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Pieniak M, Höfer B, Knipping J, Faria V, Richter M, Schriever VA, Haehner A, Gossrau G. Children and adolescents with primary headaches exhibit altered sensory profiles - a multi-modal investigation. J Headache Pain 2024; 25:111. [PMID: 38982389 PMCID: PMC11234718 DOI: 10.1186/s10194-024-01819-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 06/27/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Pediatric headache is an increasing medical problem that has adverse effects on children's quality of life, academic performance, and social functioning. Children with primary headaches exhibit enhanced sensory sensitivity compared to their healthy peers. However, comprehensive investigations including multimodal sensory sensitivity assessment are lacking. This study aimed to compare sensory sensitivity of children with primary headaches with their healthy peers across multiple sensory domains. METHODS The study included 172 participants aged 6 to 17 years (M = 13.09, SD = 3.02 years; 120 girls). Of these 80 participants were patients with migraine, 23 were patients with tension-type headache, and 69 were healthy controls. The following sensory measures were obtained: Mechanical Detection Threshold (MDT), Mechanical Pain Threshold (MPT), Mechanical Pain Sensitivity (MPS), detection and pain threshold for Transcutaneous Electrical Nerve Stimulation (TENS), olfactory and intranasal trigeminal detection threshold, and odor identification ability. Sensory sensitivity was compared between groups with a series of Kruskal-Wallis tests. Binomial regression models were used to compare the relative utility of sensory sensitivity measures in classifying participants into patients and healthy controls, as well as into patients with migraine and tension-type headache. RESULTS Patients with migraine had lower MPT measured at the forearm than patients with tension-type headaches and healthy controls. MPS was higher in patients with migraine than in healthy controls. All patients with headaches had lower detection threshold of TENS and higher olfactory sensitivity. Healthy controls showed increased intranasal trigeminal sensitivity. Scores in MPS, TENS, and olfactory and trigeminal thresholds were significantly predicting presence of primary headaches. Additionally, scores in MPT, olfactory and trigeminal threshold were positive predictors of type of headache. CONCLUSIONS Children with primary headaches exhibit different sensory profiles than healthy controls. The obtained results suggest presence of increased overall, multimodal sensitivity in children with primary headaches, what may negatively impact daily functioning and contribute to further pain chronification. TRIAL REGISTRATION The study was registered in the German Registry of Clinical Trials (DRKS) DRKS00021062.
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Affiliation(s)
- Michal Pieniak
- Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Smell & Taste Clinic, University Hospital, TU Dresden, Dresden, Germany
- Institute of Psychology, University of Wroclaw, Wroclaw, Poland
| | - Berit Höfer
- Interdisciplinary Pain Center, Faculty of Medicine Carl Gustav Carus, University Hospital, TU Dresden, Dresden, Germany
| | - Jenny Knipping
- Department of Pediatric Neurology, Faculty of Medicine Carl Gustav Carus, University Hospital, TU Dresden, Dresden, Germany
| | - Vanda Faria
- Interdisciplinary Pain Center, Faculty of Medicine Carl Gustav Carus, University Hospital, TU Dresden, Dresden, Germany
| | - Matthias Richter
- Department of Pediatrics, Faculty of Medicine Carl Gustav Carus, University Hospital, Dresden, TU, Germany
| | - Valentin A Schriever
- Department of Pediatric Neurology, Faculty of Medicine Carl Gustav Carus, University Hospital, TU Dresden, Dresden, Germany
- Department of Pediatrics, Pediatric Neurology, Neurometabolics and Prevention, Goethe University Frankfurt, Frankfurt, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Smell & Taste Clinic, University Hospital, TU Dresden, Dresden, Germany
| | - Gudrun Gossrau
- Interdisciplinary Pain Center, Faculty of Medicine Carl Gustav Carus, University Hospital, TU Dresden, Dresden, Germany.
- Interdisciplinary Pain Center, Faculty of Medicine Carl Gustav Carus, University Hospital, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
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Pieniak M, Rokosz M, Nawrocka P, Reichert A, Zyzelewicz B, Mahmut MK, Oleszkiewicz A. Null cross-modal effects of olfactory training on visual, auditory or olfactory working memory in 6- to 9-year-old children. Neuropsychol Rehabil 2024:1-22. [PMID: 38762780 DOI: 10.1080/09602011.2024.2343484] [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: 12/20/2023] [Accepted: 04/04/2024] [Indexed: 05/20/2024]
Abstract
Systematic exposure to odours (olfactory training, OT) is a method of smell loss treatment. Due to olfactory system projections to prefrontal brain areas, OT has been hypothesized to enhance cognitive functions, but its effects have been studied predominantly in adults. This study tested OT effects on working memory (WM), i.e., the ability to store and manipulate information for a short time, in healthy children aged 6-9 years. We expected OT to improve olfactory WM and establish cross-modal transfer to visual and auditory WM. Participants performed 12 weeks of bi-daily OT with either 4 odours (lemon, eucalyptus, rose, cloves; OT group) or odourless propylene glycol (placebo group). Pre- and post-training, participants' WM was measured utilizing odours (olfactory WM) or pictures (visual WM) and a word-span task (auditory WM). 84 children (40 girls) completed the study. The analyses revealed no changes in the WM performance following OT. The olfactory WM task was the most difficult for children, highlighting the need to include olfactory-related tasks in educational programmes to improve children's odour knowledge and memory, just as they learn about sounds and pictures. Further neuroimaging research is needed to fully understand the impact of OT on cognitive functions in children.
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Affiliation(s)
- Michal Pieniak
- Institute of Psychology, University of Wroclaw, Wroclaw, Poland
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Marta Rokosz
- Institute of Psychology, University of Wroclaw, Wroclaw, Poland
| | | | - Aleksandra Reichert
- Institute of Psychology, University of Wroclaw, Wroclaw, Poland
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | - Mehmet K Mahmut
- Food, Flavour and Fragrance Lab, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Anna Oleszkiewicz
- Institute of Psychology, University of Wroclaw, Wroclaw, Poland
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Gellrich J, Zickmüller C, Thieme T, Karpinski C, Fitze G, Smitka M, von der Hagen M, Schriever VA. Olfactory function after mild traumatic brain injury in children-a longitudinal case control study. Cereb Cortex 2024; 34:bhae162. [PMID: 38629798 DOI: 10.1093/cercor/bhae162] [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: 01/16/2024] [Revised: 03/08/2024] [Accepted: 03/27/2024] [Indexed: 04/19/2024] Open
Abstract
The prevalence of posttraumatic olfactory dysfunction in children after mild traumatic brain injury ranges from 3 to 58%, with potential factors influencing this variation, including traumatic brain injury severity and assessment methods. This prospective longitudinal study examines the association between mild traumatic brain injury and olfactory dysfunction in children. Seventy-five pediatric patients with mild traumatic brain injury and an age-matched healthy control group were enrolled. Olfactory function was assessed using the Sniffin' Sticks battery, which focuses on olfactory threshold and odor identification. The study found that children with mild traumatic brain injury had impaired olfactory function compared with healthy controls, particularly in olfactory threshold scores. The prevalence of olfactory dysfunction in the patient group was 33% and persisted for 1 yr. No significant association was found between traumatic brain injury symptoms (e.g. amnesia, loss of consciousness) and olfactory dysfunction. The study highlights the importance of assessing olfactory function in children after mild traumatic brain injury, given its potential impact on daily life. Although most olfactory dysfunction appears transient, long-term follow-up is essential to fully understand the recovery process. The findings add valuable insights to the limited literature on this topic and urge the inclusion of olfactory assessments in the management of pediatric mild traumatic brain injury.
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Affiliation(s)
- Janine Gellrich
- Abteilung Neuropädiatrie, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Claudia Zickmüller
- Abteilung Neuropädiatrie, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Theresa Thieme
- Abteilung Neuropädiatrie, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian Karpinski
- Klinik und Poliklinik für Kinderchirurgie, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Guido Fitze
- Klinik und Poliklinik für Kinderchirurgie, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Martin Smitka
- Abteilung Neuropädiatrie, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Maja von der Hagen
- Abteilung Neuropädiatrie, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Valentin A Schriever
- Center for Chronically Sick Children (Sozialpädiatrisches Zentrum, SPZ), Charité - Universitätsmedizin Berlin, Campus Virchow-KlinikumAugustenburger Pl. 113353 Berlin, Germany
- Department of Pediatric Neurology, Charité - Universitätsmedizin Berlin, Charité Campus Virchow-Klinikum, Mittelallee 9, 13353 Berlin, Germany
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Challakere Ramaswamy VM, Butler T, Ton B, Wilhelm K, Mitchell PB, Knight L, Greenberg D, Ellis A, Gebski V, Schofield PW. Neuropsychiatric correlates of olfactory identification and traumatic brain injury in a sample of impulsive violent offenders. Front Psychol 2023; 14:1254574. [PMID: 37842698 PMCID: PMC10570745 DOI: 10.3389/fpsyg.2023.1254574] [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: 07/07/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Background Olfactory deficits have a diverse etiology and can be detected with simple olfactory tests. Key olfactory pathways are located within the frontal and temporal lobes where they are vulnerable to damage due to head trauma. Orbitofrontal cortex (OFC) integrity is important for olfaction and aspects of behavioral regulation. We measured olfactory identification ability in a sample of impulsive violent offenders to determine its associations with history of traumatic brain injury (TBI) and a range of neuropsychiatric indices, including proxies for cognitive ability, impulsivity and social connectedness. Methods Male participants were drawn from the ReINVEST study, a randomized controlled trial of sertraline to reduce recidivism in violent impulsive offenders. Criteria for participation in the study included a minimum age of 18 years, a documented history of two or more violent offenses, and a score of 70 or above on the Barratt Impulsiveness Scale (BIS-11). The 16-item "Sniffin sticks" (SS) odor identification test (OI) was administered as were standardized questionnaires regarding previous TBI, additional measures to screen cognition [word reading test of the Wechsler Individuals Achievement Test (WIAT), social connectedness (the Duke Social Support Scale), and a range of other neuropsychiatric conditions or symptoms]. The sample SS scores were compared against published age-specific norms. Univariate and multivariate analyses were performed with SS score (linear regression, within those without hyposmia) or hyposmia (logistic regression) as the outcome. Results The mean OI scores were lower than population norms and 16% of participants were classified as hyposmic. Univariate analyses showed associations of SS score with age, WIAT score, impulsivity, TBI and TBI severity, social connectedness, childhood sexual abuse, suicidality and current use of heroin. In multivariate analyses, age, TBI severity and WIAT remained as significant independent predictors of SS score (within the normosmic range) or hyposmia (logistic regression). Conclusion Olfactory performance was associated with multiple behavioral phenomena in a pattern that would be consistent with this serving as a proxy for orbitofrontal functioning. As such, OI testing may have utility in further studies of offenders. In future, we will examine whether olfactory score predicts recidivism or response to the administration of sertraline, in terms of reducing recidivism.
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Affiliation(s)
| | - Tony Butler
- University of New South Wales, Sydney, NSW, Australia
| | - Bianca Ton
- University of New South Wales, Sydney, NSW, Australia
| | - Kay Wilhelm
- University of New South Wales, Sydney, NSW, Australia
| | | | - Lee Knight
- University of New South Wales, Sydney, NSW, Australia
| | - David Greenberg
- University of New South Wales, Sydney, NSW, Australia
- Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
| | - Andrew Ellis
- University of New South Wales, Sydney, NSW, Australia
- Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
| | - Val Gebski
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
| | - Peter William Schofield
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
- Neuropsychiatry Service, Hunter New England Mental Health, Newcastle, NSW, Australia
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Pieniak M, Seidel K, Oleszkiewicz A, Gellrich J, Karpinski C, Fitze G, Schriever VA. Olfactory training effects in children after mild traumatic brain injury. Brain Inj 2023; 37:1272-1284. [PMID: 37486172 DOI: 10.1080/02699052.2023.2237889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 05/29/2023] [Accepted: 06/12/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE Mild traumatic brain injury (mTBI) might impair the sense of smell and cognitive functioning. Repeated, systematic exposure to odors, i.e., olfactory training (OT) has been proposed for treatment of olfactory dysfunctions, including post-traumatic smell loss. Additionally, OT has been shown to mitigate cognitive deterioration in older population and enhance selected cognitive functions in adults. We aimed to investigate olfactory and cognitive effects of OT in the pediatric population after mTBI, likely to exhibit cognitive and olfactory deficits. METHODS Our study comprised 159 children after mTBI and healthy controls aged 6-16 years (M = 9.68 ± 2.78 years, 107 males), who performed 6-months-long OT with a set of 4 either high- or low-concentrated odors. Before and after OT we assessed olfactory functions, fluid intelligence, and executive functions. RESULTS OT with low-concentrated odors increased olfactory sensitivity in children after mTBI. Regardless of health status, children who underwent OT with low-concentrated odors had higher fluid intelligence scores at post-training measurement, whereas scores of children performing OT with high-concentrated odors did not change. CONCLUSION Our study suggests that OT with low-concentrated odors might accelerate rehabilitation of olfactory sensitivity in children after mTBI and support cognitive functions in the area of fluid intelligence regardless of head trauma.
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Affiliation(s)
- Michal Pieniak
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Faculty of Historical and Pedagogical Sciences, Institute of Psychology, University of Wrocław, Wroclaw, Poland
| | - Katharina Seidel
- Abteilung Neuropädiatrie, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Anna Oleszkiewicz
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Faculty of Historical and Pedagogical Sciences, Institute of Psychology, University of Wrocław, Wroclaw, Poland
| | - Janine Gellrich
- Abteilung Neuropädiatrie, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian Karpinski
- Klinik Und Poliklinik Für Kinderchirurgie, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Guido Fitze
- Klinik Und Poliklinik Für Kinderchirurgie, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Valentin A Schriever
- Abteilung Neuropädiatrie, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Center for Chronically Sick Children (Sozialpädiatrisches Zentrum, SPZ), Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Pediatric Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Lohrer EC, Dworschak A, Croy I, Gellrich J, Sabha M, Parisato L, Schriever VA. Children’s Personal Significance of Olfaction — the ChiPSO Questionnaire. CHEMOSENS PERCEPT 2022. [DOI: 10.1007/s12078-022-09303-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract
Introduction
The human sense of smell has different functions which can be categorized as “food,” “social,” and “environment.” Different questionnaires about the importance of olfaction in adults are available, but little attention has been paid to children and adolescents. Therefore, we aimed to develop a questionnaire about children’s personal significance of olfaction (ChiPSO).
Methods
The questionnaire was developed in two steps. The first questionnaire included 33 statements about the importance of olfactory information in daily life — covering three subscales “food,” “environment,” and “social” administered to 191 participants (mean age: 14.4 ± 1.7 years). The five best fitting items of each subscale were chosen for the final 15-item questionnaire. In the second part, we administered the developed questionnaire to 208 children and adolescents (mean age: 11.5 ± 3.5 years) who additionally underwent olfactory testing to investigate the association between olfactory function and questionnaire results. Participants were separated in two age groups: (i) 6–11 years (children), (ii) 12–17 years (adolescents).
Results
A significant influence of age on the total ChiPSO score and all three subscales with adolescents scoring higher than children was found. Additionally, there was a significant influence of sex in adolescents on total ChiPSO score and subscales “social” and “food” with girls scoring higher than boys.
Conclusion
We report an association between questionnaires results and olfactory performance. Additionally, olfactory information seems to be more important to adolescents compared to children and girls compared to boys.
Implications
The ChiPSO questionnaire is a practical tool to evaluate the importance of olfactory information in children and adolescents aged 6–17 years.
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Challakere Ramaswamy VM, Schofield PW. Olfaction and Executive Cognitive Performance: A Systematic Review. Front Psychol 2022; 13:871391. [PMID: 35615205 PMCID: PMC9125097 DOI: 10.3389/fpsyg.2022.871391] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/14/2022] [Indexed: 11/30/2022] Open
Abstract
Objective tests of olfaction are widely available to aid in the assessment of olfaction. Their clearest role is in the characterization of olfactory changes, either reported by or suspected in a patient. There is a rapidly growing literature concerned with the association of olfactory changes with certain neuropsychiatric conditions and the use of olfactory testing to supplement conventional assessments in clinical and research practice is evolving. Neural pathways important for olfactory processing overlap extensively with pathways important for cognitive functioning, and especially those important for executive functioning, many of which are concentrated in the frontal lobes. Previous work has identified associations between performance on certain olfactory tests (most frequently olfactory identification) and executive functioning and behavioral measures (e.g. of impulsivity). More recently, similar associations have also been identified in non-clinical samples, raising new questions as to the utility of olfactory test scores as proxy measures for non-olfactory phenomena. In this systemic review, we sought to identify studies, both clinical and non-clinical, that investigated the associations of olfaction with performance on tasks sensitive to frontal lobe functioning. Our search criteria led to the identification of 70 studies published in English. We examined in detail and tabulated the data from these studies, highlighted each study's key findings, and critically evaluated these studies. We use the results of this review to reflect on some of the current and future challenges concerning the use of olfactory testing in clinical neuropsychiatric practice and research and speculate on the potential benefits of administering phonemic fluency in combination with olfactory testing to enhance its predictive value.
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Affiliation(s)
- Vasudeva Murthy Challakere Ramaswamy
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
- *Correspondence: Vasudeva Murthy Challakere Ramaswamy
| | - Peter William Schofield
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
- Neuropsychiatry Service, Hunter New England Mental Health, New Lambton, NSW, Australia
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