1
|
Stekic A, Dragic M, Stanojevic J, Zaric Kontic M, Stevanovic I, Zeljkovic Jovanovic M, Mihajlovic K, Nedeljkovic N. Impaired olfactory performance and anxiety-like behavior in a rat model of multiple sclerosis are associated with enhanced adenosine signaling in the olfactory bulb via A 1R, A 2BR, and A 3R. Front Cell Neurosci 2024; 18:1407975. [PMID: 39139401 PMCID: PMC11320153 DOI: 10.3389/fncel.2024.1407975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/02/2024] [Indexed: 08/15/2024] Open
Abstract
The present study shows that animals with experimental autoimmune encephalomyelitis (EAE) exhibit olfactory dysfunction and impaired general cognitive abilities, as well as anxiety-like behavior. Olfactory dysfunction occurs on average at 2 dpi, well before the onset of the first motor signs of EAE (8-10 dpi). After the initial olfactory dysfunction, the EAE animals show a fluctuation in olfactory performance that resembles the relapsing-remitting course of human MS. The study also shows severe neuroinflammation in the olfactory bulb (OB), with numerous infiltrated CD4+ T cells and peripheral macrophages in the superficial OB layers, marked microgliosis, and massive induction of TNF-α, IL-1β, and IL-6. Reduced tyrosine hydroxylase activity in the glomerular layer, pronounced granule cell atrophy, and reduced numbers of type B neuroblasts in the rostral migratory stream also indicate altered plasticity of the neuronal network in the OB. Considering the exceptionally high purinome expression in the OB, the possible involvement of purinergic signaling was also investigated. The study shows that macrophages infiltrating the OB overexpress A3R, while highly reactive microglia overexpress the adenosine-producing enzyme eN/CD73 as well as A2BR, A3R, and P2X4R. Given the simultaneous induction of complement component C3, the results suggest that the microglial cells develop a functional phenotype of phagocytizing microglia. The study also demonstrates transcriptional and translational upregulation of A1R in mitral and tufted cells, which likely influence resting network activity in OB and likely contribute to olfactory dysfunction in EAE. Overall, our study shows that olfactory dysfunction and altered social and cognitive behavior in EAE are associated with increased adenosine signaling via A1R, A2BR, and A3R.
Collapse
Affiliation(s)
- Andjela Stekic
- Laboratory for Neurobiology, Department of General Physiology and Biophysics, Faculty of Biology, University of Belgrade, Belgrade, Serbia
| | - Milorad Dragic
- Laboratory for Neurobiology, Department of General Physiology and Biophysics, Faculty of Biology, University of Belgrade, Belgrade, Serbia
- Vinca Institute of Nuclear Sciences, Institute of National Significance, University of Belgrade, Belgrade, Serbia
| | - Jelena Stanojevic
- Medical Faculty of Military Medical Academy, University of Defense, Belgrade, Serbia
| | - Marina Zaric Kontic
- Department of Molecular Biology and Endocrinology, VINČA Institute of Nuclear Sciences - National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Ivana Stevanovic
- Medical Faculty of Military Medical Academy, University of Defense, Belgrade, Serbia
| | - Milica Zeljkovic Jovanovic
- Laboratory for Neurobiology, Department of General Physiology and Biophysics, Faculty of Biology, University of Belgrade, Belgrade, Serbia
| | - Katarina Mihajlovic
- Laboratory for Neurobiology, Department of General Physiology and Biophysics, Faculty of Biology, University of Belgrade, Belgrade, Serbia
| | - Nadezda Nedeljkovic
- Laboratory for Neurobiology, Department of General Physiology and Biophysics, Faculty of Biology, University of Belgrade, Belgrade, Serbia
| |
Collapse
|
2
|
Gao Z, Danzhen Z, Zhu J, Li Y, Xu Z, Chu L. Vitamin D levels and olfactory dysfunction in multiple sclerosis patients. Int J Neurosci 2024:1-8. [PMID: 38372675 DOI: 10.1080/00207454.2024.2304081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 01/06/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE The objective was to explore the possible relationship between the serum vitamin D level and olfactory impairment in a population of multiple sclerosis (MS) patients in Guizhou, China. METHODS We included 25 patients with MS and 18 healthy controls (HCs) who were recruited from the Affiliated Hospital of Guizhou Medical University from February 2021 to September 2021. The University of Pennsylvania Smell Identification Test (UPSIT) was used to test the patients' sense of smell, and the level of serum 25-hydroxyethylene polyprotein D was measured. RESULTS Serum vitamin D levels and UPSIT scores were significantly different between the MS group and the control group (both p < 0.001). Moreover, a significant positive correlation emerged between vitamin D levels and UPSIT scores in MS patients (r = 0.537, p = 0.021). CONCLUSIONS The serum vitamin D level may be involved in the regulation of olfactory dysfunction in MS patients in Guizhou, China.
Collapse
Affiliation(s)
- Zidan Gao
- School of Clinical Medicine, Soochow University, Suzhou, China
| | - Zhuoma Danzhen
- School of Clinical Medicine, Guizhou Medical University, Gui Yang, China
- Basic Medical College of Guizhou Medical University, Gui Yang, China
| | - Junyu Zhu
- School of Clinical Medicine, Guizhou Medical University, Gui Yang, China
| | - Yao Li
- School of Clinical Medicine, Guizhou Medical University, Gui Yang, China
| | - Zhu Xu
- School of Clinical Medicine, Guizhou Medical University, Gui Yang, China
| | - Lan Chu
- School of Clinical Medicine, Soochow University, Suzhou, China
- School of Clinical Medicine, Guizhou Medical University, Gui Yang, China
- Basic Medical College of Guizhou Medical University, Gui Yang, China
| |
Collapse
|
3
|
Boot E, Levy A, Gaeta G, Gunasekara N, Parkkinen E, Kontaris E, Jacquot M, Tachtsidis I. fNIRS a novel neuroimaging tool to investigate olfaction, olfactory imagery, and crossmodal interactions: a systematic review. Front Neurosci 2024; 18:1266664. [PMID: 38356646 PMCID: PMC10864673 DOI: 10.3389/fnins.2024.1266664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/02/2024] [Indexed: 02/16/2024] Open
Abstract
Olfaction is understudied in neuroimaging research compared to other senses, but there is growing evidence of its therapeutic benefits on mood and well-being. Olfactory imagery can provide similar health benefits as olfactory interventions. Harnessing crossmodal visual-olfactory interactions can facilitate olfactory imagery. Understanding and employing these cross-modal interactions between visual and olfactory stimuli could aid in the research and applications of olfaction and olfactory imagery interventions for health and wellbeing. This review examines current knowledge, debates, and research on olfaction, olfactive imagery, and crossmodal visual-olfactory integration. A total of 56 papers, identified using the PRISMA method, were evaluated to identify key brain regions, research themes and methods used to determine the suitability of fNIRS as a tool for studying these topics. The review identified fNIRS-compatible protocols and brain regions within the fNIRS recording depth of approximately 1.5 cm associated with olfactory imagery and crossmodal visual-olfactory integration. Commonly cited regions include the orbitofrontal cortex, inferior frontal gyrus and dorsolateral prefrontal cortex. The findings of this review indicate that fNIRS would be a suitable tool for research into these processes. Additionally, fNIRS suitability for use in naturalistic settings may lead to the development of new research approaches with greater ecological validity compared to existing neuroimaging techniques.
Collapse
Affiliation(s)
| | - Andrew Levy
- Metabolight Ltd., London, United Kingdom
- Wellcome Centre for Human Neuroimaging, University College, London, United Kingdom
| | - Giuliano Gaeta
- Health and Well-being Centre of Excellence, Givaudan UK Limited, Ashford, United Kingdom
| | - Natalie Gunasekara
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Emilia Parkkinen
- Health and Well-being Centre of Excellence, Givaudan UK Limited, Ashford, United Kingdom
| | - Emily Kontaris
- Health and Well-being Centre of Excellence, Givaudan UK Limited, Ashford, United Kingdom
| | - Muriel Jacquot
- Health and Well-being Centre of Excellence, Givaudan UK Limited, Ashford, United Kingdom
| | - Ilias Tachtsidis
- Metabolight Ltd., London, United Kingdom
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| |
Collapse
|
4
|
Sun D, Wang R, Du Q, Zhang Y, Chen H, Shi Z, Wang X, Zhou H. Causal relationship between multiple sclerosis and cortical structure: a Mendelian randomization study. J Transl Med 2024; 22:83. [PMID: 38245759 PMCID: PMC10800041 DOI: 10.1186/s12967-024-04892-7] [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: 06/29/2023] [Accepted: 01/13/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Observational studies have suggested an association between multiple sclerosis (MS) and cortical structure, but the results have been inconsistent. OBJECTIVE We used two-sample Mendelian randomization (MR) to assess the causal relationship between MS and cortical structure. METHODS MS data as the exposure trait, including 14,498 cases and 24,091 controls, were obtained from the International Multiple Sclerosis Genetics Consortium. Genome-wide association study (GWAS) data for cortical surface area (SAw/nw) and thickness (THw/nw) in 51,665 individuals of European ancestry were obtained from the ENIGMA Consortium. The inverse-variance weighted (IVW) method was used as the primary analysis for MR. Sensitivity analyses were conducted to evaluate heterogeneity and pleiotropy. Enrichment analysis was performed on MR analyses filtered by sensitivity analysis. RESULTS After IVW and sensitivity analysis filtering, only six surviving MR results provided suggestive evidence supporting a causal relationship between MS and cortical structure, including lingual SAw (p = .0342, beta (se) = 5.7127 (2.6969)), parahippocampal SAw (p = .0224, beta (se) = 1.5577 (0.6822)), rostral middle frontal SAw (p = .0154, beta (se) = - 9.0301 (3.7281)), cuneus THw (p = .0418, beta (se) = - 0.0020 (0.0010)), lateral orbitofrontal THw (p = .0281, beta (se) = 0.0025 (0.0010)), and lateral orbitofrontal THnw (p = .0417, beta (se) = 0.0029 (0.0014)). Enrichment analysis suggested that leukocyte cell-related pathways, JAK-STAT signaling pathway, NF-kappa B signaling pathway, cytokine-cytokine receptor interaction, and prolactin signaling pathway may be involved in the effect of MS on cortical morphology. CONCLUSION Our results provide evidence supporting a causal relationship between MS and cortical structure. Enrichment analysis suggests that the pathways mediating brain morphology abnormalities in MS patients are mainly related to immune and inflammation-driven pathways.
Collapse
Affiliation(s)
- Dongren Sun
- Department of Neurology, West China Hospital, Sichuan University, Guo Xuexiang #37, Chengdu, 610041, China
| | - Rui Wang
- Department of Neurology, West China Hospital, Sichuan University, Guo Xuexiang #37, Chengdu, 610041, China
| | - Qin Du
- Department of Neurology, West China Hospital, Sichuan University, Guo Xuexiang #37, Chengdu, 610041, China
| | - Ying Zhang
- Department of Neurology, West China Hospital, Sichuan University, Guo Xuexiang #37, Chengdu, 610041, China
| | - Hongxi Chen
- Department of Neurology, West China Hospital, Sichuan University, Guo Xuexiang #37, Chengdu, 610041, China
| | - Ziyan Shi
- Department of Neurology, West China Hospital, Sichuan University, Guo Xuexiang #37, Chengdu, 610041, China
| | - Xiaofei Wang
- Department of Neurology, West China Hospital, Sichuan University, Guo Xuexiang #37, Chengdu, 610041, China.
| | - Hongyu Zhou
- Department of Neurology, West China Hospital, Sichuan University, Guo Xuexiang #37, Chengdu, 610041, China.
| |
Collapse
|
5
|
Weerasinghe-Mudiyanselage PDE, Kim JS, Shin T, Moon C. Understanding the spectrum of non-motor symptoms in multiple sclerosis: insights from animal models. Neural Regen Res 2024; 19:84-91. [PMID: 37488849 PMCID: PMC10479859 DOI: 10.4103/1673-5374.375307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 07/26/2023] Open
Abstract
Multiple sclerosis is a chronic autoimmune disease of the central nervous system and is generally considered to be a non-traumatic, physically debilitating neurological disorder. In addition to experiencing motor disability, patients with multiple sclerosis also experience a variety of non-motor symptoms, including cognitive deficits, anxiety, depression, sensory impairments, and pain. However, the pathogenesis and treatment of such non-motor symptoms in multiple sclerosis are still under research. Preclinical studies for multiple sclerosis benefit from the use of disease-appropriate animal models, including experimental autoimmune encephalomyelitis. Prior to understanding the pathophysiology and developing treatments for non-motor symptoms, it is critical to characterize the animal model in terms of its ability to replicate certain non-motor features of multiple sclerosis. As such, no single animal model can mimic the entire spectrum of symptoms. This review focuses on the non-motor symptoms that have been investigated in animal models of multiple sclerosis as well as possible underlying mechanisms. Further, we highlighted gaps in the literature to explain the non-motor aspects of multiple sclerosis in experimental animal models, which will serve as the basis for future studies.
Collapse
Affiliation(s)
- Poornima D. E. Weerasinghe-Mudiyanselage
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju, Republic of Korea
| | - Joong-Sun Kim
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju, Republic of Korea
| | - Taekyun Shin
- Department of Veterinary Anatomy, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju, Republic of Korea
| | - Changjong Moon
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR program, Chonnam National University, Gwangju, Republic of Korea
| |
Collapse
|
6
|
Hummel T, Power Guerra N, Gunder N, Hähner A, Menzel S. Olfactory Function and Olfactory Disorders. Laryngorhinootologie 2023; 102:S67-S92. [PMID: 37130532 PMCID: PMC10184680 DOI: 10.1055/a-1957-3267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The sense of smell is important. This became especially clear to patients with infection-related olfactory loss during the SARS-CoV-2 pandemic. We react, for example, to the body odors of other humans. The sense of smell warns us of danger, and it allows us to perceive flavors when eating and drinking. In essence, this means quality of life. Therefore, anosmia must be taken seriously. Although olfactory receptor neurons are characterized by regenerative capacity, anosmia is relatively common with about 5 % of anosmic people in the general population. Olfactory disorders are classified according to their causes (e. g., infections of the upper respiratory tract, traumatic brain injury, chronic rhinosinusitis, age) with the resulting different therapeutic options and prognoses. Thorough history taking is therefore important. A wide variety of tools are available for diagnosis, ranging from short screening tests and detailed multidimensional test procedures to electrophysiological and imaging methods. Thus, quantitative olfactory disorders are easily assessable and traceable. For qualitative olfactory disorders such as parosmia, however, no objectifying diagnostic procedures are currently available. Therapeutic options for olfactory disorders are limited. Nevertheless, there are effective options consisting of olfactory training as well as various additive drug therapies. The consultation and the competent discussion with the patients are of major importance.
Collapse
Affiliation(s)
- T Hummel
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
| | - N Power Guerra
- Rudolf-Zenker-Institut für Experimentelle Chirurgie, Medizinische Universität Rostock, Rostock
| | - N Gunder
- Universitäts-HNO Klinik Dresden, Dresden
| | - A Hähner
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
| | - S Menzel
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
| |
Collapse
|
7
|
Hummel T, T. Liu D, A. Müller C, A. Stuck B, Welge-Lüssen A, Hähner A. Olfactory Dysfunction: Etiology, Diagnosis, and Treatment. DEUTSCHES ARZTEBLATT INTERNATIONAL 2023; 120:146-154. [PMID: 36647581 PMCID: PMC10198165 DOI: 10.3238/arztebl.m2022.0411] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/03/2022] [Accepted: 12/21/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Disorders of the sense of smell have received greater attention because of the frequency with which they occur as a symptom of SARS-CoV-2 infection. Olfactory dysfunction can lead to profound reduction in quality of life and may arise from many different causes. METHODS A selective literature review was conducted with consideration of the current version of the guideline issued by the Association of the Scientific Medical Societies in Germany. RESULTS The cornerstones of diagnosis are the relevant medical history and psychophysical testing of olfactory function using standardized validated tests. Modern treatment strategies are oriented on the cause of the dysfunction. While treatment of the underlying inflammation takes precedence in patients with sinunasal dysosmia, olfactory training is the primary treatment option for other forms of the disorder. The prognosis is determined not only by the cause of the olfactory dysfunction and the patient's age, but also by the olfactory performance as measured at the time of diagnosis. CONCLUSION Options for the treatment of olfactory dysfunction are available but limited, depending on the cause. It is therefore important to carry out a detailed diagnostic work-up and keep the patient informed of the expected course and prognosis.
Collapse
Affiliation(s)
- Thomas Hummel
- Interdisciplinary Center for Smell and Taste, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden
| | - David T. Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, Austria
| | - Christian A. Müller
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, Austria
| | - Boris A. Stuck
- Department of Otorhinolaryngology, Head and Neck Surgery, Giessen and Marburg University Hospital Ltd., Marburg
| | - Antje Welge-Lüssen
- Interdisciplinary Center for Smell and Taste, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden
| | - Antje Hähner
- Department of Otorhinolaryngology, Basel University Hospital, Switzerland
| |
Collapse
|
8
|
Okada K, Kakeda S, Tahara M. Olfactory Dysfunction Reflects Disease Progression in Japanese Patients with Multiple Sclerosis. Intern Med 2022; 61:3181-3187. [PMID: 35400704 PMCID: PMC9683806 DOI: 10.2169/internalmedicine.8541-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective Olfactory dysfunction is an important clinical feature in patients with multiple sclerosis (MS). The incidence and extent of olfactory dysfunction are reportedly higher in secondary progressive (SP) MS than in relapsing and remitting (RR) MS. We investigated the use of olfactory dysfunction for evaluating the disease status of Japanese patients with MS. Methods Olfactory identification was evaluated using the Odor Stick Identification Test for the Japanese (OSIT-J) in patients with RRMS (n=40) and SPMS (n=11) and compared the findings with those of healthy controls (n=40). Patients with RRMS for more than 10 years (L-RRMS, n=10) were included in the RRMS group. The cognitive function was evaluated using the Japanese version of the Wechsler Adult Intelligence Scale, 3rd edition. The third ventricle width (3rd VW) was measured as a marker of central brain atrophy using magnetic resonance imaging. Results SPMS patients had significantly lower OSIT-J scores than RRMS and L-RRMS patients. More SPMS patients had OSIT-J scores below the lower limit of the normal score (LLN) than RRMS patients. The LLN effectively discriminated between RRMS and SPMS (sensitivity 70%, specificity 91.5%, area under the curve 0.933, 95% confidence interval 0.874-1.000). Patients with SPMS had a significantly lower processing speed and larger 3rd VW than those with RRMS or L-RRMS. Conclusion The olfactory dysfunction was worse, along with cognitive impairment and brain atrophy, in SPMS patients than in RRMS patients, independent of disease duration, in our Japanese population. This directly reflected the disease progression and may have been able to distinguish SPMS from RRMS, independent of ethnic and cultural background.
Collapse
Affiliation(s)
- Kazumasa Okada
- Department of Neurology, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Shingo Kakeda
- Department of Diagnostic Radiology, Hirosaki University Graduate School of Medicine, Japan
| | - Masayuki Tahara
- Department of Neurology, Clinical Research Center, National Hospital Organization Utano National Hospital, Japan
| |
Collapse
|
9
|
Printza A, Boziki M, Valsamidis C, Bakirtzis C, Constantinidis J, Grigoriadis N, Triaridis S. Smell as a Disease Marker in Multiple Sclerosis. J Clin Med 2022; 11:jcm11175215. [PMID: 36079145 PMCID: PMC9457284 DOI: 10.3390/jcm11175215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Existing data suggest that people with multiple sclerosis (pwMS) are at an elevated risk for experiencing olfactory impairment. We investigated if smell dysfunction can be used as an MS disease marker. This is a cross-sectional, case−control study. All data were collected prospectively from 171 participants, 115 pwMS and 56 controls (age and sex stratified and matched to the patients), who reported smell, taste, and nasal breathing, and completed the Greek-validated questionnaires for nasal obstruction (NOSE), nasal-symptoms QoL (SNOT-22), and olfaction-associated QoL (QOD). The smell was assessed with the “Sniffin’ sticks” (odor threshold (OT), discrimination (OD), identification (OI) test, and total TDI). We recorded the pwMS disease characteristics (Expanded Disability Status Scale-EDSS, the disease type and duration), cognitive function, emotional status, fatigue, and impact of MS in everyday activities. A TDI < 30.75 (hyposmia) was detected in 30.8% of the patients. The patients’ OD and TDI scores were significantly lower than the controls’ (p = 0.005, and 0.015, respectively). The hyposmia correlated with disease severity and duration. The EDSS score correlated negatively with OD (r = −0.299, p = 0.001) and TDI (r = −0.242, p = 0.01). The disease duration correlated negatively with OD (r = −0.305, p = 0.001, OI (r = −0.253, p = 0.008) and TDI (r = −0.3, p = 0.001). The information processing speed (SDMT) correlated with OD, OT, and TDI (r = 0.302, p = 0.002; r = 0.242, p = 0.016; r = 0.326, p = 0.001). The olfactory function is changing in MS in accordance with disease progression.
Collapse
Affiliation(s)
- Athanasia Printza
- 1st Otolaryngology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA Hospital, 54124 Thessaloniki, Greece
- Correspondence:
| | - Marina Boziki
- 2nd Neurology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA Hospital, 54124 Thessaloniki, Greece
| | - Constantinos Valsamidis
- 1st Otolaryngology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA Hospital, 54124 Thessaloniki, Greece
| | - Christos Bakirtzis
- 2nd Neurology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA Hospital, 54124 Thessaloniki, Greece
| | - Jannis Constantinidis
- 1st Otolaryngology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA Hospital, 54124 Thessaloniki, Greece
| | - Nikolaos Grigoriadis
- 2nd Neurology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA Hospital, 54124 Thessaloniki, Greece
| | - Stefanos Triaridis
- 1st Otolaryngology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA Hospital, 54124 Thessaloniki, Greece
| |
Collapse
|
10
|
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.
Collapse
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,
| |
Collapse
|
11
|
Ercoli T, Masala C, Cadeddu G, Mascia MM, Orofino G, Gigante AF, Solla P, Defazio G, Rocchi L. Does Olfactory Dysfunction Correlate with Disease Progression in Parkinson’s Disease? A Systematic Review of the Current Literature. Brain Sci 2022; 12:brainsci12050513. [PMID: 35624900 PMCID: PMC9139278 DOI: 10.3390/brainsci12050513] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/13/2022] [Accepted: 04/17/2022] [Indexed: 02/06/2023] Open
Abstract
Background. Loss of olfaction is a well-established early feature of Parkinson’s disease (PD). Although olfactory dysfunction has been widely described as a prodromal feature of PD in the literature, whether it can be considered a biomarker of PD progression is still a matter of debate. Objective. The aim of this work is to define the possible relationship between the progression of olfactory dysfunction and other putative clinical hallmarks of PD over time, through a systematic review of the current literature. Methods. We conducted a systematic review of the literature on PubMed from inception to March 2022. We included only longitudinal studies conducted on patients with diagnosis of idiopathic PD who underwent olfactory function testing at baseline and repeated it at least once during follow-up. Results. Among 5740 records identified through database searching, nine longitudinal studies met full criteria and underwent data extraction. Conclusions. Olfaction seemed to decrease over time, albeit with a degree of fluctuation. Moreover, smell detection ability seems to deteriorate more rapidly in the early phase of disease, indicating a possible association with disease progression. More studies are needed to better understand the role of olfaction as a biomarker of PD progression over time.
Collapse
Affiliation(s)
- Tommaso Ercoli
- Department of Medical Sciences and Public Health, Institute of Neurology, University of Cagliari, SS 554 km 4.500, 09042 Cagliari, Italy; (G.C.); (G.D.); (L.R.)
- Correspondence:
| | - Carla Masala
- Department of Biomedical Sciences, University of Cagliari, SP 8 Cittadella Universitaria, 09042 Monserrato, Italy;
| | - Gianluca Cadeddu
- Department of Medical Sciences and Public Health, Institute of Neurology, University of Cagliari, SS 554 km 4.500, 09042 Cagliari, Italy; (G.C.); (G.D.); (L.R.)
| | - Marcello Mario Mascia
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, SS 554 km 4.500, 09042 Cagliari, Italy; (M.M.M.); (G.O.)
| | - Gianni Orofino
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, SS 554 km 4.500, 09042 Cagliari, Italy; (M.M.M.); (G.O.)
| | | | - Paolo Solla
- Unit of Neurology, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Giovanni Defazio
- Department of Medical Sciences and Public Health, Institute of Neurology, University of Cagliari, SS 554 km 4.500, 09042 Cagliari, Italy; (G.C.); (G.D.); (L.R.)
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, SS 554 km 4.500, 09042 Cagliari, Italy; (M.M.M.); (G.O.)
| | - Lorenzo Rocchi
- Department of Medical Sciences and Public Health, Institute of Neurology, University of Cagliari, SS 554 km 4.500, 09042 Cagliari, Italy; (G.C.); (G.D.); (L.R.)
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, SS 554 km 4.500, 09042 Cagliari, Italy; (M.M.M.); (G.O.)
| |
Collapse
|
12
|
Echevarria-Cooper SL, Zhou G, Zelano C, Pestilli F, Parrish TB, Kahnt T. Mapping the Microstructure and Striae of the Human Olfactory Tract with Diffusion MRI. J Neurosci 2022; 42:58-68. [PMID: 34759031 PMCID: PMC8741165 DOI: 10.1523/jneurosci.1552-21.2021] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/30/2021] [Accepted: 10/31/2021] [Indexed: 11/21/2022] Open
Abstract
The human sense of smell plays an important role in appetite and food intake, detecting environmental threats, social interactions, and memory processing. However, little is known about the neural circuity supporting its function. The olfactory tracts project from the olfactory bulb along the base of the frontal cortex, branching into several striae to meet diverse cortical regions. Historically, using diffusion magnetic resonance imaging (dMRI) to reconstruct the human olfactory tracts has been prevented by susceptibility and motion artifacts. Here, we used a dMRI method with readout segmentation of long variable echo-trains (RESOLVE) to minimize image distortions and characterize the human olfactory tracts in vivo We collected high-resolution dMRI data from 25 healthy human participants (12 male and 13 female) and performed probabilistic tractography using constrained spherical deconvolution (CSD). At the individual subject level, we identified the lateral, medial, and intermediate striae with their respective cortical connections to the piriform cortex and amygdala (AMY), olfactory tubercle (OT), and anterior olfactory nucleus (AON). We combined individual results across subjects to create a normalized, probabilistic atlas of the olfactory tracts. We then investigated the relationship between olfactory perceptual scores and measures of white matter integrity, including mean diffusivity (MD). Importantly, we found that olfactory tract MD negatively correlated with odor discrimination performance. In summary, our results provide a detailed characterization of the connectivity of the human olfactory tracts and demonstrate an association between their structural integrity and olfactory perceptual function.SIGNIFICANCE STATEMENT This study provides the first detailed in vivo description of the cortical connectivity of the three olfactory tract striae in the human brain, using diffusion magnetic resonance imaging (dMRI). Additionally, we show that tract microstructure correlates with performance on an odor discrimination task, suggesting a link between the structural integrity of the olfactory tracts and odor perception. Lastly, we generated a normalized probabilistic atlas of the olfactory tracts that may be used in future research to study its integrity in health and disease.
Collapse
Affiliation(s)
- Shiloh L Echevarria-Cooper
- Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611
- The Graduate School, Northwestern University Interdepartmental Neuroscience (NUIN), Evanston, Illinois 60208
| | - Guangyu Zhou
- Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611
| | - Christina Zelano
- Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611
| | - Franco Pestilli
- Department of Psychology, The University of Texas at Austin, Austin, Texas 78712
- Center for Perceptual Systems, The University of Texas at Austin, Austin, Texas 78712
| | - Todd B Parrish
- Department of Radiology, Northwestern University, Chicago, Illinois 60611
| | - Thorsten Kahnt
- Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611
- Department of Psychology, Northwestern University, Weinberg College of Arts and Sciences, Evanston, Illinois 60208
| |
Collapse
|
13
|
Shin T, Ahn M, Kim J, Jung K, Moon C, Kim MD. Visual Dysfunction in Multiple Sclerosis and its Animal Model, Experimental Autoimmune Encephalomyelitis: a Review. Mol Neurobiol 2021; 58:3484-3493. [PMID: 33745114 DOI: 10.1007/s12035-021-02355-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/09/2021] [Indexed: 01/09/2023]
Abstract
Visual disabilities in central nervous system autoimmune diseases such as multiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE), are important symptoms. Past studies have focused on neuro-inflammatory changes and demyelination in the white matter of the brain and spinal cord. In MS, neuro-inflammatory lesions have been diagnosed in the visual pathway; the lesions may perturb visual function. Similarly, neuropathological changes in the retina and optic nerves have been found in animals with chronic EAE. Although the retina and optic nerves are immunologically privileged sites via the blood-retina barrier and blood-brain barrier, respectively, inflammation can occur via other routes, such as the uvea (e.g., iris and choroid) and cerebrospinal fluid in the meninges. This review primarily addresses the direct involvement of the blood-retina barrier and the blood-brain barrier in the development of retinitis and optic neuritis in EAE models. Additional routes, including pro-inflammatory mediator-filled choroidal and subarachnoid spaces, are also discussed with respect to their roles in EAE-induced visual disability and as analogues of MS in humans.
Collapse
Affiliation(s)
- Taekyun Shin
- College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju, 63243, Republic of Korea.
| | - Meejung Ahn
- Department of Animal Science, College of Life Science, Sangji University, Wonju, 26339, Republic of Korea
| | - Jeongtae Kim
- Department of Anatomy, Kosin University College of Medicine, Busan, 43267, Republic of Korea
| | - Kyungsook Jung
- Functional Biomaterials Research Center, Korea Research Institute of Bioscience and Biotechnology, 181 Ipsin-gil, Jeongeup-si, Jeonbuk, 56212, Republic of Korea
| | - Changjong Moon
- Department of Veterinary Anatomy, College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Moon-Doo Kim
- Department of Psychiatry, School of Medicine, Jeju National University, Jeju, 63241, Republic of Korea
| |
Collapse
|
14
|
The Olfactory System as Marker of Neurodegeneration in Aging, Neurological and Neuropsychiatric Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136976. [PMID: 34209997 PMCID: PMC8297221 DOI: 10.3390/ijerph18136976] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/19/2021] [Accepted: 06/24/2021] [Indexed: 12/14/2022]
Abstract
Research studies that focus on understanding the onset of neurodegenerative pathology and therapeutic interventions to inhibit its causative factors, have shown a crucial role of olfactory bulb neurons as they transmit and propagate nerve impulses to higher cortical and limbic structures. In rodent models, removal of the olfactory bulb results in pathology of the frontal cortex that shows striking similarity with frontal cortex features of patients diagnosed with neurodegenerative disorders. Widely different approaches involving behavioral symptom analysis, histopathological and molecular alterations, genetic and environmental influences, along with age-related alterations in cellular pathways, indicate a strong correlation of olfactory dysfunction and neurodegeneration. Indeed, declining olfactory acuity and olfactory deficits emerge either as the very first symptoms or as prodromal symptoms of progressing neurodegeneration of classical conditions. Olfactory dysfunction has been associated with most neurodegenerative, neuropsychiatric, and communication disorders. Evidence revealing the dual molecular function of the olfactory receptor neurons at dendritic and axonal ends indicates the significance of olfactory processing pathways that come under environmental pressure right from the onset. Here, we review findings that olfactory bulb neuronal processing serves as a marker of neuropsychiatric and neurodegenerative disorders.
Collapse
|
15
|
Arici Duz O, Saatci O, Karakulak EZ, Birday E, Hanoglu L. Olfactory Dysfunction and Cognition in Radiologically Isolated Syndrome and Relapsing-Remitting Multiple Sclerosis. Eur Neurol 2021; 84:175-182. [PMID: 33831865 DOI: 10.1159/000514433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/09/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a neuroinflammatory, neurodegenerative, demyelinating disease that causes cognitive, olfactory, and other neurological dysfunctions. Radiologically Isolated Syndrome (RIS), in which only radiological findings are monitored, is accepted as the preclinical stage of demyelinating disease and is considered an important period for disease pathology. Therefore, in this study, we aimed to evaluate the olfactory and cognitive functions and their clinical correlation in RIS and Relapsing-Remitting MS (RRMS) patients and a healthy control group. METHODS Our study included 10 RRMS patients, 10 RIS patients, and 10 healthy controls. We conducted an olfactor evaluation via the "Sniffin' Sticks" test. The subjects underwent a neuropsychometric test battery to evaluate cognitive functions, including memory, visuospatial, and executive functions. Depression was evaluated using the Beck depression scale. Fatigue and daily life activity were evaluated using the Fatigue Severity Scale (FSS) and the 36-Item Short Form Survey (SF-36), respectively. Disability assessment was done with the Expanded Disability Status Scale (EDSS). RESULTS RRMS and RIS patients' olfactory test scores were significantly different from those in the control group (p < 0.05). There was a significant difference between the odor threshold scores of patients in the RRMS and RIS groups. There was a significant correlation between memory-oriented cognitive tests and olfactory tests in the RRMS and RIS groups. CONCLUSION Olfactory dysfunction can be seen in RIS patients, like in RRMS patients. Cognitive and olfactory dysfunction may be together a sign of degeneration in demyelinating diseases.
Collapse
Affiliation(s)
- Ozge Arici Duz
- Department of Neurology, Istanbul Medipol University, Istanbul, Turkey
| | - Ozlem Saatci
- Department of Otorhinolaryngology, Sancaktepe Education and Research Hospital Ministry of Health Sancaktepe Sehit Prof.Dr. Ilhan Varank Training And Research Hospital, Istanbul, Turkey
| | | | - Erkingul Birday
- Department of Neurology, Istanbul Medipol University, Istanbul, Turkey
| | - Lutfu Hanoglu
- Department of Neurology, Istanbul Medipol University, Istanbul, Turkey
| |
Collapse
|
16
|
Samancı B, Şahin E, Şen C, Samancı Y, Sezgin M, Emekli S, Kocasoy Orhan E, Orhan KS, Baykan B. Olfactory dysfunction in patients with cluster headache. Eur Arch Otorhinolaryngol 2021; 278:4361-4365. [PMID: 33713191 DOI: 10.1007/s00405-021-06738-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Cluster headache (CH) is a primary headache characterized by strictly unilateral, short-lasting severe headache attacks accompanied by at least one ipsilateral autonomic symptom. Our study aimed to determine whether CH patients had olfactory dysfunction and to correlate it with clinical characteristics. MATERIALS AND METHODS Twenty patients and 57 healthy volunteers were included in the study. All participants were examined in the otorhinolaryngology outpatient clinics to exclude other clinical problems causing olfactory dysfunction. The Sniffin' Sticks test was performed, and threshold (T), discrimination (D), identification (I) scores, and TDI global olfactory score were evaluated. RESULTS The CH patients had significantly lower threshold scores than healthy controls (6.9 ± 1.70 vs. 7.8 ± 1.08, p = 0.007). The mean threshold scores of CH patients during in-bout (n = 9) were significantly lower than CH patients during out-of-bout (n = 11) in subgroup analysis (5.9 ± 1.16 vs. 7.6 ± 1.76, p = 0.038). CH patients with left-sided headache had significantly lower discrimination scores compared to CH patients with right-sided headache (12.8 ± 1.24 vs. 14.4 ± 1.51, p = 0.03). CONCLUSION There is marked impairment in olfactory function in CH patients compared to healthy controls.
Collapse
Affiliation(s)
- Bedia Samancı
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Erdi Şahin
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Cömert Şen
- Department of Otorhinolaryngology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Yavuz Samancı
- Neurosurgery Clinic, Koc University, Istanbul, Turkey.,Department of Neuroscience, Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Mine Sezgin
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Serkan Emekli
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Elif Kocasoy Orhan
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Kadir Serkan Orhan
- Department of Otorhinolaryngology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Betül Baykan
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| |
Collapse
|
17
|
Wnuk M, Drabik L, Marona M, Szaleniec J, Bryll A, Karcz P, Kolasinska J, Kolasinska M, Ziekiewicz M, Skladzien J, Popiela T, Slowik A. Olfactory Dysfunction in Patients With Relapsing-Remitting Multiple Sclerosis Treated With Disease-Modifying Therapies. EAR, NOSE & THROAT JOURNAL 2020; 101:640-644. [PMID: 33236917 DOI: 10.1177/0145561320973777] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Olfactory dysfunction evaluated with time-consuming tests was more common in patients with multiple sclerosis (MS) than in controls and correlated with neurological deficit. The aim of the present study was to compare olfactory function between patients with relapsing-remitting MS (RRMS) and controls with short and simple screening tool-the Sniffin' Sticks Identification Test (SSIT)-and search for its association with clinical and radiological features of the disease. METHODS The study included 30 controls and 30 patients with RRMS treated with disease-modifying therapies-injectables (interferon β or glatiramer acetate, N = 18) and oral drugs (dimethyl fumarate or fingolimod, N = 12). Hyposmia was defined as a score of 6 points or fewer in the SSIT olfactory test. The data concerning number of previous relapses, disability in Expanded Disability Status Scale (EDSS), and recent brain magnetic resonance imaging (MRI) scan were collected. Moreover, thalamic volume and third ventricle width were recorded in every patient. Additionally, cognition and fatigue in patients were evaluated 24 months after olfactory assessment with the Symbol Digit Modalities Test (SDMT) and Fatigue Scale for Motor and Cognitive Functions (FSMC), respectively. RESULTS Patients with RRMS had a higher risk of hyposmia than controls (66.7% vs 36.7%, OR = 1.82, 95% CI, 1.10-3.67, P = .02). Neither inflammatory (number of previous relapses or new brain MRI lesions) nor neurodegenerative (EDSS, SDMT, and FSMC scores; thalamic volume; third ventricle width) MS features did not correlate with SSIT score (P > .05). In patients treated with oral drugs, olfactory dysfunction correlated with FSMC cognitive subscale (r = -0.90, P = .006). CONCLUSIONS Olfactory dysfunction is nearly twice as common in RRMS as in controls and correlates with fatigue level in patients treated with dimethyl fumarate or fingolimod.
Collapse
Affiliation(s)
- Marcin Wnuk
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.,University Hospital in Krakow, Poland
| | - Leszek Drabik
- Department of Pharmacology, Jagiellonian University Medical College, Krakow, Poland.,John Paul II Hospital, Krakow, Poland
| | - Monika Marona
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.,University Hospital in Krakow, Poland
| | - Joanna Szaleniec
- University Hospital in Krakow, Poland.,Department of Otorhinolaryngology, Jagiellonian University Medical College, Krakow, Poland
| | - Amira Bryll
- University Hospital in Krakow, Poland.,Department of Radiology, Jagiellonian University Medical College, Krakow, Poland
| | - Paulina Karcz
- Faculty of Health Sciences, Department of Electroradiology, Institute of Physiotherapy, Jagiellonian University Medical College, Krakow, Poland
| | | | | | | | - Jacek Skladzien
- University Hospital in Krakow, Poland.,Department of Otorhinolaryngology, Jagiellonian University Medical College, Krakow, Poland
| | - Tadeusz Popiela
- University Hospital in Krakow, Poland.,Department of Radiology, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Slowik
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.,University Hospital in Krakow, Poland
| |
Collapse
|
18
|
Goverover Y, Chen MH, Costa SL, Chiaravalloti ND, DeLuca J. Smell as a clinical-marker for functional limitations in multiple sclerosis: A pilot study. Mult Scler Relat Disord 2020; 46:102508. [PMID: 33011622 DOI: 10.1016/j.msard.2020.102508] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Olfactory dysfunction is a common symptom of multiple sclerosis (MS). The questions of whether and to what degree olfactory dysfunction can serve as a clinical marker of MS disability (i.e. cognitive impairments and functional limitations) are not yet answered. The current study aimed to explore associations between olfactory function (i.e. smell identification) with cognitive capacities, functional performance and quality of life (QOL) in persons with MS. METHODS Olfactory function was measured by the University of Pennsylvania Smell Identification Test (UPSIT). Functional ability was assessed by the Actual RealityTM (AR) task. QOL was assessed by the Multiple Sclerosis Quality of Life-54 (MSQOL-54). Cognition was assessed by the Brief International Cognitive Assessment for MS (BICAMS) in 23 MS patients and 15 matched healthy controls. RESULTS MS patients had lower UPSIT scores than healthy controls. Worse UPSIT scores were associated with reduced performances on the BICAMS and AR task as well as lower MSQOL-54 scores. Specifically, UPSIT scores were related to MSQOL-54 scores independent of BICAMS composite scores, while the relationship between UPSIT score and AR performance was mediated by BICAMS composite score. CONCLUSION This study confirms previous studies which concluded that olfactory function is impaired in MS. Furthermore, olfactory dysfunction is related to limitations in activity performance and QOL. Taken together with previous studies, olfactory function may be considered as a clinical marker related to MS disability. Longitudinal studies are needed to confirm these results.
Collapse
Affiliation(s)
- Yael Goverover
- Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, and Kessler Foundation, 82 Washington Square East, New York, NY, 10003, United States.
| | - Michelle H Chen
- Kessler Foundation, 120 Eagle Rock Avenue, Suite 100, East Hanover, NJ 07936-3147
| | - Silvana L Costa
- Kessler Foundation, 120 Eagle Rock Avenue, Suite 100, East Hanover, NJ 07936-3147
| | | | - John DeLuca
- Kessler Foundation, 120 Eagle Rock Avenue, Suite 100, East Hanover, NJ 07936-3147
| |
Collapse
|
19
|
da Silva AM, Torres C, Ferreira I, Moreira I, Samões R, Sousa AP, Santos E, Teixeira-Pinto A, Cavaco S. Prognostic value of odor identification impairment in multiple sclerosis: 10-Years follow-up. Mult Scler Relat Disord 2020; 46:102486. [PMID: 32916510 DOI: 10.1016/j.msard.2020.102486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/23/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Olfactory dysfunction has been linked to clinical severity variables in multiple MS populations. Though, its prognostic value is still unknown. OBJECTIVE The aim of this study was to explore the long-term outcome associated with Brief-Smell Identification Test (B-SIT) performance in a cohort of MS patients. METHODS A retrospective review of the clinical records was conducted in 149 patients who participated in a previous study, with a median follow-up of 121 months. Demographic and clinical data regarding the last clinical appointment with EDSS measurement were collected. Multiple Sclerosis Severity Scale (MSSS) and Age-Related Multiple Sclerosis Severity (ARMSS) scores were calculated. Date of the last clinical contact or death was recorded. RESULTS Among MS patients with progressive clinical course (n = 33), those with impaired B-SIT at baseline had greater change per month during follow-up (as measured by increases in MSSS and ARMSS scores) and a higher hazard of death. No significant associations were found among patients with relapsing and remitting MS (n = 116). CONCLUSIONS The study results demonstrate that odor identification impairment has prognostic value in progressive MS, suggesting that a brief odor identification measure can be a marker of neurodegeneration in progressive MS.
Collapse
Affiliation(s)
- Ana Martins da Silva
- Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal.
| | - C Torres
- Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - I Ferreira
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal; Neuropsychology Unit, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - I Moreira
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal; Neuropsychology Unit, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - R Samões
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - A P Sousa
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal; Neurophysiology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - E Santos
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - A Teixeira-Pinto
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - S Cavaco
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal; Neuropsychology Unit, Centro Hospitalar Universitário do Porto, Porto, Portugal
| |
Collapse
|
20
|
Olfactory identification associates with cognitive function and the third ventricle width in patients with relapsing-remitting multiple sclerosis. Mult Scler Relat Disord 2020; 38:101507. [DOI: 10.1016/j.msard.2019.101507] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/29/2019] [Accepted: 11/04/2019] [Indexed: 01/26/2023]
|
21
|
OuYang Q, Wang Y, Zhang YW, Yu M, Wang X. Change in Functional Brain Activation Patterns Induced by Olfactory Stimulation in Multiple Sclerosis. Neuropsychiatr Dis Treat 2020; 16:1451-1458. [PMID: 32606698 PMCID: PMC7294099 DOI: 10.2147/ndt.s252933] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 05/01/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Olfactory disorder is one of the commonly appearing symptoms in diseases like Parkinson's disease (PD) and Alzheimer's disease (AD). However, reports of olfactory changes in multiple sclerosis (MS) are scarce and usually ignored or seldom recognized by clinicians. The majority of current research is based on subjective answers obtained by smelling odorants. OBJECTIVE To gain better insights into the central brain regions involved in the olfactory process. We measured preliminary contrast assessment characteristics of brain activation in MS patients and healthy controls using functional magnetic resonance imaging (fMRI) under an odor stimulation task. METHODS Olfactory event-related fMRI was used to assess the olfactory network neuronal activity during passively inhaled volatile gases of lavender and rose solutions alternately in 18 MS patients and 20 healthy sex- and age-matched adults. Spearman correlation analysis was conducted between the lesions in central and olfactory-induced activated brain regions. RESULTS We observed significant reductions in the number of activated brain areas compared with healthy controls in MS patients under a standard activation mode; the right insula, right amygdala, right inferior frontal gyrus, right frontal middle gyrus, and left supramarginal gyrus were activated in MS patients (t = 2.04, P < 0.05). Meanwhile, the intensity of the activated olfactory brain network revealed attenuation. The Spearman correlation analysis indicated the distribution and number of demyelination lesions, exerting a little impact on major activation of brain regions during olfactory stimulation (r = -0.524, P = 0.054). CONCLUSION This study establishes that olfaction-related brain regions were altered in patients with MS confirmed by fMRI. The finding refreshes the awareness that olfactory disturbance involved just in structural pathology like olfactory bulbs and tracts or olfactory sulcus, which reportedly is responsible for the deficits.
Collapse
Affiliation(s)
- Qingrong OuYang
- Department of Neurology, Suining Central Hospital, Sui Ning 629000, People's Republic of China
| | - Yinxu Wang
- Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, People's Republic of China
| | - Yun-Wei Zhang
- Department of Neurology, Suining Central Hospital, Sui Ning 629000, People's Republic of China
| | - Ming Yu
- Department of Neurology, Suining Central Hospital, Sui Ning 629000, People's Republic of China
| | - Xiaoming Wang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, People's Republic of China
| |
Collapse
|
22
|
Samancı B, Samancı Y, Şen C, Şahin E, Sezgin M, Kocasoy Orhan E, Orhan KS, Baykan B. Assessment of the Olfactory Function in Patients With Idiopathic Intracranial Hypertension Using the Sniffin' Sticks Test: A Case-Control Study. Headache 2019; 59:848-857. [PMID: 31001819 DOI: 10.1111/head.13538] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Despite the lack of recognition in clinical practice, there is increasing evidence that patients with idiopathic intracranial hypertension may suffer from hyposmia. The current case-control study aims to evaluate olfactory dysfunction in a large series of patients with idiopathic intracranial hypertension. METHODS All subjects, 44 idiopathic intracranial hypertension patients and 57 healthy controls, underwent olfactory function assessment using standardized "Sniffin' Sticks" test at a tertiary referral center of a university hospital. Threshold, discrimination, identification, and total threshold-discrimination-identification scores have been determined and analyzed statistically. RESULTS Idiopathic intracranial hypertension patients had significantly lower threshold (6.5 [3.69] vs 8 [1.88], P < .001, 95% CI [-2.250, -0.750]) and threshold-discrimination-identification scores (29.75 [5.56] vs 32.5 [5.25], P = .003, 95% CI [-4.250, -0.750]). Twenty-five patients (57%) were diagnosed with hyposmia. Test scores of patients with active idiopathic intracranial hypertension (n = 18) were not statistically different from patients with inactive disease (n = 26), except for discrimination score (14 [2.50] vs 11 [2.25], P = .005, 95% CI [-3.000, -1.000]). Although idiopathic intracranial hypertension patients with a cerebrospinal fluid opening pressure of ≥330 mmH2 O had lower test scores, the difference was significant only for total threshold-discrimination-identification scores (28.5 [5.50] vs 30.5 [4.38], P = .044, 95% CI [0.750, 5.500]). Multiple regression analysis revealed that test scores were related to disease activity, cerebrospinal fluid opening pressure, papilledema, headache, and medication. CONCLUSION Our clinical study revealed significant olfactory dysfunction in patients with idiopathic intracranial hypertension compared with healthy controls. Future research should employ larger samples to search for usability of olfactory testing in clinical management of patients with idiopathic intracranial hypertension.
Collapse
Affiliation(s)
- Bedia Samancı
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Yavuz Samancı
- Org. Abdurrahman Nafiz Gürman Cad. Etyemez, İstanbul, Turkey.,Department of Neuroscience, Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Cömert Şen
- Department of Otorhinolaryngology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Erdi Şahin
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mine Sezgin
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Elif Kocasoy Orhan
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Kadir Serkan Orhan
- Department of Otorhinolaryngology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Betül Baykan
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| |
Collapse
|
23
|
Kim J, Ahn M, Choi Y, Ekanayake P, Park CM, Moon C, Jung K, Tanaka A, Matsuda H, Shin T. Gene Expression Profile of Olfactory Transduction Signaling in an Animal Model of Human Multiple Sclerosis. Exp Neurobiol 2019; 28:74-84. [PMID: 30853826 PMCID: PMC6401553 DOI: 10.5607/en.2019.28.1.74] [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] [Received: 10/09/2018] [Revised: 12/26/2018] [Accepted: 01/18/2019] [Indexed: 12/14/2022] Open
Abstract
Olfactory dysfunction occurs in multiple sclerosis in humans, as well as in an animal model of experimental autoimmune encephalomyelitis (EAE). The aim of this study was to analyze differentially expressed genes (DEGs) in olfactory bulb of EAE-affected mice by next generation sequencing, with a particular focus on changes in olfaction-related signals. EAE was induced in C57BL/6 mice following immunization with myelin oligodendrocyte glycoprotein and adjuvant. Inflammatory lesions were identified in the olfactory bulbs as well as in the spinal cord of immunized mice. Analysis of DEGs in the olfactory bulb of EAE-affected mice revealed that 44 genes were upregulated (and which were primarily related to inflammatory mediators), while 519 genes were downregulated; among the latter, olfactory marker protein and stomatin-like 3, which have been linked to olfactory signal transduction, were significantly downregulated (log2 [fold change] >1 and p-value <0.05). These findings suggest that inflammation in the olfactory bulb of EAE-affected mice is associated with the downregulation of some olfactory signal transduction genes, particularly olfactory marker protein and stomatin-like 3, which may lead to olfactory dysfunction in an animal model of human multiple sclerosis.
Collapse
Affiliation(s)
- Jeongtae Kim
- Department of Veterinary Anatomy, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju 63243, Korea
| | - Meejung Ahn
- Department of Veterinary Anatomy, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju 63243, Korea
| | - Yuna Choi
- Department of Veterinary Anatomy, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju 63243, Korea
| | - Poornima Ekanayake
- Department of Veterinary Anatomy, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju 63243, Korea
| | - Chul Min Park
- Department of Obstetrics and Gynecology, School of Medicine, Jeju National University, Jeju 63243, Korea
| | - Changjong Moon
- Department of Veterinary Anatomy, College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju 61186, Korea
| | - Kyungsook Jung
- Immunoregulatory Materials Research Center, Korea Research Institute of Bioscience and Biotechnology, Jeongeup 56212, Korea
| | - Akane Tanaka
- Laboratory of Comparative Animal Medicine, Division of Animal Life Science, Institute of Agriculture, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan
| | - Hiroshi Matsuda
- Laboratory of Veterinary Molecular Pathology and Therapeutics, Division of Animal Life Science, Graduate School, Institute of Agriculture, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan
| | - Taekyun Shin
- Department of Veterinary Anatomy, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju 63243, Korea
| |
Collapse
|
24
|
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]
|
25
|
Leibovitch EC, Caruso B, Ha SK, Schindler MK, Lee NJ, Luciano NJ, Billioux BJ, Guy JR, Yen C, Sati P, Silva AC, Reich DS, Jacobson S. Herpesvirus trigger accelerates neuroinflammation in a nonhuman primate model of multiple sclerosis. Proc Natl Acad Sci U S A 2018; 115:11292-11297. [PMID: 30322946 PMCID: PMC6217390 DOI: 10.1073/pnas.1811974115] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Pathogens, particularly human herpesviruses (HHVs), are implicated as triggers of disease onset/progression in multiple sclerosis (MS) and other neuroinflammatory disorders. However, the time between viral acquisition in childhood and disease onset in adulthood complicates the study of this association. Using nonhuman primates, we demonstrate that intranasal inoculations with HHV-6A and HHV-6B accelerate an MS-like neuroinflammatory disease, experimental autoimmune encephalomyelitis (EAE). Although animals inoculated intranasally with HHV-6 (virus/EAE marmosets) were asymptomatic, they exhibited significantly accelerated clinical EAE compared with control animals. Expansion of a proinflammatory CD8 subset correlated with post-EAE survival in virus/EAE marmosets, suggesting that a peripheral (viral?) antigen-driven expansion may have occurred post-EAE induction. HHV-6 viral antigen in virus/EAE marmosets was markedly elevated and concentrated in brain lesions, similar to previously reported localizations of HHV-6 in MS brain lesions. Collectively, we demonstrate that asymptomatic intranasal viral acquisition accelerates subsequent neuroinflammation in a nonhuman primate model of MS.
Collapse
Affiliation(s)
- Emily C Leibovitch
- Viral Immunology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892
| | - Breanna Caruso
- Viral Immunology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892
| | - Seung Kwon Ha
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892
| | - Matthew K Schindler
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892
| | - Nathanael J Lee
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892
| | - Nicholas J Luciano
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892
| | - Bridgette J Billioux
- Viral Immunology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892
| | - Joseph R Guy
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892
| | - Cecil Yen
- Cerebral Microcirculation Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892
| | - Pascal Sati
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892
| | - Afonso C Silva
- Cerebral Microcirculation Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892
| | - Daniel S Reich
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892
| | - Steven Jacobson
- Viral Immunology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892;
| |
Collapse
|
26
|
Olfactory Dysfunction in CNS Neuroimmunological Disorders: a Review. Mol Neurobiol 2018; 56:3714-3721. [PMID: 30191380 DOI: 10.1007/s12035-018-1341-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 08/31/2018] [Indexed: 12/21/2022]
Abstract
Olfactory dysfunction is deeply associated with quality of human life in the aging population. Olfactory dysfunction is an occasional presymptomatic sign of neuroimmunological multiple sclerosis, neuromyelitis optica, and systemic lupus erythematosus. Olfaction is initially processed by olfactory receptor cells that capture odor molecules, and the signals are transmitted to the glomeruli in the olfactory bulbs via olfactory nerves and processed in the primary olfactory cortex in the brain. Damage to either the olfactory receptor cells or the olfactory bulb and primary olfactory cortex may influence olfactory functioning. A close link between neuroimmunological disorders and olfactory dysfunction has been reported in patients and animal models. This review summarizes the literature data concerning olfactory dysfunction in autoimmune diseases including multiple sclerosis, neuromyelitis optica, and systemic lupus erythematosus; animal models thereof; and inflammation in the olfactory bulb.
Collapse
|
27
|
Abstract
PURPOSE OF REVIEW This article aims to educate clinical neurologists on the importance of taste and smell disorders in clinical neurology. These disorders commonly occur in head trauma, multiple sclerosis, seizure disorders, and neurodegenerative diseases such as idiopathic Parkinson disease and dementia, mild cognitive impairment, and Alzheimer disease, just to name a few. This article covers the basic anatomy of smell and taste, notes the important points of taking a proper history, and discusses smell and taste testing, which are inexpensive, minimally time-consuming procedures. Recurrent bad smells and tastes are not uncommon in these disorders, which cause major impairment in quality of life, including loss of appetite, decreased eating, and weight loss. The diagnosis and treatment of these disorders will also be discussed. RECENT FINDINGS Despite past widespread negative prognoses of taste and smell disorders, more recent work in the last 10 years has shown an improved prognosis for smell and taste recovery in most disorders, and recommendations for changes in food preparation have helped many patients enjoy their food and increase their appetite. Recent experimental evidence has shown that smell loss and testing can assist in separating idiopathic Parkinson disease from other parkinsonian syndromes, can suggest which patients with rapid eye movement (REM) sleep behavior disorder will more likely develop Parkinson disease, and can be predictive of the progression of cognitive impairment and Alzheimer dementia. SUMMARY This article discusses the common smell and taste disorders that a clinical neurologist will encounter in practice. The anatomy and function of smell and taste will be reviewed, followed by office evaluation and testing. The common disorders will be reviewed, along with their prognosis and management.
Collapse
|
28
|
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.
Collapse
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
| | | |
Collapse
|
29
|
Kim J, Choi Y, Ahn M, Jung K, Shin T. Olfactory Dysfunction in Autoimmune Central Nervous System Neuroinflammation. Mol Neurobiol 2018; 55:8499-8508. [PMID: 29557516 DOI: 10.1007/s12035-018-1001-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 03/07/2018] [Indexed: 12/31/2022]
Abstract
Olfactory dysfunction is an early sign of neuroinflammation of the central nervous system (CNS). Microgliosis and astrogliosis are representative pathological changes that develop during neuroinflammation of CNS tissues. Autoimmune CNS inflammation, including human multiple sclerosis, is an occasional cause of olfactory disorders. We evaluated whether gliosis and olfactory dysfunction developed in animals with experimental autoimmune encephalomyelitis (EAE), a model of human multiple sclerosis. Neuroinflammatory lesions characterized by infiltration of inflammatory cells and microglial cell activation were occasionally found in the olfactory bulbs of EAE-affected rats. Microglial activation, visualized by immunohistochemical staining of ionized calcium binding protein (Iba)-1, and astrogliosis in the olfactory bulb were also evident in the olfactory bulb of EAE rats. Inflammatory cells were found along the olfactory nerves and in the olfactory submucosa. Western blot analysis of olfactory marker protein (OMP) levels showed that OMP expression was significantly downregulated in the olfactory mucosa of EAE rats. On the buried food test, EAE-affected mice required significantly more time to find a bait pellet. Collectively, the results suggest that the olfactory dysfunction of EAE is closely linked to downregulation of OMP and the development of inflammatory foci in the olfactory system in an animal model of human multiple sclerosis.
Collapse
Affiliation(s)
- Jeongtae Kim
- Department of Veterinary Anatomy, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, 102 Jejudaehakno, Jeju, 63243, Republic of Korea
- Veterinary Medical Research Institute, Jeju National University, Jeju, 63243, Republic of Korea
| | - Yuna Choi
- Department of Veterinary Anatomy, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, 102 Jejudaehakno, Jeju, 63243, Republic of Korea
| | - Meejung Ahn
- Department of Veterinary Anatomy, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, 102 Jejudaehakno, Jeju, 63243, Republic of Korea
- Veterinary Medical Research Institute, Jeju National University, Jeju, 63243, Republic of Korea
| | - Kyungsook Jung
- Immunoregulatory Materials Research Center Korea Research Institute of Bioscience and Biotechnology, 181 Ipsin-gil, Jeongeup-si, 56212, Jeonbuk, Republic of Korea
| | - Taekyun Shin
- Department of Veterinary Anatomy, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, 102 Jejudaehakno, Jeju, 63243, Republic of Korea.
- Veterinary Medical Research Institute, Jeju National University, Jeju, 63243, Republic of Korea.
| |
Collapse
|
30
|
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: 17] [Impact Index Per Article: 2.8] [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.
Collapse
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.
| |
Collapse
|
31
|
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: 183] [Impact Index Per Article: 30.5] [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.
Collapse
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
| |
Collapse
|
32
|
Bsteh G, Hegen H, Ladstätter F, Berek K, Amprosi M, Wurth S, Auer M, Di Pauli F, Deisenhammer F, Reindl M, Berger T, Lutterotti A. Change of olfactory function as a marker of inflammatory activity and disability progression in MS. Mult Scler 2017; 25:267-274. [PMID: 29185867 DOI: 10.1177/1352458517745724] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND Impaired olfactory threshold has been reported in early inflammatory phases of MS, while impaired odor identification was associated with more widespread disability. OBJECTIVE To prospectively assess the development of olfactory function and its correlation with relapse and disability progression. METHODS In this prospective, 3-year longitudinal study on 151 MS patients and 30 healthy controls, three different qualities of olfactory function (threshold, discrimination, and identification) were quantified using the Sniffin' Sticks test. The influence of relapses and disability on olfactory function was analyzed at different time points and in a multivariate model. RESULTS Discrimination and identification capability significantly worsened over 3 years, while threshold did not. Threshold was markedly impaired in patients with relapse activity within 12 months, recovered in the absence of relapse, and was associated with a 2.5-fold increased risk of relapse. Deterioration of discrimination and identification was irreversible and both strongly associated with and predictive of EDSS progression. CONCLUSION Olfactory function changes over time in MS. Threshold impairment is transient and predicts inflammatory disease activity, while odor identification and discrimination are associated with disability progression. Olfactory dysfunction might be a useful and easily obtainable parameter to monitor patients with regard to inflammation and neurodegeneration in MS.
Collapse
Affiliation(s)
- Gabriel Bsteh
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Harald Hegen
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Felix Ladstätter
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Klaus Berek
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Matthias Amprosi
- 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
| | | | - Markus Reindl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Berger
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Andreas Lutterotti
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria/Department of Neurology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland
| |
Collapse
|
33
|
Keune PM, Hansen S, Weber E, Zapf F, Habich J, Muenssinger J, Wolf S, Schönenberg M, Oschmann P. Exploring resting-state EEG brain oscillatory activity in relation to cognitive functioning in multiple sclerosis. Clin Neurophysiol 2017; 128:1746-1754. [DOI: 10.1016/j.clinph.2017.06.253] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/21/2017] [Accepted: 06/26/2017] [Indexed: 11/26/2022]
|
34
|
Schmidt FA, Maas MB, Geran R, Schmidt C, Kunte H, Ruprecht K, Paul F, Göktas Ö, Harms L. Olfactory dysfunction in patients with primary progressive MS. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2017. [PMID: 28638852 PMCID: PMC5471346 DOI: 10.1212/nxi.0000000000000369] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Objective: We tested the hypothesis that olfactory function is more impaired in patients with primary progressive MS (PPMS) than that in relapsing-remitting MS (RRMS). Methods: Standardized olfactory testing was performed in 32 patients with PPMS, 32 patients with RRMS, and 32 healthy controls (HCs). Patients with olfactory dysfunction due to an alternative primary etiology were excluded. The validated olfactory testing method yielded individual scores for olfactory threshold, odor discrimination, and odor identification, along with a composite Threshold Discrimination Identification (TDI) score. Results: Olfactory dysfunction was identified in 27 (84%) patients with PPMS, 10 (31%) patients with RRMS, and 1 (3%) HC. While age and sex were similar between PPMS and HCs, the TDI score and all olfactory subscores were significantly worse in patients with PPMS compared with HCs (all p < 0.001). After adjustment for differences in age, sex, Expanded Disability Status Scale (EDSS), and disease duration, odor discrimination, odor identification, and the composite TDI score were worse in patients with PPMS vs RRMS (p = 0.03, 0.04, and 0.02, respectively). Neither age, sex, EDSS, nor disease duration was significantly associated with the composite TDI score. Conclusions: Olfactory dysfunction was more frequent and severe in PPMS compared with RRMS, independent of disease duration and overall disability status. Further research on cellular level differences in olfactory neural pathways may lead to new insights about disease pathogenesis in MS.
Collapse
Affiliation(s)
- Felix A Schmidt
- Clinical and Experimental Multiple Sclerosis Research Center (F.A.S., R.G., H.K., K.R., F.P., L.H.), Department of Neurology, NeuroCure Clinical Research Center (F.A.S., F.P.), Department of Psychiatry (C.S.), Department of Audiology and Phoniatrics (Ö.G.), Charité-Universitätsmedizin Berlin (F.P.), Germany; Department of Neurology (M.B.M.), Feinberg School of Medicine, Northwestern University, Chicago, IL; MSB Medical School Berlin (H.K.), Germany; and Experimental and Clinical Research Center (F.P.), Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Matthew B Maas
- Clinical and Experimental Multiple Sclerosis Research Center (F.A.S., R.G., H.K., K.R., F.P., L.H.), Department of Neurology, NeuroCure Clinical Research Center (F.A.S., F.P.), Department of Psychiatry (C.S.), Department of Audiology and Phoniatrics (Ö.G.), Charité-Universitätsmedizin Berlin (F.P.), Germany; Department of Neurology (M.B.M.), Feinberg School of Medicine, Northwestern University, Chicago, IL; MSB Medical School Berlin (H.K.), Germany; and Experimental and Clinical Research Center (F.P.), Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Rohat Geran
- Clinical and Experimental Multiple Sclerosis Research Center (F.A.S., R.G., H.K., K.R., F.P., L.H.), Department of Neurology, NeuroCure Clinical Research Center (F.A.S., F.P.), Department of Psychiatry (C.S.), Department of Audiology and Phoniatrics (Ö.G.), Charité-Universitätsmedizin Berlin (F.P.), Germany; Department of Neurology (M.B.M.), Feinberg School of Medicine, Northwestern University, Chicago, IL; MSB Medical School Berlin (H.K.), Germany; and Experimental and Clinical Research Center (F.P.), Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Charlotte Schmidt
- Clinical and Experimental Multiple Sclerosis Research Center (F.A.S., R.G., H.K., K.R., F.P., L.H.), Department of Neurology, NeuroCure Clinical Research Center (F.A.S., F.P.), Department of Psychiatry (C.S.), Department of Audiology and Phoniatrics (Ö.G.), Charité-Universitätsmedizin Berlin (F.P.), Germany; Department of Neurology (M.B.M.), Feinberg School of Medicine, Northwestern University, Chicago, IL; MSB Medical School Berlin (H.K.), Germany; and Experimental and Clinical Research Center (F.P.), Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Hagen Kunte
- Clinical and Experimental Multiple Sclerosis Research Center (F.A.S., R.G., H.K., K.R., F.P., L.H.), Department of Neurology, NeuroCure Clinical Research Center (F.A.S., F.P.), Department of Psychiatry (C.S.), Department of Audiology and Phoniatrics (Ö.G.), Charité-Universitätsmedizin Berlin (F.P.), Germany; Department of Neurology (M.B.M.), Feinberg School of Medicine, Northwestern University, Chicago, IL; MSB Medical School Berlin (H.K.), Germany; and Experimental and Clinical Research Center (F.P.), Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Klemens Ruprecht
- Clinical and Experimental Multiple Sclerosis Research Center (F.A.S., R.G., H.K., K.R., F.P., L.H.), Department of Neurology, NeuroCure Clinical Research Center (F.A.S., F.P.), Department of Psychiatry (C.S.), Department of Audiology and Phoniatrics (Ö.G.), Charité-Universitätsmedizin Berlin (F.P.), Germany; Department of Neurology (M.B.M.), Feinberg School of Medicine, Northwestern University, Chicago, IL; MSB Medical School Berlin (H.K.), Germany; and Experimental and Clinical Research Center (F.P.), Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Friedemann Paul
- Clinical and Experimental Multiple Sclerosis Research Center (F.A.S., R.G., H.K., K.R., F.P., L.H.), Department of Neurology, NeuroCure Clinical Research Center (F.A.S., F.P.), Department of Psychiatry (C.S.), Department of Audiology and Phoniatrics (Ö.G.), Charité-Universitätsmedizin Berlin (F.P.), Germany; Department of Neurology (M.B.M.), Feinberg School of Medicine, Northwestern University, Chicago, IL; MSB Medical School Berlin (H.K.), Germany; and Experimental and Clinical Research Center (F.P.), Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Önder Göktas
- Clinical and Experimental Multiple Sclerosis Research Center (F.A.S., R.G., H.K., K.R., F.P., L.H.), Department of Neurology, NeuroCure Clinical Research Center (F.A.S., F.P.), Department of Psychiatry (C.S.), Department of Audiology and Phoniatrics (Ö.G.), Charité-Universitätsmedizin Berlin (F.P.), Germany; Department of Neurology (M.B.M.), Feinberg School of Medicine, Northwestern University, Chicago, IL; MSB Medical School Berlin (H.K.), Germany; and Experimental and Clinical Research Center (F.P.), Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Lutz Harms
- Clinical and Experimental Multiple Sclerosis Research Center (F.A.S., R.G., H.K., K.R., F.P., L.H.), Department of Neurology, NeuroCure Clinical Research Center (F.A.S., F.P.), Department of Psychiatry (C.S.), Department of Audiology and Phoniatrics (Ö.G.), Charité-Universitätsmedizin Berlin (F.P.), Germany; Department of Neurology (M.B.M.), Feinberg School of Medicine, Northwestern University, Chicago, IL; MSB Medical School Berlin (H.K.), Germany; and Experimental and Clinical Research Center (F.P.), Max Delbrück Center for Molecular Medicine, Berlin, Germany
| |
Collapse
|
35
|
Duda-Sobczak A, Araszkiewicz A, Urbas M, Borucki L, Kulas K, Chudzinski M, Suwalska A, Zozulinska-Ziolkiewicz D. Impaired olfactory function is related to the presence of neuropathy in adults with type 1 diabetes. Diab Vasc Dis Res 2017; 14:139-143. [PMID: 28103703 DOI: 10.1177/1479164116679079] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Olfactory dysfunction is suggested to be a clinical manifestation of central diabetic neuropathy. The aim of the study was to assess olfactory function in adult patients with type 1 diabetes. MATERIALS AND METHODS A total of 106 patients with type 1 diabetes and 30 healthy subjects were included in the study. We evaluated the metabolic control of diabetes and the presence of chronic complications. Olfactory function was assessed with Sniffin' Sticks. RESULTS We found a negative correlation between olfactory identification scores and body mass index ( Rs -0.2; p = 0.04) and triglycerides ( Rs = -0.2; p = 0.04). We showed lower olfactory identification scores in neuropathy group versus non-neuropathy group [8 (interquartile range, 7-9) vs 10 (interquartile range, 9-11) points; p = 0.005]. In multivariate linear regression, impaired olfaction was independently associated with neuropathy (beta, -0.3; p = 0.005). In multivariate logistic regression, diabetes duration (odds ratio, 1.06; 95% confidence interval, 1.00-1.11; p = 0.04) and olfactory identification score (odds ratio, 0.61; 95% confidence interval, 0.43-0.85; p = 0.003) were independently associated with neuropathy. CONCLUSION Olfactory dysfunction is observed in patients with type 1 diabetes and diabetic peripheral neuropathy.
Collapse
Affiliation(s)
- Anna Duda-Sobczak
- 1 Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznań, Poland
| | - Aleksandra Araszkiewicz
- 1 Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznań, Poland
| | - Magdalena Urbas
- 2 Department of Otorhinolaryngology, Raszeja City Hospital, Poznań, Poland
| | - Lukasz Borucki
- 2 Department of Otorhinolaryngology, Raszeja City Hospital, Poznań, Poland
| | - Katarzyna Kulas
- 3 Laboratory of Neuropsychobiology, Department of Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Maciej Chudzinski
- 3 Laboratory of Neuropsychobiology, Department of Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Aleksandra Suwalska
- 3 Laboratory of Neuropsychobiology, Department of Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | | |
Collapse
|
36
|
Banwell B, Giovannoni G, Hawkes C, Lublin F. Editors' Welcome. Mult Scler Relat Disord 2016; 6:A1-A2. [DOI: 10.1016/j.msard.2016.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|