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Molot J, Sears M, Anisman H. Multiple Chemical Sensitivity: It's time to catch up to the science. Neurosci Biobehav Rev 2023; 151:105227. [PMID: 37172924 DOI: 10.1016/j.neubiorev.2023.105227] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 05/06/2023] [Indexed: 05/15/2023]
Abstract
Multiple chemical sensitivity (MCS) is a complex medical condition associated with low dose chemical exposures. MCS is characterized by diverse features and common comorbidities, including fibromyalgia, cough hypersensitivity, asthma, and migraine, and stress/anxiety, with which the syndrome shares numerous neurobiological processes and altered functioning within diverse brain regions. Predictive factors linked to MCS comprise genetic influences, gene-environment interactions, oxidative stress, systemic inflammation, cell dysfunction, and psychosocial influences. The development of MCS may be attributed to the sensitization of transient receptor potential (TRP) receptors, notably TRPV1 and TRPA1. Capsaicin inhalation challenge studies demonstrated that TRPV1 sensitization is manifested in MCS, and functional brain imaging studies revealed that TRPV1 and TRPA1 agonists promote brain-region specific neuronal variations. Unfortunately, MCS has often been inappropriately viewed as stemming exclusively from psychological disturbances, which has fostered patients being stigmatized and ostracized, and often being denied accommodation for their disability. Evidence-based education is essential to provide appropriate support and advocacy. Greater recognition of receptor-mediated biological mechanisms should be incorporated in laws, and regulation of environmental exposures.
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Affiliation(s)
- John Molot
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
| | - Margaret Sears
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
| | - Hymie Anisman
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
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2
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Zhao Y, Zhang L, Rütgen M, Sladky R, Lamm C. Effective connectivity reveals distinctive patterns in response to others' genuine affective experience of disgust. Neuroimage 2022; 259:119404. [PMID: 35750254 DOI: 10.1016/j.neuroimage.2022.119404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022] Open
Abstract
Empathy is significantly influenced by the identification of others' emotions. In a recent study, we have found increased activation in the anterior insular cortex (aIns) that could be attributed to affect sharing rather than perceptual saliency, when seeing another person genuinely experiencing pain as opposed to merely acting to be in pain. In that prior study, effective connectivity between aIns and the right supramarginal gyrus (rSMG) was revealed to represent what another person really feels. In the present study, we used a similar paradigm to investigate the corresponding neural signatures in the domain of empathy for disgust - with participants seeing others genuinely sniffing unpleasant odors as compared to pretending to smell something disgusting (in fact the disgust expressions in both conditions were acted for reasons of experimental control). Consistent with the previous findings on pain, we found stronger activations in aIns associated with affect sharing for genuine disgust (inferred) compared with pretended disgust. However, instead of rSMG we found engagement of the olfactory cortex. Using dynamic causal modeling (DCM), we estimated the neural dynamics of aIns and the olfactory cortex between the genuine and pretended conditions. This revealed an increased excitatory modulatory effect for genuine disgust compared to pretended disgust. For genuine disgust only, brain-to-behavior regression analyses highlighted a link between the observed modulatory effect and a few empathic traits. Altogether, the current findings complement and expand our previous work, by showing that perceptual saliency alone does not explain responses in the insular cortex. Moreover, it reveals that different brain networks are implicated in a modality-specific way when sharing the affective experiences associated with pain vs. disgust.
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Affiliation(s)
- Yili Zhao
- Social, Cognitive and Affective Neuroscience Unit, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, Vienna 1010, Austria
| | - Lei Zhang
- Social, Cognitive and Affective Neuroscience Unit, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, Vienna 1010, Austria
| | - Markus Rütgen
- Social, Cognitive and Affective Neuroscience Unit, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, Vienna 1010, Austria; Vienna Cognitive Science Hub, University of Vienna, Liebiggasse 5, Vienna 1010, Austria
| | - Ronald Sladky
- Social, Cognitive and Affective Neuroscience Unit, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, Vienna 1010, Austria
| | - Claus Lamm
- Social, Cognitive and Affective Neuroscience Unit, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, Vienna 1010, Austria; Vienna Cognitive Science Hub, University of Vienna, Liebiggasse 5, Vienna 1010, Austria.
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3
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Suzuki K, Suzuki S, Shiina T, Kobayashi S, Hirata K. Central Sensitization in Migraine: A Narrative Review. J Pain Res 2022; 15:2673-2682. [PMID: 36101891 PMCID: PMC9464439 DOI: 10.2147/jpr.s329280] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/16/2022] [Indexed: 11/23/2022] Open
Abstract
Central sensitization (CS) is an increase in the responsiveness of nociceptive neurons in the central nervous system to their normal afferent input. As a result, even minor irritation can induce severe pain, leading to the chronicity and severity of various diseases, such as neurological disorders. CS is associated with migraine, which is a major neurological disorder that inflicts a high disability in daily life. Specifically, CS is thought to be involved in the pathogenesis of cutaneous allodynia as well as chronification of migraine. In this article, we reviewed the association between CS and migraine, including pathophysiological aspects and evidence from clinical studies. We suggest that appropriate screening and management of CS in migraine could further improve the quality of life of migraine patients.
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Affiliation(s)
- Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Shiho Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Tomohiko Shiina
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Saro Kobayashi
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
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4
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Suzuki K, Okamura M, Haruyama Y, Suzuki S, Shiina T, Kobashi G, Hirata K. Exploring the contributing factors to multiple chemical sensitivity in patients with migraine. J Occup Health 2022; 64:e12328. [PMID: 35363938 PMCID: PMC9176718 DOI: 10.1002/1348-9585.12328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/08/2022] [Accepted: 03/20/2022] [Indexed: 12/17/2022] Open
Abstract
Objective Multiple chemical sensitivity (MCS) is a form of chemical intolerance in which various systemic symptoms are triggered by exposure to a variety of chemical substances. Although migraine has been associated with central sensitivity syndrome, the relationship between MCS and migraine has not been studied. We assessed the frequency of MCS and its related factors in patients with migraine. Methods We performed a cross‐sectional study that included 95 patients (14 M/81 F; age, 45.4 ± 12.4 years) out of 100 consecutive patients with migraine from our outpatient headache clinic. MCS was defined as having a combination of Q1 ≥ 30, Q3 ≥ 13, and Q5 ≥ 17 on the quick environment exposure sensitivity inventory (QEESI; Japanese version). Central sensitization inventory‐A scores >40 were considered an indication of central sensitization. Headache‐related disability and psychological distress were evaluated with the Migraine Disability Assessment score (MIDAS) and Kessler Psychological Distress Scale (K6), respectively. Results MCS was identified in 20% of patients with migraine; however, none had previously been diagnosed with MCS. The MCS‐positive group had higher rates of photophobia, osmophobia, visual aura, sensory aura, and central sensitization and higher MIDAS and K6 scores than the MCS‐negative group. A logistic regression analysis showed that osmophobia, sensory aura, and central sensitization were significant contributors to MCS. Conclusion We showed that MCS was observed in 20% of patients with migraine, and our study results may indicate a possible association of MCS with central sensitization and hypersensitivity‐related symptoms in patients with migraine.
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Affiliation(s)
- Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Madoka Okamura
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Yasuo Haruyama
- Integrated Research Faculty for Advanced Medical Science, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Shiho Suzuki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Tomohiko Shiina
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
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5
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Damiani G, Alessandrini M, Caccamo D, Cormano A, Guzzi G, Mazzatenta A, Micarelli A, Migliore A, Piroli A, Bianca M, Tapparo O, Pigatto PDM. Italian Expert Consensus on Clinical and Therapeutic Management of Multiple Chemical Sensitivity (MCS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111294. [PMID: 34769816 PMCID: PMC8582949 DOI: 10.3390/ijerph182111294] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 12/29/2022]
Abstract
Multiple chemical sensitivity (MCS) is a multisystem, recurrent, environmental disorder that flares in response to different exposures (i.e., pesticides, solvents, toxic metals and molds) under the threshold limit value (TLV) calculated for age and gender in the general population. MCS is a syndrome characterized by cutaneous, allergic, gastrointestinal, rheumatological, endocrinological, cardiological and neurological signs and symptoms. We performed a systematic review of the literature to summarize the current clinical and therapeutic evidence and then oriented an eDelphi consensus. Four main research domains were identified (diagnosis, treatment, hospitalization and emergency) and discussed by 10 experts and an MCS patient. Thus, the first Italian MCS consensus had the double aim: (a) to improve MCS knowledge among healthcare workers and patients by standardizing the clinical and therapeutic management to MCS patients; and (b) to improve and shed light on MCS misconceptions not supported by evidence-based medicine (EBM).
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Affiliation(s)
- Giovanni Damiani
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy;
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- PhD Degree Program in Pharmacological Sciences, Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padua, Italy
| | - Marco Alessandrini
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Daniela Caccamo
- Department of Biomedical Sciences, Dental Sciences, & Morpho-Functional Imaging, Polyclinic Hospital University, 98124 Messina, Italy;
| | - Andrea Cormano
- International Society of Doctors for Environment, 82100 Benevento, Italy;
| | - Gianpaolo Guzzi
- Italian Association for Metals and Biocompatibility Research—A.I.R.M.E.B., 20122 Milan, Italy;
| | - Andrea Mazzatenta
- Department of Neuroscience, Imaging and Clinical Science, ‘G. d’Annunzio’ University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Alessandro Micarelli
- Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy;
- ITER Center for Balance and Rehabilitation Research (ICBRR), 02032 Rome, Italy
| | - Alberto Migliore
- Department of Internal Medicine, Unit of Rheumatology, San Pietro Fatebenefratelli Hospital, 00189 Rome, Italy;
| | - Alba Piroli
- Department of MeSVA, University of L’Aquila, 67100 L’Aquila, Italy;
| | | | | | - Paolo Daniele Maria Pigatto
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy;
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Correspondence: ; Tel.: +39-02-5031-9971
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Palmieri B, Corazzari V, Vadalaʹ M, Vallelunga A, Morales-Medina JC, Iannitti T. The role of sensory and olfactory pathways in multiple chemical sensitivity. REVIEWS ON ENVIRONMENTAL HEALTH 2021; 36:319-326. [PMID: 33070122 DOI: 10.1515/reveh-2020-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023]
Abstract
Multiple chemical sensitivity (MCS) is characterised by non-specific and recurring symptoms affecting multiple organs and associated with exposure to chemicals, even at low concentrations, which are, under normal circumstances, harmless to the general population. Symptoms include general discomfort, cardiovascular instability, irritation of the sensory organs, breath disorders, hypersensitivity affecting the skin and epithelial lining of the gut, throat and lungs, anxiety, and learning and memory loss. Chemical intolerance is a key distinguishing feature of MCS, limiting considerably patients' lifestyle with serious social, occupational and economic implications. Since no specific diagnostic markers are currently available for chemical intolerance, the diagnosis relies on clinical symptoms. Despite the formulation of several hypotheses regarding the pathophysiology of MCS, its mechanisms remain undefined. A person-centred care approach, based on multidisciplinary and individualised medical plans, has shown promising results. However, more definite treatment strategies are required. We have reviewed the main experimental studies on MCS pathophysiology, focusing on the brain networks involved, the impact of environmental pollution on the olfactory system and the correlation with other pathologies such as neurodegenerative diseases. Finally, we discuss treatment strategies targeting the olfactory system.
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Affiliation(s)
- Beniamino Palmieri
- Surgical, Medical, Dental and Morphological Sciences Departments with interest in Transplants, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
- Network of Second Opinion, Modena, Italy
| | | | - Maria Vadalaʹ
- Surgical, Medical, Dental and Morphological Sciences Departments with interest in Transplants, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
- Network of Second Opinion, Modena, Italy
| | - Annamaria Vallelunga
- Department of Medicine and Surgery, Centre for Neurodegenerative Diseases (CEMAND), University of Salerno, Salerno, Italy
| | - Julio César Morales-Medina
- Centro de Investigación en Reproducción Animal, CINVESTAV- Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico
| | - Tommaso Iannitti
- Charles River Discovery Research Services UK Limited, Portishead, UK
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Mosca A, Del Casale A, Borro M, Gentile G, Pomes LM, Padovano A, Fiaschè F, Pinzone V, Rapinesi C, Zoppi T, Brugnoli R, Sani G, Kotzalidis GD, Girardi P, Ferracuti S, Simmaco M, Pompili M. PON1 polymorphisms can predict generalized anxiety and depressed mood in patients with multiple chemical sensitivity. Per Med 2021; 18:255-267. [PMID: 33728967 DOI: 10.2217/pme-2019-0141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background: Multiple chemical sensitivity (MCS) is a chronic condition with somatic, cognitive and affective symptoms that follow contact with chemical agents at usually non toxic concentrations. We aimed to assess the role of genetic polymorphisms involved in oxidative stress on anxiety and depression in MCS. Materials & methods: Our study investigated the CAT rs1001179, MPO rs2333227, PON1 rs662 and PON1 rs705379 polymorphisms in MCS. Results: The AG genotype of the PON1 rs662 and the TT and CT genotypes of the PON1 rs705379 were involved in anxiety and depression. Discussion: These results are in line with existing evidence of PON1 involvement in MCS and suggest a further role of this gene in the exhibition of anxiety and depression in this disease.
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Affiliation(s)
- Alessio Mosca
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy
| | - Antonio Del Casale
- Department of Dynamic & Clinical Psychology, & Health Studies, Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Marina Borro
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Laboratory & Advanced Molecular Diagnostics, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Giovanna Gentile
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Laboratory & Advanced Molecular Diagnostics, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Leda Marina Pomes
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Laboratory & Advanced Molecular Diagnostics, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Alessio Padovano
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Federica Fiaschè
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Vito Pinzone
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Chiara Rapinesi
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy
| | - Teodolinda Zoppi
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Roberto Brugnoli
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Gabriele Sani
- Institute of Psychiatry & Psychology, Department of Geriatrics, Neuroscience & Orthopedics, Fondazione Policlinico Universitario IRCCS "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Georgios Demetrios Kotzalidis
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy
| | - Paolo Girardi
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Stefano Ferracuti
- Department of Human Neuroscience, Sapienza University; Unit of Risk Management, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Maurizio Simmaco
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Laboratory & Advanced Molecular Diagnostics, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
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8
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Food Implications in Central Sensitization Syndromes. J Clin Med 2020; 9:jcm9124106. [PMID: 33352747 PMCID: PMC7766296 DOI: 10.3390/jcm9124106] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022] Open
Abstract
Fibromyalgia (FM), chronic fatigue syndrome (CFS) and multiple chemical sensitivity (MCS) are some of the central sensitization syndromes (CSSs). The complexity of their diagnosis, the high interindividual heterogeneity and the existence of multi-syndromic patients requires a multifaceted treatment. The scientific literature is contradictory regarding the role of food in CSS, and evidence on the role of nutrition in MCS is particularly scarce. This review consists in gathering information about the current status of dietary recommendations (i.e., special dietary interventions, the role of additives, presence of micronutrient deficiencies, nutritional supplements and elimination of other nutrients and substances) and discussing the scientific evidence in depth to shed light on appropriate nutritional treatment managements for CSS patients. Current indications show that dietary modifications may vastly improve the patients’ quality of life at a low cost. We suggest personalized treatment, taking into consideration the severity of the disease symptoms, quality of life, coexistence with other diseases, pharmacological treatment, changing clinical characteristics, nutritional status, energy requirements and food tolerances, among others, as the best ways to tailor specific dietary interventions. These approaches will partially overcome the lack of scientific and clinical research on MSC. Patients should also be advised on the serious consequences of following dietary guidelines without a dietitian’s and clinician’s supervision.
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Del Casale A, Ferracuti S, Mosca A, Pomes LM, Fiaschè F, Bonanni L, Borro M, Gentile G, Martelletti P, Simmaco M. Multiple Chemical Sensitivity Syndrome: A Principal Component Analysis of Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186551. [PMID: 32916833 PMCID: PMC7558401 DOI: 10.3390/ijerph17186551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/03/2020] [Accepted: 09/07/2020] [Indexed: 12/12/2022]
Abstract
Multiple Chemical Sensitivity (MCS) is a chronic and/or recurrent condition with somatic, cognitive, and affective symptoms following a contact with chemical agents whose concentrations do not correlate with toxicity in the general population. Its prevalence is not well defined; it mainly affects women between 40 and 50 years, without variations in ethnicity, education and economic status. We aimed to assess the core symptoms of this illness in a sample of Italian patients. Two physicians investigated different symptoms with a checklist compilation in 129 patients with MCS (117 women). We conducted a categorical Principal Component Analysis (CATPCA) with Varimax rotation on the checklist dataset. A typical triad was documented: hyperosmia, asthenia, and dyspnoea were the most common symptoms. Patients also frequently showed cough and headache. The CATPCA showed seven main factors: 1, neurocognitive symptoms; 2, physical (objective) symptoms; 3, gastrointestinal symptoms; 4, dermatological symptoms; 5, anxiety-depressive symptoms; 6, respiratory symptoms; 7, hyperosmia and asthenia. Patients showed higher mean prevalence of factors 7 (89.9%), 6 (71.7%), and 1 (62.13%). In conclusion, MCS patients frequently manifest hyperosmia, asthenia, and dyspnoea, which are often concomitant with other respiratory and neurocognitive symptoms. Considering the clinical association that is often made with anxiety, more studies are necessary on the psychosomatic aspects of this syndrome. Further analytical epidemiological studies are needed to support the formulation of aetiological hypotheses of MCS.
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Affiliation(s)
- Antonio Del Casale
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
- Correspondence:
| | - Stefano Ferracuti
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University, 00185 Rome, Italy;
- Unit of Risk Management, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Alessio Mosca
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, 66100 Chieti, Italy;
| | - Leda Marina Pomes
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Federica Fiaschè
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
| | - Luca Bonanni
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
| | - Marina Borro
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Giovanna Gentile
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Paolo Martelletti
- Department of Medical and Molecular Sciences, Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy;
- Headache Centre Unit, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Maurizio Simmaco
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
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10
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Harter K, Hammel G, Fleming M, Traidl-Hoffmann C. Multiple chemical sensitivity (MCS) - a guide for dermatologists on how to manage affected individuals. J Dtsch Dermatol Ges 2020; 18:119-130. [PMID: 32026633 DOI: 10.1111/ddg.14027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 01/13/2020] [Indexed: 02/03/2023]
Abstract
Multiple chemical sensitivity (MCS) is a condition characterized by a subjectively perceived increase in sensitivity to environmental chemicals. Individuals affected report a wide variety of nonspecific complaints, and frequently attribute cutaneous and mucosal symptoms to chemical exposures. Dermatologists should therefore be familiar with this condition. MCS is a diagnosis of exclusion. Other causes for the patients' symptoms should be ruled out by routine laboratory tests, allergy tests and, if indicated, monitoring for toxic (environmental) substances. The primary job of dermatologists is to rule out skin diseases or hypersensitivities as possible causes of the complaints. Interdisciplinary patient management is essential, especially in severe cases in which those affected have problems coping with everyday life. Relevant specialties in this context include environmental medicine, psychosomatic medicine as well as occupational and social medicine. Cutaneous symptoms are usually addressed with symptomatic treatment using basic skin care products. There are currently no evidence-based treatment recommendations for MCS. It is crucial that MCS patients be protected from unnecessary treatments and thus from mental, social and financial strain. In addition to medical skills, managing MCS patients requires communicative and psychosocial competence in particular. Physicians involved in the treatment will benefit from training in psychotherapy. Irrespective of the mechanisms that lead to MCS, diagnosis and treatment of this condition require an actively supportive attitude towards these patients, a good doctor-patient relationship and interdisciplinary cooperation.
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Affiliation(s)
- Katharina Harter
- Chair and Institute of Environmental Medicine, UNIKA-T, Medical Faculty of the Technical University Munich and Helmholtz Center Munich, Augsburg, Germany.,Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Gertrud Hammel
- Chair and Institute of Environmental Medicine, UNIKA-T, Medical Faculty of the Technical University Munich and Helmholtz Center Munich, Augsburg, Germany.,Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Megan Fleming
- Chair and Institute of Environmental Medicine, UNIKA-T, Medical Faculty of the Technical University Munich and Helmholtz Center Munich, Augsburg, Germany.,Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.,Outpatient Clinic for Environmental Medicine at Augsburg University Medical Center, Augsburg, Germany
| | - Claudia Traidl-Hoffmann
- Chair and Institute of Environmental Medicine, UNIKA-T, Medical Faculty of the Technical University Munich and Helmholtz Center Munich, Augsburg, Germany.,Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.,Outpatient Clinic for Environmental Medicine at Augsburg University Medical Center, Augsburg, Germany
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11
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Harter K, Hammel G, Fleming M, Traidl-Hoffmann C. Multiple Chemikaliensensibilität (MCS) – Ein Leitfaden für die Dermatologie zum Umgang mit den Betroffenen. J Dtsch Dermatol Ges 2020; 18:119-131. [PMID: 32026641 DOI: 10.1111/ddg.14027_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 01/13/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Katharina Harter
- Lehrstuhl und Institut für Umweltmedizin, UNIKA-T, Medizinische Fakultät der Technischen Universität München und Helmholtzzentrum München, Augsburg, Deutschland.,Christine-Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Schweiz.,Professur für Soziologie mit Schwerpunkt Gesundheitsforschung, Philosophisch-Sozialwissenschaftliche Fakultät, Universität Augsburg, Augsburg, Deutschland
| | - Gertrud Hammel
- Lehrstuhl und Institut für Umweltmedizin, UNIKA-T, Medizinische Fakultät der Technischen Universität München und Helmholtzzentrum München, Augsburg, Deutschland.,Christine-Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Schweiz
| | - Megan Fleming
- Lehrstuhl und Institut für Umweltmedizin, UNIKA-T, Medizinische Fakultät der Technischen Universität München und Helmholtzzentrum München, Augsburg, Deutschland.,Christine-Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Schweiz.,Hochschulambulanz für Umweltmedizin, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - Claudia Traidl-Hoffmann
- Lehrstuhl und Institut für Umweltmedizin, UNIKA-T, Medizinische Fakultät der Technischen Universität München und Helmholtzzentrum München, Augsburg, Deutschland.,Christine-Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Schweiz.,Hochschulambulanz für Umweltmedizin, Universitätsklinikum Augsburg, Augsburg, Deutschland
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12
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Micarelli A, Cormano A, Caccamo D, Alessandrini M. Olfactory-Related Quality of Life in Multiple Chemical Sensitivity: A Genetic-Acquired Factors Model. Int J Mol Sci 2019; 21:ijms21010156. [PMID: 31881664 PMCID: PMC6981591 DOI: 10.3390/ijms21010156] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/21/2019] [Accepted: 12/24/2019] [Indexed: 12/19/2022] Open
Abstract
Genetic polymorphisms as well as environmental exposures to chemical compounds, iatrogenic, psychological, and physical trauma may play a pathophysiological role in multiple chemical sensitivity (MCS) olfactory complaints, given that xenobiotic metabolism is influenced by sequence variations in genes of metabolizing enzymes. Thus, the aim of the present study was to depict-by means of multiple regression analysis-how different genetic conditions, grouped according to their function as well as clinical background and environmental exposure may interfere with those olfactory complaints referred by MCS patients. Therefore, MCS patients after gene polymorphism sequencing, the olfactory-related quality of life score-calculated by means of the Questionnaire of Olfactory Disorder in forty-six MCS patients-have been found to significantly rely on the phase I and II enzymes score and exposure to previous compounds and surgical treatments. The present work-implementing for the first time a genetic-acquired factors model on a regression analysis-further reinforces those theories, positing MCS as a complex, multifactorial, disease in which the genetic risk related to phase I and II enzymes involved in xenobiotic detoxification, olfactory, and neurodegenerative diseases play a necessary, but probably not sufficient role, along the pathophysiological route of the disease.
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Affiliation(s)
- Alessandro Micarelli
- Institute of Mountain Emergency Medicine, EURAC Research, I-39100 Bolzano, Italy
- ITER Center for Balance and Rehabilitation Research (ICBRR), 02032 Rome, Italy
- Correspondence:
| | | | - Daniela Caccamo
- Department of Biomedical Sciences, Dental Sciences and Morpho-functional Imaging, Polyclinic Hospital University, 98124 Messina, Italy;
| | - Marco Alessandrini
- Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
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13
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Azuma K, Uchiyama I, Tanigawa M, Bamba I, Azuma M, Takano H, Yoshikawa T, Sakabe K. Chemical intolerance: involvement of brain function and networks after exposure to extrinsic stimuli perceived as hazardous. Environ Health Prev Med 2019; 24:61. [PMID: 31640568 PMCID: PMC6806489 DOI: 10.1186/s12199-019-0816-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/23/2019] [Indexed: 01/09/2023] Open
Abstract
Background Chemical intolerance (CI) is a chronic condition characterized by recurring and severe symptoms triggered by exposure to low levels of odorous or pungent substances. The etiology of CI has been a controversial subject for a long time. The aim of this review is to summarize findings on the neurological processing of sensory information during and after exposure to low levels of odorous or pungent substances in individuals with CI, focusing on the brain function and networks. Methods Scientific studies on CI published between 2000 and 2019 in academic peer-reviewed journals were systematically searched using medical and scientific literature databases. Only peer-reviewed articles reporting original research from experimental human studies directly associated with CI, and involving related neurological responses or brain imaging after exposure to odorous or pungent substances (i.e., in chemical provocation tests), were considered. Results Forty-seven studies were found to be eligible for a full-text review. Twenty-three studies met the selection criteria and were included in this review. Evidence indicated that differences between subjects with CI and healthy controls were observed by brain imaging during and after exposure to odorous or pungent substances. Differences in brain imaging were also observed between initial exposure and after exposure to these substances. Neurological processing of sensory information after exposure to extrinsic stimuli in the limbic system and related cortices were altered in subjects with CI. A previous documentable exposure event was likely to be involved in this alteration. Conclusions This review documents consistent evidence for the altered neurological processing of sensory information in individuals with CI. Further neurophysiological research exploring the processing of extrinsic stimuli and cognition of sensation through the limbic system and related cortices in CI, and the appearance of symptoms in individuals with CI, are required.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 589-8511, Japan. .,Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan.
| | - Iwao Uchiyama
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan.,Outpatient Department of Sick-house Syndrome, Hyakumanben Clinic, Kyoto, 606-8225, Japan
| | - Mari Tanigawa
- Outpatient Department of Sick-house Syndrome, Hyakumanben Clinic, Kyoto, 606-8225, Japan.,Clinical Immune Function Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan
| | - Ikuko Bamba
- Faculty of Education, Home Economics, Tokyo Gakugei University, Koganei, 184-8501, Japan
| | - Michiyo Azuma
- Department of Human Environmental Design, Faculty of Health Science, Kio University, Kitakatsuragi-gun, 635-0832, Japan
| | - Hirohisa Takano
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Toshikazu Yoshikawa
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan
| | - Kou Sakabe
- Department of Anatomy and Cellular Biology, Tokai University School of Medicine, Isehara, 259-1193, Japan
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14
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Multiple Chemical Sensitivity: Review of the State of the Art in Epidemiology, Diagnosis, and Future Perspectives. J Occup Environ Med 2019; 60:138-146. [PMID: 29111991 PMCID: PMC5794238 DOI: 10.1097/jom.0000000000001215] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Systematic bibliography analysis of about the last 17 years on multiple chemical sensitivity (MCS) was carried out in order to detect new diagnostic and epidemiological evidence. The MCS is a complex syndrome that manifests as a result of exposure to a low level of various common contaminants. The etiology, diagnosis, and treatment are still debated among researchers. METHOD Querying PubMed, Web of Science, Scopus, Cochrane library, both using some specific MESH terms combined with MESH subheadings and through free search, even by Google. RESULTS The studies were analyzed by verifying 1) the typology of study design; 2) criteria for case definition; 3) presence of attendances in the emergency departments and hospital admissions, and 4) analysis of the risk factors. OUTLOOK With this review, we give some general considerations and hypothesis for possible future research.
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15
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Evaluation of Task-Related Brain Activity: Is There a Role for 18F FDG-PET Imaging? BIOMED RESEARCH INTERNATIONAL 2019; 2019:4762404. [PMID: 31355263 PMCID: PMC6634077 DOI: 10.1155/2019/4762404] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 02/03/2019] [Accepted: 06/12/2019] [Indexed: 12/22/2022]
Abstract
Positron emission tomography (PET) with 2-[18F]-fluorodeoxyglucose (FDG) has been widely used for the evaluation of cortical glucose metabolism in several neurodegenerative disorders while its potential role in the evaluation of cortical and subcortical activity during a task in the healthy and pathological brain still remains to be a matter of debate. Few studies have been carried out in order to investigate the potential role of this radiotracer for the evaluation of brain glucose consumption during dynamic brain activation. The aim of this review is to provide a general overview of the applications of FDG-PET in the evaluation of cortical activation at rest and during tasks, describing first the physiological basis of FDG distribution in brain and its kinetic in vivo. An overview of the imaging protocols and image interpretation will be provided as well. As a last aspect, the results of the main studies in this field will be summarized and the results of PET findings performed in healthy subjects and patients suffering from various diseases will be reported.
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16
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Watson-Wright C, Queiroz P, Rodrigues S, Donaghey TC, Brain JD, Molina RM. Repeated pulmonary exposures to zinc ions enhance inflammatory responses to subsequent metal exposures. Exp Lung Res 2018; 44:252-261. [PMID: 30295553 DOI: 10.1080/01902148.2018.1517837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIM OF STUDY Metal contaminants contribute to adverse human health effects via acute and chronic exposures. Acute metal exposures followed by prolonged secondary metal exposures may elicit exaggerated inflammatory responses in certain individuals. The aim of this study is to determine whether repeated pulmonary exposures to zinc chloride (ZnCl2) alter subsequent responses to zinc or cerium exposures. MATERIALS AND METHODS Rats were intratracheally (IT) instilled with physiologic saline (n = 24) or 0.05 mg/kg ZnCl2 (n = 16) twice weekly for 4 weeks. Four days after last dosing, the saline group was divided into three subgroups, each IT-instilled with either saline, ZnCl2 or CeCl3 (both at 0.1 mg/kg). The ZnCl2 pre-instilled rats were divided into two subgroups, each instilled with 0.1 mg/kg ZnCl2 or CeCl3. Biomarkers of lung injury/inflammation were assessed in bronchoalveolar lavage (BAL) fluid collected 24 hours later. Oxidative stress was evaluated as total and reduced glutathione in BAL. RESULTS Increases in inflammatory cells, LDH, albumin, leptin, MCP-1, IP-10, fractalkine, TNFα and RANTES were observed in rats instilled with multiple PBS and then with 0.1 mg/kg ZnCl2 and CeCl3. However, rats pre-exposed repeatedly to 0.05 mg/kg ZnCl2 and then challenged with 0.1 mg/kg ZnCl2 or CeCl3 showed even more eosinophils, lymphocytes, and increased concentrations of hemoglobin and MIP-1α. Significant reduction in GSH/GSSG ratios in BAL in response to all ZnCl2 or CeCl3 exposures indicated oxidative stress. CONCLUSION Previous exposure to zinc ions increases responsiveness to subsequent exposures to zinc and cerium ions. These findings suggest enhanced sensitization possibly due to a reduction in antioxidant defenses.
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Affiliation(s)
- Christa Watson-Wright
- a Molecular and Integrative Physiological Sciences Program, Department of Environmental Health , Harvard T.H. Chan School of Public Health , Boston , Massachusetts , USA
| | - Priscila Queiroz
- a Molecular and Integrative Physiological Sciences Program, Department of Environmental Health , Harvard T.H. Chan School of Public Health , Boston , Massachusetts , USA
| | - Sylvia Rodrigues
- a Molecular and Integrative Physiological Sciences Program, Department of Environmental Health , Harvard T.H. Chan School of Public Health , Boston , Massachusetts , USA
| | - Thomas C Donaghey
- a Molecular and Integrative Physiological Sciences Program, Department of Environmental Health , Harvard T.H. Chan School of Public Health , Boston , Massachusetts , USA
| | - Joseph D Brain
- a Molecular and Integrative Physiological Sciences Program, Department of Environmental Health , Harvard T.H. Chan School of Public Health , Boston , Massachusetts , USA
| | - Ramon M Molina
- a Molecular and Integrative Physiological Sciences Program, Department of Environmental Health , Harvard T.H. Chan School of Public Health , Boston , Massachusetts , USA
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17
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The effect of industrial noise exposure on attention, reaction time, and memory. Int Arch Occup Environ Health 2018; 92:111-116. [DOI: 10.1007/s00420-018-1361-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 09/18/2018] [Indexed: 01/12/2023]
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18
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Hojo S, Mizukoshi A, Azuma K, Okumura J, Ishikawa S, Miyata M, Mizuki M, Ogura H, Sakabe K. Survey on changes in subjective symptoms, onset/trigger factors, allergic diseases, and chemical exposures in the past decade of Japanese patients with multiple chemical sensitivity. Int J Hyg Environ Health 2018; 221:1085-1096. [PMID: 30115513 DOI: 10.1016/j.ijheh.2018.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 07/19/2018] [Accepted: 08/02/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Recently, with rapid changes in the Japanese lifestyle, the clinical condition of patients with multiple chemical sensitivity (MCS) may also have undergone change. Thus, we conducted a new survey for subjective symptoms, ongoing chemical exposures, the prevalence of allergic diseases, and presumed onset/trigger factors in patients with MCS and compared results with those of an old survey from ten years ago. METHODS The new survey was conducted from 2012 to 2015 and the old survey was independently conducted from 1999 to 2003, meaning it was not a follow-up study. Patients were initially diagnosed by physicians at five medical institutions with MCS specialty outpatient services, with 111 and 103 patients participating in the new and old surveys, respectively. The controls were a general population living in Japan, with 1313 and 2382 participants in the new and old surveys, respectively. Subjective symptoms and ongoing chemical exposure were evaluated using a quick environmental exposure sensitivity inventory. Additionally, from clinical findings recorded by an attending physician, the prevalence of allergic diseases and presumed onset/trigger factors were evaluated. Differences between new and old surveys were analyzed using logistic regression analyses and significance tests. RESULTS Compared with ten years ago: (1) Regarding factors affecting patients with ongoing chemical exposures, the proportion of patients affected decreased significantly for two items only (insecticides and second-hand smoke). The proportion of controls showing ongoing exposure to 8 out of 10 items changed significantly. (2) In patients, scores for chemical intolerances, other intolerances, and life impacts increased significantly. (3) In terms of the prevalence of allergic diseases among patients with MCS, bronchial asthma (adjusted odds ratio [AOR]: 5.19), atopic dermatitis (AOR: 3.77), allergic rhinitis (AOR: 5.34), and food allergies (AOR: 2.63) increased significantly, while hay fever (AOR: 0.38) and drug allergies (AOR: 0.40) decreased significantly. (4) With regard to construction and renovation, which was the presumed predominant onset/trigger factor for MCS 10 years ago, this decreased from 68.9% to 35.1%; in contrast, electromagnetic fields (0.0%-26.1%), perfume (0.0%-20.7%), and medical treatment (1.9%-7.2%) increased significantly, confirming the diversification of onset/trigger factors. CONCLUSION Compared to ten years ago, for patients with MCS, an increase in avoidance behavior toward chemical substance exposures, which were presumed to be aggravating factors for symptoms, was confirmed. It has been suggested that the ongoing chemical exposure of the general population in Japan has largely changed. In addition, for patients with MCS, chemical intolerances and life impacts have become severe, the prevalence of the main allergic diseases has increased, and onset/trigger factors have become diversified.
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Affiliation(s)
- Sachiko Hojo
- Institute of Applied Brain Sciences, Waseda University, Tokorozawa, Japan; Shokei Gakuin University, Natori, Japan; Graduate School of Dentistry, Tohoku University, Sendai, Japan.
| | - Atsushi Mizukoshi
- Institute of Applied Brain Sciences, Waseda University, Tokorozawa, Japan; Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Jiro Okumura
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Satoshi Ishikawa
- Environmental Medical Center, Kitasato Institute Hospital, Tokyo, Japan
| | | | - Masami Mizuki
- Department of Respiratory Medicine and Allergy, Morioka National Hospital, Morioka, Japan
| | - Hideo Ogura
- Department of Clinical Research and Allergy, Kochi National Hospital, Kochi, Japan
| | - Kou Sakabe
- Environmental Medical Center, Kitasato Institute Hospital, Tokyo, Japan; Department of Human Structure and Function, Tokai University School of Medicine, Isehara, Japan
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19
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Viziano A, Micarelli A, Pasquantonio G, Della-Morte D, Alessandrini M. Perspectives on multisensory perception disruption in idiopathic environmental intolerance: a systematic review. Int Arch Occup Environ Health 2018; 91:923-935. [PMID: 30088144 DOI: 10.1007/s00420-018-1346-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 07/31/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE Multiple chemical sensitivity (MCS) also known as idiopathic environmental intolerance/illness (IEI) encompasses a cohort of subjective symptoms characterized by susceptibility to a wide spectrum of environmental compounds, causing symptoms involving various organs and a decrease in quality of life. The aim of this systematic review is to summarize evidence about MCS, with focus on indexed studies analyzing sensory pathway-related disorders. METHODS Medical databases were searched for English language articles related to the topic, published between 1965 and 2017 in academic, peer-reviewed journals. Particular focus was concentrated on articles depicting disturbances involving sensory organs. References of the relevant articles were examined to identify additional significant documents. RESULTS Fifty-eight studies were eligible for full text review. Of these, 34 studies met the selection criteria and were included in this analysis. Many variables, such as different diagnostic criteria, lack of homogeneous symptom questionnaires and the general incidence of personality traits in control subjects, biased studies as confounding factors. However, moderate evidences show that sensory pathways are somewhat altered, especially with respect to information processing in the limbic system and related cortical areas. Recent studies suggested the presence, in MCS cohorts, of attention bias, sensitization and limbic kindling, as well as recently revealed subclinical organic alterations along sensory pathways. CONCLUSIONS Evidences are consistent with MCS/IEI to be the result of a neural altered processing of sensorial ascending pathways, which combined with peculiar personality traits constitutes the underpinning of a multisensory condition needing multidisciplinary clinical approach.
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Affiliation(s)
- Andrea Viziano
- Department of Clinical Sciences and Translational Medicine, University of Rome'Tor Vergata', Via Montpellier, 1; E sud Tower, 00133, Rome, Italy.
| | - Alessandro Micarelli
- Department of Clinical Sciences and Translational Medicine, University of Rome'Tor Vergata', Via Montpellier, 1; E sud Tower, 00133, Rome, Italy
| | - Guido Pasquantonio
- Department of Clinical Sciences and Translational Medicine, University of Rome'Tor Vergata', Via Montpellier, 1; E sud Tower, 00133, Rome, Italy
| | - David Della-Morte
- University of Rome Tor Vergata, Rome, Italy.,San Raffaele Roma Open University, Rome, Italy.,Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Marco Alessandrini
- Department of Clinical Sciences and Translational Medicine, University of Rome'Tor Vergata', Via Montpellier, 1; E sud Tower, 00133, Rome, Italy
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Brain metabolic correlates of CSF Tau protein in a large cohort of Alzheimer's disease patients: A CSF and FDG PET study. Brain Res 2017; 1678:116-122. [PMID: 29066367 DOI: 10.1016/j.brainres.2017.10.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 10/04/2017] [Accepted: 10/16/2017] [Indexed: 11/23/2022]
Abstract
AIMS Physiopathological mechanisms of Alzheimer's disease (AD) are still matter of debate. Especially the role of amyloid β and tau pathology in the development of the disease are still matter of debate. Changes in tau and amyloid β peptide concentration in cerebrospinal fluid (CSF) and hypometabolic patterns at fluorine-18 fluorodeoxyglucose (18F-FDG) PET scanning are considered as biomarkers of AD. The present study was aimed to evaluate the relationships between the concentrations of CSF total Tau (t-Tau), phosphorilated Tau (p-Tau) and Aβ1-42 amyloid peptide with 18F-FDG brain distribution in a group of patients with AD. MATERIALS AND METHODS We examined 131 newly diagnosed AD patients according to the NINCDS-ADRDA criteria and 20 healthy controls. The mean (±SD) age of the patients was 70 (±7) years; 57 were male and 74 were female. All patients and controls underwent a complete clinical investigation, including medical history, neurological examination, mini-mental state examination (MMSE), a complete blood screening (including routine exams, thyroid hormones and a complete neuropsychological evaluation). Structural MRI was performed not earlier than 1 month before the 18F-FDG PET/CT. The following patients were excluded: those with isolated deficits and/or unmodified MMSE (=25/30) on revisit (period of follow-up: 6, 12 and 18 months); patients who had had a clinically manifest acute stroke in the last 6 months with a Hachinsky score greater than 4; and patients with radiological evidence of subcortical lesions. All AD patients were taken off cholinesterase inhibitor treatment throughout the study. We performed lumbar puncture and CSF sampling for diagnostic purposes 2 weeks (±2 days) before the PET/CT scan. The relationship between brain F-FDG uptake and CSF biomarkers was analysed using statistical parametric mapping (SPM8; Wellcome Department of Cognitive Neurology, London, UK) implemented in Matlab R2012b using the MMSE score, sex and age, and other CSF biomarkers as covariates. RESULTS t-Tau, p-Tau and Aβ(1-42) in CSF resulted 774 ± 345 pg/ml, 98 ± 64 pg/ml and 348.8 ± 111 pg/ml respectively. SPM analysis showed a significant negative correlation between CSF t-Tau and 18F FDG uptake in right temporal, parietal and frontal lobe (Brodmann areas, BA, 20, 40 and 8; P fdr and few corr < 0.001, ke 19534). We did not find any significant relationships with other CSF biomarkers. CONCLUSIONS t-Tau deposition in brain is related to temporal, parietal and frontal hypometabolism in AD.
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21
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Gibson PR. Introduction to the Special Issue on Environmental Sensitivities: Living on the Margins with Access Denied. ECOPSYCHOLOGY 2017. [DOI: 10.1089/eco.2017.0017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Pamela Reed Gibson
- Department of Psychology, James Madison University, Harrisonburg, Virginia
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22
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Cerebral metabolic changes related to clinical parameters in idiopathic anosmic patients during olfactory stimulation: a pilot investigation. Eur Arch Otorhinolaryngol 2017; 274:2649-2655. [PMID: 28283789 DOI: 10.1007/s00405-017-4524-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 02/25/2017] [Indexed: 10/20/2022]
Abstract
Idiopathic olfactory loss neural consequences have been studied especially by means of magnetic resonance imaging. Since other functional neuroimaging technique findings are lacking in the literature, present study used a validated 18F-2-fluoro-2-deoxy-D-glucose (FDG) functional positron emission tomography procedure under olfactory stimulation (OS) to assess brain changes in idiopathic anosmic patients (IAPs) in comparison with healthy subjects (HS). A voxel-based analysis between these groups was used to evaluate FDG uptake in the brain and perform a correlation analysis between metabolic responses and the Sniffin' stick test as well as intensity visuo-analogue scores and disease duration (DD). A significant relative decrease of glucose metabolism in the right and left frontal lobes, left insula, right parietal lobe, and left occipital, temporal and parietal lobes was found in IAPs during OS. The same condition resulted in a relative higher glucose metabolism in the right cerebellum in IAPs. Moreover, a negative correlation between DD and FDG uptake in the left temporo-parietal joint was found in IAPs. Such a correlation suggested a possible involvement of this area metabolic decrease in self-consciousness impairment, which is known to affect IAPs. Present preliminary functional results could be of interest to further deepen such neural impairments possibly useful for future perspective in pharmaceutical and rehabilitative protocols.
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23
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Micarelli A, Chiaravalloti A, Viziano A, Danieli R, Schillaci O, Alessandrini M. Early cortical metabolic rearrangement related to clinical data in idiopathic sudden sensorineural hearing loss. Hear Res 2017; 350:91-99. [PMID: 28460253 DOI: 10.1016/j.heares.2017.04.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 04/13/2017] [Accepted: 04/23/2017] [Indexed: 12/11/2022]
Abstract
Results in studies concerning cortical changes in idiopathic sudden sensorineural hearing loss (ISSNHL) are not homogeneous, in particular due to the different neuroimaging techniques implemented and the diverse stages of ISSNHL studied. Considering the recent advances in state-of-the-art positron emission tomography (PET) cameras, the aim of this study was to gain more insight into the neuroanatomical differences associated with the earliest stages of unilateral ISSNHL and clinical-perceptual performance changes. After an audiological examination including the mean auditory threshold (mean AT), mean speech discrimination score (mean SDS) and Tinnitus Handicap Inventory (THI), 14 right-handed ISSNHL patients underwent brain [18F]fluorodeoxyglucose (FDG)-PET within 72 h of the onset of symptoms. When compared to an homogeneous group of 35 healthy subjects by means of statistical parametric mapping, a relative increase in FDG uptake was found in the right superior and medial frontal gyrus as well as in the right anterior cingulate cortex in ISSNHL patients. Conversely, the same group showed a significant relative decrease in FDG uptake in the right middle temporal, precentral and postcentral gyrus as well as in the left posterior cingulate cortex, left lingual, superior, middle temporal and middle frontal gyrus and in the left insula. Regression analysis showed a positive correlation between mean THI and glucose consumption in the right anterior cingulate cortex and a positive correlation between mean SDS and glucose consumption in the left precentral gyrus. The relative changes in FDG uptake found in these brain regions and the positive correlation with mean SDS and THI scores in ISSNHL could possibly highlight new aspects of cerebral rearrangement, contributing to further explain changes in those functions that support speech recognition during the sudden impairment of unilateral auditory input.
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Affiliation(s)
- Alessandro Micarelli
- University of Rome Tor Vergata, Department of Clinical Sciences and Translational Medicine, Otolaryngology Unit, Italy; University of Rome Tor Vergata, Department of Systems Medicine, Neuroscience Unit, Italy.
| | - Agostino Chiaravalloti
- University of Rome Tor Vergata, Department of Biomedicine and Prevention, Nuclear Medicine Unit, Italy
| | - Andrea Viziano
- University of Rome Tor Vergata, Department of Clinical Sciences and Translational Medicine, Otolaryngology Unit, Italy
| | - Roberta Danieli
- University of Rome Tor Vergata, Department of Biomedicine and Prevention, Nuclear Medicine Unit, Italy
| | - Orazio Schillaci
- University of Rome Tor Vergata, Department of Biomedicine and Prevention, Nuclear Medicine Unit, Italy; IRCCS Neuromed, Pozzilli, Italy
| | - Marco Alessandrini
- University of Rome Tor Vergata, Department of Clinical Sciences and Translational Medicine, Otolaryngology Unit, Italy
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Micarelli A, Viziano A, Bruno E, Micarelli E, Alessandrini M. Vestibular impairment in Multiple Chemical Sensitivity: Component analysis findings. J Vestib Res 2017; 26:459-468. [DOI: 10.3233/ves-160594] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Alessandro Micarelli
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Neuroscience Unit, Rome, Italy
| | - Andrea Viziano
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Ernesto Bruno
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Elisa Micarelli
- Department of Biology, University of Rome Tor Vergata, Rome, Italy
| | - Marco Alessandrini
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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25
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Azuma K, Uchiyama I, Tanigawa M, Bamba I, Azuma M, Takano H, Yoshikawa T, Sakabe K. Association of Odor Thresholds and Responses in Cerebral Blood Flow of the Prefrontal Area during Olfactory Stimulation in Patients with Multiple Chemical Sensitivity. PLoS One 2016; 11:e0168006. [PMID: 27936122 PMCID: PMC5148047 DOI: 10.1371/journal.pone.0168006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 11/24/2016] [Indexed: 12/31/2022] Open
Abstract
Multiple chemical sensitivity (MCS) is a disorder characterized by nonspecific and recurrent symptoms from various organ systems associated with exposure to low levels of chemicals. Patients with MCS process odors differently than controls do. Previously, we suggested that this odor processing was associated with increased regional cerebral blood flow (rCBF) in the prefrontal area during olfactory stimulation using near-infrared spectroscopic (NIRS) imaging. The aim of this study was to investigate the association of odor thresholds and changes in rCBF during olfactory stimulation at odor threshold levels in patients with MCS. We investigated changes in the prefrontal area using NIRS imaging and a T&T olfactometer during olfactory stimulation with two different odorants (sweet and fecal) at three concentrations (zero, odor recognition threshold, and normal perceived odor level) in 10 patients with MCS and six controls. The T&T olfactometer threshold test and subjective assessment of irritating and hedonic odors were also performed. The results indicated that the scores for both unpleasant and pungent odors were significantly higher for those for sweet odors at the normal perceived level in patients with MCS than in controls. The brain responses at the recognition threshold (fecal odor) and normal perceived levels (sweet and fecal odors) were stronger in patients with MCS than in controls. However, significant differences in the odor detection and recognition thresholds and odor intensity score between the two groups were not observed. These brain responses may involve cognitive and memory processing systems during past exposure to chemicals. Further research regarding the cognitive features of sensory perception and memory due to past exposure to chemicals and their associations with MCS symptoms is needed.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- * E-mail:
| | - Iwao Uchiyama
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- Outpatient Department of Sick-house Syndrome, Hyakumanben Clinic, Kyoto, Japan
| | - Mari Tanigawa
- Clinical Immune Function Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- Division of Internal Medicine, Hyakumanben Clinic, Kyoto, Japan
| | - Ikuko Bamba
- Faculty of Education, Home Economics, Tokyo Gakugei University, Koganei, Tokyo, Japan
| | - Michiyo Azuma
- Department of Human Environmental Design, Faculty of Health Science, Kio University, Kitakatsuragi-gun, Nara, Japan
| | - Hirohisa Takano
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Toshikazu Yoshikawa
- Department of Internal Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kou Sakabe
- Department of Anatomy and Cellular Biology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
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26
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Viziano A, Micarelli A, Alessandrini M. Noise sensitivity and hyperacusis in patients affected by multiple chemical sensitivity. Int Arch Occup Environ Health 2016; 90:189-196. [PMID: 27838888 DOI: 10.1007/s00420-016-1185-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 11/02/2016] [Indexed: 01/12/2023]
Abstract
PURPOSE The aim of this study was to investigate the presence of noise sensitivity and hyperacusis in patients suffering from multiple chemical sensitivity (MCS), a chronic condition characterized by several symptoms following low-level chemical exposure. Moreover, distortion product otoacoustic emissions (DPOAE) were performed to further study cochlear function. METHODS A questionnaire-based survey was performed. Eighteen MCS patients, selected with strict diagnostic criteria, and 20 healthy age- and gender-matched subjects filled Weinstein's Noise Sensitivity Questionnaire (WNS) and Khalfa's Hyperacusis Questionnaire (HQ). Results were compared with scores from the quick Environmental Exposure Sensitivity Index (qEESI), a routinarily used questionnaire to screen MCS symptoms, and with DPOAE values. An analysis of variance (ANOVA) was performed between MCS and control subjects scores; moreover, Spearman's rank correlation test was performed between questionnaire results. RESULTS ANOVA testing on DPOAE values showed any significant difference between groups, while WNS, HQ and qEESI scores were significantly higher in MCS group compared to controls. Correlation analysis showed strong positive correlation between WNS, HQ and qEESI in MCS subjects. CONCLUSIONS For the first time, auditory-related perceptual disorders were studied in MCS. A strong association between WNS, HQ results and MCS symptoms severity has been highlighted. These findings suggest that decreased sound tolerance and noise sensitivity could be considered as possible new aspects of this syndrome, contributing to its peculiar phenotype. Furthermore, as DPOAE values did not differ from healthy subjects, present findings might suggest a 'central' source for such disorders in this group of patients.
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Affiliation(s)
- Andrea Viziano
- Department of Clinical Sciences and Translational Medicine, 'Tor Vergata' University, Via Montpellier, 1, E sud Tower, 00133, Rome, Italy
| | - Alessandro Micarelli
- Department of Clinical Sciences and Translational Medicine, 'Tor Vergata' University, Via Montpellier, 1, E sud Tower, 00133, Rome, Italy. .,Department of Systems Medicine - Neuroscience Unit, 'Tor Vergata' University, Rome, Italy.
| | - Marco Alessandrini
- Department of Clinical Sciences and Translational Medicine, 'Tor Vergata' University, Via Montpellier, 1, E sud Tower, 00133, Rome, Italy
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27
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Deranged Dimensionality of Vestibular Re-Weighting in Multiple Chemical Sensitivity. APPLIED SCIENCES-BASEL 2016. [DOI: 10.3390/app6110330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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28
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Micarelli A, Viziano A, Genovesi G, Bruno E, Ottaviani F, Alessandrini M. Lack of contralateral suppression in transient-evoked otoacoustic emissions in multiple chemical sensitivity: a clinical correlation study. Noise Health 2016; 18:143-9. [PMID: 27157687 PMCID: PMC4918670 DOI: 10.4103/1463-1741.181997] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Multiple chemical sensitivity (MCS) is a chronic disorder characterized by a variety of symptoms associated with the exposure to chemicals at a concentration below the toxic level. Previous studies have demonstrated peculiar responses in brain activity in these patients with respect to sensory stimuli while the association between chemical sensitivity and other environmental intolerances such as noise sensitivity has been questioned by researchers. In this study, a cohort of 18 MCS patients underwent transient-evoked otoacoustic emission (TEOAE) testing with and without contralateral suppression to evaluate the functionality of the medial olivocochlear (MOC) reflex involved in speech-in-noise sensitivity. Results were compared with an age- and gender-matched control group (n = 20) and correlation analysis with disease onset and quick environmental exposure sensitivity inventory (qEESI) symptom severity scale was performed. Subjects affected by MCS showed statistically significant impairment of MOC reflex, and the onset of the disease and several symptom subscales showed to be correlated to such reduction in some of the frequencies tested. These data suggest that alterations of MOC reflex could be part of the complex features of this disease although more studies are needed to further explore auditory perception disorders in environmental intolerances.
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Affiliation(s)
- Alessandro Micarelli
- Department of Clinical Sciences and Traslational Medicine; Department of Systems Medicine, Neuroscience Unit, University of Rome 'Tor Vergata', Rome, Italy
| | - Andrea Viziano
- Department of Clinical Sciences and Traslational Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Giuseppe Genovesi
- Department of Experimental Medicine, University of Rome 'La Sapienza', Rome, Italy
| | - Ernesto Bruno
- Department of Clinical Sciences and Traslational Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Fabrizio Ottaviani
- Department of Clinical Sciences and Traslational Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Marco Alessandrini
- Department of Clinical Sciences and Traslational Medicine, University of Rome 'Tor Vergata', Rome, Italy
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29
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Mast cell activation disease and the modern epidemic of chronic inflammatory disease. Transl Res 2016; 174:33-59. [PMID: 26850903 DOI: 10.1016/j.trsl.2016.01.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 01/07/2016] [Accepted: 01/08/2016] [Indexed: 12/18/2022]
Abstract
A large and growing portion of the human population, especially in developed countries, suffers 1 or more chronic, often quite burdensome ailments which either are overtly inflammatory in nature or are suspected to be of inflammatory origin, but for which investigations to date have failed to identify specific causes, let alone unifying mechanisms underlying the multiple such ailments that often afflict such patients. Relatively recently described as a non-neoplastic cousin of the rare hematologic disease mastocytosis, mast cell (MC) activation syndrome-suspected to be of greatly heterogeneous, complex acquired clonality in many cases-is a potential underlying/unifying explanation for a diverse assortment of inflammatory ailments. A brief review of MC biology and how aberrant primary MC activation might lead to such a vast range of illness is presented.
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