Quality of odor and olfactory lateralization processes in humans

Eating-induced seizures: A semiological sign of the right temporal pole

OBJECTIVE

Eating-induced seizures (EIS) are a rare form of reflex seizures. The objective of this study was to report a series of cases of EIS involving patients admitted to our epilepsy unit, and to analyze the clinical characteristics, etiology, and treatment response of this type of infrequent seizure.

METHODS

We performed a single-center retrospective analysis of all consecutive patients diagnosed with epilepsy with eating-induced seizures between 2008 and 2020.

RESULTS

We included eight patients (six women) with mean age 54.75 years (range: 40-79), and mean age at epilepsy onset 30.75 years (range: 9-58 years). EIS were triggered during a meal in 5/8 (at dinner 1/8, at breakfast in 1/8, and without time preference in 3/8), by a certain flavor in 1/8, by eating different textures or drinking soft drinks in 1/8, and by slicing food in 1/8. All patients suffered nonreflex seizures and 3/8 other types of reflex seizures. In 6/8 of patients, EIS originated in the right hemisphere. In 5/8, the EIS progressed to impaired awareness with oromandibular automatisms. In 6/8, the epilepsy was drug-resistant. Temporopolar encephalocele was the most frequent etiology, in 4/8. Three of the eight underwent surgical treatment, with Engel IA 1 year in 3/3. Three of the eight were treated with vagal stimulation therapy, with McHugh A 1 year in 2/3.

SIGNIFICANCE

In our series, eating-induced seizures were observed in patients with focal epilepsy. It was frequently drug-resistant and started predominantly in the right hemisphere, due to temporal pole involvement in half of the patients.

Sex Differences in Odor Hedonic Perception: An Overview

Odor hedonic evaluation (pleasant/unpleasant) is considered as the first and one of the most prominent dimension in odor perception. While sex differences in human olfaction have been extensively explored, gender effect in hedonic perception appears to be less considered. However, a number of studies have included comparisons between men and women, using different types of measurements (psychophysical, psychophysiological,…). This overview presents experimental works with non-specific and body odors separately presented as well as experimental studies comparing healthy participants vs patients with psychiatric disorders. Contrary to sensitivity, identification or discrimination, the overall literature tends to prove that no so clear differences occur in odor hedonic judgment between men and women. On the whole, gender effect appears more marked for body than non-specific odors and is almost never reported in psychiatric diseases. These findings are discussed in relation to the processes classically implied in pleasantness rating and emotional processes.

A systematic review of physiological responses to odours with a focus on current methods used in event-related study designs

OBJECTIVES

In odour research, there is still a lack of knowledge regarding the detailed understanding of the determinants and the magnitude of an odour's impact on human psychophysiology. Therefore, the present review aims to summarize current evidence on psychophysiological responses to olfactory events, to highlight diversity in research methods, and to provide recommendations for further research.

MATERIAL AND METHODS

Predefined search items were used for literature research in two databases, focussing on recent investigations of cardiac and electrodermal responses to short (<10 s) olfactory stimulations, combined with self-reports on odour experience, in a healthy population. The selected 27 publications were evaluated with regard to their methods and their findings on psychophysiological correlates of odour stimulation, following a conceptual scheme proposing mediating and moderating factors of physiological responses to odour stimuli.

RESULTS

The cardiac and electrodermal activity generally followed a discriminative pattern depending on the perceived pleasantness of an odour. Moreover, the trigeminal aspect of an odour stimulus became evident in electrodermal activity in several studies. Finally, for many of the here addressed potentially mediating and moderating variables, initial findings were obtained in some studies but these await corroboration by future research. With regard to the applied methodology, the reviewed studies were highly diverse, in terms of odour application, study design, and analysis of the time series data.

CONCLUSIONS

Future research is needed to advance our understanding of, and theoretical concepts beyond, psychophysiological responses to olfactory events, and to achieve experimentally validated methodological guidelines for psychophysiological measurements in olfaction research.

Preservation of olfaction in anterior midline skull base meningiomas: a comprehensive approach

BACKGROUND

Olfaction is an undervalued sense in neurosurgery. Attempted surgical resection of anterior cranial fossa meningiomas puts the olfactory pathway at risk. Preservation of olfaction may increase the postoperative quality of life. Objective assessment of olfaction may inform clinical decision-making and influence the selection of operative approaches for surgical resection.

METHODS

We reviewed all patients who underwent surgical resection for midline anterior skull base meningiomas from July 1, 2014, through December 31, 2017. Patient demographics, tumor size, operative approach, pre- and postoperative deficits, and Simpson grade were collected and analyzed. Postoperative olfaction was assessed by clinical evaluation as well as objective evaluation using the University of Pennsylvania Smell Identification Test (UPSIT).

RESULTS

Twenty-eight patients (10 male, 18 female) were included with an average age of 53.8 years (range 27-80 years). Twenty-six patients underwent craniotomy for resection, while 2 patients had endoscopic approaches. Average tumor volume was 402.1 cm³ (6.6-2507.7 cm³). Preoperatively, five patients (17.8%) presented with olfactory impairment. Objectively, 50% of patients (14/28) consented and completed the UPSIT. The average postoperative UPSIT score was 25.8/40 (9/40-38/40). Two patients not identified on clinical assessment alone demonstrated postoperative olfactory deficit on UPSIT (2/14).

CONCLUSION

There are limited published studies evaluating olfaction in patients who undergo skull-based approaches for anterior fossa meningiomas. Our series showed the highest olfaction preservation rate (87.5%) using a comprehensive strategy and multitude of surgical approaches based on the olfactory function and tumor characteristics.

Nostril Advantage in Trigeminal/Olfactory Perception and Its Relation to Handedness

Introduction Few studies investigated nostril-advantage in chemosensory perception, particularly, in relation to handedness. The aim of the present article was therefore to assess whether trigeminal/olfactory perception is altered by handedness. Methods We tested 50 (all right-handed) and 43 (22 left-handed) participants in Studies 1 and 2, respectively. We used binary mixtures of cinnamaldehyde and eucalyptol, in different proportions presented as physical mixtures (the same exact mixture presented birhinally to each nostril) or as a dichorhinic mixtures (different mixtures presented to each nostril). Presenting dichorhinic mixtures allowed us to assess nostril dominance based on participants' report on whether the mixture smelled more like cinnamon or eucalyptus. Participants also evaluated whether the stimuli were "painful," "warm," "cold," and "intense" on visual scales. Results In Study 1, we find that in right handers, stimuli presented to the right nostril dominated over those presented to the left nostril. These stimuli were also rated as more "painful" and "intense." In Study 2, we could not corroborate the findings in the right-handed individuals, and we found limited support for a nostril advantage left-handed individuals. Conclusion Although our data points toward a certain nostril advantage in chemosensory perception, the finding is not systematic, we discuss possible underlying factors.

Unilateral endonasal transcribriform approach with septal transposition for olfactory groove meningioma: can olfaction be preserved?

BACKGROUND

Loss of olfaction has been considered inevitable in endoscopic endonasal resection of olfactory groove meningiomas. Olfaction preservation may be feasible through an endonasal unilateral transcribriform approach, with the option for expansion using septal transposition and contralateral preservation of the olfactory apparatus.

METHODS

An expanded unilateral endonasal transcribriform approach with septal transposition was performed in five cadaver heads. The approach was applied in a surgical case of a 24 × 26-mm olfactory groove meningioma originating from the right cribriform plate with partially intact olfaction.

RESULTS

The surgical approach offered adequate exposure to the anterior skull base bilaterally. The nasal/septal mucosa was preserved on the contralateral side. Gross total resection of the meningioma was achieved with the successful preservation of the contralateral olfactory apparatus and preoperative olfaction. Six months later, the left nasal cavity showed no disruption of the mucosal lining and the right side was at the appropriate stage of healing for a harvested nasoseptal flap. One year later, the preoperative olfactory function was intact and favorably viewed by the patient. Objective testing of olfaction showed microsomia.

CONCLUSIONS

Olfaction preservation may be feasible in the endoscopic endonasal resection of a unilateral olfactory groove meningioma through a unilateral transcribriform approach with septal transposition and preservation of the contralateral olfactory apparatus.

Modulation of cerebral haemodynamic response to olfactory stimuli by emotional valence detected by functional magnetic resonance imaging

Olfactory perception, although restricted to just a few contexts in everyday life, is key in medicine. Several dementia conditions have been associated with early loss of olfactory discrimination. Despite the fact that several brain areas have been associated with olfaction in functional magnetic resonance imaging (fMRI), the mechanisms by which emotional valence is conveyed to the brain are not fully understood.

Cortical and Subcortical Substrates of Cranial Nerve Function

The pivotal role of cranial nerves in a wholesome life experience cannot be overemphasized. Research has opened new avenues to understand cranial nerve function. Classical concept of strict bilateral cortical control of cranial nerves has given way to concepts of hemispheric dominance and hemispheric lateralization. An astute Neuroradiologist should keep abreast of these concepts and help patients and referring physicians by applying this knowledge in reading images. This chapter provides an overview of cranial nerve function and latest concepts pertaining to their cortical and subcortical control.

Tactile roughness perception in the presence of olfactory and trigeminal stimulants

Previous research has shown that odorants consistently evoke associations with textures and their tactile properties like smoothness and roughness. Also, it has been observed that olfaction can modulate tactile perception. We therefore hypothesized that tactile roughness perception may be biased towards the somatosensory connotation of an ambient odorant. We performed two experiments to test this hypothesis. In the first experiment, we investigated the influence of ambient chemosensory stimuli with different roughness connotations on tactile roughness perception. In addition to a pleasant odor with a connotation of softness (PEA), we also included a trigeminal stimulant with a rough, sharp or prickly connotation (Ethanol). We expected that—compared to a No-odorant control condition—tactile texture perception would be biased towards smoothness in the presence of PEA and towards roughness in the presence of Ethanol. However, our results show no significant interaction between chemosensory stimulation and perceived tactile surface roughness. It could be argued that ambient odors may be less effective in stimulating crossmodal associations, since they are by definition extraneous to the tactile stimuli. In an attempt to optimize the conditions for sensory integration, we therefore performed a second experiment in which the olfactory and tactile stimuli were presented in synchrony and in close spatial proximity. In addition, we included pleasant (Lemon) and unpleasant (Indole) odorants that are known to have the ability to affect tactile perception. We expected that tactile stimuli would be perceived as less rough when simultaneously presented with Lemon or PEA (both associated with softness) than when presented with Ethanol or Indole (odors that can be associated with roughness). Again, we found no significant main effect of chemosensory condition on perceived tactile roughness. We discuss the limitations of this study and we present suggestions for future research.

Dynamic cortical lateralization during olfactory discrimination learning

Bilateral cortical circuits are not necessarily symmetrical. Asymmetry, or cerebral lateralization, allows functional specialization of bilateral brain regions and has been described in humans for such diverse functions as perception, memory and emotion. There is also evidence for asymmetry in the human olfactory system, although evidence in non-human animal models is lacking. In the present study, we took advantage of the known changes in olfactory cortical local field potentials that occur over the course of odour discrimination training to test for functional asymmetry in piriform cortical activity during learning. Both right and left piriform cortex local field potential activities were recorded. The results obtained demonstrate a robust interhemispheric asymmetry in anterior piriform cortex activity that emerges during specific stages of odour discrimination learning, with a transient bias toward the left hemisphere. This asymmetry is not apparent during error trials. Furthermore, functional connectivity (coherence) between the bilateral anterior piriform cortices is learning- and context-dependent. Steady-state interhemispheric anterior piriform cortex coherence is reduced during the initial stages of learning and then recovers as animals acquire competent performance. The decrease in coherence is seen relative to bilateral coherence expressed in the home cage, which remains stable across conditioning days. Similarly, transient, trial-related interhemispheric coherence increases with task competence. Taken together, the results demonstrate transient asymmetry in piriform cortical function during odour discrimination learning until mastery, suggesting that each piriform cortex may contribute something unique to odour memory.

Memories evoked by odors stimulating the olfactory nerve versus odors stimulating both the olfactory and trigeminal nerves: possible qualitative differences?

The purpose of the study was to establish whether autobiographical memories differ when a stimulus producing olfactory or/and trigeminal sensations was used as memory cue. The following hypothesis was formulated: memories evoked by odors activating the trigeminal and olfactory nerves would be subjectively assessed as more detailed, more clear, more important and less happy, as compared to memories evoked by odors activating exclusively the olfactory nerve. The hypothesis was based on the assumption that trigeminal odors are perceived as signaling potential threats for the organism. 30 Polish psychology students (M age = 22 yr.; 20 women, 10 men) were tested using six odors: three stimulating the olfactory nerve only and three stimulating both the olfactory and trigeminal nerves. Participants were asked whether a particular odor evoked any memories, and if they answered "yes," they were to respond to four questions related to the qualities of the memory. Ratings of memories evoked by odors that stimulated the olfactory nerve and those that stimulated both the olfactory and trigeminal nerves differed in clarity. Odors stimulating the trigeminal nerve may induce less happy memories. The results are promising as to the role of the trigeminal system in coding and retrieval of survival-related memories.

Permanent anosmia and ageusia after resection of a left temporoinsular low-grade glioma: anatomofunctional considerations

Five percent of the general population has olfactory or gustatory disorders, although most do not complain about it. However, in some cases, these symptoms can be disabling and may affect quality of life. Anosmia was reported as a possible complication following head injury and neurosurgical procedures, particularly after the resection of tumors located in the anterior fossa and the treatment of aneurysms in the anterior circulation. Nonetheless, in all of these situations, olfactory dysfunction could be explained by damage to the peripheral olfactory system.

Here, the authors report a case of complete anosmia associated with ageusia following awake resection of a low-grade glioma involving the left temporoinsular region, with no recovery during a follow-up of 3 years. The frontal lobe was not retracted, and the olfactory tract was not visualized during surgery; therefore, postoperative anosmia and ageusia are likely explained by damage to the cortex and central pathways responsible for these senses. The authors suggest that the patient might have had a subclinical right hemianosmia before surgery, which is a common condition. After resection of the central structures critical for smell and taste processing in the left hemisphere, the patient could have finally had bilateral and complete olfactory and gustatory loss.

This is the first known report of permanent anosmia and ageusia following glioma surgery. Because these symptoms might have been underestimated, more attention should be devoted to olfaction and taste, especially with regard to possible subclinical preoperative deficit.

Lateralisation in wine olfactory threshold detection: comparison between experts and novices

The study of olfactory lateralisation in humans has given rise to many publications, but few studies have been focused on possible differences in relation to the experience towards specific odorants. The aim of the present study was to compare unilateral detection thresholds for three wines between expert and novice judges. Additionally, irritation and hedonic valence were also evaluated using monorhinal stimulations. Results showed that the novices had lower detection thresholds with the left nostril--whatever the wine--compared to the experts. Concerning hedonic rating, no nostril difference existed in the expert group contrary to the novice group, which evaluated wines as more pleasant with the left than with the right nostril. Irritation rating appeared not to be lateralised in both groups. However, the novices rated the three wines as more irritant than the experts with the right as well as with the left nostril. These findings suggest that the level of experience induced specific differences in terms of lateralisation between wine experts and novices.

Assessing implicit odor localization in humans using a cross-modal spatial cueing paradigm

Background

Navigation based on chemosensory information is one of the most important skills in the animal kingdom. Studies on odor localization suggest that humans have lost this ability. However, the experimental approaches used so far were limited to explicit judgements, which might ignore a residual ability for directional smelling on an implicit level without conscious appraisal.

Methods

A novel cueing paradigm was developed in order to determine whether an implicit ability for directional smelling exists. Participants performed a visual two-alternative forced choice task in which the target was preceded either by a side-congruent or a side-incongruent olfactory spatial cue. An explicit odor localization task was implemented in a second experiment.

Results

No effect of cue congruency on mean reaction times could be found. However, a time by condition interaction emerged, with significantly slower responses to congruently compared to incongruently cued targets at the beginning of the experiment. This cueing effect gradually disappeared throughout the course of the experiment. In addition, participants performed at chance level in the explicit odor localization task, thus confirming the results of previous research.

Conclusion

The implicit cueing task suggests the existence of spatial information processing in the olfactory system. Response slowing after a side-congruent olfactory cue is interpreted as a cross-modal attentional interference effect. In addition, habituation might have led to a gradual disappearance of the cueing effect. It is concluded that under immobile conditions with passive monorhinal stimulation, humans are unable to explicitly determine the location of a pure odorant. Implicitly, however, odor localization seems to exert an influence on human behaviour. To our knowledge, these data are the first to show implicit effects of odor localization on overt human behaviour and thus support the hypothesis of residual directional smelling in humans.

Cortical hemodynamic responses to intravenous thiamine propyldisulphide administration detected by multichannel near infrared spectroscopy (NIRS) system

Intravenous injection of thiamine propyldisulphide (TPD), which induces sensation of a garlic-like odor, has been used as a representative subjective olfactory test in Japan. However, cortical loci activated by TPD still remain unclear. We recorded cerebral hemodynamic responses (changes in Oxy-Hb concentrations) induced by TPD administration using whole-head multi-channel near infrared spectroscopy (NIRS) system based on 3D-MRIs. TPD as an odorant and saline as a control were injected from the cephalic vein in the left forearm in ten male normosmic (five young and five elderly) subjects and five dysosmic elderly patients. The all normosmic, but not dysosmic, subjects felt the garlic-like odor in the all TPD trials. There was no significant difference in hemodynamic responses between the young and elderly normosmic subjects. However, TPD injection induced significantly larger hemodynamic responses in the bilateral operculums, bilateral dorsolateral prefrontal cortices (PFC) and anteromedial PFC in the normosmic subjects, compared with saline injection. Onset latencies of these hemodynamic responses were significantly correlated with onset latencies of subjective odor sensation in the normosmic subjects. Comparison of hemodynamic responses between the normosmic and dysosmic subjects indicated a significant difference in the bilateral operculums. The results demonstrated that Oxy-Hb increases in the bilateral operculums reflected olfactory sensation induced by TPD injection. Consideration of a route for intravenous TPD to reach the olfactory mucosa suggests that these hemodynamic responses might be attributed to food-related retronasal olfactory responses to TPD.

Trigeminal perception is necessary to localize odors

The human ability to localize odorants has been examined in a number of studies, but the findings are contradictory. In the present study we investigated the human sensitivity and ability to localize hydrogen sulphide (H(2)S), which in low concentrations stimulates the olfactory system selectively, the olfactory-trigeminal substance isoamyl acetate (IAA), and the trigeminal substance carbon dioxide (CO(2)). A general requirement for testing of localization was the conscious perception of the applied stimuli by the participants. Using Signal Detection Theory, we determined the human sensitivity in response to stimulation with these substances. Then the subjects' ability to localize the three different substances was tested. We found that humans can detect H(2)S in low concentration (2 ppm) with moderate sensitivity, and possess a high sensitivity in response to stimulation with 8 ppm H(2)S, 17.5% IAA, 50% v/v CO(2). In the localization experiment, subjects could localize neither the low nor the high concentration of H(2)S. In contrast, subjects possessed the ability to localize IAA and CO(2) stimuli. These results clearly demonstrate that humans, in spite of the aware perception, are not able to localize substances which only activate the olfactory system independent of their concentration, but they possess an ability to localize odorants that additionally excite the trigeminal system.

Neural substrates of olfactory processing in schizophrenia patients and their healthy relatives

Odorants represent powerful stimuli capable of eliciting various emotional responses. In schizophrenia patients and their non-affected relatives, olfactory and emotional functions are impaired, revealing a familial influence on these deficits. We aimed at determining the neural basis of emotional olfactory dysfunctions using odors of different emotional valence for mood induction and functional magnetic resonance imaging (fMRI) by comparing 13 schizophrenia patients, their non-affected brothers and 26 matched healthy controls. Blood-oxygen-level-dependent (BOLD) effects and subjective mood changes were assessed during negative (rotten yeast), positive (vanilla) and neutral (ambient air) olfactory stimulation. Group comparisons of brain activation were performed in regions of interest. Subjective ratings were comparable between groups and indicated successful mood induction. However, during stimulation with the negative odor, hypofunctional activity emerged in regions of the right frontal and temporal cortex in the patients. A familial influence in the neural substrates of negative olfactory dysfunction was indicated by a similar reduced frontal brain activity in relatives. Dysfunctions therefore appeared to be located in regions involved in higher cognitive processes associated with olfaction. No familial influences were indicated for cerebral dysfunctions during positive olfactory stimulation. Results point to a differentiation between trait and state components in cerebral dysfunctions during emotional olfactory processing in schizophrenia.

Influence of nasal trigeminal stimuli on olfactory sensitivity

In the nose, the capacity to detect and react to volatile chemicals is mediated by two separate but interrelated sensory pathways, the olfactory and trigeminal systems. Because most chemosensory stimulants, at sufficient concentration, produce both olfactory and trigeminal sensations (i.e., stinging, burning or pungent), it is relevant to seek how these anatomically distinct systems could interact. This study was designed to evaluate by psychophysical measurements the modifications of the olfactory sensitivity of 20 subjects to phenyl ethyl alcohol (PEA) and butanol (BUT), after trigeminal stimulation with allyl isothiocyanate (AIC). Thresholds obtained in two separate sessions, one with and the other without previous trigeminal stimulation, were compared using a two-alternative forced-choice procedure, with a classical ascending concentrations method. The results showed that, whatever the odorant (PEA or BUT), AIC trigeminal activation produced a decrease in the olfactory thresholds, corresponding to an increase in olfactory sensitivity. These data confirm that in physiological conditions the trigeminal system modulates the activity of olfactory receptor cells but do not exclude the possibility of a central modulation of olfactory information by trigeminal stimuli. These findings are discussed in terms of methodological and physiological conditions.

Unconscious odor detection could not be due to odor itself

Unconscious odor detection has been demonstrated but the mechanisms implied in this process have been poorly studied. In so far, most odorants activate both olfactory and trigeminal systems, it is relevant to explore how each system could be involved in the unconscious detection processes. This study used three methods to determine the detection thresholds for three odorants. The results showed that (1). psychophysical were lower than self-evaluated thresholds whatever the odorant; (2). an odorant with trigeminal component had the ability to produce an autonomic (skin conductance response-SCR) activation with lower concentrations than psychophysical and self-evaluated thresholds; on the contrary, an odorant, which stimulates only the olfactory system, induces an autonomic activation only with higher concentrations than psychophysical and self-evaluated thresholds. These findings suggest that unconscious odor detection could be due to the trigeminal component of odorants.

Differential human electrodermal responses to odours

Evaluation of the pleasantness of odours is an important function of the olfactory system. Electrodermal recordings monitor activity in the autonomic nervous system and it has been hypothesized that such measurements could be especially valuable for investigations of affective processes in the olfactory system. In this study we measured changes in skin conductance on both hands while subjects were exposed birhinally to two pleasant and two unpleasant odours. All odours were iso-intense and non-trigeminal. We wanted to test the hypothesis that skin conductance is contra laterally governed. Furthermore, we tested the hypothesis that unpleasant odours produce larger skin conductance responses than pleasant odours. Our results indicate that there are differential skin conductance responses to different odours, but we did not find that unpleasant odours in general produce larger skin conduction responses than pleasant odours. Neither did we find support for the hypothesis that skin conduction is contralaterally governed. Rather, our data are consistent with the existence of an ipsilateral system for the control of emotional responses.

Anosmia: diagnosis and management

Disorders of the sense of smell can be frustrating for both the patient and physician. Ongoing research in this field has provided insight into the possible mechanisms for smell loss; however, therapy is still limited. Commercially distributed smell testing kits and newer screening tests using material available in all clinical settings have made diagnosis and measurement of the degree of impairment available to all physicians. A detailed history and physical examination are the most powerful tools in the evaluation of smell disorders, whereas imaging studies are reserved for preoperative planning or detailed assessment of positive physical findings.