Localization of odors can be learned

Assessment of Intranasal Function of the Trigeminal Nerve in Daily Clinical Practice

BACKGROUND

The trigeminal nerve is a mixed cranial nerve responsible for the motor innervation of the masticatory muscles and the sensory innervation of the face, including the nasal cavities. Through its nasal innervation, we perceive sensations, such as cooling, tingling, and burning, while the trigeminal system mediates the perception of airflow. However, the intranasal trigeminal system has received little attention in the clinical evaluation of patients with nasal pathology.

SUMMARY

Testing methods that enable the clinical assessment of intranasal trigeminal function have recently been developed. This study aims to present the current clinical methods that can be utilised in everyday practice, as described in the literature. These methods include four assessment techniques: (1) the quick screening test of trigeminal sensitivity involves patients rating the intensity of ammonium vapour presented in a lipstick-like container. (2) The lateralisation test requires subjects to identify which nasal cavity is being stimulated by a trigeminal stimulus, such as eucalyptol or menthol, while the other side receives an odourless stimulus. (3) The trigeminal sticks test evaluates the trigeminal function similarly to the olfactory function using sticks filled with trigeminal stimulant liquids. (4) The automated CO2 stimulation device is used for measuring trigeminal pain thresholds, utilising intranasal CO2 stimuli to define the pain threshold.

KEY MESSAGES

Assessing intranasal trigeminal function clinically may prove useful in evaluating rhinology patients, particularly those who encounter nasal obstruction without anatomical blockage and those experiencing olfactory disorders with suspected trigeminal dysfunction. Despite their limitations, the presented methods may provide useful information about nasal patency, chemosensitivity, and pain sensation in the daily clinical practice of such patients, leading to better therapeutic decisions.

Implicit versus explicit processing of visual, olfactory, and multimodal landmark information in human wayfinding

Despite the predominant focus on visual perception in most studies, the role of humans' sense of smell in navigation has often been neglected. Recent research, however, could show that humans are indeed able to use their sense of smell for orientation, particularly when processed implicitly. In this study, we investigate whether implicit perception of olfactory landmarks enhanced wayfinding performance compared to explicit perception. Fifty-two people completed a wayfinding and a recognition task in a virtual maze at two times of testing 1 month apart. Participants either received olfactory, visual, or both cues at the intersections. Wayfinding performance was better for olfactory landmarks, which were not correctly remembered in the recognition task. In contrast, wayfinding performance was better when visual landmarks were correctly remembered. In the multimodal condition, wayfinding performance was better with landmarks being remembered at t1 and remained the same at t2. Our results suggest distinct implicit processing mechanisms within the olfactory system and therefore hold important implications for the nature of spatial odor processing extending beyond explicit odor localization tasks. The study highlights the importance for future studies to develop and employ further experimental methods that capture implicit processing across all of our senses. This is crucial for a comprehensive understanding of consciousness, as olfaction strongly influences our behavior, but remains largely latent unless deliberately honed through practice.

Enhanced Odorant Localization Abilities in Congenitally Blind but not in Late-Blind Individuals

Although often considered a nondominant sense for spatial perception, chemosensory perception can be used to localize the source of an event and potentially help us navigate through our environment. Would blind people who lack the dominant spatial sense-vision-develop enhanced spatial chemosensation or suffer from the lack of visual calibration on spatial chemosensory perception? To investigate this question, we tested odorant localization abilities across nostrils in blind people compared to sighted controls and if the time of vision loss onset modulates those abilities. We observed that congenitally blind individuals (10 subjects) outperformed sighted (20 subjects) and late-blind subjects (10 subjects) in a birhinal localization task using mixed olfactory-trigeminal stimuli. This advantage in congenitally blind people was selective to olfactory localization but not observed for odorant detection or identification. We, therefore, showed that congenital blindness but not blindness acquired late in life is linked to enhanced localization of chemosensory stimuli across nostrils, most probably of the trigeminal component. In addition to previous studies highlighting enhanced localization abilities in auditory and tactile modalities, our current results extend such enhanced abilities to chemosensory localization.

Odor lateralization and spatial localization: Null effects of blindness

People can navigate through an environment using different sensory information, including olfactory cues. Correct intranasal localization and external location of odors can be learned, and some people are able to lateralize olfactory stimuli above chance, which raises the question: What determines the spectrum of olfactory localization abilities. Here, we explored whether odor lateralization and localization abilities are increased in the course of sensory compensation. In a series of studies, we combined two different aspects of odor localization. Study 1 compared abilities of 69 blind people (M_age = 41 ± 1.6 years; 32 females) and 45 sighted controls (M_age = 38.3 ± 2.1 years; 25 females) to correctly lateralize eucalyptol, an odorant with a strong trigeminal component, presented to either nostril. Studies 2 and 3 involved a more ecologically valid task, namely spatial localization of olfactory stimuli. In Study 2, 13 blind individuals (M_age = 28.5 ± 3.5 years; seven females) and 16 sighted controls (M_age = 34.9 ± 3.2 years; ten females) tried to localize a single odorant, while in Study 3, 97 blind individuals (M_age = 43.1 ± .5 years; 48 females) and 47 sighted controls (M_age = 38.7 ± .7 years; 27 females) attempted to localize a single target odor in an experimental olfactory space comprising four different odorants. Blind and sighted subjects did not differ in their abilities to lateralize and to localize odors, and their performance across all tasks suggests that odor lateralization and localization are important for navigation in an environment regardless of visual status.

The intranasal trigeminal system

Many odors activate the intranasal chemosensory trigeminal system where they produce cooling and other somatic sensations such as tingling, burning, or stinging. Specific trigeminal receptors are involved in the mediation of these sensations. Importantly, the trigeminal system also mediates sensitivity to airflow. The intranasal trigeminal and the olfactory system are closely connected. With regard to central nervous processing, it is most interesting that trigeminal stimuli can activate the piriform cortex, which is typically viewed as the primary olfactory cortex. This suggests that interactions between the two systems may form at a relatively early stage of processing. For example, there is evidence showing that acquired olfactory loss leads to reduced trigeminal sensitivity, probably on account of the lack of interaction in the central nervous system. Decreased trigeminal sensitivity may also be responsible for changes in airflow perception, leading to the impression of congested nasal airways.

Changes in olfactory bulb volume following lateralized olfactory training

Repeated exposure to odors modifies olfactory function. Consequently, "olfactory training" plays a significant role in hyposmia treatment. In addition, numerous studies show that the olfactory bulb (OB) volume changes in disorders associated with olfactory dysfunction. Aim of this study was to investigate whether and how olfactory bulb volume changes in relation to lateralized olfactory training in healthy people. Over a period of 4 months, 97 healthy participants (63 females and 34 males, mean age: 23.74 ± 4.16 years, age range: 19-43 years) performed olfactory training by exposing the same nostril twice a day to 4 odors (lemon, rose, eucalyptus and cloves) while closing the other nostril. Before and after olfactory training, magnetic resonance imaging (MRI) scans were performed to measure OB volume. Furthermore, participants underwent lateralized odor threshold and odor identification testing using the "Sniffin' Sticks" test battery.OB volume increased significantly after olfactory training (11.3 % and 13.1 % respectively) for both trained and untrained nostril. No significant effects of sex, duration and frequency of training or age of the subjects were seen. Interestingly, PEA odor thresholds worsened after training, while olfactory identification remained unchanged.These data show for the first time in humans that olfactory training may involve top-down process, which ultimately lead to a bilateral increase in olfactory bulb volume.

Human olfactory lateralization requires trigeminal activation

Rats are able to lateralize odors. This ability involves specialized neurons in the orbitofrontal cortex which are able to process the left, right and bilateral presentation of stimuli. However, it is not clear whether this function is preserved in humans. Humans are in general not able to differentiate whether a selective olfactory stimulant has been applied to the left or right nostril; however exceptions have been reported. Following a screening of 152 individuals with an olfactory lateralization test, we identified 19 who could lateralize odors above chance level. 15 of these "lateralizers" underwent olfactory fMRI scanning in a block design and were compared to 15 controls matched for age and sex distribution. As a result, both groups showed comparable activation of olfactory eloquent brain areas. However, subjects with lateralization ability had a significantly enhanced activation of cerebral trigeminal processing areas (somatosensory cortex, intraparietal sulcus). In contrast to controls, lateralizers furthermore exhibited no suppression in the area of the trigeminal principal sensory nucleus. An exploratory study with an olfactory change detection paradigm furthermore showed that lateralizers oriented faster towards changes in the olfactory environment. Taken together, our study suggests that the trigeminal system is activated to a higher degree by the odorous stimuli in the group of "lateralizers". We conclude that humans are not able to lateralize odors based on the olfactory input alone, but vary in the degree to which the trigeminal system is recruited.