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Yao L, Liu J, Yi X, Gu Q. The effect of nasopharyngeal obstruction on the olfactory bulb volume and olfactory sulcus depth in children : First author. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08945-x. [PMID: 39242410 DOI: 10.1007/s00405-024-08945-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 08/21/2024] [Indexed: 09/09/2024]
Abstract
PURPOSE Smell ability is associated with nasopharyngeal obstruction. Herein, we evaluated the effect of nasopharyngeal obstruction by adenoid hypertrophy on the olfactory bulb (OB) volume and olfactory sulcus (OS) depth in children. METHODS A total of 135 children who were candidates for brain magnetic resonance imagining scanning were enrolled in the study. The olfactory disorder-negative statements questionnaire was utilized to assess the patient-reported olfactory status. A validated sleep questionnaire was used to assess sleeping status. According to the adenoidal/nasopharyngeal (A/N) ratio, the children were divided into two groups: those with an A/N ratio ≤ 0.5 (n = 70) and those with an A/N ratio > 0.5 (n = 65). OB volume and OS depth measurements were performed on coronal T2-weighted images using planimetric manual contouring. The mean OB volumes and OS depths on the right and left sides were used for the evaluation. RESULTS The mean OB volume of the group with an A/N ratio > 0.5 was significantly lower than that of the group with an A/N ratio ≤ 0.5 (P = 0.003), while there was no difference in the mean OS depth between groups (P = 0.061). In those with an A/N ratio > 0.5, the mean OB volume in older children (aged 9-12 years) was significantly lower than that in younger children (aged 5-8 years) (P = 0.012). In terms of laterality, the OS depth on the right side was significantly larger than that on the left side in both groups (P = 0.039 and P = 0.001). In the group with an A/N ratio ≤ 0.5, the OB volume on the right side was also significantly larger than that on the left side (P = 0.040); however, no such difference was observed in the group with an A/N ratio > 0.5 (P = 0.630). No sex-based differences were evident for any variable. CONCLUSIONS Children with nasopharyngeal obstruction greater than 50% have a significantly smaller OB volume. Our results suggest that morphological alterations in OB may contribute to the pathogenic mechanism of olfactory dysfunction related to nasopharyngeal obstruction.
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Affiliation(s)
- Linyin Yao
- Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jia Liu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Children's Hospital, Capital Institute of Pediatrics, Yabao Road 2, Beijing, 100020, China
| | - Xiaoli Yi
- Department of Radiology, The Affiliated Children's Hospital, Capital Institute of Pediatrics, Yabao Road 2, Beijing, 100020, China.
| | - Qinglong Gu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Children's Hospital, Capital Institute of Pediatrics, Yabao Road 2, Beijing, 100020, China.
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2
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Ren H, Li Z, Li J, Zhou J, He Y, Li C, Wang Q, Chen X, Tang J. Correlation Between Cortical Thickness Abnormalities of the Olfactory Sulcus and Olfactory Identification Disorder and Persistent Auditory Verbal Hallucinations in Chinese Patients With Chronic Schizophrenia. Schizophr Bull 2024; 50:1232-1242. [PMID: 38577952 PMCID: PMC11349016 DOI: 10.1093/schbul/sbae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
BACKGROUND AND HYPOTHESIS Persistent auditory verbal hallucinations (pAVHs) and olfactory identification impairment are common in schizophrenia (SCZ), but the neuroimaging mechanisms underlying both pAVHs and olfactory identification impairment are unclear. This study aimed to investigate whether pAVHs and olfactory identification impairment in SCZ patients are associated with changes in cortical thickness. STUDY DESIGN In this study, cortical thickness was investigated in 78 SCZ patients with pAVHs (pAVH group), 58 SCZ patients without AVHs (non-AVH group), and 83 healthy controls (HC group) using 3T magnetic resonance imaging. The severity of pAVHs was assessed by the Auditory Hallucination Rating Scale. Olfactory identification deficits were assessed using the Odor Stick Identification Test for Japanese (OSIT-J). In addition, the relationship between the severity of pAVHs and olfactory identification disorder and cortical thickness abnormalities was determined. STUDY RESULTS Significant reductions in cortical thickness were observed in the right medial orbital sulcus (olfactory sulcus) and right orbital sulcus (H-shaped sulcus) in the pAVH group compared to both the non-AVH and HC groups (P < .003, Bonferroni correction). Furthermore, the severity of pAVHs was found to be negatively correlated with the reduction in cortical thickness in the olfactory sulcus and H-shaped sulcus. Additionally, a decrease in cortical thickness in the olfactory sulcus showed a positive correlation with the OSIT-J scores (P < .05, false discovery rate correction). CONCLUSIONS Cortical thickness abnormalities in the olfactory sulcus may be a common neuroimaging mechanism for pAVHs and olfactory identification deficits in SCZ patients.
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Affiliation(s)
- Honghong Ren
- Department of Clinical Psychology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Clinical Psychology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zongchang Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jinguang Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jun Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ying He
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Chunwang Li
- Department of Radiology, Hunan Children’s Hospital, Changsha, China
| | - Qianjin Wang
- Department of Clinical Psychology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Clinical Psychology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaogang Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Hunan Provincial Brain Hospital (The second people's Hospital of Hunan Province), Changsha, China
- Zigong Mental Health Center, Zigong, China
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Petersen M, Becker B, Schell M, Mayer C, Naegele FL, Petersen E, Twerenbold R, Thomalla G, Cheng B, Betz C, Hoffmann AS. Reduced olfactory bulb volume accompanies olfactory dysfunction after mild SARS-CoV-2 infection. Sci Rep 2024; 14:13396. [PMID: 38862636 PMCID: PMC11167024 DOI: 10.1038/s41598-024-64367-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 06/06/2024] [Indexed: 06/13/2024] Open
Abstract
Despite its high prevalence, the determinants of smelling impairment in COVID-19 remain not fully understood. In this work, we aimed to examine the association between olfactory bulb volume and the clinical trajectory of COVID-19-related smelling impairment in a large-scale magnetic resonance imaging (MRI) analysis. Data of non-vaccinated COVID-19 convalescents recruited within the framework of the prospective Hamburg City Health Study COVID Program between March and December 2020 were analyzed. At baseline, 233 participants underwent MRI and neuropsychological testing as well as a structured questionnaire for olfactory function. Between March and April 2022, olfactory function was assessed at follow-up including quantitative olfactometric testing with Sniffin' Sticks. This study included 233 individuals recovered from mainly mild to moderate SARS-CoV-2 infections. Longitudinal assessment demonstrated a declining prevalence of self-reported olfactory dysfunction from 67.1% at acute infection, 21.0% at baseline examination and 17.5% at follow-up. Participants with post-acute self-reported olfactory dysfunction had a significantly lower olfactory bulb volume at baseline than normally smelling individuals. Olfactory bulb volume at baseline predicted olfactometric scores at follow-up. Performance in neuropsychological testing was not significantly associated with the olfactory bulb volume. Our work demonstrates an association of long-term self-reported smelling dysfunction and olfactory bulb integrity in a sample of individuals recovered from mainly mild to moderate COVID-19. Collectively, our results highlight olfactory bulb volume as a surrogate marker that may inform diagnosis and guide rehabilitation strategies in COVID-19.
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Affiliation(s)
- Marvin Petersen
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Benjamin Becker
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Schell
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Carola Mayer
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Felix L Naegele
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Elina Petersen
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
| | - Raphael Twerenbold
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- University Center of Cardiovascular Science, University Heart and Vascular Center, Hamburg, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Bastian Cheng
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Christian Betz
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anna S Hoffmann
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Kumaresan K, Bengtsson S, Sami S, Clark A, Hummel T, Boardman J, High J, Sobhan R, Philpott C. A double-blinded randomised controlled trial of vitamin A drops to treat post-viral olfactory loss: study protocol for a proof-of-concept study for vitamin A nasal drops in post-viral olfactory loss (APOLLO). Pilot Feasibility Stud 2023; 9:174. [PMID: 37828592 PMCID: PMC10568902 DOI: 10.1186/s40814-023-01402-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/28/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Smell loss is a common problem with an estimated 5% of the population having no functioning sense of smell. Viral causes of smell loss are the second most common cause and the coronavirus (COVID-19) pandemic is estimated to have caused 20,000 more people this year to have a lasting loss of smell. Isolation, depression, anxiety, and risk of danger from hazards such as toxic gas and spoiled food are all negative impacts. It also affects appetite with weight loss/gain in two-thirds of those affected. Phantosmia or smell distortion can also occur making most foods seem unpalatable. Smell training has been tried with good results in the immediate post-viral phase. Evidence behind treatment with steroids has not shown to have proven effectiveness. With this, a key problem for patients and their clinicians is the lack of proven effective therapeutic treatment options. Based on previous studies, there is some evidence supporting the regenerative potential of retinoic acid, the metabolically active form of vitamin A in the regeneration of olfactory receptor neurons. It is based on this concept that we have chosen vitamin A as our study comparator. AIM To undertake a two-arm randomised trial of intranasally delivered vitamin A vs no intervention to determine proof of concept. METHODS/DESIGN The study will compare 10,000 IU once daily Vitamin A self-administered intranasal drops versus peanut oil drops (placebo) delivered over 12 weeks in patients with post-viral olfactory loss. Potentially eligible patients will be recruited from the Smell & Taste Clinic and via the charity Fifth Sense. They will be invited to attend the Brain Imaging Centre at the University of East Anglia on two occasions, 3 months apart. If they meet the eligibility criteria, they will be consented to enter the study and randomised to receive vitamin A drops or no treatment in a 2:1 ratio. MRI scanning will enable volumetric measurement of the OB and ROS; fMRI will then be conducted using an olfactometer to deliver pulsed odours-phenethylalcohol (rose-like) and hydrogen sulphide (rotten eggs). Participants will also perform a standard smell test at both visits as well as complete a quality-of-life questionnaire. Change in OB volume will be the primary outcome measure. DISCUSSION We expect the outputs of this study to enable a subsequent randomised controlled trial of Vitamin A versus placebo. With PPI input we will make the outputs publicly available using journals, conferences, and social media via Fifth Sense. We have already prepared a draft RCT proposal in partnership with the Norwich Clinical Trials Unit and plan to develop this further in light of the findings. TRIAL REGISTRATION ISRCTN registry 39523. Date of registration in the primary registry: 23rd February 2021.
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Affiliation(s)
- Kala Kumaresan
- Norwich Medical School, University of East Anglia, Norwich, UK
- Norfolk & Waveney ENT Service, James Paget University Hospital NHS Foundation Trust, Great Yarmouth, UK
| | - Sara Bengtsson
- School of Psychology, University of East Anglia, Norwich, UK
| | - Saber Sami
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Allan Clark
- Norwich Medical School, University of East Anglia, Norwich, UK
| | | | | | - Juliet High
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Rashed Sobhan
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Carl Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK.
- Norfolk & Waveney ENT Service, James Paget University Hospital NHS Foundation Trust, Great Yarmouth, UK.
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5
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Rezaeyan A, Asadi S, Kamrava SK, Zare-Sadeghi A. Brain structural analysis in patients with post-traumatic anosmia: Voxel-based and surface-based morphometry. J Neuroradiol 2023; 50:482-491. [PMID: 36610937 DOI: 10.1016/j.neurad.2022.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE AND BACKGROUND Voxel-based morphometry (VBM) and surfaced-based morphometry (SBM) investigate the characteristics of gray matter (GM) in various diseases such as post-traumatic anosmia (PTA). This study uses SBM and VBM to examine neuroanatomical measurements of GM and its functional correlates in patients with PTA. METHODS MRI images and olfactory test results were collected from 39 PTA patients and 39 healthy controls. Sniffin' Sticks test was used to assess olfactory function. GM structure was analyzed using CAT12 and FreeSurfer, and olfactory bulb (OB) volume and olfactory sulcus (OS) depth were calculated using 3D-Slicer. RESULTS Anosmic patients showed lower scores in the Sniffin' Sticks olfactory test, as well as reduction of OB volume and OS depth compared to control subjects. In these patients, overlapping changes were found between the VBM and SBM findings in the areas with significant effects, in particular, orbitofrontal cortex, superior and middle frontal gyrus, superior and middle temporal gyrus, anterior cingulate cortex, and insular cortex. Using SBM, decreased cortical thickness clusters were located in inferior and superior parietal gyrus. Further analysis in the region of interest demonstrated correlations between the orbitofrontal cortex and odor threshold score as well as the middle frontal gyrus and smell loss duration. CONCLUSION These findings show that the morphological alterations in the OB, OS, and the central olfactory pathways might contribute to the pathogenic mechanism of olfactory dysfunction after head injury.
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Affiliation(s)
- Abolhasan Rezaeyan
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran; Department of Medical Physics, Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Somayeh Asadi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - S Kamran Kamrava
- ENT and Head and Neck Research Center and Department, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Zare-Sadeghi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; ENT and Head and Neck Research Center and Department, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran; Finetech in Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran.
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6
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Hänsel M, Schmitz-Peiffer H, Hähner A, Reichmann H, Schneider H. Olfactory dysfunction after autoimmune encephalitis depending on the antibody type and limbic MRI pathologies. Front Neurol 2023; 14:1225975. [PMID: 37693764 PMCID: PMC10486887 DOI: 10.3389/fneur.2023.1225975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 08/01/2023] [Indexed: 09/12/2023] Open
Abstract
Objective Patients' olfactory function after autoimmune encephalitis (AE) involving limbic structures may be impaired. This study aimed to characterize olfactory function in patients after autoimmune encephalitides. Methods A case-control study was performed including 11 AE patients with antibodies against NMDAR (n = 4), GAD (n = 3), VGKC (n = 3) and antibody-negative AE (n = 1) and a control group of 12 patients with pneumococcal meningo-encephalitis (PC). In subgroup analyses, AE patients with and without NMDAR-antibodies were compared. Olfactory function was assessed using the Sniffin Sticks test and the resulting TDI-score (threshold, discrimination, identification). Involvement of limbic structures was evaluated on imaging data (MRI). Statistical analyses were performed to test for correlations of TDI-score and MRI results. Results The overall olfactory function of the AE-group and the PC-group was comparable (mean TDI 32.0 [CI 27.3-36.7], 32.3 [CI 28.5-36.0)]. The proportions of hyposmic patients were similar compared to the general population. However, AE patients of the non-NMDAR group had significantly lower TDI-scores (28.9 ± 6,8) than NMDAR patients (37.4 ± 3.5) (p = 0.046) and a significantly lower discrimination capability than the NMDAR patients (9.9 ± 2.0 vs. 14.5 ± 0.6) (p = 0.002). The non-NMDAR patients had significantly more limbic MRI pathologies (6/7) compared to the NMDAR patients (0/4) (p = 0.015). Furthermore, a correlation between limbic MRI pathologies and worse capability of smelling discrimination was found (p = 0.016, r = -0.704, n = 11). Conclusion Our results indicate that patients with NMDAR autoimmune encephalitis have normal long term olfactory function. However, patients with non-NMDAR autoimmune encephalitis appear to have a persistently impaired olfactory function, probably mediated by encephalitic damage to limbic structures.
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Affiliation(s)
- Martin Hänsel
- Department of Neurology, University of Dresden, Dresden, Germany
- Department of Internal Medicine, GZO – Zurich Regional Health Center, Wetzikon, Switzerland
| | | | - Antje Hähner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Medical Faculty Carl-Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Heinz Reichmann
- Department of Neurology, University of Dresden, Dresden, Germany
| | - Hauke Schneider
- Department of Neurology, University of Dresden, Dresden, Germany
- Department of Neurology, Augsburg University Hospital, Augsburg, Germany
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Postma EM, Noothout JMH, Boek WM, Joshi A, Herrmann T, Hummel T, Smeets PAM, Išgum I, Boesveldt S. The potential for clinical application of automatic quantification of olfactory bulb volume in MRI scans using convolutional neural networks. Neuroimage Clin 2023; 38:103411. [PMID: 37163913 PMCID: PMC10193118 DOI: 10.1016/j.nicl.2023.103411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/17/2023] [Indexed: 05/12/2023]
Abstract
The olfactory bulbs (OBs) play a key role in olfactory processing; their volume is important for diagnosis, prognosis and treatment of patients with olfactory loss. Until now, measurements of OB volumes have been limited to quantification of manually segmented OBs, which is a cumbersome task and makes evaluation of OB volumes in large scale clinical studies infeasible. Hence, the aim of this study was to evaluate the potential of our previously developed automatic OB segmentation method for application in clinical practice and to relate the results to clinical outcome measures. To evaluate utilization potential of the automatic segmentation method, three data sets containing MR scans of patients with olfactory loss were included. Dataset 1 (N = 66) and 3 (N = 181) were collected at the Smell and Taste Center in Ede (NL) on a 3 T scanner; dataset 2 (N = 42) was collected at the Smell and Taste Clinic in Dresden (DE) on a 1.5 T scanner. To define the reference standard, manual annotation of the OBs was performed in Dataset 1 and 2. OBs were segmented with a method that employs two consecutive convolutional neural networks (CNNs) that the first localize the OBs in an MRI scan and subsequently segment them. In Dataset 1 and 2, the method accurately segmented the OBs, resulting in a Dice coefficient above 0.7 and average symmetrical surface distance below 0.3 mm. Volumes determined from manual and automatic segmentations showed a strong correlation (Dataset 1: r = 0.79, p < 0.001; Dataset 2: r = 0.72, p = 0.004). In addition, the method was able to recognize the absence of an OB. In Dataset 3, OB volumes computed from automatic segmentations obtained with our method were related to clinical outcome measures, i.e. duration and etiology of olfactory loss, and olfactory ability. We found that OB volume was significantly related to age of the patient, duration and etiology of olfactory loss, and olfactory ability (F(5, 172) = 11.348, p < 0.001, R2 = 0.248). In conclusion, the results demonstrate that automatic segmentation of the OBs and subsequent computation of their volumes in MRI scans can be performed accurately and can be applied in clinical and research population studies. Automatic evaluation may lead to more insight in the role of OB volume in diagnosis, prognosis and treatment of olfactory loss.
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Affiliation(s)
- Elbrich M Postma
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands; Department of Otorhinolaryngology, Hospital Gelderse Vallei, Ede, The Netherlands.
| | - Julia M H Noothout
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Biomedical Engineering and Physics, Amsterdam UMC - location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Wilbert M Boek
- Department of Otorhinolaryngology, Hospital Gelderse Vallei, Ede, The Netherlands
| | - Akshita Joshi
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Theresa Herrmann
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Paul A M Smeets
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Ivana Išgum
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Biomedical Engineering and Physics, Amsterdam UMC - location AMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Radiology and Nuclear Medicine, Amsterdam UMC - location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sanne Boesveldt
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
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8
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Hu C, Gao Y, Feng Y, Sun Z, Yu Z. Assessment of factors influencing the olfactory bulb volume in patients with post-viral olfactory dysfunction. Eur Arch Otorhinolaryngol 2023:10.1007/s00405-023-07932-y. [PMID: 37004522 DOI: 10.1007/s00405-023-07932-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/14/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE To investigate the factors influencing the volume of the olfactory bulb (OB) in patients with post-viral olfactory dysfunction (PVOD). METHODS We collected 92 olfactory bulb volumes from patients with PVOD who underwent a sinus computed tomographic and magnetic resonance imaging (MRI) scan of the head and collected clinical information including gender, age, disease course, minimal cross-sectional area, nasal airway resistance, and olfactory function. OB volume was measured in MRI and the scans were evaluated according to the Lund-Mackay (LM) scoring system. RESULTS Male patients with PVOD had a larger OB volume (β = 0.284, P < 0.05). OB volume was smaller in patients with a longer course of olfactory dysfunction (β = - 0.254, P < 0.05). According to the LM scoring system, patients with a higher anterior ethmoidal sinus score had smaller OB volume (β = - 0.476, P < 0.05). CONCLUSIONS The study revealed that gender, disease course, and the score of anterior ethmoidal sinusitis can affect the OB volume in patients with PVOD.
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Affiliation(s)
- Chunhua Hu
- Department of Otolaryngology-Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Beijing, 100029, China
| | - Yang Gao
- Department of Otolaryngology-Head and Neck Surgery, Xuanwu Hospital Capital Medical University, 45 Changchun Street, Beijing, 100053, China
| | - Yanjun Feng
- Department of Otolaryngology-Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Beijing, 100029, China
| | - Zhifu Sun
- Department of Otolaryngology-Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Beijing, 100029, China.
| | - Zhan Yu
- Department of Otolaryngology-Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Beijing, 100029, China.
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Li Z, Abdul Manan H, Heitmann H, Witte V, Wirkner K, Riedel-Heller S, Villringer A, Hummel T. The association between depth of the olfactory sulcus, age, gender and olfactory function: an MRI-based investigation in more than 1000 participants. Neuroscience 2023; 519:31-37. [PMID: 36934780 DOI: 10.1016/j.neuroscience.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/07/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVE The present study aimed to investigate the relationship between olfactory sulcus (OS) depth and olfactory function considering age and gender and to provide normative data on OS depth in a population with normal olfactory function. MATERIALS AND METHODS OS depth was obtained using T1 magnetic resonance imaging scans. Participants (mean age ± sd = 57 ± 16 years, ranging from 20-80 years) were screened for olfactory function using the Sniffin' Sticks Screening 12 test. They were divided into an olfactory dysfunction group (n = 604) and a normosmia group (n = 493). Participants also completed questionnaires measuring depression, anxiety and quality of life. RESULTS The right OS was deeper than the left side in all age groups. On the left side, women had deeper OS compared with men, exhibiting a higher degree of symmetry in left and right OS depth in women. Variance of olfactory function was largely determined by age, OS depth explained only minor portions of this variance. Normative data for minimum OS depth was 7.55 mm on the left and 8.78 mm on the right for participants aged between 18 and 35 years (n = 144), 6.47 mm on the left and 6.99 mm on the right for those aged 36-55 years (n = 120), and 5.28 mm on the left and 6.19 mm on the right for participants older than 55 years (n = 222). CONCLUSION Considering the limited resolution of the presently used T1 weighted MR scans and the nature of the olfactory screening test, OS depth explained only minor portions of the variance of olfactory function, which was largely determined by age. Age-related normative data of OS depth are presented as a reference for future work.
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Affiliation(s)
- Zetian Li
- Smell & Taste Clinic, Depatrment of Otrohinolaryngology, Technische Universität Dresden, Fetscherstarsse 74, 01307 Dresden, Germany.
| | - Hanani Abdul Manan
- Smell & Taste Clinic, Depatrment of Otrohinolaryngology, Technische Universität Dresden, Fetscherstarsse 74, 01307 Dresden, Germany; Functional Image Processing Laboratory, Department of Radiology, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Cheras, Kuala Lumpur 56000, Malaysia; Department of Radiology and Intervency, Hospital Pakar Kanak-Kanak (Specialist Children Hospital), University Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia
| | - Hanna Heitmann
- Smell & Taste Clinic, Depatrment of Otrohinolaryngology, Technische Universität Dresden, Fetscherstarsse 74, 01307 Dresden, Germany
| | - Veronica Witte
- Institute of Social Medicine, Occupational Health and Public Health, University Leipzig, Germany
| | - Kerstin Wirkner
- Leipzig Research Centre for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, D-04103 Leipzig, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University Leipzig, Germany
| | - Arno Villringer
- Institute of Social Medicine, Occupational Health and Public Health, University Leipzig, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Depatrment of Otrohinolaryngology, Technische Universität Dresden, Fetscherstarsse 74, 01307 Dresden, Germany
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10
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Capelli S, Caroli A, Barletta A, Arrigoni A, Napolitano A, Pezzetti G, Longhi LG, Zangari R, Lorini FL, Sessa M, Remuzzi A, Gerevini S. MRI evidence of olfactory system alterations in patients with COVID-19 and neurological symptoms. J Neurol 2023; 270:1195-1206. [PMID: 36656356 PMCID: PMC9850323 DOI: 10.1007/s00415-023-11561-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/29/2022] [Accepted: 01/09/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND OBJECTIVE Despite olfactory disorders being among the most common neurological complications of coronavirus disease 2019 (COVID-19), their pathogenesis has not been fully elucidated yet. Brain MR imaging is a consolidated method for evaluating olfactory system's morphological modification, but a few quantitative studies have been published so far. The aim of the study was to provide MRI evidence of olfactory system alterations in patients with COVID-19 and neurological symptoms, including olfactory dysfunction. METHODS 196 COVID-19 patients (median age: 53 years, 56% females) and 39 controls (median age 55 years, 49% females) were included in this cross-sectional observational study; 78 of the patients reported olfactory loss as the only neurological symptom. MRI processing was performed by ad-hoc semi-automatic processing procedures. Olfactory bulb (OB) volume was measured on T2-weighted MRI based on manual tracing and normalized to the brain volume. Olfactory tract (OT) median signal intensity was quantified on fluid attenuated inversion recovery (FLAIR) sequences, after preliminary intensity normalization. RESULTS COVID-19 patients showed significantly lower left, right and total OB volumes than controls (p < 0.05). Age-related OB atrophy was found in the control but not in the patient population. No significant difference was found between patients with olfactory disorders and other neurological symptoms. Several outliers with abnormally high OT FLAIR signal intensity were found in the patient group. CONCLUSIONS Brain MRI findings demonstrated OB damage in COVID-19 patients with neurological complications. Future longitudinal studies are needed to clarify the transient or permanent nature of OB atrophy in COVID-19 pathology.
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Affiliation(s)
- Serena Capelli
- grid.4527.40000000106678902Bioengineering Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, BG Italy
| | - Anna Caroli
- grid.4527.40000000106678902Bioengineering Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, BG Italy
| | - Antonino Barletta
- grid.460094.f0000 0004 1757 8431Department of Neuroradiology, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127 Bergamo, Italy
| | - Alberto Arrigoni
- grid.4527.40000000106678902Bioengineering Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, BG Italy
| | - Angela Napolitano
- grid.460094.f0000 0004 1757 8431Department of Neuroradiology, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127 Bergamo, Italy
| | - Giulio Pezzetti
- grid.460094.f0000 0004 1757 8431Department of Neuroradiology, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127 Bergamo, Italy
| | - Luca Giovanni Longhi
- grid.460094.f0000 0004 1757 8431Neurosurgical Intensive Care Unit, Department of Anesthesia and Critical Care Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Rosalia Zangari
- grid.460094.f0000 0004 1757 8431FROM Research Foundation, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Ferdinando Luca Lorini
- grid.460094.f0000 0004 1757 8431Department of Emergency and Critical Care Area, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Maria Sessa
- grid.460094.f0000 0004 1757 8431Department of Neurology, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
| | - Andrea Remuzzi
- grid.33236.370000000106929556Department of Management, Information and Production Engineering, University of Bergamo, Dalmine, BG Italy
| | - Simonetta Gerevini
- Department of Neuroradiology, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127, Bergamo, Italy.
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11
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Chouinard‐Leclaire C, Manescu S, Collignon O, Lepore F, Frasnelli J. Altered morphological traits along central olfactory centers in congenitally blind subjects. Eur J Neurosci 2022; 56:4486-4500. [DOI: 10.1111/ejn.15758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 11/27/2022]
Affiliation(s)
| | - Simona Manescu
- Centre de Recherche en Neuropsychologie et Cognition (CERNEC) Université de Montréal Montréal Québec Canada
| | - Olivier Collignon
- Institutes for research in Psychology (IPSY) and Neurosciences (IoNS) University of Louvain Belgium
| | - Franco Lepore
- Centre de Recherche en Neuropsychologie et Cognition (CERNEC) Université de Montréal Montréal Québec Canada
| | - Johannes Frasnelli
- Centre de Recherche en Neuropsychologie et Cognition (CERNEC) Université de Montréal Montréal Québec Canada
- Department of Anatomy Université du Québec à Trois‐Rivières Canada
- Centre d’études avancées en médecine du sommeil (CÉAMS), Centre de Recherche de l’Hôpital du Sacré‐Cœur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord‐de‐l’Île‐de‐Montréal (CIUSSS du Nord‐de‐l’Île‐de‐Montréal) Canada
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12
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Hura N, Yi JS, Lin SY, Roxbury CR. Magnetic Resonance Imaging as a Diagnostic and Research Tool in Patients with Olfactory Dysfunction: A Systematic Review. Am J Rhinol Allergy 2022; 36:668-683. [PMID: 35585698 DOI: 10.1177/19458924221096913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patients with acquired, idiopathic olfactory dysfunction (OD) commonly undergo magnetic resonance imaging (MRI) evaluation to rule out intracranial pathologies. This practice is highly debated given the expense of MRI relative to the probability of detecting a treatable lesion. This, combined with the increasing use of MRI in research to investigate the mechanisms underlying OD, provided the impetus for this comprehensive review. OBJECTIVE The purpose of this systematic review was to both assess the utility of MRI in diagnosis of idiopathic OD and to describe MRI findings among mixed OD etiologies to better understand its role as a research tool in this patient population. METHODS A literature search of PubMed, Embase, Cochrane, Web of Science, and Scopus for studies with original MRI data for patients with OD was completed. Studies exclusively investigating patients with neurocognitive deficits or those studying traumatic or congenital etiologies of OD were excluded. RESULTS From 1758 candidate articles, 33 studies were included. Four studies reviewed patients with idiopathic OD for structural pathologies on MRI, of which 17 of 372 (4.6%) patients had a potential central cause identified, and 3 (0.8%) had an olfactory meningioma or olfactory neuroblastoma. Fourteen studies (42.4%) reported significant correlation between olfactory bulb volume and olfactory outcomes, and 6 studies (18.8%) reported gray matter volume reduction, specifically in the orbitofrontal cortex, anterior cingulate cortex, insular cortex, parahippocampal, and piriform cortex areas, in patients with mixed OD etiologies. Functional MRI studies reported reduced brain activation and functional connectivity in olfactory network areas. CONCLUSION MRI uncommonly detects intracranial pathology in patients with idiopathic OD. Among patients with mixed OD etiologies, reduced olfactory bulb and gray matter volume are the most common abnormal findings on MRI. Further research is required to better understand the role of MRI and its cost-effectiveness in patients with acquired, idiopathic OD.
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Affiliation(s)
- Nanki Hura
- Department of Otolaryngology - Head and Neck Surgery, 1500The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Otolaryngology - Head and Neck Surgery, 6595University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Julie S Yi
- Department of Otolaryngology - Head and Neck Surgery, 1500The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sandra Y Lin
- Department of Otolaryngology - Head and Neck Surgery, 1500The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Christopher R Roxbury
- Section of Otolaryngology - Head and Neck Surgery, 21727The University of Chicago Medical Center, Chicago, Illinois, USA
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13
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Patel ZM, Holbrook EH, Turner JH, Adappa ND, Albers MW, Altundag A, Appenzeller S, Costanzo RM, Croy I, Davis GE, Dehgani-Mobaraki P, Doty RL, Duffy VB, Goldstein BJ, Gudis DA, Haehner A, Higgins TS, Hopkins C, Huart C, Hummel T, Jitaroon K, Kern RC, Khanwalkar AR, Kobayashi M, Kondo K, Lane AP, Lechner M, Leopold DA, Levy JM, Marmura MJ, Mclelland L, Miwa T, Moberg PJ, Mueller CA, Nigwekar SU, O'Brien EK, Paunescu TG, Pellegrino R, Philpott C, Pinto JM, Reiter ER, Roalf DR, Rowan NR, Schlosser RJ, Schwob J, Seiden AM, Smith TL, Soler ZM, Sowerby L, Tan BK, Thamboo A, Wrobel B, Yan CH. International consensus statement on allergy and rhinology: Olfaction. Int Forum Allergy Rhinol 2022; 12:327-680. [PMID: 35373533 DOI: 10.1002/alr.22929] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/01/2021] [Accepted: 11/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O). METHODS Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus. RESULTS The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies. CONCLUSION This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.
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Affiliation(s)
- Zara M Patel
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Eric H Holbrook
- Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Justin H Turner
- Otolaryngology, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Nithin D Adappa
- Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark W Albers
- Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Aytug Altundag
- Otolaryngology, Biruni University School of Medicine, İstanbul, Turkey
| | - Simone Appenzeller
- Rheumatology, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Richard M Costanzo
- Physiology and Biophysics and Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Ilona Croy
- Psychology and Psychosomatic Medicine, TU Dresden, Dresden, Germany
| | - Greg E Davis
- Otolaryngology, Proliance Surgeons, Seattle and Puyallup, Washington, USA
| | - Puya Dehgani-Mobaraki
- Associazione Naso Sano, Umbria Regional Registry of Volunteer Activities, Corciano, Italy
| | - Richard L Doty
- Smell and Taste Center, Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Valerie B Duffy
- Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | | | - David A Gudis
- Otolaryngology, Columbia University Irving Medical Center, New York, USA
| | - Antje Haehner
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | - Thomas S Higgins
- Otolaryngology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Claire Hopkins
- Otolaryngology, Guy's and St. Thomas' Hospitals, London Bridge Hospital, London, UK
| | - Caroline Huart
- Otorhinolaryngology, Cliniques universitaires Saint-Luc, Institute of Neuroscience, Université catholgique de Louvain, Brussels, Belgium
| | - Thomas Hummel
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | | | - Robert C Kern
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ashoke R Khanwalkar
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Masayoshi Kobayashi
- Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Kenji Kondo
- Otolaryngology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Andrew P Lane
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matt Lechner
- Otolaryngology, Barts Health and University College London, London, UK
| | - Donald A Leopold
- Otolaryngology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Joshua M Levy
- Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael J Marmura
- Neurology Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lisha Mclelland
- Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Takaki Miwa
- Otolaryngology, Kanazawa Medical University, Ishikawa, Japan
| | - Paul J Moberg
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Sagar U Nigwekar
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Erin K O'Brien
- Otolaryngology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Teodor G Paunescu
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Carl Philpott
- Otolaryngology, University of East Anglia, Norwich, UK
| | - Jayant M Pinto
- Otolaryngology, University of Chicago, Chicago, Illinois, USA
| | - Evan R Reiter
- Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - David R Roalf
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nicholas R Rowan
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rodney J Schlosser
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - James Schwob
- Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Allen M Seiden
- Otolaryngology, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - Timothy L Smith
- Otolaryngology, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Zachary M Soler
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - Leigh Sowerby
- Otolaryngology, University of Western Ontario, London, Ontario, Canada
| | - Bruce K Tan
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andrew Thamboo
- Otolaryngology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bozena Wrobel
- Otolaryngology, Keck School of Medicine, USC, Los Angeles, California, USA
| | - Carol H Yan
- Otolaryngology, School of Medicine, UCSD, La Jolla, California, USA
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14
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Lee S, Kim J, Kim BJ, Kim RY, Ha E, Kim S, Hong SN, Lyoo IK, Kim DW. Gray matter volume reduction in the emotional brain networks in adults with anosmia. J Neurosci Res 2022; 100:1321-1330. [PMID: 35240720 DOI: 10.1002/jnr.25037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 01/24/2022] [Accepted: 02/12/2022] [Indexed: 11/10/2022]
Abstract
Loss of olfaction, or anosmia, frequently accompanies emotional dysfunctions, partly due to the overlapping brain regions between the olfactory and emotional processing centers. Here, we investigated whether anosmia was associated with gray matter volume alterations at a network level, and whether these alterations were related to the olfactory-specific quality of life (QOL) and depressive symptoms. Structural brain magnetic resonance imaging was acquired in 22 individuals with postinfectious or idiopathic anosmia (the anosmia group) and 30 age- and sex-matched controls (the control group). Using independent component analysis on the gray matter volumes, we identified 10 morphometric networks. The gray matter volumes of these networks were compared between the two groups. Olfactory-specific QOL and depressive symptoms were assessed by self-report questionnaires and clinician-administered interviews, respectively. The anosmia group showed lower gray matter volumes in the hippocampus-amygdala and the precuneus networks, relative to the control group. Lower gray matter volumes in the hippocampus-amygdala network were also linearly associated with lower olfactory-specific QOL and higher depressive symptom scores. These findings suggest a close relationship between anosmia and gray matter volume alterations in the emotional brain networks, albeit without determined causal relations.
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Affiliation(s)
- Suji Lee
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea
| | - Jungyoon Kim
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea
| | - Bong Jik Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Chungnam National University Sejong Hospital, Sejong, South Korea
| | - Rye Young Kim
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea.,Graduate School of Pharmaceutical Sciences, Ewha W. University, Seoul, South Korea
| | - Eunji Ha
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea
| | - Shinhye Kim
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea
| | - Seung-No Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea.,Graduate School of Pharmaceutical Sciences, Ewha W. University, Seoul, South Korea.,The Brain Institute and Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Dae Woo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
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15
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The Shape of the Olfactory Bulb Predicts Olfactory Function. Brain Sci 2022; 12:brainsci12020128. [PMID: 35203892 PMCID: PMC8870545 DOI: 10.3390/brainsci12020128] [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: 11/24/2021] [Revised: 01/13/2022] [Accepted: 01/14/2022] [Indexed: 12/04/2022] Open
Abstract
The olfactory bulb (OB) plays a key role in the processing of olfactory information. A large body of research has shown that OB volumes correlate with olfactory function, which provides diagnostic and prognostic information in olfactory dysfunction. Still, the potential value of the OB shape remains unclear. Based on our clinical experience we hypothesized that the shape of the OB predicts olfactory function, and that it is linked to olfactory loss, age, and gender. The aim of this study was to produce a classification of OB shape in the human brain, scalable to clinical and research applications. Results from patients with the five most frequent causes of olfactory dysfunction (n = 192) as well as age/gender-matched healthy controls (n = 77) were included. Olfactory function was examined in great detail using the extended “Sniffin’ Sticks” test. A high-resolution structural T2-weighted MRI scan was obtained for all. The planimetric contours (surface in mm2) of OB were delineated manually, and then all surfaces were added and multiplied to obtain the OB volume in mm3. OB shapes were outlined manually and characterized on a selected slice through the posterior coronal plane tangential to the eyeballs. We looked at OB shapes in terms of convexity and defined two patterns/seven categories based on OB contours: convex (olive, circle, and plano-convex) and non-convex (banana, irregular, plane, and scattered). Categorization of OB shapes is possible with a substantial inter-rater agreement (Cohen’s Kappa = 0.73). Our results suggested that non-convex OB patterns were significantly more often observed in patients than in controls. OB shapes were correlated with olfactory function in the whole group, independent of age, gender, and OB volume. OB shapes seemed to change with age in healthy subjects. Importantly, the results indicated that OB shapes were associated with certain causes of olfactory disorders, i.e., an irregular OB shape was significantly more often observed in post-traumatic olfactory loss. Our study provides evidence that the shape of the OB can be used as a biomarker for olfactory dysfunction.
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16
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Manan HA, Yahya N, Han P, Hummel T. A systematic review of olfactory-related brain structural changes in patients with congenital or acquired anosmia. Brain Struct Funct 2022; 227:177-202. [PMID: 34635958 PMCID: PMC8505224 DOI: 10.1007/s00429-021-02397-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/26/2021] [Indexed: 02/08/2023]
Abstract
Brain structural features of healthy individuals are associated with olfactory functions. However, due to the pathophysiological differences, congenital and acquired anosmia may exhibit different structural characteristics. A systematic review was undertaken to compare brain structural features between patients with congenital and acquired anosmia. A systematic search was conducted using PubMed/MEDLINE and Scopus electronic databases to identify eligible reports on anosmia and structural changes and reported according to PRISMA guidelines. Reports were extracted for information on demographics, psychophysical evaluation, and structural changes. Then, the report was systematically reviewed based on various aetiologies of anosmia in relation to (1) olfactory bulb, (2) olfactory sulcus, (3) grey matter (GM), and white matter (WM) changes. Twenty-eight published studies were identified. All studies reported consistent findings with strong associations between olfactory bulb volume and olfactory function across etiologies. However, the association of olfactory function with olfactory sulcus depth was inconsistent. The present study observed morphological variations in GM and WM volume in congenital and acquired anosmia. In acquired anosmia, reduced olfactory function is associated with reduced volumes and thickness involving the gyrus rectus, medial orbitofrontal cortex, anterior cingulate cortex, and cerebellum. These findings contrast to those observed in congenital anosmia, where a reduced olfactory function is associated with a larger volume and higher thickness in parts of the olfactory network, including the piriform cortex, orbitofrontal cortex, and insula. The present review proposes that the structural characteristics in congenital and acquired anosmia are altered differently. The mechanisms behind these changes are likely to be multifactorial and involve the interaction with the environment.
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Affiliation(s)
- Hanani Abdul Manan
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
- Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), Department of Radiology, University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56 000, Kuala Lumpur, Malaysia.
| | - Noorazrul Yahya
- Diagnostic Imaging and Radiotherapy Program, Faculty of Health Sciences, School of Diagnostic and Applied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Pengfei Han
- The Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
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17
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郭 怡, 姚 淋, 孙 智, 黄 小, 刘 佳, 魏 永. [Prognostic value of olfactory bulb volume in patients with post-viral olfactory dysfunction]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:8-13. [PMID: 34979611 PMCID: PMC10128224 DOI: 10.13201/j.issn.2096-7993.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Indexed: 06/14/2023]
Abstract
Objective:The purpose of this study was to compare the olfactory function examination results of patients with post-viral olfactory dysfunction(PVOD) in different prognostic groups and analyze prognostic factors, especially the influence of olfactory bulb volume(OBV) on prognosis, so as to provide objective basis for clinical diagnosis and treatment. Methods:After approval by the hospital ethics committee, the patients with PVOD admitted to Beijing Anzhen Hospital's outpatient department from January 2019 to December 2019 were followed up for at least 1 year. These patients completed the Sniffin' Sticks test and MRI examination of the olfactory pathway before treatment. According to the results of the Sniffin' Sticks test after 1 year follow-up(threshold-discrimination-identification(TDI) score of the patients was increased at least 6 points), the patients were divided into two groups as the improvement group and the non-improvement group. The prognostic factors of PVOD patients were preliminarily determined by comparing the differences of various factors and the results of olfactory function examination between the two groups. Results:In this study, 47 patients with PVOD were included, with the smell improvement rate was 53.2%. Compared with the improvement group, the patients in the non-improvement group had longer duration, poorer initial olfactory function, higher olfactory threshold, and poorer olfactory discrimination and recognition ability(All P<0.01). There was no statistical difference in terms of gender, age, allergic rhinitis and smoking between the two groups(All P>0.05).The OBV of the non-improvement group was (59.48±23.92) mm³, which was significantly lower than that in the improvement group([92.77±14.35]mm³, P<0.001). Multiple logistic regression analysis showed that prognostic factors included course of disease(OR 0.677, 95%CI 0.461-0.993, P=0.046), initial T value(OR 263.806, 95%CI 1.028-67 675.884, P=0.049) and OBV(OR 1.160, 95%CI 1.002-1.343, P=0.047). The area under the receiver operating characteristic curve(ROC curve) of OBV was 0.888(0.797-0.979, P<0.001). The correct diagnostic index of OBV≥78.50 mm³was used to determine the prognosis of olfactory function, with a specificity of 0.818 and a sensitivity of 0.840. The ROC curve analysis showed that the area under the ROC curve of duration was 0.822(0.703-0.940, P<0.001). The correct diagnostic index of the duration ≤6 months was used to determine the prognosis of olfactory function, with a specificity of 0.727 and a sensitivity of 0.800. The area of T score was 0.793(0.662-0.924, P=0.001). T score ≥1.25 was used as the correct diagnostic index to determine the prognosis of olfactory function. The specificity and sensitivity were 0.818 and 0.680, respectively. Conclusion:The prognosis of olfactory function in PVOD patients is related to the course of disease, the degree of olfactory loss and OBV. Those with no improvement in olfactory function have a longer disease course, aggravated olfactory damage and reduced OBV than those with improved olfactory function. The factors of Duration ≤6 months, T value ≥1.25 and OBV≥78.50 mm³suggested better prognosis, and the results of objective olfactory examination have greater value in evaluating the prognosis of olfactory function.
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Affiliation(s)
- 怡辰 郭
- 首都医科大学附属北京安贞医院耳鼻咽喉头颈外科(北京,100029)Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - 淋尹 姚
- 首都医科大学附属北京安贞医院耳鼻咽喉头颈外科(北京,100029)Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - 智甫 孙
- 首都医科大学附属北京安贞医院耳鼻咽喉头颈外科(北京,100029)Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - 小兵 黄
- 首都医科大学附属北京安贞医院耳鼻咽喉头颈外科(北京,100029)Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - 佳 刘
- 首都儿童研究所耳鼻咽喉头颈外科Department of Otorhinolaryngology Head and Neck Surgery, Capital Institute of Pediatrics
| | - 永祥 魏
- 首都儿童研究所耳鼻咽喉头颈外科Department of Otorhinolaryngology Head and Neck Surgery, Capital Institute of Pediatrics
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Estrada S, Lu R, Diers K, Zeng W, Ehses P, Stöcker T, Breteler MMB, Reuter M. Automated olfactory bulb segmentation on high resolutional T2-weighted MRI. Neuroimage 2021; 242:118464. [PMID: 34389442 PMCID: PMC8473894 DOI: 10.1016/j.neuroimage.2021.118464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/09/2021] [Accepted: 08/09/2021] [Indexed: 11/09/2022] Open
Abstract
The neuroimage analysis community has neglected the automated segmentation of the olfactory bulb (OB) despite its crucial role in olfactory function. The lack of an automatic processing method for the OB can be explained by its challenging properties (small size, location, and poor visibility on traditional MRI scans). Nonetheless, recent advances in MRI acquisition techniques and resolution have allowed raters to generate more reliable manual annotations. Furthermore, the high accuracy of deep learning methods for solving semantic segmentation problems provides us with an option to reliably assess even small structures. In this work, we introduce a novel, fast, and fully automated deep learning pipeline to accurately segment OB tissue on sub-millimeter T2-weighted (T2w) whole-brain MR images. To this end, we designed a three-stage pipeline: (1) Localization of a region containing both OBs using FastSurferCNN, (2) Segmentation of OB tissue within the localized region through four independent AttFastSurferCNN - a novel deep learning architecture with a self-attention mechanism to improve modeling of contextual information, and (3) Ensemble of the predicted label maps. For this work, both OBs were manually annotated in a total of 620 T2w images for training (n=357) and testing. The OB pipeline exhibits high performance in terms of boundary delineation, OB localization, and volume estimation across a wide range of ages in 203 participants of the Rhineland Study (Dice Score (Dice): 0.852, Volume Similarity (VS): 0.910, and Average Hausdorff Distance (AVD): 0.215 mm). Moreover, it also generalizes to scans of an independent dataset never encountered during training, the Human Connectome Project (HCP), with different acquisition parameters and demographics, evaluated in 30 cases at the native 0.7 mm HCP resolution (Dice: 0.738, VS: 0.790, and AVD: 0.340 mm), and the default 0.8 mm pipeline resolution (Dice: 0.782, VS: 0.858, and AVD: 0.268 mm). We extensively validated our pipeline not only with respect to segmentation accuracy but also to known OB volume effects, where it can sensitively replicate age effects (β=-0.232, p<.01). Furthermore, our method can analyze a 3D volume in less than a minute (GPU) in an end-to-end fashion, providing a validated, efficient, and scalable solution for automatically assessing OB volumes.
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Affiliation(s)
- Santiago Estrada
- Image Analysis, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Ran Lu
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Kersten Diers
- Image Analysis, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Weiyi Zeng
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Philipp Ehses
- MR Physics, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Tony Stöcker
- MR Physics, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Physics and Astronomy, University of Bonn, Germany
| | - Monique M B Breteler
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Martin Reuter
- Image Analysis, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston MA, USA; Department of Radiology, Harvard Medical School, Boston MA, USA.
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19
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Automatic Segmentation of the Olfactory Bulb. Brain Sci 2021; 11:brainsci11091141. [PMID: 34573163 PMCID: PMC8471091 DOI: 10.3390/brainsci11091141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022] Open
Abstract
The olfactory bulb (OB) has an essential role in the human olfactory pathway. A change in olfactory function is associated with a change of OB volume. It has been shown to predict the prognosis of olfactory loss and its volume is a biomarker for various neurodegenerative diseases, such as Alzheimer’s disease. Thus far, obtaining an OB volume for research purposes has been performed by manual segmentation alone; a very time-consuming and highly rater-biased process. As such, this process dramatically reduces the ability to produce fair and reliable comparisons between studies, as well as the processing of large datasets. Our study aims to solve this by proposing a novel methodological framework for the unbiased measurement of OB volume. In this paper, we present a fully automated tool that successfully performs such a task, accurately and quickly. In order to develop a stable and versatile algorithm and to train the neural network, we used four datasets consisting of whole-brain T1 and high-resolution T2 MRI scans, as well as the corresponding clinical information of the subject’s smelling ability. One dataset contained data of patients suffering from anosmia or hyposmia (N = 79), and the other three datasets contained data of healthy controls (N = 91). First, the manual segmentation labels of the OBs were created by two experienced raters, independently and blinded. The algorithm consisted of the following four different steps: (1) multimodal data co-registration of whole-brain T1 images and T2 images, (2) template-based localization of OBs, (3) bounding box construction, and lastly, (4) segmentation of the OB using a 3D-U-Net. The results from the automated segmentation algorithm were tested on previously unseen data, achieving a mean dice coefficient (DC) of 0.77 ± 0.05, which is remarkably convergent with the inter-rater DC of 0.79 ± 0.08 estimated for the same cohort. Additionally, the symmetric surface distance (ASSD) was 0.43 ± 0.10. Furthermore, the segmentations produced using our algorithm were manually rated by an independent blinded rater and have reached an equivalent rating score of 5.95 ± 0.87 compared to a rating score of 6.23 ± 0.87 for the first rater’s segmentation and 5.92 ± 0.81 for the second rater’s manual segmentation. Taken together, these results support the success of our tool in producing automatic fast (3–5 min per subject) and reliable segmentations of the OB, with virtually matching accuracy with the current gold standard technique for OB segmentation. In conclusion, we present a newly developed ready-to-use tool that can perform the segmentation of OBs based on multimodal data consisting of T1 whole-brain images and T2 coronal high-resolution images. The accuracy of the segmentations predicted by the algorithm matches the manual segmentations made by two well-experienced raters. This method holds potential for immediate implementation in clinical practice. Furthermore, its ability to perform quick and accurate processing of large datasets may provide a valuable contribution to advancing our knowledge of the olfactory system, in health and disease. Specifically, our framework may integrate the use of olfactory bulb volume (OBV) measurements for the diagnosis and treatment of olfactory loss and improve the prognosis and treatment options of olfactory dysfunctions.
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Investigating morphological changes in the brain in relation to etiology and duration of olfactory dysfunction with voxel-based morphometry. Sci Rep 2021; 11:12704. [PMID: 34135435 PMCID: PMC8209212 DOI: 10.1038/s41598-021-92224-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/24/2021] [Indexed: 02/05/2023] Open
Abstract
Olfactory loss (OL) affects up to 20% of the general population and is related to changes in olfaction-related brain regions. This study investigated the effect of etiology and duration of OL on gray matter volume (GMV) of these regions in 257 patients. Voxel-based morphometry was applied to measure GMV in brain regions of interest to test the effects of etiology and duration on regional GMV and the relation between olfactory function and regional GMV. Etiology of OL had a significant effect on GMV in clusters representing the gyrus rectus and orbitofrontal cortex (OFC), bilaterally. Patients with congenital anosmia had reduced GMV in the gyrus rectus and an increased OFC volume compared to patients with acquired OL. There was a significant association between volume of the left OFC and olfactory function. This implies that changes in GMV in patients with acquired OL are mainly reflected in the OFC and depend on olfactory function. Morphology of olfactory areas in the brain therefore seems to relate to olfactory function and the subsequent degree of exposure to olfactory input in patients with acquired OL. Differences in GMV in congenital anosmia are most likely due to the fact that patients were never able to smell.
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Wang E, Jia Y, Ya Y, Xu J, Mao C, Luo W, Fan G, Jiang Z. Patterns of Sulcal depth and cortical thickness in Parkinson's disease. Brain Imaging Behav 2021; 15:2340-2346. [PMID: 34018166 DOI: 10.1007/s11682-020-00428-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 10/21/2022]
Abstract
Previous voxel-based morphometry (VBM) and cortical thickness (CT) studies on Parkinson's disease (PD) have mainly reported the gray matter size reduction, whereas the shape of cortical surface can also change in PD patients. For the first time, we analyzed sulcal depth (SD) patterns in PD patients by using whole brain region of interest (ROI)-based approach. In a cross-sectional study, high-resolution brain structural MRI images were collected from 60 PD patients without dementia and 56 age-and sex-matched healthy controls (HC). SD and CT were estimated using the Computational Anatomy Toolbox (CAT12) and statistically compared between groups on whole brain ROI-based level using statistical parametric mapping 12 (SPM12). Additionally, correlations between regional brain changes and clinical variables were also examined. Compared to HC, PD patients showed lower SD in widespread regions, including temporal (the bilateral transverse temporal, the left inferior temporal, the right middle temporal and the right superior temporal), insular (the left insula), frontal (the left pars triangularis, the left pars opercularis and the left precentral), parietal (the bilateral superior parietal) and occipital (the right cuneus) regions. For CT, only the left pars opercularis showed lower CT in PD patients compared to HC. No regions showed higher SD or CT in PD patients compared to HC. In PD patients, a significant positive correlation was found between SD of the left pars opercularis and MMSE scores, such that lower MMSE scores were related to lower SD of the left pars opercularis. Our results of widespread lower SD, but relatively localized lower CT, indicate that SD seems to be more sensitive to brain changes than CT and may be mainly affected by white matter damage. Hence, SD may be a more promising indicator to investigate the surface shape changes in PD patients. The significant positive correlation between SD of the left pars opercularis and MMSE scores suggests that SD may be prognostic of future cognitive decline.
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Affiliation(s)
- Erlei Wang
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yujing Jia
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yang Ya
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jin Xu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Chengjie Mao
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Weifeng Luo
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Guohua Fan
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
| | - Zhen Jiang
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
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22
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Post-traumatic olfactory loss and brain response beyond olfactory cortex. Sci Rep 2021; 11:4043. [PMID: 33597627 PMCID: PMC7889874 DOI: 10.1038/s41598-021-83621-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 01/29/2021] [Indexed: 01/31/2023] Open
Abstract
Olfactory impairment after a traumatic impact to the head is associated with changes in olfactory cortex, including decreased gray matter density and decreased BOLD response to odors. Much less is known about the role of other cortical areas in olfactory impairment. We used fMRI in a sample of 63 participants, consisting of 25 with post-traumatic functional anosmia, 16 with post-traumatic hyposmia, and 22 healthy controls with normosmia to investigate whole brain response to odors. Similar neural responses were observed across the groups to odor versus odorless stimuli in the primary olfactory areas in piriform cortex, whereas response in the frontal operculum and anterior insula (fO/aI) increased with olfactory function (normosmia > hyposmia > functional anosmia). Unexpectedly, a negative association was observed between response and olfactory perceptual function in the mediodorsal thalamus (mdT), ventromedial prefrontal cortex (vmPFC) and posterior cingulate cortex (pCC). Finally, connectivity within a network consisting of vmPFC, fO, and pCC could be used to successfully classify participants as having functional anosmia or normosmia. We conclude that, at the neural level, olfactory impairment due to head trauma is best characterized by heightened responses and differential connectivity in higher-order areas beyond olfactory cortex.
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TAK-242 ameliorates olfactory dysfunction in a mouse model of allergic rhinitis by inhibiting neuroinflammation in the olfactory bulb. Int Immunopharmacol 2021; 92:107368. [PMID: 33454639 DOI: 10.1016/j.intimp.2021.107368] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/19/2020] [Accepted: 01/03/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Olfactory dysfunction (OD) is a common symptom of allergic rhinitis (AR) that can seriously affect patient quality of life; however, the associated pathogenesis remains unclear. This study aimed to explore the relationship between OD and damage of the olfactory bulb (OB) in allergic rhinitis (AR). The therapeutic potential of TAK-242, a selective TLR4 inhibitor, was evaluated for OD. METHOD An AR mouse model was established with ovalbumin (OVA) to test the olfactory function of AR mice using the buried food pellet test (BFPT). Mice with OD were intraperitoneally injected with TAK-242 or 1% DMSO (vehicle). Immunohistochemistry was used to detect microglia and astrocyte activation in the OB. TUNNEL staining was performed to detect apoptosis in the OB. Proteins in the TLR4 signaling pathway were detected by Western blot. The level of proinflammatory factor mRNA in the OB was determined by RT-PCR. RESULT Neuroinflammation was observed in the OB of the OD group, as evidenced by glial cell activation and increased proinflammatory factor expression. The number of apoptotic cells was significantly increased in the OB of the OD group. The expression of TLR4, MyD88, and p-NF-κBp65 was significantly up-regulated in the OB of the OD group. TAK-242 treatment significantly reduced the level of IL-1β, IL-6, and TNF-α mRNA expression, as well as activation of microglia and astrocytes in the OB tissues. CONCLUSION TAK-242 improve olfactory function in AR mice mainly by reducing neuroinflammation and apoptosis in the OB, which may be related to blocking the TLR4/MyD88/NF-κB signaling pathway.
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Addison AB, Wong B, Ahmed T, Macchi A, Konstantinidis I, Huart C, Frasnelli J, Fjaeldstad AW, Ramakrishnan VR, Rombaux P, Whitcroft KL, Holbrook EH, Poletti SC, Hsieh JW, Landis BN, Boardman J, Welge-Lüssen A, Maru D, Hummel T, Philpott CM. Clinical Olfactory Working Group consensus statement on the treatment of postinfectious olfactory dysfunction. J Allergy Clin Immunol 2021; 147:1704-1719. [PMID: 33453291 DOI: 10.1016/j.jaci.2020.12.641] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/28/2020] [Accepted: 12/08/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Respiratory tract viruses are the second most common cause of olfactory dysfunction. As we learn more about the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the recognition that olfactory dysfunction is a key symptom of this disease process, there is a greater need than ever for evidence-based management of postinfectious olfactory dysfunction (PIOD). OBJECTIVE Our aim was to provide an evidence-based practical guide to the management of PIOD (including post-coronavirus 2019 cases) for both primary care practitioners and hospital specialists. METHODS A systematic review of the treatment options available for the management of PIOD was performed. The written systematic review was then circulated among the members of the Clinical Olfactory Working Group for their perusal before roundtable expert discussion of the treatment options. The group also undertook a survey to determine their current clinical practice with regard to treatment of PIOD. RESULTS The search resulted in 467 citations, of which 107 articles were fully reviewed and analyzed for eligibility; 40 citations fulfilled the inclusion criteria, 11 of which were randomized controlled trials. In total, 15 of the articles specifically looked at PIOD whereas the other 25 included other etiologies for olfactory dysfunction. CONCLUSIONS The Clinical Olfactory Working Group members made an overwhelming recommendation for olfactory training; none recommended monocycline antibiotics. The diagnostic role of oral steroids was discussed; some group members were in favor of vitamin A drops. Further research is needed to confirm the place of other therapeutic options.
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Affiliation(s)
- Alfred B Addison
- East Sussex North Essex Foundation Trust, Ipswich, United Kingdom
| | - Billy Wong
- East Sussex North Essex Foundation Trust, Ipswich, United Kingdom
| | - Tanzime Ahmed
- East Sussex North Essex Foundation Trust, Ipswich, United Kingdom
| | - Alberto Macchi
- ENT University of Insubria, Italian Academy of Rhinology, Varese, Italy
| | - Iordanis Konstantinidis
- Smell and Taste Clinic, 2nd ORL University Department, Aristotle University, Thessaloniki, Greece
| | - Caroline Huart
- Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Johannes Frasnelli
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada; Research Center, Sacré-Coeur Hospital Montréal, Montréal, Québec, Canada
| | - Alexander W Fjaeldstad
- Flavour Clinic, ENT Department, Regional Hospital West Jutland, Holstebro, Denmark; Flavour Institute, Aarhus University, Aarhus, Denmark
| | - Vijay R Ramakrishnan
- Department of Otolaryngology, University of Colorado Anschutz Medical Campus, Aurora, Colo; Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colo
| | - Philippe Rombaux
- Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Katherine L Whitcroft
- Centre for the Study of the Senses, Institute of Philosophy, School of Advanced Study, London, United Kingdom; South Yorkshire Deanery, Yorkshire and Humber School of Surgery, Yorkshire, United Kingdom
| | - Eric H Holbrook
- Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass
| | - Sophia C Poletti
- Department of Otorhinolaryngology - Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Julien W Hsieh
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology, University Hospitals of Geneva, Geneva, Switzerland
| | - Basile N Landis
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology, University Hospitals of Geneva, Geneva, Switzerland
| | | | - Antje Welge-Lüssen
- Department of Otorhinolaryngology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Devina Maru
- Royal College of General Practitioners, London, United Kingdom
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
| | - Carl M Philpott
- Fifth Sense, Barrow-in-Furness, United Kingdom; Norfolk Smell and Taste Clinic, James Paget University Hospital NHS Foundation Trust, Gorleston, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
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Yan X, Whitcroft KL, Hummel T. Olfaction: Sensitive indicator of inflammatory burden in chronic rhinosinusitis. Laryngoscope Investig Otolaryngol 2020; 5:992-1002. [PMID: 33364387 PMCID: PMC7752087 DOI: 10.1002/lio2.485] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/14/2020] [Accepted: 10/16/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Olfactory dysfunction has a high prevalence in chronic rhinosinusitis (CRS) patients and significantly affects quality of life. CRS is recognized as a complex disorder encompassing heterogeneous inflammatory processes in the nose and paranasal sinuses. Olfactory dysfunction in CRS patients is associated with the level of inflammatory mediators and the efficiency of inflammatory control. Learning about the association between CRS-related inflammation and olfactory function will provide clues to the pathogenesis of CRS. STRUCTURE The first section of this review describes the assessment of olfactory function using various measures, from ratings to MR based imaging. Then, we discuss the conductive and inflammatory mechanisms related to olfactory dysfunction in CRS: olfaction is associated with certain inflammatory patterns and is potentially a marker of CRS subtype. Finally, we review anti-inflammatory therapies including conservative and surgical approaches, and their effectiveness in olfactory dysfunction in CRS. CONCLUSION Assessment of olfactory function should be considered in the clinical evaluation of CRS patients, not only for detecting and quantifying patients' symptom, but also because it appears to be useful to objectively assess the efficacy of CRS treatment over time. In addition, olfaction can be expected to expand the library of CRS phenotypes and endotypes and, hence, pave the way for more precise, tailored treatment options.
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Affiliation(s)
- Xiaoguang Yan
- Smell and Taste Clinic, Department of OtorhinolaryngologyTU DresdenDresdenGermany
| | - Katherine Lisa Whitcroft
- Smell and Taste Clinic, Department of OtorhinolaryngologyTU DresdenDresdenGermany
- UCL Ear Institute, University College LondonLondonUK
| | - Thomas Hummel
- Smell and Taste Clinic, Department of OtorhinolaryngologyTU DresdenDresdenGermany
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Tremblay C, Mei J, Frasnelli J. Olfactory bulb surroundings can help to distinguish Parkinson's disease from non-parkinsonian olfactory dysfunction. NEUROIMAGE-CLINICAL 2020; 28:102457. [PMID: 33068873 PMCID: PMC7567959 DOI: 10.1016/j.nicl.2020.102457] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/19/2020] [Accepted: 09/27/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The olfactory bulb is one of the first regions of insult in Parkinson's disease (PD), consistent with the early onset of olfactory dysfunction. Investigations of the olfactory bulb may, therefore, help early pre-motor diagnosis. We aimed to investigate olfactory bulb and its surrounding regions in PD-related olfactory dysfunction when specifically compared to other forms of non-parkinsonian olfactory dysfunction (NPOD) and healthy controls. METHODS We carried out MRI-based olfactory bulb volume measurements from T2-weighted imaging in scans from 15 patients diagnosed with PD, 15 patients with either post-viral or sinonasal NPOD and 15 control participants. Further, we applied a deep learning model (convolutional neural network; CNN) to scans of the olfactory bulb and its surrounding area to classify PD-related scans from NPOD-related scans. RESULTS Compared to controls, both PD and NPOD patients had smaller olfactory bulbs, when measured manually (both p < .001) whereas no difference was found between PD and NPOD patients. In contrast, when a CNN was used to differentiate between PD patients and NPOD patients, an accuracy of 88.3% was achieved. The cortical area above the olfactory bulb which stretches around and into the olfactory sulcus appears to be a region of interest in the differentiation between PD and NPOD patients. CONCLUSION Measures from and around the olfactory bulb in combination with the use of a deep learning model may help differentiate PD patients from patients with NPOD, which may be used to develop early diagnostic tools based on olfactory dysfunction.
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Affiliation(s)
- Cécilia Tremblay
- Department of Anatomy, Université du Québec à Trois-Rivières, 3351 Boul. des Forges, Trois-Rivières, Québec G9A 5H7, Canada.
| | - Jie Mei
- Department of Anatomy, Université du Québec à Trois-Rivières, 3351 Boul. des Forges, Trois-Rivières, Québec G9A 5H7, Canada
| | - Johannes Frasnelli
- Department of Anatomy, Université du Québec à Trois-Rivières, 3351 Boul. des Forges, Trois-Rivières, Québec G9A 5H7, Canada; Research Center, Sacré-Coeur Hospital of Montreal, 5400 boul. Gouin Ouest, Montréal, Québec H4J 1C5, Canada
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27
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Strauss SB, Lantos JE, Heier LA, Shatzkes DR, Phillips CD. Olfactory Bulb Signal Abnormality in Patients with COVID-19 Who Present with Neurologic Symptoms. AJNR Am J Neuroradiol 2020; 41:1882-1887. [PMID: 32855190 DOI: 10.3174/ajnr.a6751] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/30/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND PURPOSE Unique among the acute neurologic manifestations of Severe Acute Respiratory Syndrome coronavirus 2, the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic, is chemosensory dysfunction (anosmia or dysgeusia), which can be seen in patients who are otherwise oligosymptomatic or even asymptomatic. The purpose of this study was to determine if there is imaging evidence of olfactory apparatus pathology in patients with COVID-19 and neurologic symptoms. MATERIALS AND METHODS A retrospective case-control study compared the olfactory bulb and olfactory tract signal intensity on thin-section T2WI and postcontrast 3D T2 FLAIR images in patients with COVID-19 and neurologic symptoms, and age-matched controls imaged for olfactory dysfunction. RESULTS There was a significant difference in normalized olfactory bulb T2 FLAIR signal intensity between the patients with COVID-19 and the controls with anosmia (P = .003). Four of 12 patients with COVID-19 demonstrated intraneural T2 signal hyperintensity on postcontrast 3D T2 FLAIR compared with none of the 12 patients among the controls with anosmia (P = .028). CONCLUSIONS Olfactory bulb 3D T2 FLAIR signal intensity was greater in the patients with COVID-19 and neurologic symptoms compared with an age-matched control group with olfactory dysfunction, and this was qualitatively apparent in 4 of 12 patients with COVID-19. Analysis of these preliminary finding suggests that olfactory apparatus vulnerability to COVID-19 might be supported on conventional neuroimaging and may serve as a noninvasive biomarker of infection.
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Affiliation(s)
- S B Strauss
- From the Department of Radiology (S.B.S., J.E.L., L.A.H., C.D.P.), Weill Cornell Medical College, New York-Presbyterian, New York, New York
| | - J E Lantos
- From the Department of Radiology (S.B.S., J.E.L., L.A.H., C.D.P.), Weill Cornell Medical College, New York-Presbyterian, New York, New York
| | - L A Heier
- From the Department of Radiology (S.B.S., J.E.L., L.A.H., C.D.P.), Weill Cornell Medical College, New York-Presbyterian, New York, New York
| | - D R Shatzkes
- Department of Radiology (D.R.S.), Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital and The New York Head and Neck Institute, New York, New York
| | - C D Phillips
- From the Department of Radiology (S.B.S., J.E.L., L.A.H., C.D.P.), Weill Cornell Medical College, New York-Presbyterian, New York, New York
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Zang Y, Whitcroft KL, Glöckler C, Hummel T. Is Handedness Associated with the Depth of the Olfactory Sulcus? ORL J Otorhinolaryngol Relat Spec 2020; 82:115-120. [PMID: 32408302 DOI: 10.1159/000507787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 04/06/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Structural and functional asymmetry is frequent in biological systems. The aim of the present study was to examine whether there is a relation between handedness and the depth of the olfactory sulcus (OS) and reinvestigate whether there is a lateralization of OS depth. METHODS Forty-two healthy volunteers (mean age 24.1 years; 23 right-handed and 19 left-handed) participated. The subjects' brains were scanned using magnetic resonance imaging to assess OS depth. Normal olfactory function was ascertained using the Sniffin' Sticks odor identification test. RESULTS There was no significant difference in OS depth between right- and left-handed participants (right-handed mean: right OS depth = 11.3 mm, left OS = 10.6 mm; left-handed mean: right OS = 11.3 mm, left OS = 11.0 mm). Across all subjects, OS depth was significantly larger on the right side compared to the left. CONCLUSION Handedness has no major influence on OS depth. The present study confirmed that the right OS is deeper compared to the left OS, possibly indicating a right-sided lateralization of the olfactory system. IMPLICATIONS The depth of the right OS is larger than that of the left OS. No major effect of handedness was observed.
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Affiliation(s)
- Yunpeng Zang
- Smell and Taste Clinic, Department of Otorhinolaryngology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.,Department of Otorhinolaryngology, the Affiliated Hospital Xuzhou Medical University, Xuzhou, China
| | - Katie L Whitcroft
- Smell and Taste Clinic, Department of Otorhinolaryngology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.,UCL Ear Institute, London, United Kingdom.,Centre for the Study of the Senses, Institute of Philosophy, School of Advanced Studies, London, United Kingdom
| | - Carmina Glöckler
- Smell and Taste Clinic, Department of Otorhinolaryngology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany,
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Evaluation of olfactory bulbus volume and olfactory sulcus depth by 3 T MR. Surg Radiol Anat 2020; 42:1113-1118. [DOI: 10.1007/s00276-020-02484-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/25/2020] [Indexed: 11/25/2022]
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30
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Association between olfactory sulcus morphology and olfactory functioning in schizophrenia and psychosis high-risk status. Heliyon 2019; 5:e02642. [PMID: 31667432 PMCID: PMC6812217 DOI: 10.1016/j.heliyon.2019.e02642] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/07/2019] [Accepted: 10/08/2019] [Indexed: 01/15/2023] Open
Abstract
Olfactory impairment has been reported in patients with schizophrenia and individuals with a high risk of psychosis, but its neural basis is largely unknown. We used magnetic resonance imaging to investigate the morphology of the olfactory sulcus (an indicator of olfactory system development) and its relation to olfactory function in 38 persons with an at-risk mental state (ARMS), 62 patients with schizophrenia, and 61 healthy controls. Odor detection and identification were examined with a T & T olfactometer. Compared with the controls, the olfactory sulcus was significantly shallower and odor identification was inferior among the ARMS and schizophrenia subjects. Across all subjects, but not within each group, the olfactory sulcus depth was significantly related to better identification of odors. Our results support the concept that olfactory sulcus morphology reflects the neurodevelopmental process of the olfactory system.
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31
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Han P, Zang Y, Akshita J, Hummel T. Magnetic Resonance Imaging of Human Olfactory Dysfunction. Brain Topogr 2019; 32:987-997. [PMID: 31529172 DOI: 10.1007/s10548-019-00729-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/06/2019] [Indexed: 12/11/2022]
Abstract
Olfactory dysfunctions affect a larger portion of population (up to 15% with partial olfactory loss, and 5% with complete olfactory loss) as compared to other sensory dysfunctions (e.g. auditory or visual) and have a negative impact on the life quality. The impairment of olfactory functions may happen at each stage of the olfactory system, from epithelium to cortex. Non-invasive neuroimaging techniques such as the magnetic resonance imaging (MRI) have advanced the understanding of the advent and progress of olfactory dysfunctions in humans. The current review summarizes recent MRI studies on human olfactory dysfunction to present an updated and comprehensive picture of the structural and functional alterations in the central olfactory system as a consequence of olfactory loss and regain. Furthermore, the review also highlights recent progress on optimizing the olfactory functional MRI as well as new approaches for data processing that are promising for future clinical practice.
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Affiliation(s)
- Pengfei Han
- Faculty of Psychology, Southwest University, Chongqing, China. .,Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China. .,Department of Otorhinolaryngology, Interdisciplinary Center Smell and Taste, TU Dresden, Dresden, Germany.
| | - Yunpeng Zang
- Department of Otorhinolaryngology, Interdisciplinary Center Smell and Taste, TU Dresden, Dresden, Germany
| | - Joshi Akshita
- Department of Otorhinolaryngology, Interdisciplinary Center Smell and Taste, TU Dresden, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Interdisciplinary Center Smell and Taste, TU Dresden, Dresden, Germany
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Geran R, Uecker FC, Prüss H, Haeusler KG, Paul F, Ruprecht K, Harms L, Schmidt FA. Olfactory and Gustatory Dysfunction in Patients With Autoimmune Encephalitis. Front Neurol 2019; 10:480. [PMID: 31156532 PMCID: PMC6528690 DOI: 10.3389/fneur.2019.00480] [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: 12/28/2018] [Accepted: 04/23/2019] [Indexed: 12/21/2022] Open
Abstract
Objective: To test the hypothesis that olfactory (OF) and gustatory function (GF) is disturbed in patients with autoimmune encephalitides (AE). Methods: The orthonasal OF was tested in 32 patients with AE and 32 age- and sex-matched healthy controls (HC) with the standardized Threshold Discrimination Identification (TDI) score. This validated olfactory testing method yields individual scores for olfactory threshold (T), odor discrimination (D), and identification (I), along with a composite TDI score. The GF was determined by the Taste Strip Test (TST). Results: Overall, 24/32 (75%) of patients with AE, but none of 32 HC (p < 0.001) had olfactory dysfunction in TDI testing. The results of the threshold, discrimination and identification subtests were significantly reduced in patients with AE compared to HC (all p < 0.001). Assessed by TST, 5/19 (26.3%) of patients with AE, but none of 19 HC presented a significant limitation in GF (p < 0.001). The TDI score was correlated with the subjective estimation of the olfactory capacity on a visual analog scale (VAS; rs = 0.475, p = 0.008). Neither age, sex, modified Rankin Scale nor disease duration were associated with the composite TDI score. Conclusions: This is the first study investigating OF and GF in AE patients. According to unblinded assessment, patients with AE have a reduced olfactory and gustatory capacity compared to HC, suggesting that olfactory and gustatory dysfunction are hitherto unrecognized symptoms in AE. Further studies with larger number of AE patients would be of interest to verify our results.
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Affiliation(s)
- Rohat Geran
- Department of Neurology, Clinical and Experimental Multiple Sclerosis Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Center for Stroke Research, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Florian C Uecker
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Harald Prüss
- Department of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | | | - Friedemann Paul
- Department of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Klemens Ruprecht
- Department of Neurology, Clinical and Experimental Multiple Sclerosis Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Lutz Harms
- Department of Neurology, Clinical and Experimental Multiple Sclerosis Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Felix A Schmidt
- Department of Neurology, Clinical and Experimental Multiple Sclerosis Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
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Congenital olfactory impairment is linked to cortical changes in prefrontal and limbic brain regions. Brain Imaging Behav 2019; 12:1569-1582. [PMID: 29442274 DOI: 10.1007/s11682-017-9817-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The human sense of smell is closely associated with morphological differences of the fronto-limbic system, specifically the piriform cortex and medial orbitofrontal cortex (mOFC). Still it is unclear whether cortical volume in the core olfactory areas and connected brain regions are shaped differently in individuals who suffer from lifelong olfactory deprivation relative to healthy normosmic individuals. To address this question, we examined if regional variations in gray matter volume were associated with smell ability in seventeen individuals with isolated congenital olfactory impairment (COI) matched with sixteen normosmic controls. All subjects underwent whole-brain magnetic resonance imaging, and voxel-based morphometry was used to estimate regional variations in grey matter volume. The analyses showed that relative to controls, COI subjects had significantly larger grey matter volumes in left middle frontal gyrus and right superior frontal sulcus (SFS). COI subjects with severe olfactory impairment (anosmia) had reduced grey matter volume in the left mOFC and increased volume in right piriform cortex and SFS. Within the COI group olfactory ability, measured with the "Sniffin' Sticks" test, was positively associated with larger grey matter volume in right posterior cingulate and parahippocampal cortices whereas the opposite relationship was observed in controls. Across COI subjects and controls, better olfactory detection threshold was associated with smaller volume in right piriform cortex, while olfactory identification was negatively associated with right SFS volume. Our findings suggest that lifelong olfactory deprivation trigger changes in the cortical volume of prefrontal and limbic brain regions previously linked to olfactory memory.
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Ramos JN, Ribeiro JC, Pereira AC, Ferreira S, Duarte IC, Castelo-Branco M. Evidence for impaired olfactory function and structural brain integrity in a disorder of ciliary function, Usher syndrome. NEUROIMAGE-CLINICAL 2019; 22:101757. [PMID: 30897432 PMCID: PMC6425118 DOI: 10.1016/j.nicl.2019.101757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 02/23/2019] [Accepted: 03/09/2019] [Indexed: 11/29/2022]
Abstract
Diseases involving cilia dysfunction, such as Usher Syndrome (USH), often involve visual and auditory loss. Psychophysical evidence has suggested that this may also hold true for the peripheral olfactory domain. Here we aimed to go a step further by attempting to establish relations between the integrity of cortical structures and olfactory function in this condition. We investigated olfactory function for USH types 1 (USH1) and 2 (USH2). Bilateral olfactory bulb (OB) volume and olfactory sulcus (OS) depth were also analysed. Thirty-three controls with no previous olfactory deficits were age, sex and handedness-matched to 32 USH patients (11 USH1, 21 USH2). A butanol detection threshold test was performed to measure olfactory function. For OB volume and OS depth, morphometric measurements were performed using magnetic resonance imaging (MRI) based on detailed segmentation by three independent operators. Averaged values across these were used for the statistical analyses. Total intracranial volume was estimated using Freesurfer to account for head size variability. Olfactory threshold was significantly lower in controls when compared to USH, USH1, and USH2. OS depth was found to be shallower in both hemispheres in USH patients when compared with the control group. OB volume was not significantly different between control and USH groups, or respective subgroups. Nevertheless, butanol threshold was negatively correlated with the left OB volume for the USH type 1 subgroup. The main effect of OS depth reduction was found to be mainly due to the comparison between USH2 and controls. Our results provide evidence for morphometric changes and olfactory dysfunction in patients with USH. This correlated with a reduction in left OB volume in the USH1 subgroup, the most severe USH phenotype. The main effect of reduced OS depth was found to stem mainly from USH2 raising questions regarding a possible complex interaction between sensory olfactory loss and central cortical changes in this disease. Evidence for olfactory loss in a disease involving ciliary dysfunction Olfactory sulcus depth is bilaterally reduced in Usher Syndrome (USH). Butanol threshold is negatively correlated with olfactory bulb volume in USH type 1.
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Affiliation(s)
- João Nuno Ramos
- Faculty of Medicine of the University of Coimbra, Coimbra, Portugal; Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), University of Coimbra, Coimbra, Portugal; Institute of Nuclear Sciences Applied to Health (ICNAS) and Coimbra Institute for Biomedical Imaging and Life Sciences (CIBIT), University of Coimbra, Coimbra, Portugal
| | - João Carlos Ribeiro
- Faculty of Medicine of the University of Coimbra, Coimbra, Portugal; Department of Otorhinolaryngology, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Andreia Carvalho Pereira
- Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), University of Coimbra, Coimbra, Portugal; Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Institute of Nuclear Sciences Applied to Health (ICNAS) and Coimbra Institute for Biomedical Imaging and Life Sciences (CIBIT), University of Coimbra, Coimbra, Portugal
| | - Sónia Ferreira
- Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), University of Coimbra, Coimbra, Portugal
| | - Isabel Catarina Duarte
- Institute of Nuclear Sciences Applied to Health (ICNAS) and Coimbra Institute for Biomedical Imaging and Life Sciences (CIBIT), University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Faculty of Medicine of the University of Coimbra, Coimbra, Portugal; Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), University of Coimbra, Coimbra, Portugal; Institute of Nuclear Sciences Applied to Health (ICNAS) and Coimbra Institute for Biomedical Imaging and Life Sciences (CIBIT), University of Coimbra, Coimbra, Portugal.
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Abstract
The senses of taste and smell developed early in evolution and are of high ecological and clinical relevance in humans. Chemosensory systems function, in large part, as hazard avoidance systems, thereby ensuring survival. Moreover, they play a critical role in nutrition and in determining the flavor of foods and beverages. Their dysfunction has been shown to be a key element of early stages of a number of diseases, including Alzheimer's and Parkinson's diseases. Advanced neuroimaging methods provide a unique means for understanding, in vivo, neural and psychological processing of smell, taste, and flavor, and how diseases can impact such processing. This chapter provides, from a neuroimaging perspective, a comprehensive overview of the anatomy and physiology involved in the odor and taste processing in the central nervous system. Some methodological challenges associated with chemosensory neuroimaging research are discussed. Multisensory integration, the mechanisms that enable holistic sensory experiences, is emphasized.
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Affiliation(s)
- Jonas K Olofsson
- Gösta Ekman Laboratory, Department of Psychology, Stockholm University, Stockholm, Sweden.
| | - Jessica Freiherr
- Department of Psychiatry and Psychotherapy, University Hospital, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
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Rottstaedt F, Weidner K, Hummel T, Croy I. Pre-aging of the Olfactory Bulb in Major Depression With High Comorbidity of Mental Disorders. Front Aging Neurosci 2018; 10:354. [PMID: 30467473 PMCID: PMC6235905 DOI: 10.3389/fnagi.2018.00354] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 10/17/2018] [Indexed: 12/31/2022] Open
Abstract
Recent studies suggest that accelerated aging of the brain is a neuroanatomical signature of the state of mental diseases. In major depression, this pre-aging effect is negatively associated with the duration since the first onset of the disease. The olfactory bulb (OB) shrinks with age in healthy subjects and patients with mental diseases show reduced OB volumes, especially those with major depression. It is unclear whether this OB reduction in mental diseases resembles a pre-aging process and whether it is associated to the duration since the onset of the mental disease. To this aim, we investigated OB volume in 73 patients (mean-age 40.4 years, SD = 12.1 years, 57 women) with major depression and mixed comorbid mental diseases (diagnoses ranged from 1 to 6, median: 3) and 51 healthy controls (mean-age 39.2 years, SD = 13.0 years, 26 women) matched for age and sex. Patient’s first onset of disease ranged from 15 to 53 years (mean 24.2 years). All participants underwent structural MR imaging with a spin-echo T2-wheighted sequence covering the anterior and middle segments of the skull base. All results were corrected for total intracranial volume (TIV) and sex. Individual OB volume was calculated by planimetric manual contouring and the pronounced diameter change in transition from bulb to tract was used as the distal demarcation of the OB. Inter-rater correlation between two independent persons analyzing the data was high (IRC = 0.81, p < 0.005). An age-dependent decline of the OB volume was confirmed in healthy controls (r = −0.34, p < 0.05). However, this pattern was altered in patients where the OB volume was not related to age, but to the duration since the onset of the mental disease (r = −0.25, p < 0.05). This association remained stable when controlling for age. Additionally, analyses of age sub-groups revealed that the association between duration since the onset of the mental disease and OB volume was mainly driven by the group aged 50 years and above (r = −0.68; p < 0.01). We conclude that there are time windows where the OB volume is susceptible for the effects of a mental disease, e.g., depression. These effects result in cumulative pre-aging in the OB in older patients with mental diseases.
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Affiliation(s)
- Fabian Rottstaedt
- Department of Psychosomatic Medicine and Psychotherapy, Technische Universität Dresden Dresden, Germany
| | - Kerstin Weidner
- Department of Psychosomatic Medicine and Psychotherapy, Technische Universität Dresden Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden Dresden, Germany
| | - Ilona Croy
- Department of Psychosomatic Medicine and Psychotherapy, Technische Universität Dresden Dresden, Germany
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37
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Olfactory function in patients with nonsyndromic orofacial clefts and their unaffected relatives. Am J Med Genet A 2018; 176:2375-2381. [DOI: 10.1002/ajmg.a.40348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 05/10/2018] [Accepted: 05/11/2018] [Indexed: 01/24/2023]
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Aktürk T, Tanık N, Serin Hİ, Saçmacı H, İnan LE. Olfactory bulb atrophy in migraine patients. Neurol Sci 2018; 40:127-132. [PMID: 30280362 DOI: 10.1007/s10072-018-3597-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 09/29/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Osmophobia and headache triggered by odors are commonly seen in migraine, and these are symptoms that differentiate migraine from other primary headaches. Since these odor-related symptoms are disease-specific, we aimed to measure the volume of olfactory bulb and depth of olfactory sulcus in migraine patients. PATIENTS AND METHOD A total of 93 subjects, consisting of 62 episodic migraine (32 with osmophobia, 30 without osmophobia) patients and 31 healthy controls, were included in this study. Diagnosis and classification of migraine were performed according to the beta version criteria of International Classification of Headache Disorders (ICHD-3 Beta version). Beck depression and beck anxiety inventory were applied to the patients, and the measurement of bilateral olfactory bulb volume (OBV) and olfactory sulcus depth (OSD) was performed manually in the brain magnetic resonance imaging (MRI). RESULTS More significantly in the left OBV, low OBV has been determined in migraine patients compared to the control group (p < 0.001, p = 0.020). When migraine patients with or without osmophobia were compared to the control group; OBV was determined to be the lowest in migraine group with osmophobia, and left-weighted bilateral OBV was determined to be low (p < 0.001, p = 0.046). No statistically significant difference was determined between groups in OSD measurements (p = 0.646, p = 0.490). CONCLUSION Left-weighted bilateral OBV atrophy determined in migraine patients may be guiding for the clarification of migraine pathophysiology and enlightening of the relation between migraine and odor.
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Affiliation(s)
- Tülin Aktürk
- Department of Neurology, Bozok University Medical School, Yozgat, Turkey.
| | - Nermin Tanık
- Department of Neurology, Bozok University Medical School, Yozgat, Turkey
| | | | - Hikmet Saçmacı
- Department of Neurology, Bozok University Medical School, Yozgat, Turkey
| | - Levent Ertuğrul İnan
- Department of Neurology, Ministry of Health Ankara Research and Training Hospital, Ankara, Turkey
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Negoias S, Pietsch K, Hummel T. Changes in olfactory bulb volume following lateralized olfactory training. Brain Imaging Behav 2018; 11:998-1005. [PMID: 27448159 DOI: 10.1007/s11682-016-9567-9] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Repeated exposure to odors modifies olfactory function. Consequently, "olfactory training" plays a significant role in hyposmia treatment. In addition, numerous studies show that the olfactory bulb (OB) volume changes in disorders associated with olfactory dysfunction. Aim of this study was to investigate whether and how olfactory bulb volume changes in relation to lateralized olfactory training in healthy people. Over a period of 4 months, 97 healthy participants (63 females and 34 males, mean age: 23.74 ± 4.16 years, age range: 19-43 years) performed olfactory training by exposing the same nostril twice a day to 4 odors (lemon, rose, eucalyptus and cloves) while closing the other nostril. Before and after olfactory training, magnetic resonance imaging (MRI) scans were performed to measure OB volume. Furthermore, participants underwent lateralized odor threshold and odor identification testing using the "Sniffin' Sticks" test battery.OB volume increased significantly after olfactory training (11.3 % and 13.1 % respectively) for both trained and untrained nostril. No significant effects of sex, duration and frequency of training or age of the subjects were seen. Interestingly, PEA odor thresholds worsened after training, while olfactory identification remained unchanged.These data show for the first time in humans that olfactory training may involve top-down process, which ultimately lead to a bilateral increase in olfactory bulb volume.
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Affiliation(s)
- S Negoias
- Smell & Taste Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, Technical University Dresden, Fetscherstr. 74, 01307, Dresden, Germany. .,Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
| | - K Pietsch
- Smell & Taste Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, Technical University Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - T Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, Technical University Dresden, Fetscherstr. 74, 01307, Dresden, Germany
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Impaired brain response to odors in patients with varied severity of olfactory loss after traumatic brain injury. J Neurol 2018; 265:2322-2332. [DOI: 10.1007/s00415-018-9003-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/24/2018] [Accepted: 08/06/2018] [Indexed: 12/21/2022]
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Size matters - The olfactory bulb as a marker for depression. J Affect Disord 2018; 229:193-198. [PMID: 29324366 DOI: 10.1016/j.jad.2017.12.047] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 12/08/2017] [Accepted: 12/27/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Major Depression is mainly related to structural and functional alterations in brain networks involving limbic and prefrontal regions. Reduced olfactory sensitivity in depression is associated with reduced olfactory bulb (OB) volume. We determined if the OB volume reduction is a specific biomarker for depression and whether its diagnostic accuracy allows its use as a valid biomarker to support its diagnosis. METHODS 84 in-patients with mixed mental disorders and 51 age-matched healthy controls underwent structural MR imaging with a spin-echo T2-wheighted sequence. Individual OB volume was calculated manually (interrater-reliability = .81, p < .001) and compared between groups. Multiple regression analysis with OB volume as dependent variable and Receiver Operator Characteristic analysis to obtain its diagnostic accuracy for depression were ruled out. RESULTS Patients exhibited a 13.5% reduced OB volume. Multiple regression analysis showed that the OB volume variation was best explained by depression (β = -.19), sex (β = -.31) and age (β = -.29), but not by any other mental disorder. OB volume attained a diagnostic accuracy of 68.1% for depression. LIMITATIONS The patient group mainly contained highly comorbid patients with mostly internalizing disorders which limits the generalisability of the results of the regression analysis. CONCLUSION The OB may serve as a marker for depression. We assume that reduced neural olfactory input to subsequent limbic and salience processing structures moderates this relation. However, the OB was in an inferior position compared to conventional questionnaires for diagnosis of depression. Combination with further structural or functional measurements is suggested.
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Gellrich J, Han P, Manesse C, Betz A, Junghanns A, Raue C, Schriever VA, Hummel T. Brain volume changes in hyposmic patients before and after olfactory training. Laryngoscope 2017; 128:1531-1536. [PMID: 29238983 DOI: 10.1002/lary.27045] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 10/26/2017] [Accepted: 11/10/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVES/HYPOTHESIS Olfactory dysfunction is thought to be associated with reduced gray matter (GM) volume in olfactory-related brain areas. The aim of this study was to determine GM structural changes within olfactory-related regions of the brain in patients with smell loss due to upper respiratory tract infection (URTI) before and after olfactory rehabilitation. STUDY DESIGN Prospective intervention case-control study. METHODS Magnetic resonance imaging structural brain images were collected from 30 patients with smell loss due to URTI and 31 controls. Patients exposed themselves to odors (olfactory training [OT]) over 12 weeks and then were rescanned. Olfactory testing was performed using the validated Sniffin' Sticks test. GM was investigated with voxel-based morphometry. RESULTS GM volumes were found to be reduced in the limbic system and thalamus among pretraining patients compared to controls; in patients, OT was associated with a significant increase of GM volume in these two regions. The GM volume within other olfactory-related regions was not different between patients and controls. In addition, no relevant difference between the GM volume pre- and post-OT was observed in primary olfactory-related regions. CONCLUSIONS OT was associated with an increase in GM volume of the hippocampus and the thalamus, possibly pointing toward a strategy for more effective exploitation of olfactory signals based on a higher degree of attention toward odors and association of memories with olfactory input. LEVEL OF EVIDENCE 3b. Laryngoscope, 128:1531-1536, 2018.
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Affiliation(s)
- Janine Gellrich
- Department of Otorhinolaryngology.,Department of Neuropediatrics
| | | | | | | | | | - Claudia Raue
- Department of Neuroradiology, Technical University of Dresden, Dresden, Germany
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Yao L, Yi X, Pinto JM, Yuan X, Guo Y, Liu Y, Wei Y. Olfactory cortex and Olfactory bulb volume alterations in patients with post-infectious Olfactory loss. Brain Imaging Behav 2017; 12:1355-1362. [DOI: 10.1007/s11682-017-9807-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
For the visual and auditory senses, an array of studies has reported on neuronal reorganization processes after sensory loss. In contrast to this, neuroplasticity has been investigated only scarcely after loss of the olfactory sense. The present review focuses on the current extent of literature on structural and functional neuroplasticity effects after loss, with a focus on magnetic resonance imaging-based studies. We also include findings on the regain of the olfactory sense, for example after successful olfactory training. Existing studies indicate that widespread structural changes beyond the level of the olfactory bulb occur in the brain after loss of the olfactory sense. Moreover, on a functional level, loss of olfactory input not only entails changes in olfaction-related brain regions but also in the trigeminal system. Existing evidence should be strengthened by future longitudinal studies, a more thorough investigation of the neuronal consequences of congenital anosmia, and the application of state-of-the-art neuroimaging methods, such as connectivity analyses and joint analyses of brain structure and function.
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Affiliation(s)
- Johanna L Reichert
- 1 Institute of Psychology, University of Graz, Graz, Austria.,2 BioTechMed, Graz, Austria
| | - Veronika Schöpf
- 1 Institute of Psychology, University of Graz, Graz, Austria.,2 BioTechMed, Graz, Austria
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46
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Han P, Whitcroft KL, Fischer J, Gerber J, Cuevas M, Andrews P, Hummel T. Olfactory brain gray matter volume reduction in patients with chronic rhinosinusitis. Int Forum Allergy Rhinol 2017; 7:551-556. [DOI: 10.1002/alr.21922] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/03/2017] [Accepted: 01/10/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Pengfei Han
- Smell & Taste Clinic, Department of Otorhinolaryngology; Technische Universität Dresden; Dresden Germany
- Department of Neuropediatrics; University Hospital Carl Gustav Carus; Dresden Germany
| | - Katherine L. Whitcroft
- Smell & Taste Clinic, Department of Otorhinolaryngology; Technische Universität Dresden; Dresden Germany
- UCL Ear Institute; London UK
| | - Jessica Fischer
- Smell & Taste Clinic, Department of Otorhinolaryngology; Technische Universität Dresden; Dresden Germany
| | - Johannes Gerber
- Department of Neuroradiology; Technische Universität Dresden; Dresden Germany
| | - Mandy Cuevas
- Smell & Taste Clinic, Department of Otorhinolaryngology; Technische Universität Dresden; Dresden Germany
| | | | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology; Technische Universität Dresden; Dresden Germany
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Uecker FC, Olze H, Kunte H, Gerz C, Göktas Ö, Harms L, Schmidt FA. Longitudinal Testing of Olfactory and Gustatory Function in Patients with Multiple Sclerosis. PLoS One 2017; 12:e0170492. [PMID: 28107525 PMCID: PMC5249198 DOI: 10.1371/journal.pone.0170492] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 01/05/2017] [Indexed: 11/24/2022] Open
Abstract
Background The aim of the study was to investigate changes of the olfactory and gustatory capacity in patients with multiple sclerosis (MS). Methodology 20 MS patients were tested longitudinally for 3 years after initial testing. The Threshold Discrimination Identification test (TDI) was used for subjective olfactometry. Objective olfactometry was performed by registering olfactory evoked potentials (OEP) by EEG. The Taste Strip Test (TST) was used for gustatory testing. Results 45% of the patients showed olfactory dysfunction in the follow-up TDI test and 50% showed delayed OEP´s. 20% of the patients showed gustatory dysfunction on follow-up visit. The patients showed mild disease activity with 0,3 ± 0,5 relapses over the testing period and no significant change of their olfactory and gustatory capacity. The olfactory capacity for the discrimination of odors correlated inversely with the number of relapses (r = -0.5, p ≤ 0.05). The patients were aware of their olfactory deficit. Conclusions Olfactory and gustatory dysfunction is a symptom in MS patients and may be a useful parameter to estimate disease progression in MS patients. As the discrimination of odors is processed in higher central regions of the central nervous system (CNS), the results suggest that olfactory dysfunction could be due to CNS damage.
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Affiliation(s)
| | - Heidi Olze
- Department of Otorhinolaryngology, Charité –Universitätsmedizin Berlin, Berlin, Germany
| | - Hagen Kunte
- Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité –Universitätsmedizin Berlin, Berlin, Germany
- MSB - Medical School Berlin, Berlin, Germany
| | - Christian Gerz
- Department of Otorhinolaryngology, Charité –Universitätsmedizin Berlin, Berlin, Germany
| | - Önder Göktas
- Department of Otorhinolaryngology, Charité –Universitätsmedizin Berlin, Berlin, Germany
| | - Lutz Harms
- Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité –Universitätsmedizin Berlin, Berlin, Germany
| | - Felix Alexander Schmidt
- Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité –Universitätsmedizin Berlin, Berlin, Germany
- * E-mail:
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Alarabawy RA, Eltomey MA, Shehata EM. Volumetric study of the olfactory bulb in patients with chronic rhinonasal sinusitis using MRI. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2016. [DOI: 10.1016/j.ejrnm.2016.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Braun JJ, Noblet V, Kremer S, Molière S, Dollfus H, Marion V, Goetz N, Muller J, Riehm S. Value of MRI olfactory bulb evaluation in the assessment of olfactory dysfunction in Bardet-Biedl syndrome. Clin Genet 2016; 90:79-83. [PMID: 26586152 DOI: 10.1111/cge.12697] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 11/16/2015] [Accepted: 11/16/2015] [Indexed: 11/27/2022]
Abstract
Olfactory bulb (OB) volume evaluation by magnetic resonance imaging (MRI) has been demonstrated to be related to olfactory dysfunction in many different diseases. Olfactory dysfunction is often overlooked in Bardet-Biedl syndrome (BBS) patients and is rarely objectively evaluated by MRI. We present a series of 20 BBS patients with olfactory dysfunction. The OB was evaluated separately and blindly by two radiologists (SR and SM) with 3 Tesla MRI imaging comparatively to 12 normal control subjects by global visual evaluation and by quantitative measurement of OB volume. In the 12 control cases OB visual evaluation was considered as normal in all cases for radiologist (SR) and in 10 cases for radiologist (SM). In the 20 BBS patients, OB visual evaluation was considered as abnormal in 18 cases for SR and in all cases for SM. OB volumetric evaluation for SR and SM in BBS patients was able to provide significant correlation between BBS and olfactory dysfunction. This study indicates that OB volume evaluation by MRI imaging like structural MRI scan for gray matter modifications demonstrates that olfactory dysfunction in BBS patients is a constant and cardinal symptom integrated in a genetical syndrome with peripheral and central olfactory structure alterations.
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Affiliation(s)
- J J Braun
- Service ORL-CCF, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - V Noblet
- Laboratoire ICUBE, UMR CNRS 7357, Strasbourg, France
| | - S Kremer
- Laboratoire ICUBE, UMR CNRS 7357, Strasbourg, France.,Service de Radiologie 2, Hôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - S Molière
- Service de Radiologie 2, Hôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - H Dollfus
- Service de Génétique Médicale, centre de Référence pour les Affections Rares en Génétique Ophtalmologique (CARGO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Laboratoire de Génétique Médicale, INSERM U1112, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - V Marion
- Laboratoire de Génétique Médicale, INSERM U1112, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - N Goetz
- Service de Génétique Médicale, centre de Référence pour les Affections Rares en Génétique Ophtalmologique (CARGO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - J Muller
- Laboratoire de Génétique Médicale, INSERM U1112, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.,Laboratoire de Diagnostic Génétique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - S Riehm
- Service de Radiologie 1, Hôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
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