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Berek K, Hegen H, Auer M, Barket R, Di Pauli F, Hocher J, Krajnc N, Zinganell A, Deisenhammer F, Berger T, Bsteh G. Olfactory threshold as a biomarker of long-term relapse activity in multiple sclerosis. Mult Scler Relat Disord 2024; 85:105545. [PMID: 38479044 DOI: 10.1016/j.msard.2024.105545] [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: 01/23/2024] [Revised: 02/25/2024] [Accepted: 03/07/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Olfactory threshold (OT) is a marker of short-term inflammatory activity in multiple sclerosis (MS). OBJECTIVE To investigate whether OT predicts long-term MS clinical disease course. METHODS This was a 6-year prospective longitudinal study on MS patients at the MS clinic Innsbruck. Clinical visits assessing the occurrence of relapses, Expanded Disability Status Scale (EDSS) scores, and disease-modifying treatment (DMT), were conducted biannually. OT testing was performed at baseline (BL), year 1 (Y1), year 2 (Y2) and year 6 (Y6), using the threshold subscore of the "Sniffin' Sticks" test. Cognitive function was assessed by the Symbol Digit Modalities Test. RESULTS Of 139 MS patients, 92 were eligible for Y6 follow-up. 68% experienced relapses, 53% EDSS worsening, 29% progression independent of relapse activity (PIRA) and 41% cognitive deterioration. OT scores were lower at BL, Y1 and Y2 in patients requiring DMT escalation. In multivariable analysis, higher OT scores at BL, Y1, Y2 and Y6 were associated with lower risk of relapse (hazard ratio, HR: 0.65-0.92) and EDSS worsening (HR: 0.86-0.89), while no associations were found for PIRA and cognitive deterioration. CONCLUSIONS OT is a potential surrogate marker for long-term inflammatory disease activity and DMT failure in MS.
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Affiliation(s)
- Klaus Berek
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Harald Hegen
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Auer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Robert Barket
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Franziska Di Pauli
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Jakob Hocher
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Nik Krajnc
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Anne Zinganell
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Thomas Berger
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Gabriel Bsteh
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria.
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Echevarria‐Cooper SL, Ho EH, Gershon RC, Weintraub S, Kahnt T. Evaluation of the NIH Toolbox Odor Identification Test across normal cognition, amnestic mild cognitive impairment, and dementia due to Alzheimer's disease. Alzheimers Dement 2024; 20:288-300. [PMID: 37603693 PMCID: PMC10843554 DOI: 10.1002/alz.13426] [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: 03/21/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 08/23/2023]
Abstract
INTRODUCTION Olfactory decline is associated with cognitive decline in aging, amnestic mild cognitive impairment (aMCI), and amnestic dementia associated with Alzheimer's disease neuropathology (ADd). The National Institutes of Health Toolbox Odor Identification Test (NIHTB-OIT) may distinguish between these clinical categories. METHODS We compared NIHTB-OIT scores across normal cognition (NC), aMCI, and ADd participants (N = 389, ≥65 years) and between participants positive versus negative for AD biomarkers and the APOE ε4 allele. RESULTS NIHTB-OIT scores decreased with age (p < 0.001) and were lower for aMCI (p < 0.001) and ADd (p < 0.001) compared to NC participants, correcting for age and sex. The NIHTB-OIT detects aMCI (ADd) versus NC participants with 49.4% (56.5%) sensitivity and 88.8% (89.5%) specificity. NIHTB-OIT scores were lower for participants with positive AD biomarkers (p < 0.005), but did not differ based on the APOE ε4 allele (p > 0.05). DISCUSSION The NIHTB-OIT distinguishes clinically aMCI and ADd participants from NC participants. HIGHLIGHTS National Institutes of Health Toolbox Odor Identification Test (NIHTB-OIT) discriminated normal controls from mild cognitive impairment. NIHTB-OIT discriminated normal controls from Alzheimer's disease dementia. Rate of olfactory decline with age was similar across all diagnostic categories. NIHTB-OIT scores were lower in participants with positive Alzheimer's biomarker tests. NIHTB-OIT scores did not differ based on APOE genotype.
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Affiliation(s)
| | - Emily H. Ho
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Richard C. Gershon
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's DiseaseNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Thorsten Kahnt
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Cellular and Neurocomputational Systems BranchNational Institute on Drug Abuse Intramural Research ProgramBaltimoreMarylandUSA
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Berek K, Hegen H, Auer M, Barket R, Di Pauli F, Hocher J, Krajnc N, Zinganell A, Deisenhammer F, Berger T, Bsteh G. Odour discrimination and identification as a biomarker of long-term disability worsening in multiple sclerosis. Mult Scler 2024; 30:55-62. [PMID: 37850472 PMCID: PMC10782652 DOI: 10.1177/13524585231201093] [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: 06/04/2023] [Revised: 08/06/2023] [Accepted: 08/23/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Odour discrimination and identification (DI) are markers associated with disability worsening and neuroaxonal damage in multiple sclerosis (MS). OBJECTIVE The main objective of this research is to investigate whether longitudinal change of DI predicts long-term MS disease course. METHODS This is a 6-year prospective longitudinal study on MS patients at the MS Clinic Innsbruck. Clinical, bi-annual visits assessed patients' history and Expanded Disability Status Scale (EDSS) score. DI and cognitive function were assessed at baseline (BL), Year 1 (Y1), Year 2 (Y2) and Year 6 (Y6) by the 'Sniffin' Sticks'/Symbol Digit Modalities Test. RESULTS Around 92 of 139 patients were available for Y6 follow-up. Mean DI scores significantly decreased over time (BL = 27.8, Y1 = 27.5, Y2 = 26.3 and Y6 = 26.3; p < 0.001) and negatively correlated with patients' age (rs = -0.120, p = 0.032) and disease duration (rs = -0.103, p = 0.041). Multivariable regression analyses revealed that lower absolute DI scores and larger DI score loss over time were associated with higher probability of EDSS worsening (per -1 point: hazard ratio (HR) = 1.40 (1.16-1.68) and 2.34 (1.27-4.21)), progression independent of relapse activity (PIRA) (HR = 1.49 (1.20-1.85) and 2.22 (1.33-3.31)) and cognitive deterioration (HR = 1.75 (1.35-2.27) and 4.29 (1.26-2.84)) at Y6, but not with time to first relapse. CONCLUSION Odour DI is an irreversible marker of neuroaxonal damage, associated with PIRA, cognitive deterioration and EDSS worsening.
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Affiliation(s)
- Klaus Berek
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Harald Hegen
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Auer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Robert Barket
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Franziska Di Pauli
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Jakob Hocher
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Nik Krajnc
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Anne Zinganell
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Thomas Berger
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Gabriel Bsteh
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
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Schubert C, Schulz K, Träger S, Plath AL, Omriouate A, Rosenkranz SC, Morellini F, Friese MA, Hirnet D. Neuronal Adenosine A1 Receptor is Critical for Olfactory Function but Unable to Attenuate Olfactory Dysfunction in Neuroinflammation. Front Cell Neurosci 2022; 16:912030. [PMID: 35846561 PMCID: PMC9279574 DOI: 10.3389/fncel.2022.912030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
Adenine nucleotides, such as adenosine triphosphate (ATP), adenosine diphosphate (ADP), as well as the nucleoside adenosine are important modulators of neuronal function by engaging P1 and P2 purinergic receptors. In mitral cells, signaling of the G protein-coupled P1 receptor adenosine 1 receptor (A1R) affects the olfactory sensory pathway by regulating high voltage-activated calcium channels and two-pore domain potassium (K2P) channels. The inflammation of the central nervous system (CNS) impairs the olfactory function and gives rise to large amounts of extracellular ATP and adenosine, which act as pro-inflammatory and anti-inflammatory mediators, respectively. However, it is unclear whether neuronal A1R in the olfactory bulb modulates the sensory function and how this is impacted by inflammation. Here, we show that signaling via neuronal A1R is important for the physiological olfactory function, while it cannot counteract inflammation-induced hyperexcitability and olfactory deficit. Using neuron-specific A1R-deficient mice in patch-clamp recordings, we found that adenosine modulates spontaneous dendro-dendritic signaling in mitral and granule cells via A1R. Furthermore, neuronal A1R deficiency resulted in olfactory dysfunction in two separate olfactory tests. In mice with experimental autoimmune encephalomyelitis (EAE), we detected immune cell infiltration and microglia activation in the olfactory bulb as well as hyperexcitability of mitral cells and olfactory dysfunction. However, neuron-specific A1R activity was unable to attenuate glutamate excitotoxicity in the primary olfactory bulb neurons in vitro or EAE-induced olfactory dysfunction and disease severity in vivo. Together, we demonstrate that A1R modulates the dendro-dendritic inhibition (DDI) at the site of mitral and granule cells and impacts the processing of the olfactory sensory information, while A1R activity was unable to counteract inflammation-induced hyperexcitability.
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Affiliation(s)
- Charlotte Schubert
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kristina Schulz
- Division of Neurophysiology, Institute of Cell and Systems Biology of Animals, University of Hamburg, Hamburg, Germany
| | - Simone Träger
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anna-Lena Plath
- Research Group Behavioral Biology, Center for Molecular Neurobiology (ZMNH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Asina Omriouate
- Research Group Behavioral Biology, Center for Molecular Neurobiology (ZMNH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sina C. Rosenkranz
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fabio Morellini
- Research Group Behavioral Biology, Center for Molecular Neurobiology (ZMNH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Manuel A. Friese
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- *Correspondence: Manuel A. Friese,
| | - Daniela Hirnet
- Division of Neurophysiology, Institute of Cell and Systems Biology of Animals, University of Hamburg, Hamburg, Germany
- Daniela Hirnet,
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Mirmosayyeb O, Ebrahimi N, Barzegar M, Afshari-Safavi A, Bagherieh S, Shaygannejad V. Olfactory dysfunction in patients with multiple sclerosis; A systematic review and meta-analysis. PLoS One 2022; 17:e0266492. [PMID: 35439251 PMCID: PMC9017946 DOI: 10.1371/journal.pone.0266492] [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: 01/07/2022] [Accepted: 03/22/2022] [Indexed: 01/02/2023] Open
Abstract
Background The importance and prevalence of olfactory dysfunction is recently gaining attention in patients with multiple sclerosis (MS) as a result of their chronic inflammatory disease, yet different prevalence rates are reported for it. Therefore, we have designed this systematic review to estimate the pooled prevalence of olfactory dysfunction in patients with MS. To our knowledge, this is the first systematic review and meta-analysis on the prevalence of olfactory dysfunction in MS patients. Methods We searched PubMed, Scopus, EMBASE, Web of Science, ProQuest, and gray literature including references from the identified studies, review studies, and conference abstracts which were published up to January 2021. Articles that were relevant to our topic and could provide information regarding the prevalence of olfactory dysfunction, or the scores of smell threshold, discrimination, or identification (TDI) among MS patients and healthy individuals were included. The pooled prevalence was calculated using a random-effects model and a funnel plot and Egger’s regression test were used to see publication bias. Results The literature search found 1630 articles. After eliminating duplicates, 897 articles remained. Two conference abstracts were included for final analysis. A total of 1099 MS cases and 299 MS patients with olfactory dysfunction were included in the analysis. The pooled prevalence of olfactory dysfunction in the included studies was 27.2%. Also, the overall TDI score in MS patients was lower than that in the control group, and the level of Threshold, Discrimination, and Identification per se were lower in MS compared with control respectively. Conclusion The results of this systematic review show that the prevalence of olfactory dysfunction in MS patients is high and more attention needs to be drawn to this aspect of MS.
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Affiliation(s)
- Omid Mirmosayyeb
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narges Ebrahimi
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahdi Barzegar
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Afshari-Safavi
- Department of Biostatistics and Epidemiology, Faculty of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Sara Bagherieh
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- * E-mail:
| | - Vahid Shaygannejad
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Patel ZM, Holbrook EH, Turner JH, Adappa ND, Albers MW, Altundag A, Appenzeller S, Costanzo RM, Croy I, Davis GE, Dehgani-Mobaraki P, Doty RL, Duffy VB, Goldstein BJ, Gudis DA, Haehner A, Higgins TS, Hopkins C, Huart C, Hummel T, Jitaroon K, Kern RC, Khanwalkar AR, Kobayashi M, Kondo K, Lane AP, Lechner M, Leopold DA, Levy JM, Marmura MJ, Mclelland L, Miwa T, Moberg PJ, Mueller CA, Nigwekar SU, O'Brien EK, Paunescu TG, Pellegrino R, Philpott C, Pinto JM, Reiter ER, Roalf DR, Rowan NR, Schlosser RJ, Schwob J, Seiden AM, Smith TL, Soler ZM, Sowerby L, Tan BK, Thamboo A, Wrobel B, Yan CH. International consensus statement on allergy and rhinology: Olfaction. Int Forum Allergy Rhinol 2022; 12:327-680. [PMID: 35373533 DOI: 10.1002/alr.22929] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/01/2021] [Accepted: 11/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O). METHODS Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus. RESULTS The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies. CONCLUSION This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.
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Affiliation(s)
- Zara M Patel
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Eric H Holbrook
- Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Justin H Turner
- Otolaryngology, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Nithin D Adappa
- Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark W Albers
- Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Aytug Altundag
- Otolaryngology, Biruni University School of Medicine, İstanbul, Turkey
| | - Simone Appenzeller
- Rheumatology, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Richard M Costanzo
- Physiology and Biophysics and Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Ilona Croy
- Psychology and Psychosomatic Medicine, TU Dresden, Dresden, Germany
| | - Greg E Davis
- Otolaryngology, Proliance Surgeons, Seattle and Puyallup, Washington, USA
| | - Puya Dehgani-Mobaraki
- Associazione Naso Sano, Umbria Regional Registry of Volunteer Activities, Corciano, Italy
| | - Richard L Doty
- Smell and Taste Center, Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Valerie B Duffy
- Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | | | - David A Gudis
- Otolaryngology, Columbia University Irving Medical Center, New York, USA
| | - Antje Haehner
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | - Thomas S Higgins
- Otolaryngology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Claire Hopkins
- Otolaryngology, Guy's and St. Thomas' Hospitals, London Bridge Hospital, London, UK
| | - Caroline Huart
- Otorhinolaryngology, Cliniques universitaires Saint-Luc, Institute of Neuroscience, Université catholgique de Louvain, Brussels, Belgium
| | - Thomas Hummel
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | | | - Robert C Kern
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ashoke R Khanwalkar
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Masayoshi Kobayashi
- Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Kenji Kondo
- Otolaryngology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Andrew P Lane
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matt Lechner
- Otolaryngology, Barts Health and University College London, London, UK
| | - Donald A Leopold
- Otolaryngology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Joshua M Levy
- Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael J Marmura
- Neurology Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lisha Mclelland
- Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Takaki Miwa
- Otolaryngology, Kanazawa Medical University, Ishikawa, Japan
| | - Paul J Moberg
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Sagar U Nigwekar
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Erin K O'Brien
- Otolaryngology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Teodor G Paunescu
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Carl Philpott
- Otolaryngology, University of East Anglia, Norwich, UK
| | - Jayant M Pinto
- Otolaryngology, University of Chicago, Chicago, Illinois, USA
| | - Evan R Reiter
- Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - David R Roalf
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nicholas R Rowan
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rodney J Schlosser
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - James Schwob
- Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Allen M Seiden
- Otolaryngology, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - Timothy L Smith
- Otolaryngology, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Zachary M Soler
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - Leigh Sowerby
- Otolaryngology, University of Western Ontario, London, Ontario, Canada
| | - Bruce K Tan
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andrew Thamboo
- Otolaryngology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bozena Wrobel
- Otolaryngology, Keck School of Medicine, USC, Los Angeles, California, USA
| | - Carol H Yan
- Otolaryngology, School of Medicine, UCSD, La Jolla, California, USA
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Chen C, Kong W, Liang J, Lu J, Chen D, Sun Y, Zhang X, Qing Z, Feng X, Sun L, Zhang B. Impaired olfactory neural circuit in patients with SLE at early stages. Lupus 2021; 30:1078-1085. [PMID: 33858264 DOI: 10.1177/09612033211005556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the changes of olfactory function and odor-induced brain activation in patients with systemic lupus erythematosus (SLE) at early stages compared with healthy controls. MATERIALS AND METHODS Olfactory function and odor-induced brain activation in 12 SLE patients at early stages and 12 age, gender and education matched healthy controls were evaluated using olfactory behavior test and odor-induced task-functional magnetic resonance imaging (task-fMRI). RESULTS No significant differences in olfactory behavior scores (including olfactory threshold, olfactory identification, and olfactory memory) were found in the patients with SLE at early stages compared with the healthy controls, while significantly decreased odor-induced activations in olfactory-related brain regions were observed in the patients. In the SLE group, the patients with better performance in the olfactory threshold test had significantly lower levels of anti-dsDNA antibody. CONCLUSION The current study demonstrated that significant alterations in odor-induced brain activations occurred prior to measurable olfactory decline in SLE at early stages, which provided a new method for early diagnosis of olfactory dysfunction in SLE.
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Affiliation(s)
- Chen Chen
- Department of Radiology, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Wei Kong
- Department of Rheumatology and Immunology, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Jun Liang
- Department of Rheumatology and Immunology, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Jiaming Lu
- Department of Radiology, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Dajie Chen
- Department of Radiology, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yi Sun
- Department of Radiology, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xin Zhang
- Department of Radiology, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhao Qing
- Department of Radiology, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China.,Institute of Brain Science, Nanjing University, Nanjing, China
| | - Xuebing Feng
- Department of Rheumatology and Immunology, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Lingyun Sun
- Department of Rheumatology and Immunology, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Bing Zhang
- Department of Radiology, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China.,Institute of Brain Science, Nanjing University, Nanjing, China
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Thomas DC, Baddireddy SM, Kohli D. Anosmia: A review in the context of coronavirus disease 2019 and orofacial pain. J Am Dent Assoc 2020; 151:696-702. [PMID: 32854871 PMCID: PMC7328601 DOI: 10.1016/j.adaj.2020.06.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 12/23/2022]
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9
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Bsteh G, Steiger R, Tuovinen N, Hegen H, Berek K, Wurth S, Auer M, Di Pauli F, Gizewski ER, Deisenhammer F, Berger T, Scherfler C. Impairment of odor discrimination and identification is associated with disability progression and gray matter atrophy of the olfactory system in MS. Mult Scler 2019; 26:706-715. [PMID: 30895860 PMCID: PMC7232781 DOI: 10.1177/1352458519838205] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Impairment of odor discrimination (D), identification (I), and threshold (T) are characteristic features of multiple sclerosis (MS). OBJECTIVE To identify patterns of gray matter concentration (GMC) associated with different qualities of olfactory function. METHODS Olfactory function (T and combined DI score) was measured by Sniffin' Sticks-Test over 2 years longitudinally, and T1-weighted 3-T magnetic resonance imaging (MRI) was performed in 37 MS patients and 18 matched healthy controls (HCs). Statistical parametric mapping (SPM) was applied to objectively identify changes of voxel-wise-GMC throughout the entire brain volume and to correlate image parameters with odor function. RESULTS SPM localized significant GMC decreases in the anterior cingulum as well as temporomesial and frontobasal brain areas of the MS group compared with HCs, and revealed significant correlations between lower DI scores and GMC decreases in the olfactory gyrus, anterior cingulum, temporal regions including the parahippocampus, and putamen. Contrarily, no correlations were found between T and GMC. Patients with disability progression had significantly lower mean temporomesial/putamen GMC (0.782 vs 0.804, p = 0.004) compared to patients without Expanded Disability Status Scale (EDSS) progression. CONCLUSION Impairment of DI, but not T is associated with GM atrophy in brain regions related to olfactory function. Further studies are warranted to investigate DI scores and temporomesial/putamen GMC as biomarkers for disability progression.
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Affiliation(s)
- Gabriel Bsteh
- Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.,Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ruth Steiger
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria/Neuroimaging Research Core Facility, Medical University of Innsbruck, Innsbruck, Austria
| | - Noora Tuovinen
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria/Neuroimaging Research Core Facility, Medical University of Innsbruck, Innsbruck, Austria
| | - Harald Hegen
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Klaus Berek
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sebastian Wurth
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Auer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Franziska Di Pauli
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Elke R Gizewski
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria/Neuroimaging Research Core Facility, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Thomas Berger
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Scherfler
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria/Neuroimaging Research Core Facility, Medical University of Innsbruck, Innsbruck, Austria
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10
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Carotenuto A, Costabile T, Moccia M, Falco F, Scala M, Russo C, Saccà F, De Rosa A, Lanzillo R, Brescia Morra V. Olfactory function and cognition in relapsing–remitting and secondary-progressive multiple sclerosis. Mult Scler Relat Disord 2019; 27:1-6. [DOI: 10.1016/j.msard.2018.09.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 09/18/2018] [Accepted: 09/21/2018] [Indexed: 10/28/2022]
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11
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Bsteh G, Berek K, Hegen H, Teuchner B, Auer M, Wurth S, Di Pauli F, Deisenhammer F, Berger T. Smelling multiple sclerosis: Different qualities of olfactory function reflect either inflammatory activity or neurodegeneration. Mult Scler 2018; 26:57-68. [PMID: 30465490 DOI: 10.1177/1352458518814113] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Peripapillary retinal nerve fiber layer (pRNFL) thickness and olfactory function are both emerging biomarkers in multiple sclerosis (MS). Impairment of odor identification and discrimination is an irreversible feature of more advanced MS suggested to be associated with neurodegeneration, while olfactory threshold is a transient feature of early, active MS possibly associated with short-term inflammatory disease activity. Objective: The aim of this study was to validate the association of olfactory (dys)function and parameters of MS disease course in a large cohort of MS patients and to correlate olfactory function with pRNFL thickness as a surrogate biomarker of neurodegeneration. Methods: In a cross-sectional design, olfactory function was assessed using the Sniffin’ Sticks test, which quantifies three different qualities of olfactory function (threshold, discrimination, and identification). pRNFL thickness was measured by spectral-domain optical coherence tomography (OCT). Results were correlated with age, sex, disease duration, relapses, Expanded Disability Status Scale (EDSS), cognitive function, depression, smoking, and pRNFL thickness by multivariable linear regression models. Results: We included 260 MS patients (mean age of 35.9 years, 68.7% female). Olfactory threshold correlated significantly with number of relapses in the year prior to assessment and shorter disease duration. Odor discrimination, identification, and their sum score were significantly correlated with longer disease duration, higher EDSS, and reduced cognitive function. pRNFL thickness was associated with identification and discrimination, but not with threshold. Conclusion: Olfactory threshold is a marker of short-term inflammatory relapse activity unrelated to parameters of neurodegeneration, while odor identification and discrimination are markers of neurodegeneration mostly independent of relapse activity. Assessment of olfactory function provides an opportunity to stratify MS patients with regard to inflammation and neurodegeneration.
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Affiliation(s)
- Gabriel Bsteh
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Klaus Berek
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Harald Hegen
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Teuchner
- Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Auer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sebastian Wurth
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Franziska Di Pauli
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Thomas Berger
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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12
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The Effect of Unilateral Concha Bullosa on Olfactory Bulb Volume: an Assessment by Magnetic Resonance Imaging. J Craniofac Surg 2018; 29:400-402. [PMID: 29084110 DOI: 10.1097/scs.0000000000004086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In this study, the authors compared the right and left olfactory bulb volumes by magnetic resonance image findings of patients with unilateral concha bullosa (CB). METHODS The cranial magnetic resonance imaging studies of 24 patients having unilateral CB were reviewed. There were 10 males and 14 females ranging in age from 29 to 51 years (mean age, 29 ± 15.2 years). The volumes of both olfactory bulbs (contralateral and ipsilateral to the concha bullosa side) were calculated by using the computer program. RESULTS The average values for olfactory bulb volumes were 46.57 ± 8.03 mm in the CB side of the nasal cavity and 54.80 ± 10.031 mm in the normal side of the nasal cavity. We found a statistically significant difference in olfactory bulb volume between the contralateral and ipsilateral to the concha bullosa side of the patients (t = -3.08 and P < 0.01 for CB side, t = -3.47 and P < 0.01 for left normal side). CONCLUSION Our results may point out a possible relationship between CB and ipsilateral decreased olfactory bulb volume, yet the exact mechanism still remains unclear. Decreased nasal air flow on the CB side may be attributed to the pathophysiologic mechanism of this finding. Also, the significant reduction in olfactory bulb volumes ipsilateral to CB compared with the contralateral olfactory bulb volumes seems to support our hypothesis.
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13
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Ciurleo R, Bonanno L, De Salvo S, Romeo L, Rifici C, Sessa E, D’Aleo G, Russo M, Bramanti P, Marino S, Caminiti F. Olfactory dysfunction as a prognostic marker for disability progression in Multiple Sclerosis: An olfactory event related potential study. PLoS One 2018; 13:e0196006. [PMID: 29664936 PMCID: PMC5903665 DOI: 10.1371/journal.pone.0196006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 04/04/2018] [Indexed: 11/18/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic inflammatory disease and one of the leading causes of disability in young adults. Functional markers able to predict MS progression are still lacking. It is recognized that olfactory dysfunction may be an early symptom in MS. The aim of this study was to investigate whether alterations in olfactory event-related potentials could play a prognostic role in MS. Thirty patients affected by MS relapsing-remitting underwent an olfactory potential examination (T0). Three years after baseline (T1), 28 of 30 patients were clinically evaluated by expanded disability status scale. In addition, the number of Disease Modifying Therapies (DMTs) and the total number of relapses occurred in the last 3 years were collected. At T1, we observed a negative correlation between presence/absence of olfactory potentials and expanded disability status scale scores (rpb = -0.48; p = 0.009). A significant trend for a negative correlation between presence/absence of olfactory potentials and disease duration (rpb = -0.36; p = 0.06) and total number of relapses (rpb = -0.34; p = 0.08) was found. Only patients with olfactory potential absence showed a significant trend in the difference of the disability status scale (p = 0.06) between T0 and T1. In the sub-group of patients with reduced olfactory potential amplitude, we detected a trend for a negative correlation between the disability status scale and the amplitude of N1-P2 components more marked at T1 (r = -0.52; p = 0.06) than T0 (r = -0.47; p = 0.09). This is the first study that evaluated the prognostic role of olfactory event-related potentials in MS. Our results highlighted that olfactory alterations of MS patients were related to disability progression and, to a lesser extent, disease activity. The analysis of olfactory potential parameters confirmed the involvement in olfactory network damage of inflammatory and/or neurodegeneration processes which could predict the progressive course of the disease.
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Affiliation(s)
- Rosella Ciurleo
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
- * E-mail:
| | - Lilla Bonanno
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
| | | | - Laura Romeo
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
| | | | - Edoardo Sessa
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
| | | | | | | | - Silvia Marino
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
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14
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Atalar AÇ, Erdal Y, Tekin B, Yıldız M, Akdoğan Ö, Emre U. Olfactory dysfunction in multiple sclerosis. Mult Scler Relat Disord 2018. [PMID: 29529530 DOI: 10.1016/j.msard.2018.02.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is a common chronic neurological disease that causes disability. MS can have various clinical manifestations, one of which is olfactory dysfunction. In clinical practice, olfactory disturbances are usually underdiagnosed. The aim of our study is to assess olfactory function and its relationship with MS disease duration, disability and cognition. METHOD We assessed 31 MS patients and 24 healthy controls matched in sex and age at our MS outpatient clinic of the Istanbul Education and Research Hospital Neurology Department. Each subject was interviewed to obtain demographic data. The Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test and Montreal Cognitive Assessment (MOCA) were applied to each participant. RESULTS The CCCRC test scores of the MS patients were lower than those in the control group (p < 0.05). Patients with a longer disease duration and more frequent attacks had lower CCCRC scores (p < 0.05). The Expanded Disability Status Scale scores had no correlation with the CCCRC test scores. The MOCA score was positively correlated with all domains of the olfactory test scores. CONCLUSION This study supports the presence of olfactory dysfunction in early stages of MS and the correlation of cognitive impairment with olfactory dysfunction, even in the early stages of the disease in young and less physically- disabled patients. The assessment of olfaction may be helpful as a surrogate method for tracking disease progression in patients over time.
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Affiliation(s)
- Arife Çimen Atalar
- Neurology Department, Istanbul Education and Research Hospital, Istanbul, Turkey.
| | - Yüksel Erdal
- Neurology Department, Istanbul Education and Research Hospital, Istanbul, Turkey.
| | | | - Muhammed Yıldız
- Otorhinolaryngology Department, Istanbul Education and Research Hospital, Turkey.
| | - Özlem Akdoğan
- Neurology Department, Istanbul Education and Research Hospital, Istanbul, Turkey.
| | - Ufuk Emre
- Neurology Department, Istanbul Education and Research Hospital, Istanbul, Turkey.
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15
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Bombini MF, Peres FA, Lapa AT, Sinicato NA, Quental BR, Pincelli ÁDSM, Amaral TN, Gomes CC, Del Rio AP, Marques-Neto JF, Costallat LTL, Fernandes PT, Cendes F, Rittner L, Appenzeller S. Olfactory function in systemic lupus erythematosus and systemic sclerosis. A longitudinal study and review of the literature. Autoimmun Rev 2018; 17:405-412. [PMID: 29444467 DOI: 10.1016/j.autrev.2018.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 11/28/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND/PURPOSE To evaluate olfactory function in systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and healthy controls over a 2-year period, and to determine the association of olfactory dysfunction with age, disease activity, disease damage, treatment, anxiety and depression symptoms and limbic structures volumes. METHODS Consecutive SLE and SSc patients were enrolled in this study. Clinical, laboratory disease activity and damage were assessed according to diseases specific guidelines. Olfactory functions were evaluated using the Sniffin' Sticks test (TDI). Volumetric magnetic resonance imaging (MRI) was obtained in a 3T Phillips scanner. Amygdalae and hippocampi volumes were analyzed using FreeSurfer® software. RESULTS We included 143 SLE, 57 SSc and 166 healthy volunteers. Olfactory dysfunction was observed in 78 (54.5%) SLE, 35 (59.3%) SSc patients and in 24 (14.45%) controls (p<0.001) at study entry. SLE and SSc patients had significantly lower mean in all three phases (TDI) of the olfactory assessment when compared with healthy volunteers. In SLE, the presence of olfactory dysfunction was associated with older age, disease activity, higher anxiety and depression symptoms score, smaller left hippocampus volume, smaller left and right amygdalae volume and the presence of anti-ribosomal P (anti-P) antibodies. In SSc the presence of olfactory impairment was associated with older age, disease activity, smaller left and right hippocampi volumes and smaller right amygdala volume. Olfactory function was repeated after a 2-year period in 90 SLE, 35 SSc and 62 controls and was stable in all three groups. CONCLUSION Both SLE and SSc patients with longstanding disease had significant reduction in all stages of TDI that maintained stable over a 2-year period. Olfactory dysfunction was associated with age, inflammation and hippocampi and amygdalae volumes. In SLE, additional association with anti-P, anxiety and depression symptoms was observed.
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Affiliation(s)
- Mariana Freschi Bombini
- Physiopathology Graduate Program, School of Medical Sciences, University of Campinas, Brazil; Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil
| | - Fernando Augusto Peres
- Medicine Graduate Program, School of Medical Sciences, University of Campinas, Brazil; Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil
| | - Aline Tamires Lapa
- Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil; Child and Adolescent Health Graduate Program, School of Medical Sciences, University of Campinas, Brazil
| | - Nailú Angélica Sinicato
- Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil; Child and Adolescent Health Graduate Program, School of Medical Sciences, University of Campinas, Brazil
| | - Beatriz Ricato Quental
- Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil
| | - Ágatha de Souza Melo Pincelli
- Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil
| | - Tiago Nardi Amaral
- Medicine Graduate Program, School of Medical Sciences, University of Campinas, Brazil; Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil; Department of Medicine, Rheumatology Unit, School of Medical Sciences, University of Campinas, Brazil
| | | | - Ana Paula Del Rio
- Department of Medicine, Rheumatology Unit, School of Medical Sciences, University of Campinas, Brazil
| | | | - Lilian T L Costallat
- Department of Medicine, Rheumatology Unit, School of Medical Sciences, University of Campinas, Brazil
| | | | - Fernando Cendes
- Medical Imaging Computing Laboratory, School of Electrical and Computer Engineering, University of Campinas, Brazil
| | - Leticia Rittner
- Department of Neurology, School of Medical Sciences, University of Campinas, Brazil
| | - Simone Appenzeller
- Rheumatology Lab, School of Medical Sciences, University of Campinas, Brazil; Autoimmunity Lab School of Medical Sciences, University of Campinas, Brazil; Department of Medicine, Rheumatology Unit, School of Medical Sciences, University of Campinas, Brazil.
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16
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Li LM, Guo HY, Zhao N, Zhang LJ, Zhang N, Liu J, Yang L. Comparison of olfactory function between neuromyelitis optica and multiple sclerosis. Int J Neurosci 2018; 128:772-777. [PMID: 29297712 DOI: 10.1080/00207454.2018.1424152] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Olfactory dysfunction (ODF) has been reported in patients with neuromyelitis optica (NMO) and multiple sclerosis (MS). However, the comparison of olfactory function and olfactory-related gray matter (GM) between patients with NMO and MS needed to be further elucidated. MATERIALS AND METHODS Thirty-seven patients with NMO and 37 with MS were enrolled. Olfactory function was evaluated with a Japanese T&T olfactometer test kit, and the neuroanatomical features of olfactory-related GM were assessed using voxel-based morphometry. RESULTS Olfactory deficits were found in 51.4% of patients with NMO and 40.5% of patients with MS. Patients with NMO with ODF had significantly smaller olfactory bulbs than patients with MS with ODF (p = 0.031). Olfactory-related GM atrophy was found in patients with NMO in several regions of the right orbitofrontal cortex and right superior frontal gyrus; in patients with MS, reduced GM volume was found in the right parahippocampal gyrus and piriform cortex (p < 0.05, cluster size > 200 voxels). CONCLUSIONS Olfactory deficits are common in both NMO and MS. However, the neuroanatomical features related to olfactory deficits differ greatly between the two diseases.
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Affiliation(s)
- Li-Min Li
- a Department of Neurology , Tianjin Neurological Institute, Tianjin Medical University General Hospital , Tianjin , China
| | - Hui-Yue Guo
- a Department of Neurology , Tianjin Neurological Institute, Tianjin Medical University General Hospital , Tianjin , China
| | - Ning Zhao
- b Department of Neurology , Anyang District Hospital of Puyang City , Henan Province , China
| | - Lin-Jie Zhang
- a Department of Neurology , Tianjin Neurological Institute, Tianjin Medical University General Hospital , Tianjin , China
| | - Ningnannan Zhang
- c Tianjin Key Laboratory of Functional Imaging, Department of Radiology , Tianjin Medical University General Hospital , Tianjin , China
| | - Jingchun Liu
- c Tianjin Key Laboratory of Functional Imaging, Department of Radiology , Tianjin Medical University General Hospital , Tianjin , China
| | - Li Yang
- a Department of Neurology , Tianjin Neurological Institute, Tianjin Medical University General Hospital , Tianjin , China
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17
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Rey NL, Wesson DW, Brundin P. The olfactory bulb as the entry site for prion-like propagation in neurodegenerative diseases. Neurobiol Dis 2018; 109:226-248. [PMID: 28011307 PMCID: PMC5972535 DOI: 10.1016/j.nbd.2016.12.013] [Citation(s) in RCA: 178] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/13/2016] [Accepted: 12/15/2016] [Indexed: 02/07/2023] Open
Abstract
Olfactory deficits are present in numerous neurodegenerative disorders and are accompanied by pathology in related brain regions. In several of these disorders, olfactory disturbances appear early and are considered as prodromal symptoms of the disease. In addition, pathological protein aggregates affect olfactory regions prior to other regions, suggesting that the olfactory system might be particularly vulnerable to neurodegenerative diseases. Exposed to the external environment, the olfactory epithelium and olfactory bulb allow pathogen and toxin penetration into the brain, a process that has been proposed to play a role in neurodegenerative diseases. Determining whether the olfactory bulb could be a starting point of pathology and of pathology spread is crucial to understanding how neurodegenerative diseases evolve. We argue that pathological changes following environmental insults contribute to the initiation of protein aggregation in the olfactory bulb, which then triggers the spread of the pathology within the brain by a templating mechanism in a prion-like manner. We review the evidence for the early involvement of olfactory structures in neurodegenerative diseases and the relationship between neuropathology and olfactory function. We discuss the vulnerability and putative underlying mechanisms by which pathology could be initiated in the olfactory bulb, from the entry of pathogens (promoted by increased permeability of the olfactory epithelium with aging or inflammation) to the sensitivity of the olfactory system to oxidative stress and inflammation. Finally, we review changes in protein expression and neural excitability triggered by pathogenic proteins that can promote pathogenesis in the olfactory bulb and beyond.
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Affiliation(s)
- Nolwen L Rey
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI 49503, USA.
| | - Daniel W Wesson
- Department of Neurosciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Patrik Brundin
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI 49503, USA
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18
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Good KP, Tourbier IA, Moberg P, Cuzzocreo JL, Geckle RJ, Yousem DM, Pham DL, Doty RL. Unilateral olfactory sensitivity in multiple sclerosis. Physiol Behav 2016; 168:24-30. [PMID: 27780720 DOI: 10.1016/j.physbeh.2016.10.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 09/27/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
Abstract
It is not known whether lateralized olfactory sensitivity deficits are present in MS. Since projections from the olfactory bulb to the olfactory cortex are largely ipsilateral, and since both functional imaging and psychophysical studies suggest that the right side of the brain may be more involved in olfactory processing than the left, we addressed this issue by administering well-validated tests of odor detection, along with tests of odor identification, to each side of the nose of 73 MS patients and 73 age-, gender-, and race-matched normal controls. We also determined, in 63 of the MS patients, whether correlations were present between the olfactory test measures and MRI-determined lesions in brain regions ipsilateral and contralateral to the nose side that was tested. No significant left:right differences in either olfactory sensitivity or identification were present, although in both cases mean performance was lower in the MS than in the control subjects (ps<0.0001). Scores on the two sides of the nose were positively correlated with one another (threshold r=0.56, p<0.0001; Identification r=0.71, p<0.0001). The percent of MS patients whose bilateral test scores fell below the 10th percentile of controls did not differ between the odor identification and detection threshold tests. Both left and right odor identification and detection test scores were weakly correlated with lesion volumes in temporal and frontal lobe brain regions (r's<0.40). Our findings demonstrate that MS does not differentially influence odor perception on left and right sides of the nose, regardless of whether sensitivity or identification is being measured. They also indicate that tests of odor identification and detection are similarly influenced by MS and that such influences are associated with central brain lesions.
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Affiliation(s)
- Kimberley P Good
- Department of Psychiatry and Department of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Isabelle A Tourbier
- Smell and Taste Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Department of Otorhinolarynology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Paul Moberg
- Smell and Taste Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Department of Otorhinolarynology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Jennifer L Cuzzocreo
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Rena J Geckle
- Department of Radiology, Johns Hopkins Hospital, Baltimore, MD, United States
| | - David M Yousem
- Department of Radiology, Johns Hopkins Hospital, Baltimore, MD, United States
| | - Dzung L Pham
- Center for Neuroscience and Regenerative Medicine, Henry Jackson Foundation, Bethesda, MD, United States
| | - Richard L Doty
- Smell and Taste Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Department of Otorhinolarynology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
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