics, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
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12
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Elberling J. Respiratory Symptoms from Fragrances and the Link with Dermatitis. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Del Casale A, Ferracuti S, Mosca A, Pomes LM, Fiaschè F, Bonanni L, Borro M, Gentile G, Martelletti P, Simmaco M. Multiple Chemical Sensitivity Syndrome: A Principal Component Analysis of Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186551. [PMID: 32916833 PMCID: PMC7558401 DOI: 10.3390/ijerph17186551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/03/2020] [Accepted: 09/07/2020] [Indexed: 12/12/2022]
Abstract
Multiple Chemical Sensitivity (MCS) is a chronic and/or recurrent condition with somatic, cognitive, and affective symptoms following a contact with chemical agents whose concentrations do not correlate with toxicity in the general population. Its prevalence is not well defined; it mainly affects women between 40 and 50 years, without variations in ethnicity, education and economic status. We aimed to assess the core symptoms of this illness in a sample of Italian patients. Two physicians investigated different symptoms with a checklist compilation in 129 patients with MCS (117 women). We conducted a categorical Principal Component Analysis (CATPCA) with Varimax rotation on the checklist dataset. A typical triad was documented: hyperosmia, asthenia, and dyspnoea were the most common symptoms. Patients also frequently showed cough and headache. The CATPCA showed seven main factors: 1, neurocognitive symptoms; 2, physical (objective) symptoms; 3, gastrointestinal symptoms; 4, dermatological symptoms; 5, anxiety-depressive symptoms; 6, respiratory symptoms; 7, hyperosmia and asthenia. Patients showed higher mean prevalence of factors 7 (89.9%), 6 (71.7%), and 1 (62.13%). In conclusion, MCS patients frequently manifest hyperosmia, asthenia, and dyspnoea, which are often concomitant with other respiratory and neurocognitive symptoms. Considering the clinical association that is often made with anxiety, more studies are necessary on the psychosomatic aspects of this syndrome. Further analytical epidemiological studies are needed to support the formulation of aetiological hypotheses of MCS.
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Affiliation(s)
- Antonio Del Casale
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
- Correspondence:
| | - Stefano Ferracuti
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University, 00185 Rome, Italy;
- Unit of Risk Management, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Alessio Mosca
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, 66100 Chieti, Italy;
| | - Leda Marina Pomes
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Federica Fiaschè
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
| | - Luca Bonanni
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
| | - Marina Borro
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Giovanna Gentile
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Paolo Martelletti
- Department of Medical and Molecular Sciences, Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy;
- Headache Centre Unit, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Maurizio Simmaco
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
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14
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Danioth L, Brotschi G, Croy I, Friedrich H, Caversaccio MD, Negoias S. Multisensory environmental sensitivity in patients with chronic tinnitus. J Psychosom Res 2020; 135:110155. [PMID: 32534321 DOI: 10.1016/j.jpsychores.2020.110155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 05/17/2020] [Accepted: 05/19/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The study aimed at investigating the sensitivity to noise and chemosensory environmental stressors as well as the relation to perceived stress, depression and anxiety in subjects with chronic tinnitus as compared to subjects without tinnitus. METHODS We included 75 subjects with chronic tinnitus and 75 age and sex-matched subjects without tinnitus. Standardized questionnaires assessing the level of distress and impairment of quality of life caused by tinnitus, perceived level of stress, anxiety and depression, environmental noise and chemosensory sensitivity were used. A subgroup of 27 subjects with chronic tinnitus and 20 age-matched subjects without tinnitus underwent testing of olfactory function with the Sniffin' Sticks test and testing of intranasal trigeminal function using CO2 thresholds. RESULTS Our data confirmed the increased environmental noise sensitivity (NSS) in patients with tinnitus. Furthermore, we observed an increased environmental chemosensory sensitivity (CSS), but no difference in measured chemosensory function. Subjects with tinnitus showed also significant higher levels of perceived stress, anxiety and depression and those symptoms partially correlated to CSS and NSS. Predictors of both NSS and CSS results were the presence / absence of tinnitus and high anxiety levels while neither stress nor depression were found as predicting variables. CONCLUSIONS The results suggest that chronic tinnitus is related to a multisensory environmental hypersensitivity. Anxiety seems to be a predictor of this environmental vulnerability.
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Affiliation(s)
- Laura Danioth
- Department of Otorhinolaryngology, Head and Neck Surgery, lnselspital, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland
| | - Gladys Brotschi
- Department of Otorhinolaryngology, Head and Neck Surgery, lnselspital, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland
| | - Ilona Croy
- Department of Psychotherapy and Psychosomatic Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany
| | - Hergen Friedrich
- Department of Otorhinolaryngology, Head and Neck Surgery, lnselspital, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland; Department of Otorhinolaryngology, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Marco-Domenico Caversaccio
- Department of Otorhinolaryngology, Head and Neck Surgery, lnselspital, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland
| | - Simona Negoias
- Department of Otorhinolaryngology, Head and Neck Surgery, lnselspital, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland; Department of Otorhinolaryngology, Head and Neck Surgery, Basel University Hospital, University of Basel, Basel CH-4051, Switzerland.
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15
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Nordin S. Mechanisms underlying nontoxic indoor air health problems: A review. Int J Hyg Environ Health 2020; 226:113489. [DOI: 10.1016/j.ijheh.2020.113489] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/29/2020] [Accepted: 02/10/2020] [Indexed: 02/07/2023]
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16
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Chen B, Su M, Pan Q, Zhang Z, Chen S, Huang Z, Cai Z, Li Z, Qian X, Hu X, Song Y. Fully Printed Geranium-Inspired Encapsulated Arrays for Quantitative Odor Releasing. ACS OMEGA 2019; 4:19977-19982. [PMID: 31788631 PMCID: PMC6882128 DOI: 10.1021/acsomega.9b02916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 10/18/2019] [Indexed: 06/10/2023]
Abstract
Olfactory is an extremely fine way of perception. However, the process of smelling is prone to various interference factors. Further development to enhance the communication desires an odor-releasing strategy, which could quantitatively offer a variety of fragrances. Here, we report a fully printing strategy to heterogeneously integrate odor-containing materials and protective coating films. Inspired from the fragrance-containing drum structure on the geranium leaf, encapsulated arrays are fully printed on the flexible or rigid substrates with more than 20 spices. Quantitative concentrations of odor molecules can be released from the encapsulated arrays after scraping the protective poly(lactic-co-glycolic) acid (PLGA) shells. Importantly, various odor-based arrays are printed on the same flexible substrate, which permits selective releasing and arbitrary mixing of the spices. Effective odor-releasing properties of encapsulated arrays make them promising for food security and anticounterfeiting, investigating olfactory discrimination abilities, and strengthening olfactory communication.
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Affiliation(s)
- Bingda Chen
- Key Laboratory of
Green Printing, Institute of Chemistry, Chinese Academy of Sciences, Beijing Engineering Research Center
of Nanomaterials for Green Printing Technology, Beijing National Laboratory
for Molecular Sciences (BNLMS), Zhongguancun North First Street 2, 100190 Beijing, P. R. China
- University of Chinese Academy of Sciences, Yuquan Road No.19A, 100049 Beijing, P. R. China
| | - Meng Su
- Key Laboratory of
Green Printing, Institute of Chemistry, Chinese Academy of Sciences, Beijing Engineering Research Center
of Nanomaterials for Green Printing Technology, Beijing National Laboratory
for Molecular Sciences (BNLMS), Zhongguancun North First Street 2, 100190 Beijing, P. R. China
| | - Qi Pan
- Key Laboratory of
Green Printing, Institute of Chemistry, Chinese Academy of Sciences, Beijing Engineering Research Center
of Nanomaterials for Green Printing Technology, Beijing National Laboratory
for Molecular Sciences (BNLMS), Zhongguancun North First Street 2, 100190 Beijing, P. R. China
- University of Chinese Academy of Sciences, Yuquan Road No.19A, 100049 Beijing, P. R. China
| | - Zeying Zhang
- Key Laboratory of
Green Printing, Institute of Chemistry, Chinese Academy of Sciences, Beijing Engineering Research Center
of Nanomaterials for Green Printing Technology, Beijing National Laboratory
for Molecular Sciences (BNLMS), Zhongguancun North First Street 2, 100190 Beijing, P. R. China
- University of Chinese Academy of Sciences, Yuquan Road No.19A, 100049 Beijing, P. R. China
| | - Shuoran Chen
- Research Center for Green Printing Nanophotonic
Materials, Suzhou University of Science
and Technology, 215009 Suzhou, P. R. China
| | - Zhandong Huang
- Key Laboratory of
Green Printing, Institute of Chemistry, Chinese Academy of Sciences, Beijing Engineering Research Center
of Nanomaterials for Green Printing Technology, Beijing National Laboratory
for Molecular Sciences (BNLMS), Zhongguancun North First Street 2, 100190 Beijing, P. R. China
| | - Zheren Cai
- Key Laboratory of
Green Printing, Institute of Chemistry, Chinese Academy of Sciences, Beijing Engineering Research Center
of Nanomaterials for Green Printing Technology, Beijing National Laboratory
for Molecular Sciences (BNLMS), Zhongguancun North First Street 2, 100190 Beijing, P. R. China
- University of Chinese Academy of Sciences, Yuquan Road No.19A, 100049 Beijing, P. R. China
| | - Zheng Li
- Key Laboratory of
Green Printing, Institute of Chemistry, Chinese Academy of Sciences, Beijing Engineering Research Center
of Nanomaterials for Green Printing Technology, Beijing National Laboratory
for Molecular Sciences (BNLMS), Zhongguancun North First Street 2, 100190 Beijing, P. R. China
- University of Chinese Academy of Sciences, Yuquan Road No.19A, 100049 Beijing, P. R. China
| | - Xin Qian
- Key Laboratory of
Green Printing, Institute of Chemistry, Chinese Academy of Sciences, Beijing Engineering Research Center
of Nanomaterials for Green Printing Technology, Beijing National Laboratory
for Molecular Sciences (BNLMS), Zhongguancun North First Street 2, 100190 Beijing, P. R. China
- University of Chinese Academy of Sciences, Yuquan Road No.19A, 100049 Beijing, P. R. China
| | - Xiaotian Hu
- Key Laboratory of
Green Printing, Institute of Chemistry, Chinese Academy of Sciences, Beijing Engineering Research Center
of Nanomaterials for Green Printing Technology, Beijing National Laboratory
for Molecular Sciences (BNLMS), Zhongguancun North First Street 2, 100190 Beijing, P. R. China
- University of Chinese Academy of Sciences, Yuquan Road No.19A, 100049 Beijing, P. R. China
| | - Yanlin Song
- Key Laboratory of
Green Printing, Institute of Chemistry, Chinese Academy of Sciences, Beijing Engineering Research Center
of Nanomaterials for Green Printing Technology, Beijing National Laboratory
for Molecular Sciences (BNLMS), Zhongguancun North First Street 2, 100190 Beijing, P. R. China
- University of Chinese Academy of Sciences, Yuquan Road No.19A, 100049 Beijing, P. R. China
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17
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Azuma K, Uchiyama I, Tanigawa M, Bamba I, Azuma M, Takano H, Yoshikawa T, Sakabe K. Chemical intolerance: involvement of brain function and networks after exposure to extrinsic stimuli perceived as hazardous. Environ Health Prev Med 2019; 24:61. [PMID: 31640568 PMCID: PMC6806489 DOI: 10.1186/s12199-019-0816-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/23/2019] [Indexed: 01/09/2023] Open
Abstract
Background Chemical intolerance (CI) is a chronic condition characterized by recurring and severe symptoms triggered by exposure to low levels of odorous or pungent substances. The etiology of CI has been a controversial subject for a long time. The aim of this review is to summarize findings on the neurological processing of sensory information during and after exposure to low levels of odorous or pungent substances in individuals with CI, focusing on the brain function and networks. Methods Scientific studies on CI published between 2000 and 2019 in academic peer-reviewed journals were systematically searched using medical and scientific literature databases. Only peer-reviewed articles reporting original research from experimental human studies directly associated with CI, and involving related neurological responses or brain imaging after exposure to odorous or pungent substances (i.e., in chemical provocation tests), were considered. Results Forty-seven studies were found to be eligible for a full-text review. Twenty-three studies met the selection criteria and were included in this review. Evidence indicated that differences between subjects with CI and healthy controls were observed by brain imaging during and after exposure to odorous or pungent substances. Differences in brain imaging were also observed between initial exposure and after exposure to these substances. Neurological processing of sensory information after exposure to extrinsic stimuli in the limbic system and related cortices were altered in subjects with CI. A previous documentable exposure event was likely to be involved in this alteration. Conclusions This review documents consistent evidence for the altered neurological processing of sensory information in individuals with CI. Further neurophysiological research exploring the processing of extrinsic stimuli and cognition of sensation through the limbic system and related cortices in CI, and the appearance of symptoms in individuals with CI, are required.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 589-8511, Japan. .,Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan.
| | - Iwao Uchiyama
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan.,Outpatient Department of Sick-house Syndrome, Hyakumanben Clinic, Kyoto, 606-8225, Japan
| | - Mari Tanigawa
- Outpatient Department of Sick-house Syndrome, Hyakumanben Clinic, Kyoto, 606-8225, Japan.,Clinical Immune Function Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan
| | - Ikuko Bamba
- Faculty of Education, Home Economics, Tokyo Gakugei University, Koganei, 184-8501, Japan
| | - Michiyo Azuma
- Department of Human Environmental Design, Faculty of Health Science, Kio University, Kitakatsuragi-gun, 635-0832, Japan
| | - Hirohisa Takano
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Toshikazu Yoshikawa
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan
| | - Kou Sakabe
- Department of Anatomy and Cellular Biology, Tokai University School of Medicine, Isehara, 259-1193, Japan
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18
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Multiple Chemical Sensitivity: Review of the State of the Art in Epidemiology, Diagnosis, and Future Perspectives. J Occup Environ Med 2019; 60:138-146. [PMID: 29111991 PMCID: PMC5794238 DOI: 10.1097/jom.0000000000001215] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Systematic bibliography analysis of about the last 17 years on multiple chemical sensitivity (MCS) was carried out in order to detect new diagnostic and epidemiological evidence. The MCS is a complex syndrome that manifests as a result of exposure to a low level of various common contaminants. The etiology, diagnosis, and treatment are still debated among researchers. METHOD Querying PubMed, Web of Science, Scopus, Cochrane library, both using some specific MESH terms combined with MESH subheadings and through free search, even by Google. RESULTS The studies were analyzed by verifying 1) the typology of study design; 2) criteria for case definition; 3) presence of attendances in the emergency departments and hospital admissions, and 4) analysis of the risk factors. OUTLOOK With this review, we give some general considerations and hypothesis for possible future research.
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19
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Respiratory Symptoms from Fragrances and the Link with Dermatitis. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_23-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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20
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Viziano A, Micarelli A, Pasquantonio G, Della-Morte D, Alessandrini M. Perspectives on multisensory perception disruption in idiopathic environmental intolerance: a systematic review. Int Arch Occup Environ Health 2018; 91:923-935. [PMID: 30088144 DOI: 10.1007/s00420-018-1346-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 07/31/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE Multiple chemical sensitivity (MCS) also known as idiopathic environmental intolerance/illness (IEI) encompasses a cohort of subjective symptoms characterized by susceptibility to a wide spectrum of environmental compounds, causing symptoms involving various organs and a decrease in quality of life. The aim of this systematic review is to summarize evidence about MCS, with focus on indexed studies analyzing sensory pathway-related disorders. METHODS Medical databases were searched for English language articles related to the topic, published between 1965 and 2017 in academic, peer-reviewed journals. Particular focus was concentrated on articles depicting disturbances involving sensory organs. References of the relevant articles were examined to identify additional significant documents. RESULTS Fifty-eight studies were eligible for full text review. Of these, 34 studies met the selection criteria and were included in this analysis. Many variables, such as different diagnostic criteria, lack of homogeneous symptom questionnaires and the general incidence of personality traits in control subjects, biased studies as confounding factors. However, moderate evidences show that sensory pathways are somewhat altered, especially with respect to information processing in the limbic system and related cortical areas. Recent studies suggested the presence, in MCS cohorts, of attention bias, sensitization and limbic kindling, as well as recently revealed subclinical organic alterations along sensory pathways. CONCLUSIONS Evidences are consistent with MCS/IEI to be the result of a neural altered processing of sensorial ascending pathways, which combined with peculiar personality traits constitutes the underpinning of a multisensory condition needing multidisciplinary clinical approach.
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Affiliation(s)
- Andrea Viziano
- Department of Clinical Sciences and Translational Medicine, University of Rome'Tor Vergata', Via Montpellier, 1; E sud Tower, 00133, Rome, Italy.
| | - Alessandro Micarelli
- Department of Clinical Sciences and Translational Medicine, University of Rome'Tor Vergata', Via Montpellier, 1; E sud Tower, 00133, Rome, Italy
| | - Guido Pasquantonio
- Department of Clinical Sciences and Translational Medicine, University of Rome'Tor Vergata', Via Montpellier, 1; E sud Tower, 00133, Rome, Italy
| | - David Della-Morte
- University of Rome Tor Vergata, Rome, Italy.,San Raffaele Roma Open University, Rome, Italy.,Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Marco Alessandrini
- Department of Clinical Sciences and Translational Medicine, University of Rome'Tor Vergata', Via Montpellier, 1; E sud Tower, 00133, Rome, Italy
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21
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A randomised, placebo-controlled trial of transcranial pulsed electromagnetic fields in patients with multiple chemical sensitivity. Acta Neuropsychiatr 2017; 29:267-277. [PMID: 27919300 DOI: 10.1017/neu.2016.51] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate the efficacy of transcranially applied pulsed electromagnetic fields (PEMF) on functional impairments and symptom severity in multiple chemical sensitivity (MCS) patients. METHODS The study was conducted as a nationwide trial in Denmark using a randomised, parallel-group, double-blind and placebo-controlled design. Sample size was estimated at 40 participants. Eligibility criteria were age 18-75 years and fulfilment of the MCS case criteria. Participants received either PEMF or placebo PEMF (no stimulation) applied transcranially for 6 weeks. The primary outcome was the Life Impact Scale (LIS) of the Quick Environmental Exposure and Sensitivity Inventory (QEESI). Secondary outcomes were the Symptom Severity Scale (SSS) and the Chemical Intolerance Scale of QEESI. RESULTS A total of 39 participants were randomised to PEMF or placebo treatment. No significant difference was observed on QEESI LIS between groups with a mean change score of -5.9 in the PEMF group compared with -1.5 in the placebo group (p=0.35, effect size=-0.31). However, a significant decrease was detected on QEESI SSS within and between groups with a mean change score of -11.3 in the PEMF group compared with -3.2 in the placebo group (p=0.03, effect size=-0.60). CONCLUSION PEMF treatment of 6 weeks showed no effect on functional impairments in MCS. However, a significant decrease in symptom severity was observed.
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Andersson L, Claeson AS, Nyberg L, Nordin S. Short-term olfactory sensitization involves brain networks relevant for pain, and indicates chemical intolerance. Int J Hyg Environ Health 2017; 220:503-509. [DOI: 10.1016/j.ijheh.2017.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 02/10/2017] [Indexed: 11/30/2022]
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Symptoms from masked acrolein exposure suggest altered trigeminal reactivity in chemical intolerance. Neurotoxicology 2017; 60:92-98. [PMID: 28359837 DOI: 10.1016/j.neuro.2017.03.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 03/22/2017] [Accepted: 03/23/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Chemical intolerance (CI) is a widespread occupational and public health problem characterized by symptoms that reportedly result from low-levels of chemical exposure. The mechanisms behind CI are unknown, however modifications of the chemical senses (rather than toxic processes) have been suggested as key components. The aim of this study was to investigate whether individuals with self-reported CI report more sensory irritation during masked acrolein exposure compared to controls without CI. METHODS Individuals with CI (n=18) and controls without CI (n=19) were exposed in an exposure chamber. Each participant took part in two exposure conditions - one with heptane (the masking compound), and one with heptane and acrolein at a dose below previously reported sensory irritation thresholds. The exposures lasted for 60min. Symptoms and confidence ratings were measured continuously throughout the exposure as were measurements of electrodermal activity and self-reported tear-film break-up time. Participants were blind to exposure condition. RESULTS Individuals with CI, compared with controls reported greater sensory irritation in the eyes, nose and throat when exposed to acrolein masked with heptane. There was no difference during exposure to heptane. CONCLUSIONS Masked exposure to acrolein at a concentration below the previously reported detection threshold is perceived as more irritating by individuals with CI compared with controls. The results indicate that there is altered trigeminal reactivity in those with CI compared to controls.
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Dantoft TM, Skovbjerg S, Andersson L, Claeson AS, Engkilde K, Lind N, Nordin S, Hellgren LI. Gene expression profiling in persons with multiple chemical sensitivity before and after a controlled n-butanol exposure session. BMJ Open 2017; 7:e013879. [PMID: 28232466 PMCID: PMC5337747 DOI: 10.1136/bmjopen-2016-013879] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To investigate the pathophysiological pathways leading to symptoms elicitation in multiple chemical sensitivity (MCS) by comparing gene expression in MCS participants and healthy controls before and after a chemical exposure optimised to cause symptoms among MCS participants.The first hypothesis was that unexposed and symptom-free MCS participants have similar gene expression patterns to controls and a second hypothesis that MCS participants can be separated from controls based on differential gene expression upon a controlled n-butanol exposure. DESIGN Participants were exposed to 3.7 ppm n-butanol while seated in a windowed exposure chamber for 60 min. A total of 26 genes involved in biochemical pathways found in the literature have been proposed to play a role in the pathogenesis of MCS and other functional somatic syndromes were selected. Expression levels were compared between MCS and controls before, within 15 min after being exposed to and 4 hours after the exposure. SETTINGS Participants suffering from MCS and healthy controls were recruited through advertisement at public places and in a local newspaper. PARTICIPANTS 36 participants who considered themselves sensitive were prescreened for eligibility. 18 sensitive persons fulfilling the criteria for MCS were enrolled together with 18 healthy controls. OUTCOME MEASURES 17 genes showed sufficient transcriptional level for analysis. Group comparisons were conducted for each gene at the 3 times points and for the computed area under the curve (AUC) expression levels. RESULTS MCS participants and controls displayed similar gene expression levels both at baseline and after the exposure and the computed AUC values were likewise comparable between the 2 groups. The intragroup variation in expression levels among MCS participants was noticeably greater than the controls. CONCLUSIONS MCS participants and controls have similar gene expression levels at baseline and it was not possible to separate MCS participants from controls based on gene expression measured after the exposure.
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Affiliation(s)
- Thomas M Dantoft
- Danish Research Centre for Chemical Sensitivities, Copenhagen University Hospital, Gentofte, Denmark
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Lyngby, Denmark
- Research Centre for Prevention and Health, Copenhagen, Denmark
| | - Sine Skovbjerg
- Research Centre for Prevention and Health, Copenhagen, Denmark
| | - Linus Andersson
- Department of Psychology, Umeå University, Umeå, Sweden
- Department of Occupational and Public Health Sciences, University of Gävle, Umeå, Sweden
| | | | - Kaare Engkilde
- Department of Dermato-Allergology, The National Allergy Research Center, Copenhagen University Hospital Gentofte, Denmark
| | - Nina Lind
- Department of Psychology, Umeå University, Umeå, Sweden
- Department of Economics, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Lars I Hellgren
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Lyngby, Denmark
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Micarelli A, Viziano A, Bruno E, Micarelli E, Alessandrini M. Vestibular impairment in Multiple Chemical Sensitivity: Component analysis findings. J Vestib Res 2017; 26:459-468. [DOI: 10.3233/ves-160594] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Alessandro Micarelli
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Neuroscience Unit, Rome, Italy
| | - Andrea Viziano
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Ernesto Bruno
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Elisa Micarelli
- Department of Biology, University of Rome Tor Vergata, Rome, Italy
| | - Marco Alessandrini
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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Azuma K, Uchiyama I, Tanigawa M, Bamba I, Azuma M, Takano H, Yoshikawa T, Sakabe K. Association of Odor Thresholds and Responses in Cerebral Blood Flow of the Prefrontal Area during Olfactory Stimulation in Patients with Multiple Chemical Sensitivity. PLoS One 2016; 11:e0168006. [PMID: 27936122 PMCID: PMC5148047 DOI: 10.1371/journal.pone.0168006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 11/24/2016] [Indexed: 12/31/2022] Open
Abstract
Multiple chemical sensitivity (MCS) is a disorder characterized by nonspecific and recurrent symptoms from various organ systems associated with exposure to low levels of chemicals. Patients with MCS process odors differently than controls do. Previously, we suggested that this odor processing was associated with increased regional cerebral blood flow (rCBF) in the prefrontal area during olfactory stimulation using near-infrared spectroscopic (NIRS) imaging. The aim of this study was to investigate the association of odor thresholds and changes in rCBF during olfactory stimulation at odor threshold levels in patients with MCS. We investigated changes in the prefrontal area using NIRS imaging and a T&T olfactometer during olfactory stimulation with two different odorants (sweet and fecal) at three concentrations (zero, odor recognition threshold, and normal perceived odor level) in 10 patients with MCS and six controls. The T&T olfactometer threshold test and subjective assessment of irritating and hedonic odors were also performed. The results indicated that the scores for both unpleasant and pungent odors were significantly higher for those for sweet odors at the normal perceived level in patients with MCS than in controls. The brain responses at the recognition threshold (fecal odor) and normal perceived levels (sweet and fecal odors) were stronger in patients with MCS than in controls. However, significant differences in the odor detection and recognition thresholds and odor intensity score between the two groups were not observed. These brain responses may involve cognitive and memory processing systems during past exposure to chemicals. Further research regarding the cognitive features of sensory perception and memory due to past exposure to chemicals and their associations with MCS symptoms is needed.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- * E-mail:
| | - Iwao Uchiyama
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- Outpatient Department of Sick-house Syndrome, Hyakumanben Clinic, Kyoto, Japan
| | - Mari Tanigawa
- Clinical Immune Function Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- Division of Internal Medicine, Hyakumanben Clinic, Kyoto, Japan
| | - Ikuko Bamba
- Faculty of Education, Home Economics, Tokyo Gakugei University, Koganei, Tokyo, Japan
| | - Michiyo Azuma
- Department of Human Environmental Design, Faculty of Health Science, Kio University, Kitakatsuragi-gun, Nara, Japan
| | - Hirohisa Takano
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Toshikazu Yoshikawa
- Department of Internal Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kou Sakabe
- Department of Anatomy and Cellular Biology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
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Viziano A, Micarelli A, Alessandrini M. Noise sensitivity and hyperacusis in patients affected by multiple chemical sensitivity. Int Arch Occup Environ Health 2016; 90:189-196. [PMID: 27838888 DOI: 10.1007/s00420-016-1185-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 11/02/2016] [Indexed: 01/12/2023]
Abstract
PURPOSE The aim of this study was to investigate the presence of noise sensitivity and hyperacusis in patients suffering from multiple chemical sensitivity (MCS), a chronic condition characterized by several symptoms following low-level chemical exposure. Moreover, distortion product otoacoustic emissions (DPOAE) were performed to further study cochlear function. METHODS A questionnaire-based survey was performed. Eighteen MCS patients, selected with strict diagnostic criteria, and 20 healthy age- and gender-matched subjects filled Weinstein's Noise Sensitivity Questionnaire (WNS) and Khalfa's Hyperacusis Questionnaire (HQ). Results were compared with scores from the quick Environmental Exposure Sensitivity Index (qEESI), a routinarily used questionnaire to screen MCS symptoms, and with DPOAE values. An analysis of variance (ANOVA) was performed between MCS and control subjects scores; moreover, Spearman's rank correlation test was performed between questionnaire results. RESULTS ANOVA testing on DPOAE values showed any significant difference between groups, while WNS, HQ and qEESI scores were significantly higher in MCS group compared to controls. Correlation analysis showed strong positive correlation between WNS, HQ and qEESI in MCS subjects. CONCLUSIONS For the first time, auditory-related perceptual disorders were studied in MCS. A strong association between WNS, HQ results and MCS symptoms severity has been highlighted. These findings suggest that decreased sound tolerance and noise sensitivity could be considered as possible new aspects of this syndrome, contributing to its peculiar phenotype. Furthermore, as DPOAE values did not differ from healthy subjects, present findings might suggest a 'central' source for such disorders in this group of patients.
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Affiliation(s)
- Andrea Viziano
- Department of Clinical Sciences and Translational Medicine, 'Tor Vergata' University, Via Montpellier, 1, E sud Tower, 00133, Rome, Italy
| | - Alessandro Micarelli
- Department of Clinical Sciences and Translational Medicine, 'Tor Vergata' University, Via Montpellier, 1, E sud Tower, 00133, Rome, Italy. .,Department of Systems Medicine - Neuroscience Unit, 'Tor Vergata' University, Rome, Italy.
| | - Marco Alessandrini
- Department of Clinical Sciences and Translational Medicine, 'Tor Vergata' University, Via Montpellier, 1, E sud Tower, 00133, Rome, Italy
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Deranged Dimensionality of Vestibular Re-Weighting in Multiple Chemical Sensitivity. APPLIED SCIENCES-BASEL 2016. [DOI: 10.3390/app6110330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Micarelli A, Viziano A, Genovesi G, Bruno E, Ottaviani F, Alessandrini M. Lack of contralateral suppression in transient-evoked otoacoustic emissions in multiple chemical sensitivity: a clinical correlation study. Noise Health 2016; 18:143-9. [PMID: 27157687 PMCID: PMC4918670 DOI: 10.4103/1463-1741.181997] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Multiple chemical sensitivity (MCS) is a chronic disorder characterized by a variety of symptoms associated with the exposure to chemicals at a concentration below the toxic level. Previous studies have demonstrated peculiar responses in brain activity in these patients with respect to sensory stimuli while the association between chemical sensitivity and other environmental intolerances such as noise sensitivity has been questioned by researchers. In this study, a cohort of 18 MCS patients underwent transient-evoked otoacoustic emission (TEOAE) testing with and without contralateral suppression to evaluate the functionality of the medial olivocochlear (MOC) reflex involved in speech-in-noise sensitivity. Results were compared with an age- and gender-matched control group (n = 20) and correlation analysis with disease onset and quick environmental exposure sensitivity inventory (qEESI) symptom severity scale was performed. Subjects affected by MCS showed statistically significant impairment of MOC reflex, and the onset of the disease and several symptom subscales showed to be correlated to such reduction in some of the frequencies tested. These data suggest that alterations of MOC reflex could be part of the complex features of this disease although more studies are needed to further explore auditory perception disorders in environmental intolerances.
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Affiliation(s)
- Alessandro Micarelli
- Department of Clinical Sciences and Traslational Medicine; Department of Systems Medicine, Neuroscience Unit, University of Rome 'Tor Vergata', Rome, Italy
| | - Andrea Viziano
- Department of Clinical Sciences and Traslational Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Giuseppe Genovesi
- Department of Experimental Medicine, University of Rome 'La Sapienza', Rome, Italy
| | - Ernesto Bruno
- Department of Clinical Sciences and Traslational Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Fabrizio Ottaviani
- Department of Clinical Sciences and Traslational Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Marco Alessandrini
- Department of Clinical Sciences and Traslational Medicine, University of Rome 'Tor Vergata', Rome, Italy
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Involvement of Subcortical Brain Structures During Olfactory Stimulation in Multiple Chemical Sensitivity. Brain Topogr 2015; 29:243-52. [DOI: 10.1007/s10548-015-0453-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 09/26/2015] [Indexed: 10/23/2022]
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Andersson L, Claeson AS, Dantoft TM, Skovbjerg S, Lind N, Nordin S. Chemosensory perception, symptoms and autonomic responses during chemical exposure in multiple chemical sensitivity. Int Arch Occup Environ Health 2015; 89:79-88. [PMID: 25917753 DOI: 10.1007/s00420-015-1053-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 04/17/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE Multiple chemical sensitivity (MCS) is a prevalent medically unexplained symptom characterized by symptom reactions to everyday chemical exposure below hygienic thresholds. The aim of this study was to investigate the expressions of hyper-reactivity in MCS during whole-body exposure to low concentrations of the odorant n-butanol. METHODS We exposed 18 participants with MCS and 18 non-ill controls to a low concentration of the odorant n-butanol using an exposure chamber. The first 10 min constituted blank exposure, after which the n-butanol concentration increased and reached a plateau at 11.5 mg/m(3). RESULTS MCS participants, compared with controls, reported greater perceived odor intensities, more unpleasantness to the exposure and increasing symptoms over time. MCS participants also expressed higher pulse rate and lower pulse rate variability than controls did. No group differences were found for breathing rate or tonic electrodermal activity responses. CONCLUSIONS We conclude that MCS sufferers differ from healthy controls in terms of autonomic responses, symptoms and chemosensory perception during chemical exposure.
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Affiliation(s)
- Linus Andersson
- Department of Occupational and Public Health Sciences, University of Gävle, Johan Bures Väg 13, 907 36, Umeå, Sweden.
| | | | - Thomas Meinertz Dantoft
- Danish Research Centre for Chemical Sensitivities, Copenhagen University Hospital Gentofte, Ledreborg Allé 40, 2, 2820, Gentofte, Denmark. .,Department of Systems Biology, Center for Biological Sequence Analysis, Technical University of Denmark, Kemitorvet, Building 208, 2800, Lyngby, Denmark.
| | - Sine Skovbjerg
- Danish Research Centre for Chemical Sensitivities, Copenhagen University Hospital Gentofte, Ledreborg Allé 40, 2, 2820, Gentofte, Denmark.
| | - Nina Lind
- Department of Psychology, Umeå University, 901 87, Umeå, Sweden.
| | - Steven Nordin
- Department of Psychology, Umeå University, 901 87, Umeå, Sweden.
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Chiaravalloti A, Pagani M, Micarelli A, Di Pietro B, Genovesi G, Alessandrini M, Schillaci O. Cortical activity during olfactory stimulation in multiple chemical sensitivity: a (18)F-FDG PET/CT study. Eur J Nucl Med Mol Imaging 2015; 42:733-40. [PMID: 25690545 DOI: 10.1007/s00259-014-2969-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/03/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To investigate the differences in brain glucose consumption during olfactory stimulation between subjects affected by multiple chemical sensitivity (MCS) and a group of healthy individuals. METHODS Two (18)F-FDG PET/CT scans were performed in 26 subjects (6 men and 20 women; mean age 46.7 ± 11 years) with a clinical diagnosis of MCS and in 11 healthy controls (6 women and 5 men; mean age 45.7 ± 11 years), the first scan after a neutral olfactory stimulation (NS) and the second after a pure olfactory stimulation (OS). Differences in (18)F-FDG uptake were analysed by statistical parametric mapping (SPM2). RESULTS In controls OS led to an increase in glucose consumption in BA 18 and 19 and a reduction in glucose metabolism in BA 10, 11, 32 and 47. In MCS subjects, OS led to an increase in glucose consumption in BA 20, 23, 18 and 37 and a reduction in glucose metabolism in BA 8, 9 and 10. CONCLUSION The results of our study suggest that cortical activity in subjects with MCS differs from that in healthy individuals during olfactory stimulation.
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Assessment of cerebral blood flow in patients with multiple chemical sensitivity using near-infrared spectroscopy--recovery after olfactory stimulation: a case-control study. Environ Health Prev Med 2015; 20:185-94. [PMID: 25682122 DOI: 10.1007/s12199-015-0448-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 02/04/2015] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Multiple chemical sensitivity (MCS) is a chronic acquired disorder characterized by non-specific symptoms in multiple organ systems associated with exposure to odorous chemicals. We previously observed significant activations in the prefrontal cortex (PFC) during olfactory stimulation using several different odorants in patients with MCS by near-infrared spectroscopy (NIRS) imaging. We also observed that the patients with MCS did not adequately distinguish non-odorant in the late stage of the repeated olfactory stimulation test. The sensory recovery of the olfactory system in the patients with MCS may process odors differently from healthy subjects after olfactory stimulation. METHODS We examined the recovery process of regional cerebral blood flow (rCBF) after olfactory stimulation in patients with MCS. NIRS imaging was performed in 6 patients with MCS and in 6 controls. The olfactory stimulation test was continuously repeated 10 times. The study also included a subjective assessment of the physical and psychological status and of the perception of irritating and hedonic odors. RESULTS After olfactory stimulation, significant activations were observed in the PFC of patients with MCS on both the right and left sides compared with controls. The activations were specifically strong in the orbitofrontal cortex (OFC). Compared with controls, autonomic perception and feelings identification were poorer in patients with MCS. OFC is associated with stimuli response and the representation of preferences. CONCLUSIONS These results suggest that a past strong exposure to hazardous chemicals activates the PFC during olfactory stimuli in patients with MCS, and a strong activation in the OFC remains after the stimuli.
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Andersson L, Claeson AS, Nyberg L, Stenberg B, Nordin S. Brain responses to olfactory and trigeminal exposure in idiopathic environmental illness (IEI) attributed to smells -- an fMRI study. J Psychosom Res 2014; 77:401-8. [PMID: 25294782 DOI: 10.1016/j.jpsychores.2014.09.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 08/28/2014] [Accepted: 09/22/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Idiopathic environmental intolerance (IEI) to smells is a prevalent medically unexplained illness. Sufferers attribute severe symptoms to low doses of non-toxic chemicals. Despite the label, IEI is not characterized by acute chemical senses. Theoretical models suggest that sensitized responses in the limbic system of the brain constitute an important mechanism behind the symptoms. The aim was to investigate whether and how brain reactions to low-levels of olfactory and trigeminal stimuli differ in individuals with and without IEI. METHODS Brain responses to intranasally delivered isoamyl acetate and carbon dioxide were assessed in 25 women with IEI and 26 non-ill controls using functional magnetic resonance imaging. RESULTS The IEI group had higher blood-oxygenated-level-dependent (BOLD) signal than controls in the thalamus and a number of, mainly, parietal areas, and lower BOLD signal in the superior frontal gyrus. The IEI group did not rate the exposures as more intense than the control group did, and there were no BOLD signal differences between groups in the piriform cortex or olfactory regions of the orbitofrontal cortex. CONCLUSIONS The IEI reactions were not characterized by hyper-responsiveness in sensory areas. The results can be interpreted as a limbic hyperreactivity and speculatively as an inability to inhibit salient external stimuli.
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Affiliation(s)
| | | | - Lars Nyberg
- Department of Integrative Medical Biology and Physiology, Umeå University, Sweden; Department of Radiation sciences, Umeå University, Sweden
| | - Berndt Stenberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
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Krajnik J, Kollndorfer K, Nenning KH, Lundström JN, Schöpf V. Gender effects and sexual-orientation impact on androstadienone-evoked behavior and neural processing. Front Neurosci 2014; 8:195. [PMID: 25132813 PMCID: PMC4116783 DOI: 10.3389/fnins.2014.00195] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 06/22/2014] [Indexed: 11/27/2022] Open
Abstract
In humans, the most established and investigated substance acting as a chemosignal, i.e., a substance that is excreted from the body, is 4,16-androstadien-3-one (AND). AND, which is found in sweat and saliva, is known to be responsible for influencing several variables, such as psychophysiological status, behavior, as well as cortical processing. The aim of the present review is to give insight into the variety of AND effects, with special regard to specific cross-sexual characteristics of this putative human chemosignal, emphasizing the neural activation patterns and factors such as contextual conditions. This review highlights the importance of including those contributing factors into the analysis of behavioral as well as brain-related studies.
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Affiliation(s)
- Jacqueline Krajnik
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna Vienna, Austria
| | - Kathrin Kollndorfer
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna Vienna, Austria
| | - Karl-Heinz Nenning
- Department of Biomedical Imaging and Image-Guided Therapy, Computational Image Analysis and Radiology Lab, Medical University of Vienna Vienna, Austria
| | - Johan N Lundström
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden ; Monell Chemical Senses Center Philadelphia, PA, USA ; Department of Psychology, University of Pennsylvania Philadelphia, PA, USA
| | - Veronika Schöpf
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna Vienna, Austria
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Cortico-subcortical metabolic correlates of olfactory processing in healthy resting subjects. Sci Rep 2014; 4:5146. [PMID: 24888510 PMCID: PMC4042120 DOI: 10.1038/srep05146] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 05/02/2014] [Indexed: 12/03/2022] Open
Abstract
A wide network of interconnected areas was previously found in neuroimaging studies involving normal as well as pathological subjects; however literature seems to suffer from a lack of investigation in glucose metabolism behaviour under olfactory condition. Thus, the present work describe for the first time a pure olfactory related brain response of metabolism by using 18F-fluorodeoxyglucose-Positron Emission Tomography/Computer Tomography in eleven resting subjects undergoing a neutral and a pure olfactory condition. By contrasting these experimental phases, it was possible to depict a re-organization pattern of default mode network structures in a relatively ecological environment. Moreover, by correlating such pattern with a battery of validated olfactory and neuropsychological tests, our work allowed in showing peculiar correlation data that could cluster the subjects sample in a certain range of normality. We believe the present study could integrate the current knowledge in olfactory research and could be a start-up for future contributions.
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Tran MTD, Skovbjerg S, Arendt-Nielsen L, Bech P, Lunde M, Elberling J. Two of three patients with multiple chemical sensitivity had less symptoms and secondary hyperalgesia after transcranially applied pulsed electromagnetic fields. Scand J Pain 2014; 5:104-109. [PMID: 29913674 DOI: 10.1016/j.sjpain.2013.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 11/16/2013] [Indexed: 10/25/2022]
Abstract
Background Multiple chemical sensitivity (MCS) is a chronic, disabling condition characterized by recurrent multisystem symptoms triggered by common airborne chemicals. Evidence points towards abnormal sensory processing in the central nervous system (CNS) as a likely pathophysiological mechanism. No effective treatment has yet been reported, but clinical observations suggest that as pulsed electromagnetic fields (PEMF) is a treatment for some CNS disorders (depression and chronic pain), it may also be a treatment modality for MCS. Methods In an open case study, the effects of PEMF were assessed in three MCS patients. All cases received 30 min daily treatment 5 days a week for 8 consecutive weeks. Symptoms and functional impairments related to MCS, depressive symptoms, and capsaicin-induced secondary punctate hyperalgesia were assessed at baseline and weekly until an 18-week follow-up. Results Two of the three cases showed considerable improvement on all measures of symptoms and functional impairments related to MCS in response to PEMF therapy. One case showed no improvement and during the treatment period was unexpectedly diagnosed with depression. Conclusion Our findings indicate potential benefits of PEMF therapy in MCS. Implication The therapeutic effect of PEMF in MCS needs to be investigated by a randomized placebo-controlled trial.
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Affiliation(s)
- Marie Thi Dao Tran
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Ledreborg Allé 40, 2. th., DK-2820 Gentofte, Denmark
| | - Sine Skovbjerg
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Ledreborg Allé 40, 2. th., DK-2820 Gentofte, Denmark
| | - Lars Arendt-Nielsen
- Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Frederik Bajers Vej 7 D3, DK-9220 Aalborg, Denmark
| | - Per Bech
- Psychiatric Research Unit, Mental Health Centre North Zealand, Dyrehavevej 48, DK-3400 Hillerød, Denmark
| | - Marianne Lunde
- Psychiatric Research Unit, Mental Health Centre North Zealand, Dyrehavevej 48, DK-3400 Hillerød, Denmark
| | - Jesper Elberling
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Ledreborg Allé 40, 2. th., DK-2820 Gentofte, Denmark
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Allergological and toxicological aspects in a multiple chemical sensitivity cohort. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2013; 2013:356235. [PMID: 24367721 PMCID: PMC3866722 DOI: 10.1155/2013/356235] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 05/11/2013] [Indexed: 11/30/2022]
Abstract
Background. Multiple chemical sensitivity (MCS) is a chronic condition characterized by an exaggerated response to toxicants. We ascertained the prevalence of allergy to metals and toxicological aspects in MCS patients. Methods. We conducted a retrospective review of medical records of 41 patients with MCS. We performed patch testing (n = 21) for dental series and did lymphocyte transformation test (n = 18) for metals. We measured mercury in samples of blood (n = 19), urine (n = 19), saliva (n = 20), and scalp hair (n = 17) to investigate the association between mercury levels and cases of MCS. Results. The prevalence of metal immune hypersensitivity in a subset of 26 patients was 92.3 percent. Elevations of mercury occurred in 81.2 percent (26 of 32). The mean (±SD) in blood concentrations of mercury was 7.6 ± 13.6 μg/L; mean in urine was 1.9 ± 2.5 μg/L; mean in scalp hair was 2.2 ± 2.5 μg/g; mean in saliva was 38.1 ± 52.1 μg/L. Subgroup analyses showed that elevation of mercury levels in biological matrices were associated with mercury amalgams in patients with MCS (22 patients), compared with controls (8 patients) (odds ratio 11 : 95 percent confidence interval 1.5 to 81.6; P = 0.023). Conclusions. Our data show an increased prevalence of metal allergy and elevation of mercury levels in bioindicators among patients with MCS.
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Azuma K, Uchiyama I, Takano H, Tanigawa M, Azuma M, Bamba I, Yoshikawa T. Changes in cerebral blood flow during olfactory stimulation in patients with multiple chemical sensitivity: a multi-channel near-infrared spectroscopic study. PLoS One 2013; 8:e80567. [PMID: 24278291 PMCID: PMC3836968 DOI: 10.1371/journal.pone.0080567] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 10/03/2013] [Indexed: 11/19/2022] Open
Abstract
Multiple chemical sensitivity (MCS) is characterized by somatic distress upon exposure to odors. Patients with MCS process odors differently from controls. This odor-processing may be associated with activation in the prefrontal area connecting to the anterior cingulate cortex, which has been suggested as an area of odorant-related activation in MCS patients. In this study, activation was defined as a significant increase in regional cerebral blood flow (rCBF) because of odorant stimulation. Using the well-designed card-type olfactory test kit, changes in rCBF in the prefrontal cortex (PFC) were investigated after olfactory stimulation with several different odorants. Near-infrared spectroscopic (NIRS) imaging was performed in 12 MCS patients and 11 controls. The olfactory stimulation test was continuously repeated 10 times. The study also included subjective assessment of physical and psychological status and the perception of irritating and hedonic odors. Significant changes in rCBF were observed in the PFC of MCS patients on both the right and left sides, as distinct from the center of the PFC, compared with controls. MCS patients adequately distinguished the non-odorant in 10 odor repetitions during the early stage of the olfactory stimulation test, but not in the late stage. In comparison to controls, autonomic perception and negative affectivity were poorer in MCS patients. These results suggest that prefrontal information processing associated with odor-processing neuronal circuits and memory and cognition processes from past experience of chemical exposure play significant roles in the pathology of this disorder.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kinki University Faculty of Medicine, Osakasayama, Osaka, Japan
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- * E-mail:
| | - Iwao Uchiyama
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- Outpatient Department of Sick-house Syndrome, Hyakumanben Clinic, Kyoto, Japan
| | - Hirohisa Takano
- Environmental Health Division, Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Mari Tanigawa
- Clinical Immune Function Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- Division of Internal Medicine, Hyakumanben Clinic, Kyoto, Japan
| | - Michiyo Azuma
- Department of Human Environmental Design, Faculty of Health Science, Kio University, Kitakatsuragi-gun, Nara, Japan
| | - Ikuko Bamba
- Department of Environmental Medicine and Behavioral Science, Kinki University Faculty of Medicine, Osakasayama, Osaka, Japan
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Hummel T, Olgun S, Gerber J, Huchel U, Frasnelli J. Brain responses to odor mixtures with sub-threshold components. Front Psychol 2013; 4:786. [PMID: 24167499 PMCID: PMC3807048 DOI: 10.3389/fpsyg.2013.00786] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 10/07/2013] [Indexed: 11/13/2022] Open
Abstract
Although most odorants we encounter in daily life are mixtures of several chemical substances, we still lack significant information on how we perceive and how the brain processes mixtures of odorants. We aimed to investigate the processing of odor mixtures using behavioral measures and functional magnetic resonance imaging (fMRI). The odor mixture contained a target odor (ambroxan) in a concentration at which it could be perceived by half of the subjects (sensitive group); the other half could not perceive the odor (insensitive group). In line with previous findings on multi-component odor mixtures, both groups of subjects were not able to distinguish a complex odor mixture containing or not containing the target odor. However, sensitive subjects had stronger activations than insensitive subjects in chemosensory processing areas such as the insula when exposed to the mixture containing the target odor. Furthermore, the sensitive group exhibited larger brain activations when presented with the odor mixture containing the target odor compared to the odor mixture without the target odor; this difference was smaller, though present for the insensitive group. In conclusion, we show that a target odor presented within a mixture of odors can influence brain activations although on a psychophysical level subjects are not able to distinguish the mixture with and without the target. On the practical side these results suggest that the addition of a certain compound to a mixture of odors may not be detected on a cognitive level; however, this additional odor may significantly change the cerebral processing of this mixture. In this context, FMRI offers unique possibilities to look at the subliminal effects of odors.
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Affiliation(s)
- Thomas Hummel
- Department of Otorhinolaryngology, Technical University of Dresden Medical School Dresden, Germany
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Ohla K, Lundström JN. Sex differences in chemosensation: sensory or emotional? Front Hum Neurosci 2013; 7:607. [PMID: 24133429 PMCID: PMC3783851 DOI: 10.3389/fnhum.2013.00607] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 09/06/2013] [Indexed: 11/16/2022] Open
Abstract
Although the first sex-dependent differences in chemosensory processing were reported in the scientific literature over 60 years ago, the underlying mechanisms are still unknown. Generally, more pronounced sex-dependent differences are noted with increased task difficulty or with increased levels of intranasal irritation produced by the stimulus. Whether differences between the sexes arise from differences in chemosensory sensitivity of the two intranasal sensory systems involved or from differences in cognitive processing associated with emotional evaluation of the stimulants is still not known. We used simultaneous and complementary measures of electrophysiological (EEG), psychophysiological, and psychological responses to stimuli varying in intranasal irritation and odorousness to investigate whether sex differences in the processing of intranasal irritation are mediated by varying sensitivity of the involved sensory systems or by differences in cognitive and/or emotional evaluation of the irritants. Women perceived all stimulants more irritating and they exhibited larger amplitudes of the late positive deflection of the event-related potential than men. No significant differences in sensory sensitivity, anxiety, and arousal responses could be detected. Our findings suggest that men and women process intranasal irritation differently. Importantly, the differences cannot be explained by variation in sensory sensitivity to irritants, differences in anxiety, or differences in physiological arousal. We propose that women allocate more attention to potentially noxious stimuli than men do, which eventually causes differences in cognitive appraisal and subjective perception.
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Affiliation(s)
- Kathrin Ohla
- Monell Chemical Senses Center Philadelphia, PA, USA
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Tran MTD, Skovbjerg S, Arendt-Nielsen L, Christensen KB, Elberling J. Transcranial pulsed electromagnetic fields for multiple chemical sensitivity: study protocol for a randomized, double-blind, placebo-controlled trial. Trials 2013; 14:256. [PMID: 23947742 PMCID: PMC3765111 DOI: 10.1186/1745-6215-14-256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 08/05/2013] [Indexed: 12/17/2022] Open
Abstract
Background Multiple chemical sensitivity (MCS) is a chronic condition of unknown etiology. MCS is characterized by recurrent nonspecific symptoms from multiple organ systems in response to chemical exposures in concentrations that are normally tolerated by the majority of the population. The symptoms may have severe impact on patients’ lives, but an evidence-based treatment for the condition is nonexisting. The pathophysiology is unclarified, but several indicators point towards abnormal processing of sensory signals in the central nervous system. Pulsed electromagnetic fields (PEMF) offer a promising new treatment for refractory depression and can be targeted at the brain, thereby activating biochemical cell processes. Methods/Design In a parallel, randomized, double-blind, placebo-controlled trial conducted at the Danish Research Centre for Chemical Sensitivities, the effects of PEMF in MCS patients will be assessed using the Re5 Independent System. Based on sample size estimation, 40 participants will be randomized to either PEMF therapy or placebo. The allocation sequence will be generated by computer. All involved parties (that is, participants, investigators, the research nurse, and the statistician) will be blinded to group allocation. The participants will receive PEMF therapy or placebo applied transcranially 30 minutes twice a day for 7 days a week over 6 consecutive weeks. Outcomes will be measured at baseline, once weekly during treatment, post treatment, and at 2.5-month and 4.5-month follow-up according to a predefined timetable. The primary outcome will be a measurement of the impact of MCS on everyday life. The secondary outcomes will be measurements of MCS symptoms, psychological distress (stress, anxiety or depressive symptoms), capsaicin-induced secondary punctate hyperalgesia, immunological markers in serum, and quality of life. Discussion This trial will assess the effects of PEMF therapy for MCS. Currently, there is no treatment with a documented effect on MCS, and in terms of healthcare there is very little to offer these patients. There is thus a great need for well-conducted randomized trials aimed at assessing possible treatment effects. A positive outcome will pave the way for improved healthcare and understanding of this very disabling and overlooked condition. Trial registration ClinicalTrials.gov, NCT01834781
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Affiliation(s)
- Marie Thi Dao Tran
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Ledreborg Allé 40, 2, th,, DK-2820 Gentofte, Denmark.
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Barnig C, de Blay F. [Pathophysiology of multiple chemical sensitivity]. Rev Mal Respir 2013; 30:446-50. [PMID: 23835316 DOI: 10.1016/j.rmr.2013.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 02/11/2013] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND BACKGROUND Multiple chemical sensitivity (MCS) is a complex clinical entity that includes a large number of non-specific symptoms, associated in a univocal manner in each patient and triggered by exposure to various chemicals at low concentrations, well below those known to cause toxic effects. However, no objective test exists currently to diagnose this syndrome. One of the main reasons is that the pathophysiology is poorly understood. However, many explanatory hypotheses have been proposed. VIEWPOINTS AND CONCLUSIONS Patients with symptoms of MCS are often encountered by pulmonologists. Their suffering is undeniable but, unfortunately, the lack of understanding of the pathophysiological mechanisms makes treatment difficult and empirical.
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Affiliation(s)
- C Barnig
- Service de pneumologie, d'allergologie et de pathologie respiratoire de l'environnement, pôle de pathologie thoracique, hôpitaux universitaires de Strasbourg, BP 426, 67091 Strasbourg cedex, France.
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Hillert L, Jovanovic H, Åhs F, Savic I. Women with multiple chemical sensitivity have increased harm avoidance and reduced 5-HT(1A) receptor binding potential in the anterior cingulate and amygdala. PLoS One 2013; 8:e54781. [PMID: 23349968 PMCID: PMC3551905 DOI: 10.1371/journal.pone.0054781] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 12/18/2012] [Indexed: 12/05/2022] Open
Abstract
Multiple chemical sensitivity (MCS) is a common condition, characterized by somatic distress upon exposure to odors. As in other idiopathic environmental intolerances, the underlying mechanisms are unknown. Contrary to the expectations it was recently found that persons with MCS activate the odor-processing brain regions less than controls, while their activation of the anterior cingulate cortex (ACC) is increased. The present follow-up study was designed to test the hypotheses that MCS subjects have increased harm avoidance and deviations in the serotonin system, which could render them intolerant to environmental odors. Twelve MCS and 11 control subjects, age 22–44, all working or studying females, were included in a PET study where 5-HT1A receptor binding potential (BP) was assessed after bolus injection of [11C]WAY100635. Psychological profiles were assessed by the Temperament and Character Inventory and the Swedish universities Scales of Personality. All MCS and 12 control subjects were also tested for emotional startle modulation in an acoustic startle test. MCS subjects exhibited significantly increased harm avoidance, and anxiety compared to controls. They also had a reduced 5-HT1A receptor BP in amygdala (p = 0.029), ACC (p = 0.005) (planned comparisons, significance level 0.05), and insular cortex (p = 0.003; significance level p<0.005 with Bonferroni correction), and showed an inverse correlation between degree of anxiety and the BP in the amygdala (planned comparison). No group by emotional category difference was found in the startle test. Increased harm avoidance and the observed changes in the 5-HT1A receptor BP in the regions processing harm avoidance provides a plausible pathophysiological ground for the symptoms described in MCS, and yields valuable information for our general understanding of idiopathic environmental intolerances.
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Affiliation(s)
- Lena Hillert
- Department of Public Health Sciences, Division of Occupational and Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Non-invasive assessment of exhaled breath pattern in patients with multiple chemical sensibility disorder. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2012; 756:179-88. [PMID: 22836634 DOI: 10.1007/978-94-007-4549-0_23] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Multiple chemical sensitivity (MCS) is a complex disorder initiated by chemical exposure, particularly through the airways. MCS patients report sensitivity or intolerance to low levels of a wide spectrum of chemicals. Symptoms could include asthma-like signs, rhinitis, fatigue, cognitive dysfunction, psycho-physiological alteration, and other specific tissue reactions resembling hypoxic and oxidative stress effects. To recognize physiological signs that would allow the diagnosis of MCS in a non-invasive way we investigated the potential application of a new sensor system. In healthy volunteers, we measured exhaled breath content in the control condition and under exposure to olfactory stressors that mimic hypoxic or pollutant stressors playing a potential role in the generation of the MCS disorder. The recording system used is based on metal oxide semiconductor (MOS) sensor having a sensing range of 450-2,000 ppm CO(2) equivalents, which is able to detect a broad range of compounds playing a potential role in the generation of the MCS disorder, while correlating directly with the CO(2) levels. The results indicate that the recording system employed was suitable for the analysis of exhaled breath content in humans. Interestingly, the system was able to detect and discriminate between the exhaled breath content taken from the control condition and those from conditions under stress that mimicked exposures to pollutant or hypoxia. The results suggest that chronic hypoxia could be involved in the MCS disorder.
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Seubert J, Freiherr J, Djordjevic J, Lundström JN. Statistical localization of human olfactory cortex. Neuroimage 2012; 66:333-42. [PMID: 23103688 DOI: 10.1016/j.neuroimage.2012.10.030] [Citation(s) in RCA: 133] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 10/18/2012] [Accepted: 10/19/2012] [Indexed: 10/27/2022] Open
Abstract
Functional neuroimaging methods have been used extensively during the last decades to explore the neural substrates of olfactory processing. While a general consensus on the functional anatomy of olfactory cortex is beginning to emerge, the mechanisms behind the functions of individual processing nodes still remain debated. Further, it remains unclear to which extent divergent findings result from differences in methodological approaches. Using Activation Likelihood Estimation (ALE), the aim of the present study was to statistically combine all published data on functional neuroimaging of olfaction to provide a probability map reflecting the state of the field to date. Additionally, we grouped studies according to various methodological approaches to investigate whether these systematically affected the reported findings. A total of 45 studies (69 contrasts, 594 foci) met our inclusion criteria. Significant ALE peaks for odor against baseline were observed in areas commonly labeled as primary and secondary olfactory cortex, such as the piriform and orbitofrontal cortex, amygdala, anterior insula, and ventral putamen. In addition, differences were observed in the extent to which different methods were able to induce activation in these different nodes of the olfactory network.
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Affiliation(s)
| | - Jessica Freiherr
- Clinic for Diagnostic and Interventional Neuroradiology, RWTH Aachen University, Aachen, Germany
| | | | - Johan N Lundström
- Monell Chemical Senses Center, Philadelphia, PA, USA; Department of Psychology, University of Pennsylvania, PA, USA; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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Hetherington L, Battershill J. Review of evidence for a toxicological mechanism of idiopathic environmental intolerance. Hum Exp Toxicol 2012; 32:3-17. [PMID: 23060407 DOI: 10.1177/0960327112457189] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Idiopathic environmental intolerance (IEI) is a medically unexplained disorder characterised by a wide variety of unspecific symptoms in different organ systems and attributed to nontoxic concentrations of chemicals and other environmental factors that are tolerated by the majority of individuals. Both exposure to chemicals and behavioural conditioning are considered as possible contributors to the development of IEI. However, owing to the heterogeneity of the condition, it is difficult to separate the toxicological, physiological and psychological aspects of IEI. Here, we review the evidence for postulated toxicologically mediated mechanisms for IEI. Available data do not support either a classical receptor-mediated or an idiosyncratic toxicological mechanism. Furthermore, if there were convincing evidence for a psychological cause for many patients with IEI, then this would suggest that the priority for the future is the development of psychological treatments for IEI. Finally, we advocate genome wide screening of IEI patients to elucidate genotypic features of the condition.
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Affiliation(s)
- Lh Hetherington
- General Toxicology Group, Toxicology Department, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency, Didcot, Oxon, UK.
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Tran MTD, Arendt-Nielsen L, Kupers R, Elberling J. Multiple chemical sensitivity: on the scent of central sensitization. Int J Hyg Environ Health 2012; 216:202-10. [PMID: 22487274 DOI: 10.1016/j.ijheh.2012.02.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 02/06/2012] [Accepted: 02/20/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Multiple Chemical Sensitivity (MCS) is a chronic condition characterized by recurrent, non-specific symptoms in response to chemically unrelated exposures in non-toxic concentrations. Although the pathophysiology of MCS remains unknown, central sensitization may be an important factor contributing to the clinical manifestations. PURPOSE To use quantitative sensory testing (QST) to study central hyperexcitability and multiple aspects of central sensory processing in MCS patients without comorbid overlapping disorders and to compare the results with those among matched controls. METHODS 15 MCS patients and 15 healthy matched controls underwent QST to assess the following aspects of pain: capsaicin-induced secondary punctate hyperalgesia, stimulus response function (SRF) to punctate mechanical stimuli before and after capsaicin injection, temporal summation to punctate stimuli post capsaicin injection, pressure pain thresholds, heat pain thresholds, tonic heat stimulation and conditioning pain modulation (CPM: formerly known as diffuse noxious inhibitory control or DNIC). RESULTS The mean area of capsaicin-induced secondary punctate hyperalgesia was significantly larger in MCS patients than in controls at 5, 30 and 60 min post capsaicin injection (p=0.01). In addition MCS patients reported higher ratings in response to punctate mechanical stimuli assessed by SRF compared with controls (p<0.001). The CPM test induced significantly higher pain ratings in patients than in controls (p=0.002). We found no group differences in pressure pain and heat pain thresholds, temporal summation to punctate stimuli post capsaicin injection, capsaicin and tonic heat pain ratings or CPM effect. CONCLUSION Increased capsaicin-induced secondary punctate hyperalgesia was demonstrated in MCS patients without comorbid, overlapping disorders, suggesting facilitated central sensitization in MCS.
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Affiliation(s)
- Marie Thi Dao Tran
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Denmark.
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Cornell Karnekull S, Jonsson FU, Larsson M, Olofsson JK. Affected by Smells? Environmental Chemical Responsivity Predicts Odor Perception. Chem Senses 2011; 36:641-8. [DOI: 10.1093/chemse/bjr028] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Browning M, Fletcher P, Sharpe M. Can neuroimaging help us to understand and classify somatoform disorders? A systematic and critical review. Psychosom Med 2011; 73:173-84. [PMID: 21217095 PMCID: PMC3044887 DOI: 10.1097/psy.0b013e31820824f6] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Debate about the nature of somatoform disorders and their current diagnostic classification has been stimulated by the anticipation of new editions of Diagnostic and Statistical Manual of Mental Disorders and International Statistical Classification of Diseases and Related Health Problems diagnostic classifications. In the current paper, we review systematically the literature on the neuroimaging of somatoform disorders and related conditions with the aim of addressing two specific questions: Is there evidence of altered neural function or structure that is specifically associated with somatoform disorders? What conclusions can we draw from these findings about the etiology of somatoform disorders? METHODS Studies reporting neuroimaging findings in patients with a somatoform disorder or a functional somatic syndrome (such as fibromyalgia) were found using Pubmed, PsycINFO, and EMBASE database searches. Reported structural and functional neuroimaging findings were then extracted to form a narrative review. RESULTS A relatively mature literature on symptoms of pain and less developed literatures on conversion and fatigue symptoms were identified. The available evidence indicates that, when compared with nonclinical groups, somatoform diagnoses are associated with increased activity of limbic regions in response to painful stimuli and a generalized decrease in gray matter density; however, methodological considerations restrict the interpretation of these findings. CONCLUSIONS Whereas the neuroimaging literature has provided evidence about the possible mechanisms underlying somatoform disorders, this is not yet sufficient to provide a basis for classification. By adopting a wider variety of experimental designs and a more dynamic approach to diagnosis, there is every reason to be hopeful that neuroimaging data will play a significant role in future taxonomies.
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Affiliation(s)
- Michael Browning
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford OX3 7JX, UK.
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