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Salmon MK, Cohen WG, Hu F, Aydin A, Coskun AK, Schilsky M, Doty RL. Taste and smell function in Wilson's disease. J Neurol Sci 2024; 459:122949. [PMID: 38493734 DOI: 10.1016/j.jns.2024.122949] [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: 12/04/2023] [Revised: 02/20/2024] [Accepted: 03/04/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVE Wilson's disease (WD) is a metabolic disorder associated with abnormal copper metabolism that results in hepatic, psychiatric, and neurologic symptoms. No investigation of taste function has been made in patients with WD, although olfactory dysfunction has been evaluated. METHODS Quantitative taste and smell test scores of 29 WD patients were compared to those of 790 healthy controls. Taste was measured using the 53-item Waterless Empirical Taste Test (WETT®) and smell using the 40-item revised University of Pennsylvania Smell Identification Test (R-UPSIT®). Multiple linear regression analysis controlled for age and sex. RESULTS Average WETT® scores did not differ meaningfully between WD and control subjects (respective medians & IQRs = 32 [28-42] & 34 [27-41]); linear regression coefficient = 1.19, 95% CI [-0.81, 3.19], p = 0.242). In contrast, WD was associated with significantly reduced olfactory function [respective median (IQR) R-UPSIT® scores = 35 (33-37) vs. 37 (35-38); adjusted linear regression coefficient = -1.59, 95% CI [-2.34, -0.833]; p < 0.001)]. Neither olfaction nor taste were influenced by WD symptom subtype [23 (79.3%) were hepatic-predominant; 6 (20.7%) neurologic predominant]; R-UPSIT®, p = 0.774; WETT®, p = 0.912). No effects of primary medication or years since diagnosis (R-UPSIT®, p = 0.147; WETT®, p = 0.935) were found. Weak correlations were present between R-UPSIT® and WETT® scores for both control (r=0.187, p < 0.0001) and WD (r=0.237) subjects, although the latter correlation did not reach the 0.05 α level (p = 0.084). CONCLUSION Although WD negatively impacts smell function, taste is spared. Research is needed to understand the pathophysiologic mechanisms responsible for this divergence.
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Affiliation(s)
- Mandy K Salmon
- Department of Otorhinolaryngology- Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - William G Cohen
- Department of Otorhinolaryngology- Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Fengling Hu
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Adem Aydin
- Department of Medicine and Surgery, Yale University Medical Center, New Haven, CT, USA
| | - Ayse K Coskun
- Department of Medicine and Surgery, Yale University Medical Center, New Haven, CT, USA
| | - Michael Schilsky
- Department of Medicine and Surgery, Yale University Medical Center, New Haven, CT, USA
| | - Richard L Doty
- Department of Otorhinolaryngology- Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Smell and Taste Center, Department of Otorhinolaryngology- Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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2
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Mattos JL, Hasan S, Schlosser RJ, Payne SC, Soler ZM. The association of gustatory dysfunction, olfactory dysfunction, and cognition in older adults. Int Forum Allergy Rhinol 2023; 13:1577-1583. [PMID: 36562185 PMCID: PMC10412899 DOI: 10.1002/alr.23126] [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: 08/10/2022] [Revised: 11/18/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The association of gustatory dysfunction (GD) with quality of life (QOL) and cognition in older adults is understudied. Our objective was to study the prevalence of GD in the community and explore impacts and associated factors. METHODS A prospective, multi-institutional, pre-corona virus disease (COVID) cohort of adults aged 50 years and older had smell and taste testing using "Sniffin' Sticks" (TDI) and "Taste Strips." The impact of GD on mood, QOL, and social interaction was assessed through visual analog scales. Subjects completed the Questionnaire of Olfactory Disorders, Patient Health Questionnaire 9, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment, and the DeJong scale of loneliness. RESULTS A total of 48 patients, average age of 54.7 years, were enrolled. Thirty-two percent experienced GD on taste strips, and 62% experienced olfactory dysfunction (OD) on TDI. Almost 30% (29.5%) had both GD and OD. GD and OD correlated with worsened cognitive function on MMSE (r = 0.392 and 0.05, p = 0.018 and 0.003). Subjects with both GD and OD had worse MMSE than either alone (p = 0.003). Dry mouth and difficult chewing correlated with GD (r = -0.37 and -0.31, p = 0.10 and 0.37). Self-reported GD and OD were correlated (r = 0.46, p = 0.001), as were psychophysical GD and OD (r = 0.394, p = 0.008). GD did not correlate with other metrics. CONCLUSION Thirty-two percent of subjects experienced GD on psychophysical testing, yet most are unaware without impacts on daily life. However, GD correlates with worsened cognitive function. Taste testing may play a role in screening of neurocognitive decline, and multisensory dysfunction may indicate of worsened cognitive states.
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Affiliation(s)
- Jose L. Mattos
- Division of Rhinology and Sinus Surgery, Department of Otolaryngology – Head and Neck Surgery, University of Virginia, Charlottesville, VA
- University of Virginia School of Medicine, Charlottesville, VA
| | - Shahzeb Hasan
- University of Virginia School of Medicine, Charlottesville, VA
| | - Rodney J. Schlosser
- Division of Rhinology and Sinus Surgery, Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
- Department of Surgery, Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Spencer C. Payne
- Division of Rhinology and Sinus Surgery, Department of Otolaryngology – Head and Neck Surgery, University of Virginia, Charlottesville, VA
- University of Virginia School of Medicine, Charlottesville, VA
| | - Zachary M. Soler
- Division of Rhinology and Sinus Surgery, Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
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Schmicker M, Frühling I, Menze I, Glanz W, Müller P, Noesselt T, Müller NG. The Potential Role of Gustatory Function as an Early Diagnostic Marker for the Risk of Alzheimer’s Disease in Subjective Cognitive Decline. J Alzheimers Dis Rep 2023; 7:249-262. [PMID: 37090958 PMCID: PMC10116167 DOI: 10.3233/adr220092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/23/2023] [Indexed: 04/07/2023] Open
Abstract
Background: Patients with subjective cognitive decline (SCD) report memory deterioration and are at an increased risk of converting to Alzheimer’s disease (AD) although psychophysical testing does not reveal any cognitive deficit. Objective: Here, gustatory function is investigated as a potential predictor for an increased risk of progressive cognitive decline indicating higher AD risk in SCD. Methods: Measures of smell and taste perception as well as neuropsychological data were assessed in patients with subjective cognitive decline (SCD): Subgroups with an increased likelihood of the progression to preclinical AD (SCD+) and those with a lower likelihood (SCD–) were compared to healthy controls (HC), patients with mild cognitive impairment and AD patients. The Sniffin’ Sticks test contained 12 items with different qualities and taste was measured with 32 taste stripes (sweet, salty, bitter, sour) of different concentration. Results: Only taste was able to distinguish between HC/SCD– and SCD+ patients. Conclusion: This study provides a first hint of taste as a more sensitive marker than smell for detecting preclinical AD in SCD. Longitudinal observation of cognition and pathology are necessary to further evaluate taste perception as a predictor of pathological objective decline in cognition.
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Affiliation(s)
- Marlen Schmicker
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research, Otto von Guericke University, Magdeburg, Germany
| | - Insa Frühling
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - Inga Menze
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research, Otto von Guericke University, Magdeburg, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Patrick Müller
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Medical Faculty, Otto von Guericke University, Magdeburg, Germany
- University Clinic for Cardiology and Angiology, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
- Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C)
| | - Toemme Noesselt
- Biological Psychology, Faculty of Natural Science, Otto von Guericke University, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Otto von Guericke University, Magdeburg, Germany
| | - Notger G. Müller
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Medical Faculty, Otto von Guericke University, Magdeburg, Germany
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
- Center for Behavioral Brain Sciences, Otto von Guericke University, Magdeburg, Germany
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4
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Mulheren R, Westemeyer RM, Dietsch AM. The effect of taste on swallowing: A scoping and systematic review. Crit Rev Food Sci Nutr 2022; 64:1256-1282. [PMID: 36036968 DOI: 10.1080/10408398.2022.2115003] [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] [Indexed: 11/03/2022]
Abstract
Consuming foods and liquids for nutrition requires the coordination of several muscles. Swallowing is triggered and modified by sensory inputs from the aerodigestive tract. Taste has recently received attention as a potential modulator of swallowing physiology, function, and neural activation; additionally, taste impairment is a sequela of COVID-19. This review presents factors impacting taste and swallowing, systematically summarizes the existing literature, and assesses the quality of included studies. A search was conducted for original research including taste stimulation, deglutition-related measure(s), and human participants. Study design, independent and dependent variables, and participant characteristics were coded; included studies were assessed for quality and risk of bias. Forty-eight articles were included after abstract and full-text review. Synthesis was complicated by variable sensory components of stimuli (taste category and intensity, pure taste vs. flavor, chemesthesis, volume/amount, consistency, temperature), participant characteristics, confounding variables such as genetic taster status, and methods of measurement. Most studies had a high risk of at least one type of bias and were of fair or poor quality. Interpretation is limited by wide variability in methods, taste stimulation, confounding factors, and lower-quality evidence. Existing studies suggest that taste can modulate swallowing, but more rigorous and standardized research is needed.
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Affiliation(s)
- Rachel Mulheren
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Ross M Westemeyer
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Angela M Dietsch
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
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5
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Kaltenboeck A, Halahakoon DC, Harmer CJ, Cowen P, Browning M. Enhanced Taste Recognition Following Subacute Treatment With The Dopamine D2/D3 Receptor Agonist Pramipexole in Healthy Volunteers. Int J Neuropsychopharmacol 2022; 25:720-726. [PMID: 35605609 PMCID: PMC9515131 DOI: 10.1093/ijnp/pyac030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 04/20/2022] [Accepted: 05/11/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Patients with Parkinson's disease (PD) show impaired performance in taste recognition tests, which suggests a possible dopaminergic influence on gustatory functioning. To experimentally test this hypothesis, we assessed whether pharmacological manipulation of dopaminergic signaling in healthy volunteers can affect performance in a standardized taste recognition test. METHODS Physically and mentally healthy volunteers (n = 40, age 18-43 years) were randomly allocated to treatment with either pramipexole or placebo using a double-blind, parallel-group design. After 12 to 15 days of treatment (dose titrated up from 0.25 mg/d of pramipexole salt to 1.0 mg/d), taste recognition performance was assessed using a standardized and validated assay (taste strip test). Additionally, visual analogue scale ratings of subjective pleasantness and disgustingness of taste samples were obtained. RESULTS Compared with the placebo group, participants receiving pramipexole showed significantly higher total recognition accuracy (medianpramipexole = 14.0, medianplacebo = 13.0, U = 264.5, P = .04). This was driven by a higher sensitivity for taste in the pramipexole group. Exploratory analysis of pleasantness and disgustingness ratings of appetitive (sweet) vs aversive (bitter) stimuli suggested that pramipexole treatment was associated with overall blunted hedonic responses, but this effect did not survive the inclusion of nausea (a side effect of treatment) as a covariate in the analysis. CONCLUSIONS Healthy volunteers who received subacute pramipexole treatment exhibited higher taste recognition performance compared with the placebo group. This finding is consistent with a proposed role of the dopaminergic system in gustatory functioning and could have important theoretical and clinical implications.
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Affiliation(s)
- Alexander Kaltenboeck
- Correspondence: Alexander Kaltenboeck, MSc, Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria ()
| | - Don Chamith Halahakoon
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom,Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Catherine J Harmer
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom,Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Philip Cowen
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom,Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Michael Browning
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom,Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
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6
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Caretta A, Mucignat-Caretta C. Not Only COVID-19: Involvement of Multiple Chemosensory Systems in Human Diseases. Front Neural Circuits 2022; 16:862005. [PMID: 35547642 PMCID: PMC9081982 DOI: 10.3389/fncir.2022.862005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Chemosensory systems are deemed marginal in human pathology. In appraising their role, we aim at suggesting a paradigm shift based on the available clinical and experimental data that will be discussed. Taste and olfaction are polymodal sensory systems, providing inputs to many brain structures that regulate crucial visceral functions, including metabolism but also endocrine, cardiovascular, respiratory, and immune systems. Moreover, other visceral chemosensory systems monitor different essential chemical parameters of “milieu intérieur,” transmitting their data to the brain areas receiving taste and olfactory inputs; hence, they participate in regulating the same vital functions. These chemosensory cells share many molecular features with olfactory or taste receptor cells, thus they may be affected by the same pathological events. In most COVID-19 patients, taste and olfaction are disturbed. This may represent only a small portion of a broadly diffuse chemosensory incapacitation. Indeed, many COVID-19 peculiar symptoms may be explained by the impairment of visceral chemosensory systems, for example, silent hypoxia, diarrhea, and the “cytokine storm”. Dysregulation of chemosensory systems may underlie the much higher mortality rate of COVID-19 Acute Respiratory Distress Syndrome (ARDS) compared to ARDSs of different origins. In chronic non-infectious diseases like hypertension, diabetes, or cancer, the impairment of taste and/or olfaction has been consistently reported. This may signal diffuse chemosensory failure, possibly worsening the prognosis of these patients. Incapacitation of one or few chemosensory systems has negligible effects on survival under ordinary life conditions but, under stress, like metabolic imbalance or COVID-19 pneumonia, the impairment of multiple chemosensory systems may lead to dire consequences during the course of the disease.
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Affiliation(s)
- Antonio Caretta
- National Institute for Biostructures and Biosystems (NIBB), Rome, Italy
- Department of Food and Drug Science, University of Parma, Parma, Italy
| | - Carla Mucignat-Caretta
- National Institute for Biostructures and Biosystems (NIBB), Rome, Italy
- Department of Molecular Medicine, University of Padova, Padua, Italy
- *Correspondence: Carla Mucignat-Caretta,
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7
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Chen Z, Hu C, Zhang Y, Xie H, Wei Y. Gustatory event-related potential alterations in olfactory dysfunction patients. Neurol Sci 2022; 43:2899-2908. [PMID: 35106693 PMCID: PMC8807141 DOI: 10.1007/s10072-022-05876-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/01/2022] [Indexed: 11/25/2022]
Abstract
The phenomenon that longstanding impaired olfactory function is associated with the decreased gustatory function was described in present studies, which was seems attributed to mutual chemosensory interactions. And the interaction between olfaction and gustation still needs more research to figure out. The objective of the study was to investigate how the taste was influenced by olfactory impairment in the central pathway. We tested 33 subjects with normal (n = 19) or impaired (n = 14) olfactory function for their gustatory event-related potentials (gERPs). Validated tests were used for olfactory and gustatory testing (Sniffin’ Sticks, gERPs, and three-drop test). This study reported an objective gustatory function decline in olfactory dysfunction participants. However, it also reported the increased gustatory event-related potentials of olfactory dysfunction participants, especially at the frontal electrode (FZ) and electrode 16 (E16), and the reduced latency of P2 peak of them at electrode 21 (E21), while no obvious difference was observed at the centro-parietal electrode (PZ). Inferior insula might be the main response area for the increase in gERPs, and this increase averaged amplitude of the P2 component may attribute to compensation of the secondary gustatory response that occurred in the gustatory processing of olfactory-impaired patients.
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Affiliation(s)
- Zirong Chen
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Anzhen Road, Beijing, Chaoyang District, China
- Department of Otolaryngology, Smell and Taste Center, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road 2, Beijing, Chaoyang District, 100010, China
| | - Chunhua Hu
- Department of Otolaryngology, Smell and Taste Center, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road 2, Beijing, Chaoyang District, 100010, China
| | - Yaru Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute On Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hongbo Xie
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Anzhen Road, Beijing, Chaoyang District, China
- Department of Otolaryngology, Smell and Taste Center, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road 2, Beijing, Chaoyang District, 100010, China
| | - Yongxiang Wei
- Department of Otorhinolaryngology-Head and Neck Surgery, Capital Institute of Pediatrics, Yabao Road 2, Chaoyang District, 100029, Beijing, China.
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8
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Almeida WRPL, Gomes ADOC, Belo LR, Leal LB, Coriolano MDGWDS. Olfative and taste perception in Parkinson's disease. Codas 2021; 33:e20200038. [PMID: 34586294 DOI: 10.1590/2317-1782/20202020038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 09/30/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To analyze the olfactory and gustatory perception and discrimination and self-perception of smell and taste in people with Parkinson's disease, comparing them with healthy nodes. METHODS Observational, analytical, cross-sectional, and quantitative study. Olfactory and gustatory perception and discrimination were verified following Parkinson's disease, compared to a control group, matched by sex and age, using the Olfactory Perception and Taste Strips Tests, respectively, after nasal cleaning and oral brushing. Self-perception was assessed by the Visual Analogue Scale before and after specific tests of perception and discrimination. RESULTS We included individuals of both sexes, 35 with Parkinson's Disease and 20 assigned to the control group, matched for mean age. The olfactory self-perception of the group with Parkinson's disease improved after the olfactory test. There was no difference in taste self-perception in the Parkinson's disease group before and after the taste test. In the olfactory perception assessment test, the Parkinson's disease group discriminated fewer essences than the control group. Both groups have similar generation and taste discrimination. CONCLUSION The olfactory perception of people with Parkinson's disease was lower, compared to the group of healthy desires, and the self-perception of olfactory efficacy improved after the test, in both groups. As for taste, there was no difference in perception and discrimination between groups, the sour taste was the most identified and there was an improvement in self-perception of taste efficiency in the group without Parkinson's disease after the test.
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Affiliation(s)
| | - Adriana de Oliveira C Gomes
- Programa de Pós-graduação em Saúde da Comunicação Humana, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
| | - Luciana Rodrigues Belo
- Departamento de Fonoaudiologia, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
| | - Leila Bastos Leal
- Departamento de Ciências Farmacêuticas, Universidade Federal de Pernambuco - UFPE - Recife (PE), Brasil
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9
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Nigam M, Ayadi I, Noiray C, Branquino-Bras AC, Herraez Sanchez E, Leu-Semenescu S, Vidailhet M, Dodet P, Arnulf I. Sweet or Bland Dreams? Taste Loss in Isolated REM-Sleep Behavior Disorder and Parkinson's Disease. Mov Disord 2021; 36:2431-2435. [PMID: 34117799 DOI: 10.1002/mds.28692] [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: 03/11/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Hyposmia and isolated REM sleep behavior disorder are well-established features of prodromal Parkinson's disease (PD). OBJECTIVES The objective of the present study was to evaluate whether taste loss (reported in PD and possibly suggesting brain stem involvement) is present at the isolated REM sleep behavior disorder stage. METHODS We assessed taste function using the Taste Strip Test (evaluating 4 concentrations of bitter, sweet, sour, and salty) in 44 participants with isolated REM sleep behavior disorder, 19 with PD, and 29 controls. All participants underwent video-polysomnography, standardized questionnaires, and clinical examination, including olfactory assessment. RESULTS Participants with isolated REM sleep behavior disorder and PD had lower taste scores than controls. There was no difference between isolated REM sleep behavior disorder and PD cohorts, nor was there any correlation between taste and olfaction, age, disease duration, cognition, or autonomic function. CONCLUSION This study demonstrates for the first time the presence of taste impairment in isolated REM sleep behavior disorder that is independent of olfactory dysfunction and comparable to participants with PD. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Milan Nigam
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France.,Centre for Advanced Research in Sleep Medicine, Sacré-Coeur Hospital, Montreal, Quebec, Canada.,Department of Neurosciences, University of Montreal, Montreal, Quebec, Canada
| | - Ines Ayadi
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France
| | - Camille Noiray
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France
| | - Ana Catarina Branquino-Bras
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France.,Department of Neurology - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Erika Herraez Sanchez
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France.,Hospital Universitario La Paz, Madrid, Spain
| | - Smaranda Leu-Semenescu
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France
| | - Marie Vidailhet
- Department of Neurology, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France.,Institut du Cerveau et de la Moelle (Paris Brain Institute), Paris, France.,Sorbonne University, Paris, France
| | - Pauline Dodet
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France
| | - Isabelle Arnulf
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France.,Institut du Cerveau et de la Moelle (Paris Brain Institute), Paris, France.,Sorbonne University, Paris, France
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Abstract
Taste disorders, impacting well-being and physical health, can be caused by many etiologies including the use of medication. Recently, taste disturbance is also considered as one of the predominant symptoms of COVID-19 although its pathogenesis requires further research. Localized taste disorders may be overlooked considering that whole-mouth taste perception is insured through several mechanisms. Individuals often fail to discern taste from flavor, and interviews/surveys are insufficient to properly assess taste function. Hence, various taste assessment methods have been developed. Among them, psychophysical methods are most widely applied in a clinical context. Less-biased electrophysiological, imaging, or morphological methods are used to a much lesser degree. Overall, more research is needed in the field of taste.
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Affiliation(s)
- Y Zhu
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden University Hospital, Dresden, Germany
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden University Hospital, Dresden, Germany.
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11
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Melis M, Haehner A, Mastinu M, Hummel T, Tomassini Barbarossa I. Molecular and Genetic Factors Involved in Olfactory and Gustatory Deficits and Associations with Microbiota in Parkinson's Disease. Int J Mol Sci 2021; 22:ijms22084286. [PMID: 33924222 PMCID: PMC8074606 DOI: 10.3390/ijms22084286] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/14/2021] [Accepted: 04/17/2021] [Indexed: 12/11/2022] Open
Abstract
Deficits in olfaction and taste are among the most frequent non-motor manifestations in Parkinson’s disease (PD) that start very early and frequently precede the PD motor symptoms. The limited data available suggest that the basis of the olfactory and gustatory dysfunction related to PD are likely multifactorial and may include the same determinants responsible for other non-motor symptoms of PD. This review describes the most relevant molecular and genetic factors involved in the PD-related smell and taste impairments, and their associations with the microbiota, which also may represent risk factors associated with the disease.
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Affiliation(s)
- Melania Melis
- Department of Biomedical Sciences, University of Cagliari, Monserrato, 09042 Cagliari, Italy; (M.M.); (M.M.)
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, 01307 Dresden, Germany; (A.H.); (T.H.)
| | - Mariano Mastinu
- Department of Biomedical Sciences, University of Cagliari, Monserrato, 09042 Cagliari, Italy; (M.M.); (M.M.)
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, 01307 Dresden, Germany; (A.H.); (T.H.)
| | - Iole Tomassini Barbarossa
- Department of Biomedical Sciences, University of Cagliari, Monserrato, 09042 Cagliari, Italy; (M.M.); (M.M.)
- Correspondence: ; Tel.: +39-070-675-4144
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Association between Sour Taste SNP KCNJ2-rs236514, Diet Quality and Mild Cognitive Impairment in an Elderly Cohort. Nutrients 2021; 13:nu13030719. [PMID: 33668367 PMCID: PMC7996326 DOI: 10.3390/nu13030719] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 12/18/2022] Open
Abstract
Differences in sour-taste thresholds have been identified in cognition-related diseases. Diet is a modulator of cognitive health, and taste perception influences dietary preferences and habits. Heritable genetics and polymorphisms in the KCNJ2 gene involved in the transduction of sour taste have been linked to variations in sour taste and non-gustatory functions. However, relationships between sour taste genetics, mild cognitive impairment, and diet quality are yet to be elucidated. This study investigated the associations between the presence of the KCNJ2-rs236514 variant (A) allele, diet quality indices, and mild cognitive impairment evaluated by the Mini-Mental State Examination (MMSE), in a secondary cross-sectional analysis of data from the Retirement Health & Lifestyle Study. Data from 524 elderly Australians (≥65y) were analyzed, using standard least squares regression and nominal logistic regression modeling, with demographic adjustments applied. Results showed that the presence of the KCNJ2-A allele is associated with increased proportions of participants scoring in the range indicative of mild or more severe cognitive impairment (MMSE score of ≤26) in the total cohort, and males. These associations remained statistically significant after adjusting for age, sex, and diet quality indices. The absence of association between the KCNJ2-A allele and cognitive impairment in women may be related to their higher diet quality scores in all indices. The potential link between sour taste genotype and cognitive impairment scores may be due to both oral and extra-oral functions of sour taste receptors. Further studies are required on the role and relationship of neurotransmitters, sour taste genotypes and sour taste receptors in the brain, and dietary implications, to identify potential risk groups or avenues for therapeutic or prophylactic interventions.
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13
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Contri-Degiovanni PV, Degiovanni GC, Ferriolli E, da Costa Lima NK, Moriguti JC. Impact of the severity of dementia due to Alzheimer's disease on the gustatory sensitivity of older persons. Aging Clin Exp Res 2020; 32:2303-2309. [PMID: 31894565 DOI: 10.1007/s40520-019-01442-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 12/09/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the association between the severity of dementia and taste recognition abilities in older persons with Alzheimer's disease (AD). METHODS Anthropometric measurements were performed and body mass index was used to determine the nutritional status. The taste strips were used to test gustatory functions of the five basic tastes (sweet, salty, sour, bitter and umami). RESULTS A total of 30 healthy younger subjects, 30 healthy older subjects, 37 with mild stage AD and 23 with moderate stage AD were recruited. The older subjects with moderate AD showed a significant reduction of taste, less recognition of bitter and salty taste (score: 10.6 ± 2.6; 2.6 ± 0.9; 1.7 ± 1.5) when compared to older people without cognitive impairment (score: 13.3 ± 1.8; 3.4 ± 0.9; 3.2 ± 0.9), and less recognition of sweet taste (score: 2.9 ± 1.2) when compared to subjects with mild stage AD (score: 3.6 ± 0.8). Impaired recognition of salty taste was detected since the early stages of AD. Among the factors that possibly influence gustatory function, a significant correlation was detected between taste ability and age, medication intake, mini-mental state examination and the nutritional status. CONCLUSION The severity of dementia is directly associated with greater impairment of taste sensitivity, especially among older subjects with moderate stage disease.
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Affiliation(s)
- Patricia V Contri-Degiovanni
- Medical School of Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900-Monte Alegre, Ribeirão Preto, São Paulo, 14049-900, Brazil.
- , R. Luiz Vaz de Camões, 111. Vila Celina, CEP: 13.566-448, São Carlos, São Paulo, Brazil.
| | - Gabriel C Degiovanni
- Medical School of Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900-Monte Alegre, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Eduardo Ferriolli
- Medical School of Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900-Monte Alegre, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Nereida Kilza da Costa Lima
- Medical School of Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900-Monte Alegre, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Julio C Moriguti
- Medical School of Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900-Monte Alegre, Ribeirão Preto, São Paulo, 14049-900, Brazil
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14
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Risso D, Drayna D, Morini G. Alteration, Reduction and Taste Loss: Main Causes and Potential Implications on Dietary Habits. Nutrients 2020; 12:E3284. [PMID: 33120898 PMCID: PMC7693910 DOI: 10.3390/nu12113284] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/29/2020] [Accepted: 10/23/2020] [Indexed: 01/04/2023] Open
Abstract
Our sense of taste arises from the sensory information generated after compounds in the oral cavity and oropharynx activate taste receptor cells situated on taste buds. This produces the perception of sweet, bitter, salty, sour, or umami stimuli, depending on the chemical nature of the tastant. Taste impairments (dysgeusia) are alterations of this normal gustatory functioning that may result in complete taste losses (ageusia), partial reductions (hypogeusia), or over-acuteness of the sense of taste (hypergeusia). Taste impairments are not life-threatening conditions, but they can cause sufficient discomfort and lead to appetite loss and changes in eating habits, with possible effects on health. Determinants of such alterations are multiple and consist of both genetic and environmental factors, including aging, exposure to chemicals, drugs, trauma, high alcohol consumption, cigarette smoking, poor oral health, malnutrition, and viral upper respiratory infections including influenza. Disturbances or loss of smell, taste, and chemesthesis have also emerged as predominant neurological symptoms of infection by the recent Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus strain 2 (SARS-CoV-2), as well as by previous both endemic and pandemic coronaviruses such as Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and SARS-CoV. This review is focused on the main causes of alteration, reduction, and loss of taste and their potential repercussion on dietary habits and health, with a special focus on the recently developed hypotheses regarding the mechanisms through which SARS-CoV-2 might alter taste perception.
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Affiliation(s)
- Davide Risso
- Ferrero Group, Soremartec Italia Srl, 12051 Alba, CN, Italy
| | - Dennis Drayna
- National Institute on Deafness and Other Communication Disorders, NIH, Bethesda, MD 20892, USA;
| | - Gabriella Morini
- University of Gastronomic Sciences, Piazza Vittorio Emanuele 9, Bra, 12042 Pollenzo, CN, Italy;
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15
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Olfaction as a Marker for Dystonia: Background, Current State and Directions. Brain Sci 2020; 10:brainsci10100727. [PMID: 33066144 PMCID: PMC7601998 DOI: 10.3390/brainsci10100727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/30/2020] [Accepted: 10/08/2020] [Indexed: 01/08/2023] Open
Abstract
Dystonia is a heterogeneous group of hyperkinetic movement disorders. The unifying descriptor of dystonia is the motor manifestation, characterized by continuous or intermittent contractions of muscles that cause abnormal movements and postures. Additionally, there are psychiatric, cognitive, and sensory alterations that are possible or putative non-motor manifestations of dystonia. The pathophysiology of dystonia is incompletely understood. A better understanding of dystonia pathophysiology is highly relevant in the amelioration of significant disability associated with motor and non-motor manifestations of dystonia. Recently, diminished olfaction was found to be a potential non-motor manifestation that may worsen the situation of subjects with dystonia. Yet, this finding may also shed light into dystonia pathophysiology and yield novel treatment options. This article aims to provide background information on dystonia and the current understanding of its pathophysiology, including the key structures involved, namely, the basal ganglia, cerebellum, and sensorimotor cortex. Additionally, involvement of these structures in the chemical senses are reviewed to provide an overview on how olfactory (and gustatory) deficits may occur in dystonia. Finally, we describe the present findings on altered chemical senses in dystonia and discuss directions of research on olfactory dysfunction as a marker in dystonia.
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16
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Romano RR, Carter MA, Monroe TB. Narrative Review of Sensory Changes as a Biomarker for Alzheimer's Disease. Biol Res Nurs 2020; 23:223-230. [PMID: 32799655 DOI: 10.1177/1099800420947176] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Early recognition of Alzheimer's disease (AD) in the prodromal period has not been robust yet will be necessary if effective disease-modifying drugs are to be useful in preventing or delaying the condition. The objective of this narrative review was to describe the current, evidenced based understanding of alterations in sensory data as potential biomarkers for AD. Review of empirical studies that tested senses as biomarkers for AD and were published in English within the past 50 years was completed. Eighteen empirical studies were identified that met the strict criteria for inclusion, with 12 of these studies being related to the olfactory system. Two studies examined auditory, two examined vision, one examined proprioception, and one examined taste. Thus, only olfaction has been studied to any extent, leaving a clear gap in the literature for the use of other senses. A promising area of research has begun to be reported concerning differences in responses to pain stimuli in AD relative to cognitively normal subjects. Pain is not a single sense like the others but integrates several senses and may allow for use as an early biomarker for AD, as it integrates several brain areas and pathways. Unlike the other senses, simple devices can be used to measure changes in pain perception in cognitively normal adults with genetic predispositions for possible AD, making this potentially useful for clinicians in the future.
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Affiliation(s)
- Raymond R Romano
- College of Nursing, 12326University of Tennessee Health Science Center, Memphis, TN, USA
| | - Michael A Carter
- College of Nursing, 12326University of Tennessee Health Science Center, Memphis, TN, USA
| | - Todd B Monroe
- College of Nursing, 2647Ohio State University, Columbus, OH, USA
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17
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Wood RM, Garcia Z, Daniels N, Landon SM, Humayun S, Lee HG, Macpherson LJ. Selective Peripheral Taste Dysfunction in APP/PS1 Mutant Transgenic Mice. J Alzheimers Dis 2020; 76:613-621. [PMID: 32538852 DOI: 10.3233/jad-200376] [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] [Indexed: 12/30/2022]
Abstract
BACKGROUND Previous studies indicate that taste dysfunction occurs early in the development of Alzheimer's disease. It is debatable whether the deficit in taste is due primarily to peripheral sensory mechanisms or to central processing, or a combination of the two. OBJECTIVE The aim of our current study is to combine behavior and histological data in APP/PS1 transgenic mice to determine whether APP/PS1 transgenic mice show deficits in unconditioned taste preference and avoidance behaviors and whether taste impairments are due to defects in the peripheral taste system and/or problems with central processing of taste information. METHODS The APP/PS1 transgenic mutant mice were used as a model of Alzheimer's disease. We employed a brief-access gustometer test to assess immediate orosensory taste responses of APP/PS1 mice. We used immunohistochemistry to examine tongue, gustatory ganglion, and brain tissues to determine a cytological basis for behavioral deficits. RESULTS There is a significant, selective reduction of bitter taste sensitivity in APP/PS1 mice. These mice also have a loss of TRPM5-expressing taste receptor cells in the circumvallate papillae of the tongue. While we observed no overt loss of neuron cell bodies within the primary gustatory sensory neurons, degeneration of the neurons' peripheral axons innervating the taste bud may play a role in the observed loss of TRPM5-expressing taste receptor cells. CONCLUSION This data supports a potential role for peripheral taste dysfunction in AD through the selective loss of taste receptor cells. Further study is necessary to delineate the mechanisms and pathological significance of this deficit in AD.
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Affiliation(s)
- Ryan M Wood
- The University of Texas at San Antonio, Department of Biology, One UTSA Circle, San Antonio, TX, USA
| | - Zacnite Garcia
- The University of Texas at San Antonio, Department of Biology, One UTSA Circle, San Antonio, TX, USA
| | - Nathan Daniels
- The University of Texas at San Antonio, Department of Biology, One UTSA Circle, San Antonio, TX, USA
| | - Shannon M Landon
- The University of Texas at San Antonio, Department of Biology, One UTSA Circle, San Antonio, TX, USA
| | - Saima Humayun
- The University of Texas at San Antonio, Department of Biology, One UTSA Circle, San Antonio, TX, USA
| | - Hyoung-Gon Lee
- The University of Texas at San Antonio, Department of Biology, One UTSA Circle, San Antonio, TX, USA.,The University of Texas at San Antonio, Neurosciences Institute, One UTSA Circle, San Antonio, TX, USA
| | - Lindsey J Macpherson
- The University of Texas at San Antonio, Department of Biology, One UTSA Circle, San Antonio, TX, USA.,The University of Texas at San Antonio, Neurosciences Institute, One UTSA Circle, San Antonio, TX, USA
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18
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Kouzuki M, Ichikawa J, Shirasagi D, Katsube F, Kobashi Y, Matsumoto H, Chao H, Yoshida S, Urakami K. Detection and recognition thresholds for five basic tastes in patients with mild cognitive impairment and Alzheimer's disease dementia. BMC Neurol 2020; 20:110. [PMID: 32216773 PMCID: PMC7098139 DOI: 10.1186/s12883-020-01691-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 03/18/2020] [Indexed: 11/24/2022] Open
Abstract
Background Patients with Alzheimer’s disease dementia (ADD) are thought to exhibit taste disorders; however, this has not been extensively studied. We investigated gustatory functions and factors affecting taste in patients with ADD or mild cognitive impairment (MCI) and in non-demented controls (NDCs) and evaluated associations between cognitive impairment and gustatory functions. Methods We recruited 29 patients with ADD, 43 with MCI, and 14 with NDCs. We obtained medical and medication history, measured salivary secretion volumes, and performed cognitive function tests, blood tests, whole-mouth gustatory tests, and dietary and gustatory questionnaires. Results Patients with ADD showed significantly higher recognition threshold values than NDCs (p < 0.05). Many individuals did not recognize umami at the maximum concentration, and this happened more frequently in patients with ADD or MCI than in NDCs. Evaluation items other than cognitive function tests did not show significant differences among the groups, but many individuals had decreased salivation, low serum zinc levels, and were on multiple medications. We found a significant correlation between recognition threshold and age (r = 0.229, p < 0.05) and cognitive function test score (r = 0.268, p < 0.05). Conclusions Patients with ADD showed impairment of gustatory function. Gustatory impairment in patients with MCI could not be confirmed. However, many individuals with MCI did not recognize umami, either. Our results suggest that taste disorders in elderly people with cognitive decline occur independently of factors affecting taste such as salivation, zinc levels, or prescription drugs. Trial registration The study was registered in the UMIN Clinical Trials Registry on February 10, 2017, with reference number UMIN000026087.
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Affiliation(s)
- Minoru Kouzuki
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, 683-8503, Japan.
| | - Junya Ichikawa
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, 683-8503, Japan
| | - Daiki Shirasagi
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, 683-8503, Japan
| | - Fumiya Katsube
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, 683-8503, Japan
| | - Yuuki Kobashi
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, 683-8503, Japan
| | - Hideki Matsumoto
- Research Institute for Bioscience & Fine Chemicals, Ajinomoto Co., Inc., 1-1, Suzuki-Cho, Kawasaki-Ku, Kawasaki-Shi, 210-8681, Japan
| | - Huichia Chao
- Research Institute for Bioscience & Fine Chemicals, Ajinomoto Co., Inc., 1-1, Suzuki-Cho, Kawasaki-Ku, Kawasaki-Shi, 210-8681, Japan
| | - Shintaro Yoshida
- Research Institute for Bioscience & Fine Chemicals, Ajinomoto Co., Inc., 1-1, Suzuki-Cho, Kawasaki-Ku, Kawasaki-Shi, 210-8681, Japan
| | - Katsuya Urakami
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, 683-8503, Japan
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19
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Oppo V, Melis M, Melis M, Tomassini Barbarossa I, Cossu G. "Smelling and Tasting" Parkinson's Disease: Using Senses to Improve the Knowledge of the Disease. Front Aging Neurosci 2020; 12:43. [PMID: 32161534 PMCID: PMC7052524 DOI: 10.3389/fnagi.2020.00043] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/10/2020] [Indexed: 12/31/2022] Open
Abstract
Among non-motor manifestations of Parkinson's Disease (PD), peripheral, sensory symptoms are particularly relevant. Smell dysfunction starts very early and frequently precedes the PD motor symptoms by years (being often a cue to the diagnosis). Moreover, olfactory system could be, together with gut, one of those peripheral sites where PD pathology first develops. Unlike smell loss, the relationship between PD and taste impairment is far less established. It can start early in the course of the disease but more frequently appears in advanced stages, in parallel with the advent of MCI, likely reflecting cortical involvement. Among PD patients has been demonstrated an increase in the frequency of the non-tasters for PROP (prototypical gustatory stimulus, 6- n-propylthiouracil), a genetically determined bitter taste which is mediated by TAS2RS38 receptor, and a significant increase of the recessive non-testing variant of this receptor. TAS2R38 receptors are expressed also in other tissues, such as in the epithelia of the gut and nasal cavities, where they can influence epithelial immunity ad its interaction with microbiota. Those pieces of evidence suggest that not only systematic assessment of taste and smell can be of a remarkable help for clinicians in the early diagnosis, but also that understanding the mechanisms of sensory involvement in PD could increase the knowledge of the pathophysiology of the disease.
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Affiliation(s)
- Valentina Oppo
- Department of Neuroscience, Brotzu Hospital, Cagliari, Italy
| | - Marta Melis
- Department of Neurology, Azienda Ospedaliero Universitaria, University of Cagliari, Cagliari, Italy
| | - Melania Melis
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | | | - Giovanni Cossu
- Department of Neuroscience, Brotzu Hospital, Cagliari, Italy
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20
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Herr T, Hummel T, Vollmer M, Willert C, Veit B, Gamain J, Fleischmann R, Lehnert B, Mueller JU, Stenner A, Kronenbuerger M. Smell and taste in cervical dystonia. J Neural Transm (Vienna) 2020; 127:347-354. [PMID: 32062706 PMCID: PMC8102446 DOI: 10.1007/s00702-020-02156-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 02/03/2020] [Indexed: 02/07/2023]
Abstract
The pathophysiology of cervical dystonia is not completely understood. Current concepts of the pathophysiology propose that it is a network disorder involving the basal ganglia, cerebellum and sensorimotor cortex. These structures are primarily concerned with sensorimotor control but are also involved in non-motor functioning such as the processing of information related to the chemical senses. This overlap lets us hypothesize a link between cervical dystonia and altered sense of smell and taste. To prove this hypothesis and to contribute to the better understanding of cervical dystonia, we assessed olfactory and gustatory functioning in 40 adults with idiopathic cervical dystonia and 40 healthy controls. The Sniffin Sticks were used to assess odor threshold, discrimination and identification. Furthermore, the Taste Strips were applied to assess the combined taste score. Motor and non-motor deficits of cervical dystonia including neuropsychological and psychiatric alterations were assessed as cofactors for regression analyses. We found that cervical dystonia subjects had lower scores than healthy controls for odor threshold (5.8 ± 2.4 versus 8.0 ± 3.2; p = 0.001), odor identification (11.7 ± 2.3 versus 13.1 ± 1.3; p = 0.001) and the combined taste score (9.5 ± 2.2 versus 11.7 ± 2.7; p < 0.001), while no difference was found in odor discrimination (12.0 ± 2.5 versus 12.9 ± 1.8; p = 0.097). Regression analysis suggests that age is the main predictor for olfactory decline in subjects with cervical dystonia. Moreover, performance in the Montreal Cognitive Assessment is a predictor for gustatory decline in cervical dystonia subjects. Findings propose that cervical dystonia is associated with diminished olfactory and gustatory functioning.
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Affiliation(s)
- Thorsten Herr
- Department of Neurology, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Marcus Vollmer
- Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany
| | | | - Birgitt Veit
- Neurology Group Practice, Neubrandenburg, Germany
| | - Julie Gamain
- Department of Neurology, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany
| | - Robert Fleischmann
- Department of Neurology, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany
| | - Bernhard Lehnert
- Department of Otorhinolaryngology, University Medicine Greifswald, Greifswald, Germany
| | - Jan-Uwe Mueller
- Department of Neurosurgery, University Medicine Greifswald, Greifswald, Germany
| | - Andrea Stenner
- Outpatient Department of Neurology, Paracelsus Clinic Zwickau, Zwickau, Germany
| | - Martin Kronenbuerger
- Department of Neurology, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany.
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.
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21
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Cecchini MP, Federico A, Zanini A, Mantovani E, Masala C, Tinazzi M, Tamburin S. Olfaction and taste in Parkinson's disease: the association with mild cognitive impairment and the single cognitive domain dysfunction. J Neural Transm (Vienna) 2019; 126:585-595. [PMID: 30911822 DOI: 10.1007/s00702-019-01996-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 03/19/2019] [Indexed: 01/01/2023]
Abstract
Mild cognitive impairment (MCI) and chemosensory dysfunction are non-motor symptoms of Parkinson's disease (PD), but their association is unclear. We explored if MCI and the involvement of single cognitive domains influence olfaction and taste in PD. The role of demographic, clinical and neuropsychiatric variables was tested. We recruited 50 PD patients without dementia, no other reasons for cognitive impairment, no condition that could influence evaluation of cognition, olfaction and taste. They underwent a full neuropsychological and chemosensory (i.e., olfaction and taste) test with the Sniffin' Sticks Extended test (SSET), Whole Mouth test (WMT) and Taste Strips test (TST). Fifty age- and sex-matched healthy subjects served as controls. Olfactory function and sweet identification were worse in PD than controls. MCI negatively influenced odor identification. Factors associated with poor olfactory function were age, overall cognition, apathy, and visuospatial dysfunction. Sour identification was affected by MCI and executive dysfunction, and salty identification by executive dysfunction. MCI, age and executive dysfunction worsened TST score. Awareness of olfactory dysfunction was impaired in PD with MCI. Education positively influenced SSET and TST scores. Our data confirmed that olfaction is abnormal in PD, while taste was only slightly impaired. Olfaction was worse in PD patients with visuospatial dysfunction, while sour and salty identification was worse in those with MCI and executive dysfunction, suggesting different underlying anatomical abnormalities. Future studies should incorporate neuroimaging and cerebrospinal fluid data to confirm this hypothesis. SSET odor identification and TST sour identification could be explored as quick screening tests for PD-MCI.
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Affiliation(s)
- Maria Paola Cecchini
- Section of Anatomy and Histology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy.
| | - Angela Federico
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy
| | - Alice Zanini
- Section of Anatomy and Histology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy
| | - Elisa Mantovani
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy
| | - Carla Masala
- Department of Biomedical Sciences, Section of Physiology, University of Cagliari, Cagliari, Italy
| | - Michele Tinazzi
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy
| | - Stefano Tamburin
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy.
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22
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Churnin I, Qazi J, Fermin CR, Wilson JH, Payne SC, Mattos JL. Association Between Olfactory and Gustatory Dysfunction and Cognition in Older Adults. Am J Rhinol Allergy 2019; 33:170-177. [DOI: 10.1177/1945892418824451] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The association between olfactory dysfunction (OD) and cognitive decline is becoming apparent in the emerging literature. However, the literature demonstrating a similar effect between gustatory dysfunction (GD) and cognition is not well established. Objective To determine whether OD and GD are independently associated with cognitive impairment. Methods The 2013–2014 National Health and Nutrition Examination Survey was queried for 1376 older adults, corresponding to a weighted population sample of 50 816 529, to assess olfactory and gustatory status and cognition using univariate and multivariate regression analyses. OD and GD were determined using objective measurements with validated protocols. Participants were stratified as normal or abnormal cognition status using accepted cutoff values as indicated for the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuropsychological test, Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). Results OD was associated with both mild cognitive impairment (odds ratio [OR] 1.809, P = .004) and dementia (OR 3.173, P < .001) with CERAD testing, abnormal AFT (OR 2.424, P < .001), and abnormal DSST (OR 4.028, P < .001). GD based on 1M NaCl whole mouth taste testing was associated with dementia on CERAD testing (OR 2.217, P = .004). When smell and taste parameters were included together in the regression model, both OD and GD remained significant independent predictors of dementia status based on CERAD testing (OR 3.133, P < .001, OR 1.904, P = .015). Conclusions OD and severe GD represent independent predictors of cognitive impairment in a nationally representative sample of older adults.
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Affiliation(s)
- Ian Churnin
- Department of Otolaryngology – Head & Neck Surgery, University of Virginia, Charlottesville, Virginia
| | - Jamiluddin Qazi
- School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Cyrelle R. Fermin
- School of Medicine, University of Virginia, Charlottesville, Virginia
| | - James H. Wilson
- School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Spencer C. Payne
- Department of Otolaryngology – Head & Neck Surgery, University of Virginia, Charlottesville, Virginia
| | - Jose L. Mattos
- Department of Otolaryngology – Head & Neck Surgery, University of Virginia, Charlottesville, Virginia
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Doty RL, Hawkes CH. Chemosensory dysfunction in neurodegenerative diseases. HANDBOOK OF CLINICAL NEUROLOGY 2019; 164:325-360. [PMID: 31604557 DOI: 10.1016/b978-0-444-63855-7.00020-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A number of neurodegenerative diseases are accompanied by disordered smell function. The degree of dysfunction can vary among different diseases, such that olfactory testing can aid in differentiating, for example, Alzheimer's disease (AD) from major affective disorder and Parkinson's disease (PD) from progressive supranuclear palsy. Unfortunately, altered smell function often goes unrecognized by patients and physicians alike until formal testing is undertaken. Such testing uniquely probes brain regions not commonly examined in physical examinations and can identify, in some cases, patients who are already in the "preclinical" stage of disease. Awareness of this fact is one reason why the Quality Standards Committee of the American Academy of Neurology has designated smell dysfunction as one of the key diagnostic criteria for PD. The same recommendation has been made by the Movement Disorder Society for both the diagnosis of PD and identification of prodromal PD. Similar suggestions are proposed to include olfactory dysfunction as an additional research criterion for the diagnosis of AD. Although taste impairment, i.e., altered sweet, sour, bitter, salty, and umami perception, has also been demonstrated in some disorders, taste has received much less scientific attention than smell. In this review, we assess what is known about the smell and taste disorders of a wide range of neurodegenerative diseases and describe studies seeking to understand their pathologic underpinnings.
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Affiliation(s)
- Richard L Doty
- Smell and Taste Center and Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
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Haehner A, Masala C, Walter S, Reichmann H, Hummel T. Incidence of Parkinson’s disease in a large patient cohort with idiopathic smell and taste loss. J Neurol 2018; 266:339-345. [DOI: 10.1007/s00415-018-9135-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 10/27/2022]
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Lee J, Yamate C, Taira M, Shinoda M, Urata K, Maruno M, Ito R, Saito H, Gionhaku N, Iinuma T, Iwata K. Prefrontal cortex activity during swallowing in dysphagia patients. J Oral Sci 2018; 60:329-335. [PMID: 29794397 DOI: 10.2334/josnusd.17-0238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Prefrontal cortex activity is modulated by flavor and taste stimuli and changes during swallowing. We hypothesized that changes in the modulation of prefrontal cortex activity by flavor and taste were associated with swallowing movement and evaluated brain activity during swallowing in patients with dysphagia. To evaluate prefrontal cortex activity in dysphagia patients during swallowing, change in oxidized hemoglobin (z-score) was measured with near-infrared spectroscopy while dysphagia patients and healthy controls swallowed sweetened/unsweetened and flavored/unflavored jelly. Total z-scores were positive during swallowing of flavored/unsweetened jelly and negative during swallowing of unflavored/sweetened jelly in controls but negative during swallowing of sweetened/unsweetened and flavored/unflavored jelly in dysphagia patients. These findings suggest that taste and flavor during food swallowing are associated with positive and negative z-scores, respectively. Change in negative and positive z-scores may be useful in evaluating brain activity of dysphagia patients during swallowing of sweetened and unsweetened food.
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Affiliation(s)
- Jun Lee
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry
| | - Chisato Yamate
- Department of Cognitive Neurobiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.,Center for Brain Integration Research, Tokyo Medical and Dental University
| | - Masato Taira
- Department of Cognitive Neurobiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.,Center for Brain Integration Research, Tokyo Medical and Dental University
| | - Masamichi Shinoda
- Department of Physiology, Nihon University School of Dentistry.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry
| | - Kentaro Urata
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry
| | - Mitsuru Maruno
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry
| | - Reio Ito
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry
| | - Hiroto Saito
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry
| | - Nobuhito Gionhaku
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry
| | - Toshimitsu Iinuma
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry
| | - Koichi Iwata
- Department of Physiology, Nihon University School of Dentistry.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry
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Cossu G, Melis M, Sarchioto M, Melis M, Melis M, Morelli M, Tomassini Barbarossa I. 6-n-propylthiouracil taste disruption and TAS2R38 nontasting form in Parkinson's disease. Mov Disord 2018; 33:1331-1339. [PMID: 29575306 DOI: 10.1002/mds.27391] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 02/02/2018] [Accepted: 03/04/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The few studies that evaluated taste function in Parkinson's disease (PD) showed inconsistent results. The inherited ability to taste the bitter compound of 6-n-propylthiouracil has been considered to be a paradigm of general taste perception. 6-n-propylthiouracil taste perception is mediated by the TAS2R38 receptor, and reduced 6-n-propylthiouracil sensitivity has been associated with several diseases not typically related to taste function. OBJECTIVES We evaluated the 6-n-propylthiouracil taste perception and the TAS2R38 gene as genetic risk factors for the development of idiopathic PD in PD patients and healthy controls (HC). METHODS The 6-n-propylthiouracil taste perception was assessed by testing the responsiveness, and the ability to recognize, 6-n-propylthiouracil and sodium chloride. The participants were classified for 6-n-propylthiouracil taster status and genotyped for the TAS2R38 gene. RESULTS A significant increase in the frequency of participants classified as 6-n-propylthiouracil nontasters and a reduced ability to recognize bitter taste quality of 6-n-propylthiouracil were found in PD patients when compared with healthy controls. The results also showed that only 5% of PD patients had the homozygous genotype for the dominant tasting variant of TAS2R38, whereas most of them carried the recessive nontaster form and a high number had a rare variant. CONCLUSIONS Our results show that 6-n-propylthiouracil taster status and TAS2R38 locus are associated with PD. The 6-n-propylthiouracil test may therefore represent a novel, simple way to identify increased vulnerability to PD. Moreover, the presence of the nontasting form of TAS2R38 in PD may further substantiate that disease-associated taste disruption may represent a risk factor associated with the disease. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Giovanni Cossu
- Neurology Service and Stroke Unit, A.O. Brotzu, Cagliari, Italy
| | - Melania Melis
- Department of Biomedical Sciences, University of Cagliari, Monserrato, Cagliari, Italy
| | - Marianna Sarchioto
- Neurology Service and Stroke Unit, A.O. Brotzu, Cagliari, Italy.,University of Cagliari, Department of Medical Sciences and Public Health Cagliari, University of Cagliari, Monserrato, Cagliari, Italy
| | - Marta Melis
- Neurology Service and Stroke Unit, A.O. Brotzu, Cagliari, Italy.,University of Cagliari, Department of Medical Sciences and Public Health Cagliari, University of Cagliari, Monserrato, Cagliari, Italy
| | - Maurizio Melis
- Neurology Service and Stroke Unit, A.O. Brotzu, Cagliari, Italy
| | - Micaela Morelli
- Department of Biomedical Sciences, University of Cagliari, Monserrato, Cagliari, Italy
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Kouzuki M, Suzuki T, Nagano M, Nakamura S, Katsumata Y, Takamura A, Urakami K. Comparison of olfactory and gustatory disorders in Alzheimer's disease. Neurol Sci 2017; 39:321-328. [PMID: 29128987 DOI: 10.1007/s10072-017-3187-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 11/02/2017] [Indexed: 12/21/2022]
Abstract
Patients with Alzheimer's disease (AD) develop olfactory and gustatory disorders. However, the order of failure and relevance of the pathophysiology are unclear. We compared olfactory identification and whole mouth gustation in patients with AD to those with mild cognitive impairment (MCI) and to healthy controls (HC) and assessed correlations with pathophysiology. Patients with AD (n = 40), MCI (n = 34), and HC (n = 40) were recruited. We performed the Odor Stick Identification Test for Japanese (OSIT-J), gustatory test by the intraoral dropping method using taste solutions, Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognitive subscale Japanese version (ADAS-J cog), Touch Panel-type Dementia Assessment Scale (TDAS), and measurement of amyloid β (Aβ) 42 and phosphorylated tau (p-tau) 181 levels in cerebrospinal fluid (CSF). Patients with AD and MCI had lower OSIT-J scores than did the HC. The OSIT-J score was correlated with the MMSE, ADAS-J cog, TDAS, and Aβ42 results. There were no significant differences in the gustatory test scores among the three groups. The gustatory test score was only correlated with the MMSE, ADAS-J cog, and TDAS results. Olfactory function decreased in AD and MCI patients and was associated with CSF biomarker levels and cognitive disorders. The results suggest that olfactory function is impaired in early stage of AD. Gustatory function was not correlated with CSF biomarkers, which suggests that it may not be impaired in early stage of AD.
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Affiliation(s)
- Minoru Kouzuki
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishicho, Yonago, 683-8503, Japan.
| | - Tetsuya Suzuki
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishicho, Yonago, 683-8503, Japan
| | - Masaya Nagano
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishicho, Yonago, 683-8503, Japan
| | - Syouta Nakamura
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishicho, Yonago, 683-8503, Japan
| | - Yuto Katsumata
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishicho, Yonago, 683-8503, Japan
| | - Ayumi Takamura
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishicho, Yonago, 683-8503, Japan
| | - Katsuya Urakami
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishicho, Yonago, 683-8503, Japan
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The Role of Food Antioxidants, Benefits of Functional Foods, and Influence of Feeding Habits on the Health of the Older Person: An Overview. Antioxidants (Basel) 2017; 6:antiox6040081. [PMID: 29143759 PMCID: PMC5745491 DOI: 10.3390/antiox6040081] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 10/17/2017] [Accepted: 10/18/2017] [Indexed: 02/07/2023] Open
Abstract
This overview was directed towards understanding the relationship of brain functions with dietary choices mainly by older humans. This included food color, flavor, and aroma, as they relate to dietary sufficiency or the association of antioxidants with neurodegenerative diseases such as dementia and Alzheimer’s disease. Impairment of olfactory and gustatory function in relation to these diseases was also explored. The role of functional foods was considered as a potential treatment of dementia and Alzheimer’s disease through inhibition of acetylcholinesterase as well as similar treatments based on herbs, spices and antioxidants therein. The importance of antioxidants for maintaining the physiological functions of liver, kidney, digestive system, and prevention of cardiovascular diseases and cancer has also been highlighted. Detailed discussion was focused on health promotion of the older person through the frequency and patterns of dietary intake, and a human ecology framework to estimate adverse risk factors for health. Finally, the role of the food industry, mass media, and apps were explored for today’s new older person generation.
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Sakai M, Kazui H, Shigenobu K, Komori K, Ikeda M, Nishikawa T. Gustatory Dysfunction as an Early Symptom of Semantic Dementia. Dement Geriatr Cogn Dis Extra 2017; 7:395-405. [PMID: 29430242 PMCID: PMC5806165 DOI: 10.1159/000481854] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/01/2017] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To investigate the gustatory function in patients with semantic dementia (SD). METHODS Detection and recognition thresholds of the 4 basic tastes (sweet, salty, sour, and bitter), taste discrimination, and taste identification were evaluated in 18 patients with SD, 18 patients with Alzheimer disease (AD), and 22 healthy controls. RESULTS Total detection and recognition threshold values were significantly higher in the SD and AD groups than in the control group. Patients with early-stage SD (Clinical Dementia Rating Scale score 0.5) exhibited significantly higher detection and recognition thresholds relative to controls, while increases in recognition threshold were only noted in patients with AD. Patients with SD exhibited significantly higher thresholds for the detection of sweet and salty tastes and the recognition of salty, sour, and bitter tastes, while patients with AD exhibited significantly higher thresholds only for the recognition of salty and sour tastes. Taste discrimination was preserved, whereas taste identification was disturbed, in both the SD and AD groups. CONCLUSIONS Gustatory dysfunction at both the sensory and semantic levels may be among the early symptoms of SD. Although patients with SD had difficulty detecting sweet tastes, they more easily recognized these tastes than others, which may explain their strong preference for sweets.
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Affiliation(s)
- Mariko Sakai
- Department of Clinical Rehabilitation, Osaka Prefecture University Graduate School of Comprehensive Rehabilitation, Habikino-city, Japan
- Department of Rehabilitation, Saiseikai Ibaraki Hospital, Ibaraki-city, Japan
| | - Hiroaki Kazui
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita-city, Japan
| | - Kazue Shigenobu
- Department of Psychiatry, Asakayama Hospital, Sakai-city, Japan
| | - Kenjiro Komori
- Office of Psychology, Department of Psychiatry, Juzen-Yurinoki Hospital, Niihama-city, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita-city, Japan
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto-city, Japan
| | - Takashi Nishikawa
- Department of Clinical Rehabilitation, Osaka Prefecture University Graduate School of Comprehensive Rehabilitation, Habikino-city, Japan
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The Gut and Nonmotor Symptoms in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 134:787-809. [PMID: 28805583 DOI: 10.1016/bs.irn.2017.05.027] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Gastrointestinal (GI) symptoms are one of the most common nonmotor symptoms (NMS) in patients with Parkinson's disease (PD) involving the whole GI tract (GIT) and being evident throughout the whole course of the disease. Furthermore, constipation serves as a risk factor for PD as well as an early prodromal NMS of PD. The gut as gateway to the environment with its enteric nervous system (ENS) plays a crucial role in the neurodegenerative process that leads to PD. Alpha-synucleinopathy as the pathological hallmark of PD could be found within the whole GIT in a rostrocaudal gradient interacting with the ENS, the gut microbiome, and enteric glial cells. Bidirectional interactions between the ENS and the central nervous system (CNS) via a brain-gut-enteric microbiota axis have been reported. As well as there is evidence out of animal, autopsy, and epidemiological studies that α-synuclein spreads via rostrocranial transmission by transsynaptic cell-to-cell transfer via the sympathetic and parasympathetic nervous system to the CNS causing the typical neuropathological changes of PD. Recognition of GI NMS as prodromal markers of PD as well as a better understanding of the brain-gut connection offers new insights in the pathophysiology of PD and might provide the opportunity of PD diagnosis before CNS involvement. Hereby the opportunity for development of neuroprotective and disease-modifying therapeutics, respectively, seem to be promising. This chapter covers the variety of GI NMS and its consequences in PD as well as the important role of the gut as part of the pathological process in PD.
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Tarakad A, Jankovic J. Anosmia and Ageusia in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:541-556. [PMID: 28802932 DOI: 10.1016/bs.irn.2017.05.028] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Anosmia, the loss of sense of smell, is a common nonmotor feature of Parkinson's disease (PD). Ageusia, the loss of sense of taste, is additionally an underappreciated nonmotor feature of PD. The olfactory tract is involved early in PD as indicated by frequent occurrence of hyposmia or anosmia years or decades before motor symptoms and by autopsy studies showing early synuclein pathology in the olfactory tract and anterior olfactory nucleus even in the early stages of PD. Testing for olfaction consists of evaluation of olfactory thresholds, smell identification and discrimination, and olfactory memory. Testing for gustation involves evaluating thresholds and discrimination of five basic tastes (salty, sweet, bitter, sour, and umami). The presence of a specific pattern of loss in both olfaction and gustation in PD has been proposed, but this has not yet been confirmed. Within PD, olfactory loss is strongly tied with cognitive status though links to other features of PD or a particular PD phenotype is debated. Hyposmia is more often present and typically more severe in PD patients than other parkinsonian syndromes, making it a potentially useful biomarker for the disease.
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Affiliation(s)
- Arjun Tarakad
- Parkinson's Disease Center and Movement Disorder Clinic, Baylor College of Medicine, Houston, TX, United States
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorder Clinic, Baylor College of Medicine, Houston, TX, United States.
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A prospective evaluation of taste in Parkinson’s disease. J Neural Transm (Vienna) 2016; 124:347-352. [DOI: 10.1007/s00702-016-1638-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 10/20/2016] [Indexed: 10/20/2022]
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Ogawa T, Irikawa N, Yanagisawa D, Shiino A, Tooyama I, Shimizu T. Taste detection and recognition thresholds in Japanese patients with Alzheimer-type dementia. Auris Nasus Larynx 2016; 44:168-173. [PMID: 27427537 DOI: 10.1016/j.anl.2016.06.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/13/2016] [Accepted: 06/27/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Alzheimer-type dementia (AD) is pathologically characterized by massive neuronal loss in the brain, and the taste cortex is thought to be affected. However, there are only a few reports regarding the gustatory function of AD patients, and the conclusions of this research are inconsistent. METHODS This prospective study enrolled 22 consecutive patients with mild to moderately severe Alzheimer-type dementia (AD) with mean age of 84.0 years, and 49 elderly volunteers without dementia with mean age of 71.0 years as control subjects. The control subjects were divided into two groups according to age: a younger group (N=28, mean age: 68.5) and an older group (N=21, mean age: 83.0). The gustatory function was investigated using the filter paper disc method (FPD) and electrogustometry (EGM). RESULTS The gustatory function as measured by the FPD was significantly impaired in patients with AD as compared with age-matched control subjects; no such difference was found between the younger and the older control groups. On the other hand, as for the EGM thresholds, there were no differences between the AD patient group and the age-matched controls. CONCLUSION The FPD method demonstrated decreased gustatory function in AD patients beyond that of aging. On the other hand, EGM thresholds did not differ between the AD patient group and the age-matched controls. These results suggest that failure of taste processing in the brain, but not taste transmission in the peripheral taste system, occurs in patients with AD.
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Affiliation(s)
- Takao Ogawa
- Department of Otorhinolaryngology, Shiga University of Medical Science, Otsu, Shiga, Japan.
| | - Naoya Irikawa
- Department of Otorhinolaryngology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Daijiro Yanagisawa
- Department of Molecular Neuroscience Research Center, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Akihiko Shiino
- Department of Biomedical MR Science Center, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Ikuo Tooyama
- Department of Molecular Neuroscience Research Center, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Takeshi Shimizu
- Department of Otorhinolaryngology, Shiga University of Medical Science, Otsu, Shiga, Japan
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Abstract
BACKGROUND There is growing awareness that the subjective experience of people with dementia is important for understanding behavior and improving quality of life. This paper reviews and reflects on the currently available theories on subjective experience in dementia and it explores the possibility of a knowledge gap on the influence of neurological deficits on experience in late stage dementia. METHODS A literature review on current commonly used theories on experience in dementia was supplemented with a systematic review in PubMed and Psychinfo. For the systematic review, the terms used were Perception and Dementia and Behavior; and Awareness and Dementia and Long term care. RESULTS Current models emphasize the psychosocial factors that influence subjective experience, but the consequences of neurological deficits are not elaborated upon. The systematic literature search on the neuropsychological functioning in dementia resulted in 631 papers, of which 94 were selected for review. The current knowledge is limited to the early stages of Alzheimer's disease. Next to memory impairments, perception of the direct environment, interpretation of the environment, and inhibition of own responses to the environment seem to be altered in people with dementia. CONCLUSIONS Without knowledge on how perception, interpretation and the ability for response control are altered, the behavior of people with dementia can easily be misinterpreted. Research into neuropsychological functioning of people in more severe stages and different forms of dementia is needed to be able to develop a model that is truly biopsychosocial. The proposed model can be used in such research as a starting point for developing tests and theories.
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Abstract
BACKGROUND Patients with Alzheimer's disease (AD) manifest various impairments in eating behavior. However, few previous studies have directly investigated the gustatory function of AD patients, and results have been inconsistent. METHODS Thirty-two AD patients (Clinical Dementia Rating (CDR) 0.5/1/2, respectively 11/15/6 patients) and 22 normal control participants were examined to measure detection and recognition thresholds of the four elemental tastes (sweet, salty, sour, and bitter), and their ability to discriminate between tastes. Effects of demographic and clinical factors (age, sex, histories of alcohol and tobacco consumption, and CDR grade) on gustatory threshold were examined using ordinal logistic regression analysis. Performance was compared between AD and control groups. RESULTS Total threshold values (the sum of threshold grades for the four tastes) for detection and recognition of tastes were significantly higher in the AD group. Detection thresholds for sweet, salty, and bitter, and recognition thresholds for sweet and sour, were also significantly higher in the AD group. Ordinal logistic regression analysis revealed that CDR grade was the only factor that significantly affected both total threshold values. Regarding taste discrimination, there were no significant differences between the AD group and control group. CONCLUSIONS These findings suggest that progression of dementia severity accompanies gustatory decline. Although it seemingly paradoxical, weight loss and preference for sweet tastes are frequently, often simultaneously, observed in AD. Gustatory dysfunction may be partially involved in these symptoms. Thus, the nutritional care of patients with AD could be improved by making the taste of meals stronger, while controlling calorie and mineral intake.
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Wong JC, Li J, Pavlova M, Chen S, Wu A, Wu S, Gao X. Risk factors for probable REM sleep behavior disorder: A community-based study. Neurology 2016; 86:1306-1312. [PMID: 26819459 DOI: 10.1212/wnl.0000000000002414] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 12/14/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine risk factors for REM sleep behavior disorder (RBD) in a large-scale community-based study. METHODS This community-based study included 12,784 Chinese adults (10,556 men and 2,228 women, aged 24 years or older) who were free of Parkinson disease and dementia in 2012. Probable RBD (pRBD) status was determined by a validated questionnaire (Chinese RBD questionnaire-Hong Kong) in 2012. Potential risk factors-including age, sex, smoking, socioeconomic status, physical activity, obesity, consumption of tea (surrogate for caffeine intake) and alcohol, serum concentrations of lipids and glucose, and chronic disease status-were assessed in 2006. Logistic regression was used to calculate odds ratios and 95% confidence intervals and to test differences in prevalence of pRBD across exposures. RESULTS Prevalence of pRBD was 5.9% in men and 4.1% in women. In the fully adjusted model, risk factors that were significantly associated with a higher risk of having pRBD included lower education level, coal mining and other blue collar occupation, lower physical activity level, diabetes or prediabetes, lower body mass index, head injury, higher low-density lipoprotein level, and chronic olfactory and taste dysfunction. In sensitivity analyses, restricting to pRBD cases with symptom onset within 1 year or excluding coal miners or those with history of head injury generated similar results. CONCLUSION We found several potential risk factors for pRBD, including socioeconomic status, head injury, olfactory and taste dysfunction, and various cardiovascular risk factors. Future prospective studies to establish the temporal relationship between these potential risk factors and RBD are warranted.
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Affiliation(s)
- Janice C Wong
- From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park
| | - Junjuan Li
- From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park
| | - Milena Pavlova
- From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park
| | - Shuohua Chen
- From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park
| | - Aiping Wu
- From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park
| | - Shouling Wu
- From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park.
| | - Xiang Gao
- From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park.
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Naudin M, Mondon K, El-Hage W, Perriot E, Boudjarane M, Desmidt T, Lorette A, Belzung C, Hommet C, Atanasova B. Taste identification used as a potential discriminative test among depression and Alzheimer׳s disease in elderly: A pilot study. Psychiatry Res 2015; 228:228-32. [PMID: 25998001 DOI: 10.1016/j.psychres.2015.03.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 03/08/2015] [Accepted: 03/21/2015] [Indexed: 10/23/2022]
Abstract
Major Depression and Alzheimer׳s disease (AD) are two diseases in the elderly characterized by an overlap of early symptoms including memory and emotional disorders. The identification of specific markers would facilitate their diagnosis. The aim of this study was to identify such markers by investigating gustatory function in depressed and AD patients. We included 20 patients with unipolar major depressive episodes (MDE), 20 patients with mild to moderate AD and 24 healthy individuals. We investigated the cognitive profile (depression, global cognitive efficiency and social/physical anhedonia) and gustatory function (ability to identify four basic tastes and to judge their intensity and hedonic value) in all participants. We found that AD patients performed worse than healthy participants in the taste identification test (for the analysis of all tastants together); however, this was not the case for depressed patients. We found no significant differences among the three groups in their ability to evaluate the intensity and hedonic value of the four tastes. Overall, our findings suggest that a taste identification test may be useful to distinguish AD and healthy controls but further investigation is required to conclude whether such a test can differentiate AD and depressed patients.
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Affiliation(s)
- Marine Naudin
- Institut National de la Santé et de la Recherche Médicale (INSERM) U930, équipe 4 "Troubles affectifs", Université François-Rabelais de Tours, 37200 Tours, France
| | - Karl Mondon
- Institut National de la Santé et de la Recherche Médicale (INSERM) U930, équipe 4 "Troubles affectifs", Université François-Rabelais de Tours, 37200 Tours, France; Centre Mémoire de Ressources et de Recherche Région Centre et médecine interne gériatrique, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours, 37044 Tours, France
| | - Wissam El-Hage
- Institut National de la Santé et de la Recherche Médicale (INSERM) U930, équipe 4 "Troubles affectifs", Université François-Rabelais de Tours, 37200 Tours, France; Pôle de Psychiatrie, Clinique Psychiatrique Universitaire, Centre Hospitalier Régional Universitaire de Tours, 37044 Tours, France
| | - Elise Perriot
- Institut National de la Santé et de la Recherche Médicale (INSERM) U930, équipe 4 "Troubles affectifs", Université François-Rabelais de Tours, 37200 Tours, France
| | - Mohamed Boudjarane
- Institut National de la Santé et de la Recherche Médicale (INSERM) U930, équipe 4 "Troubles affectifs", Université François-Rabelais de Tours, 37200 Tours, France
| | - Thomas Desmidt
- Institut National de la Santé et de la Recherche Médicale (INSERM) U930, équipe 4 "Troubles affectifs", Université François-Rabelais de Tours, 37200 Tours, France; Centre Mémoire de Ressources et de Recherche Région Centre et médecine interne gériatrique, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours, 37044 Tours, France
| | - Adrien Lorette
- Centre Mémoire de Ressources et de Recherche Région Centre et médecine interne gériatrique, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours, 37044 Tours, France
| | - Catherine Belzung
- Institut National de la Santé et de la Recherche Médicale (INSERM) U930, équipe 4 "Troubles affectifs", Université François-Rabelais de Tours, 37200 Tours, France
| | - Caroline Hommet
- Institut National de la Santé et de la Recherche Médicale (INSERM) U930, équipe 4 "Troubles affectifs", Université François-Rabelais de Tours, 37200 Tours, France; Centre Mémoire de Ressources et de Recherche Région Centre et médecine interne gériatrique, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours, 37044 Tours, France
| | - Boriana Atanasova
- Institut National de la Santé et de la Recherche Médicale (INSERM) U930, équipe 4 "Troubles affectifs", Université François-Rabelais de Tours, 37200 Tours, France.
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Kai K, Hashimoto M, Amano K, Tanaka H, Fukuhara R, Ikeda M. Relationship between eating disturbance and dementia severity in patients with Alzheimer's disease. PLoS One 2015; 10:e0133666. [PMID: 26266531 PMCID: PMC4534398 DOI: 10.1371/journal.pone.0133666] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 06/30/2015] [Indexed: 11/18/2022] Open
Abstract
Background Eating is one of the most important daily activities in managing patients with dementia. Although various eating disturbance occur as dementia progresses, to our knowledge, most of the studies focused on a part of eating disturbance such as swallowing and appetite. There have been few comprehensive studies including eating habits and food preference in patients with Alzheimer’s disease (AD). The aims of this study were to investigate almost all eating disturbance and to examine the relationship of eating disturbance to dementia stage in AD. Methods A total of 220 patients with AD and 30 normal elderly (NE) subjects were recruited. Eating disturbance was assessed by a comprehensive questionnaire that had been previously validated. Potential relationships between the characteristics of eating disturbance and dementia stage as classified by the Clinical Dementia Rating (CDR) were assessed. Results Overall, 81.4% of patients with AD showed some eating and swallowing disturbance, whereas only 26.7% of the NE subjects had such a disturbance. Even in an early stage, patients with AD had many types of eating disturbance; “Appetite change” was shown in nearly half of the mild AD patients (49.5%). In the moderate stage, the scores of “change of eating habits and food preference” were highest, and in the severe stage “swallowing disturbance” became critical. Conclusion In AD, the relationship of dementia stage to eating disturbance differs according to the type of eating disturbance. The relationships between various eating disturbance and the severity of dementia should be considered.
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Affiliation(s)
- Kyoko Kai
- Department of Neuropsychiatry, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
- Department of Psychiatry, Nozaki Hospital, Miyazaki, Japan
| | - Mamoru Hashimoto
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Koichiro Amano
- Department of Psychiatry, Nozaki Hospital, Miyazaki, Japan
| | - Hibiki Tanaka
- Department of Neuropsychiatry, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
| | - Ryuji Fukuhara
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Manabu Ikeda
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
- * E-mail:
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Wysokiński A, Sobów T, Kłoszewska I, Kostka T. Mechanisms of the anorexia of aging-a review. AGE (DORDRECHT, NETHERLANDS) 2015; 37:9821. [PMID: 26232135 PMCID: PMC5005824 DOI: 10.1007/s11357-015-9821-x] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 07/22/2015] [Indexed: 05/05/2023]
Abstract
Many, even healthy, older people fail to adequately regulate food intake and experience loss of weight. Aging-associated changes in the regulation of appetite and the lack of hunger have been termed as the anorexia of aging. The etiology of the anorexia of aging is multi-factorial and includes a combination of physiological changes associated with aging (decline in smell and taste, reduced central and peripheral drive to eat, delayed gastric emptying), pathological conditions (depression, dementia, somatic diseases, medications and iatrogenic interventions, oral-health status), and social factors (poverty, loneliness). However, exact mechanisms of the anorexia of aging remain to be elucidated. Many neurobiological mechanisms may be secondary to age-related changes in body composition and not associated with anorexia per se. Therefore, further studies on pathophysiological mechanisms of the anorexia of aging should employ accurate measurement of body fat and lean mass. The anorexia of aging is associated with protein-energy malnutrition, sarcopenia, frailty, functional deterioration, morbidity, and mortality. Since this symptom can lead to dramatic consequences, early identification and effective interventions are needed. One of the most important goals in the geriatric care is to optimize nutritional status of the elderly.
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Affiliation(s)
- Adam Wysokiński
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Czechosłowacka 8/10, 92-216, Łódź, Poland,
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Olfactory and gustatory dysfunction in Myasthenia gravis: A study in Turkish patients. J Neurol Sci 2015; 356:188-92. [PMID: 26148933 DOI: 10.1016/j.jns.2015.06.054] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/17/2015] [Accepted: 06/24/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Myasthenia gravis (MG) is commonly viewed as a muscle disorder. Less is known about neurosensory function and dysfunction in MG. We aim to evaluate olfactory and gustatory behavior in Turkish patients with MG, and compare these results with age and sex-matched healthy controls. MATERIAL/METHODS 30 individuals with MG, and 30 healthy volunteers were studied. Olfactory function was studied with the Sniffin' sticks test. Taste strip test was used for studying taste function. The t-test was used for analyzing continuous variables, and the chi-square test for categorical data. Clinical staging and medication status were included in a model analyzed using analysis of variances. RESULTS MG patients showed significantly lower olfactory (p<0.001) and gustatory scores (p<0.001) than the healthy controls. In addition, olfactory loss correlated with the severity of the disease. Medications for MG did not influence these results. CONCLUSION This study replicates the olfactory dysfunction found elsewhere in MG. Further, gustatory dysfunction, an activity unrelated to muscle strength, was also unveiled. Medications used for treating MG must not be blamed for the chemosensory dysfunction found in this neurological disorder.
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Doty RL, Nsoesie MT, Chung I, Osman A, Pawasarat I, Caulfield J, Hurtig H, Silas J, Dubroff J, Duda JE, Ying GS, Tekeli H, Leon-Sarmiento FE. Taste function in early stage treated and untreated Parkinson's disease. J Neurol 2014; 262:547-57. [PMID: 25480568 DOI: 10.1007/s00415-014-7589-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 11/12/2014] [Accepted: 11/15/2014] [Indexed: 10/24/2022]
Abstract
Since brain stem regions associated with early Parkinson's disease (PD) pathology encroach upon those involved in taste function, the ability to taste may be compromised in PD. However, studies on this point have been contradictory. We administered well-validated whole-mouth and regional taste tests that incorporated multiple concentrations of sucrose, citric acid, caffeine, and sodium chloride to 29 early stage PD patients and 29 age-, sex-, and race-matched controls. Electrogustometry was also performed on the anterior tongue. The PD cohort was tested both on and off dopamine-related medications in counterbalanced test sessions. While whole-mouth taste identification test scores for all stimuli were, on average, nominally lower for the PD patients than for the controls, a trend in the opposite direction was noted for the intensity ratings at the lower stimulus concentrations for all stimuli except caffeine. Moreover, regional testing found that PD subjects tended to rate the stimuli, relative to the controls, as more intense on the anterior tongue and less intense on the posterior tongue. No significant associations were evident between taste test scores and UPDRS scores, L-DOPA medication equivalency values, or [(99m)Tc]TRODAT-1 SPECT imaging of dopamine transporter uptake within the striatum and associated regions. Our findings suggest that suprathreshold measures of taste function are influenced by PD and that this disease differentially influences taste function on anterior (CN VII) and posterior (CN IX) tongue regions. Conceivably PD-related damage to CN IX releases central inhibition on CN VII at the level of the brainstem, resulting in enhanced taste intensity on the anterior tongue.
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Affiliation(s)
- Richard L Doty
- Department of Otorhinolaryngology, Head and Neck Surgery, Smell and Taste Center, Perelman School of Medicine, Hospital of the University of Pennsylvania, 5 Ravdin Pavilion, 3400 Spruce Street, Philadelphia, PA, 19104, USA,
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42
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Cecchini MP, Fasano A, Boschi F, Osculati F, Tinazzi M. Taste in Parkinson’s disease. J Neurol 2014; 262:806-13. [DOI: 10.1007/s00415-014-7518-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 09/22/2014] [Accepted: 09/23/2014] [Indexed: 10/24/2022]
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Solemdal K, Møinichen-Berstad C, Mowe M, Hummel T, Sandvik L. Impaired taste and increased mortality in acutely hospitalized older people. Chem Senses 2014; 39:263-9. [PMID: 24448597 DOI: 10.1093/chemse/bjt116] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Taste ability is known to be impaired in elderly and even more so in acutely hospitalized elderly people. To our knowledge, no study has investigated the association between taste impairment and mortality. Our aim was to examine this association in acutely hospitalized older people. In a prospective study, 200 acutely hospitalized elderly people ≥70 years of age were included between November 2009 and October 2010 at the Oslo University Hospital, Norway. Exclusion criteria were cognitive impairment, nursing home residency, and terminal diseases. Comorbidity was registered with the Cumulative Illness Rating Scale, in addition to recording of age, gender, smoking, education, and number of medications. Taste ability was assessed quantitatively with the "taste strips method" in 174 patients (mean age: 84 years). Mortality until 1 January 2012 was obtained from hospital records. Fifty-six patients died during the observation period. The relative risk of death in total taste score quartile 4 compared with total taste score quartile 1 was 0.31 (95% confidence interval [95% CI]: 0.14-0.69, P = 0.004), after adjusting for age, gender, smoking, education, and Cumulative Illness Rating Scale. Adjusted 1-year mortality decreased from 30% in total taste score quartile 1 to 9% in total taste score quartile 4. Thus, impaired taste appears to be strongly associated with mortality in acutely hospitalized elderly people.
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Affiliation(s)
- Kirsten Solemdal
- The Faculty of Dentistry, University of Oslo, PO Box 1109, Blindern, 0317 Oslo, Norway.
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Behrman S, Chouliaras L, Ebmeier KP. Considering the senses in the diagnosis and management of dementia. Maturitas 2014; 77:305-10. [PMID: 24495787 DOI: 10.1016/j.maturitas.2014.01.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 01/07/2014] [Indexed: 10/25/2022]
Abstract
Associations between dementia and impairments in hearing, vision, olfaction and (to a lesser degree) taste have been identified. Hearing impairment has been shown to precede cognitive decline, but it is not clear if the hearing loss is an early marker of dementia or a modifiable risk factor. Olfactory impairment is seen in many neurodegenerative conditions, but it has been shown that those with dementia have particular difficulties with the recognition and identification of odours rather than the detection, suggesting a link to impairment of higher cognitive function. Olfactory impairment has been shown to be predictive of conversion from mild cognitive impairment to Alzheimer's disease with 85.2% sensitivity. As cognitive function deteriorates, the world is experienced at a sensory level, with reduced ability to integrate the sensory experiences to understand the context. Thus, people with dementia are very sensitive to sensory experiences and their environment needs to be managed carefully to make it understandable, comfortable, and (if possible) therapeutic. Light can be used to stabilise the circadian rhythm, which may be disturbed in dementia. Music therapy, aromatherapy, massage and multisensory stimulation are recommended by NICE for the management of behavioural and psychological symptoms of dementia (BPSD), although the mechanisms behind such interventions are poorly understood and evidence is limited. Sensory considerations are likely to play a greater role in dementia care in the future, with the development of purpose-built dementia care facilities and the focus on non-pharmacological management strategies for BPSD.
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Affiliation(s)
- Sophie Behrman
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Leonidas Chouliaras
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Klaus P Ebmeier
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.
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Aliani M, Udenigwe CC, Girgih AT, Pownall TL, Bugera JL, Eskin MNA. Aroma and taste perceptions with Alzheimer disease and stroke. Crit Rev Food Sci Nutr 2013; 53:760-9. [PMID: 23638935 DOI: 10.1080/10408398.2011.559557] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Chemosensory disorders of smell or taste in humans have been attributed to various physiological and environmental factors including aging and disease conditions. Aroma and taste greatly condition our food preference, selection and, consumption; the decreased appetite in patients with known neurodegenerative diseases may lead to dietary restrictions that could negatively impact nutritional and health status. The decline in olfactory and gustatory systems in patients with Alzheimer disease and various types of stroke are described.
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Affiliation(s)
- Michel Aliani
- Human Nutritional Sciences, Faculty of Human Ecology, University of Manitoba, Winnipeg, Manitoba, Canada.
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Cecchini MP, Osculati F, Ottaviani S, Boschi F, Fasano A, Tinazzi M. Taste performance in Parkinson’s disease. J Neural Transm (Vienna) 2013; 121:119-22. [DOI: 10.1007/s00702-013-1089-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 09/02/2013] [Indexed: 11/28/2022]
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Aliani M, Udenigwe CC, Girgih AT, Pownall TL, Bugera JL, Eskin MNA. Zinc deficiency and taste perception in the elderly. Crit Rev Food Sci Nutr 2013; 53:245-50. [PMID: 23301822 DOI: 10.1080/10408398.2010.527023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Taste, one of the major senses in humans, is the ability to detect the flavor of substances such as food, certain minerals, and poisons. Taste distortions in human beings have been attributed to various physiological and environmental factors including aging and disease conditions. Given the fact that taste is one of the most important factors in food preference, selection, and consumption, the decreased appetite in the elderly, probably due to disease conditions, may lead to dietary restrictions that could negatively impact nutritional and health status. The role of zinc on taste distortion in the elderly population and taste impairment are described. Although several studies demonstrate the associative nature of taste degeneration with age, additional investigations are required to clarify the mechanisms by which taste perception is altered with age.
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Affiliation(s)
- Michel Aliani
- Human Nutritional Sciences, Faculty of Human Ecology, University of Manitoba, Winnipeg, Manitoba, Canada.
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Sienkiewicz-Jarosz H, Scinska A, Swiecicki L, Lipczynska-Lojkowska W, Kuran W, Ryglewicz D, Kolaczkowski M, Samochowiec J, Bienkowski P. Sweet liking in patients with Parkinson's disease. J Neurol Sci 2013; 329:17-22. [PMID: 23561981 DOI: 10.1016/j.jns.2013.03.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 02/13/2013] [Accepted: 03/06/2013] [Indexed: 01/13/2023]
Abstract
Pleasant tastes and odors are considered phylogenetically old natural rewards and their hedonic evaluation is regarded as a good indicator of the reward system function. The primary aim of the present study was to compare pleasantness ratings of sucrose solutions (1-30%, w/w) and sweet liking/disliking status in 20 patients with Parkinson's disease (PD) and in 20 age-matched healthy controls. In addition, basic sensory aspects of gustatory (intensity ratings, electrogustometric thresholds) and olfactory function (identification abilities in the Sniffin' Stick test) were assessed in both groups. The number of odors rated as pleasant, unpleasant, and neutral was also compared. As expected, the PD patients showed a significant impairment in olfactory identification abilities. There were no differences between the PD patients and controls in electrogustometric thresholds. Rated intensity of higher sucrose concentrations did not differ between the groups. The PD patients tended to rate water taste as more intense in comparison with the controls. Pleasantness ratings of sucrose solutions, the proportion of subjects rating 30% sucrose as the most pleasant (sweet likers), and the number of odors rated as pleasant did not differ between the study groups. The present results suggest that PD does not lead to any obvious alterations in pleasantness ratings of chemosensory stimuli. The study requires replication in larger samples.
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Lang CJG, Schwandner K, Hecht M. Do patients with motor neuron disease suffer from disorders of taste or smell? ACTA ACUST UNITED AC 2011; 12:368-71. [DOI: 10.3109/17482968.2011.579133] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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50
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Kim HJ, Jeon BS, Lee JY, Cho YJ, Hong KS, Cho JY. Taste function in patients with Parkinson disease. J Neurol 2010; 258:1076-9. [PMID: 21193922 DOI: 10.1007/s00415-010-5884-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2010] [Revised: 12/13/2010] [Accepted: 12/14/2010] [Indexed: 11/30/2022]
Abstract
Despite the important role of taste function in nutrition and health, little is known about changes in taste function caused by Parkinson disease (PD). The taste function of 31 PD patients and 29 healthy controls was assessed quantitatively using filter paper taste strip tests (TSTs) impregnated with four basic taste qualities at four different concentrations. The mean TST score was significantly lower in PD patients, as a consequence of taste impairment in the female PD patients (it did not differ significantly in males), which was likely to be attributable to the lower Mini-Mental State Examination score in patients with PD than in controls in women. TST scores in PD patients were not correlated with patient age, duration, or severity of their PD, or olfactory function. The findings of our study suggest that taste dysfunction should be included in the list of nonmotor symptoms of PD.
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Affiliation(s)
- Han-Joon Kim
- Department of Neurology, Movement Disorder Center, Neuroscience Research Institute, BK21, College of Medicine, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea
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