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Masala C, Loy F, Pinna I, Manis NA, Ercoli T, Solla P. Olfactory Function as a Potential Predictor of Cognitive Impairment in Men and Women. BIOLOGY 2024; 13:503. [PMID: 39056696 PMCID: PMC11274230 DOI: 10.3390/biology13070503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 06/23/2024] [Accepted: 07/04/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Different previous studies indicated olfactory function as a predictor of several types of cognitive impairment, in particular related to neurodegenerative disease. However, scanty data are available on the role of odor threshold (OT), odor discrimination (OD), and odor identification (OI) as a predictor of cognitive impairment. The aim of this study was to evaluate potential correlations between each factor of the olfactory function versus each specific cognitive domain of the Montreal Cognitive Assessment (MoCA) test on healthy subjects in relation to gender and age. METHODS Sniffin' Sticks and MoCA tests were used to determine olfactory function and cognitive abilities, respectively. RESULTS In men, significant correlations were found in OT versus language index score and OI versus language and executive index score, while in women, OD and OI were correlated to visuospatial index score. CONCLUSIONS Our data suggested that olfactory function (OT, OD, and OI) may be considered a predictor for cognitive impairment in relation to gender and age.
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Affiliation(s)
- Carla Masala
- Department of Biomedical Sciences, University of Cagliari, SP 8 Cittadella Universitaria, 09042 Monserrato, Italy; (F.L.); (I.P.); (N.A.M.)
| | - Francesco Loy
- Department of Biomedical Sciences, University of Cagliari, SP 8 Cittadella Universitaria, 09042 Monserrato, Italy; (F.L.); (I.P.); (N.A.M.)
| | - Ilenia Pinna
- Department of Biomedical Sciences, University of Cagliari, SP 8 Cittadella Universitaria, 09042 Monserrato, Italy; (F.L.); (I.P.); (N.A.M.)
| | - Nicoletta Aurora Manis
- Department of Biomedical Sciences, University of Cagliari, SP 8 Cittadella Universitaria, 09042 Monserrato, Italy; (F.L.); (I.P.); (N.A.M.)
| | - Tommaso Ercoli
- Neurological Unit, AOU Sassari, University of Sassari, Viale S. Pietro 10, 07100 Sassari, Italy; (T.E.); (P.S.)
| | - Paolo Solla
- Neurological Unit, AOU Sassari, University of Sassari, Viale S. Pietro 10, 07100 Sassari, Italy; (T.E.); (P.S.)
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Arruda JFDL, Silva LD, Brisson RT, Micheli GDC, Lima MASDD, Rosso ALZD, Fernandes RDCL. Performance of a cost-effective olfactory test to evaluate hyposmia in Parkinson's disease patients. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1-6. [PMID: 38811023 DOI: 10.1055/s-0044-1787139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
BACKGROUND Parkinson's disease (PD) causes motor and non-motor symptoms such as hyposmia, which is evaluated through olfactory tests in the clinical practice. OBJECTIVE To assess the feasibility of using the modified Connecticut Chemosensory Clinical Research Center (mCCCRC) olfactory test and to compare its performance with the Sniffin' Sticks-12 (SS-12, Burghart Messtechnik GmbH, Wedel, Germany) test. METHODS A transversal case-control study in which the patients were divided into the PD group (PDG) and the control group (CG). The cost and difficulty in handling substances to produce the mCCCRC test kits were evaluated. Sociodemographic characteristics, smoking habits, past coronavirus disease 2019 (COVID-19) infections, self-perception of odor sense, and cognition through the Montreal Cognitive Assessment (MoCA) were also evaluated. The PDG was scored by part III of the Unified Parkinson's Disease Rating Scale (UPDRS-III) and the Hoehn and Yahr Scale (H&Y) scale. Correlations were assessed through the Spearman rank correlation coefficient test (ρ, or rho). RESULTS The mCCCRC test was easily manufactured and handled at a cost ten times lower compared with the SS-12. The groups (PDG: n = 34; CG: n = 38) were similar in terms of age, sex, level of schooling, smoking habits, and history of COVID-19. The tests results showed moderate correlation (rho = 0.65; p < 0.0001). The CG presented better cognitive performance and scored better in both tests (p < 0.0001). There was a tendency for a negative correlation with age, but good correlation with the MoCA (p = 0.0029). The results of the PDG group showed no correlation with olfactory results and motor performance or disease duration. The self-perception of hyposmia was low in both groups. CONCLUSION The mCCCRC is an easy-to-apply and inexpensive method that demonstrated a similar performance to that of the SS-12 in evaluating olfaction in PD patients and healthy controls.
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Affiliation(s)
- Josevânia Fulgêncio de Lima Arruda
- Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil
| | - Liene Duarte Silva
- Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil
| | - Rodrigo Tavares Brisson
- Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil
| | - Gabriel de Castro Micheli
- Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil
| | - Marco Antônio Sales Dantas de Lima
- Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil
| | - Ana Lucia Zuma de Rosso
- Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil
| | - Rita de Cássia Leite Fernandes
- Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil
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Jacobson PT, Vilarello BJ, Tervo JP, Waring NA, Gudis DA, Goldberg TE, Devanand DP, Overdevest JB. Associations between olfactory dysfunction and cognition: a scoping review. J Neurol 2024; 271:1170-1203. [PMID: 38217708 PMCID: PMC11144520 DOI: 10.1007/s00415-023-12057-7] [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: 07/20/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION Strong evidence suggests that olfactory dysfunction (OD) can predict additional neurocognitive decline in neurodegenerative conditions such as Alzheimer's and Parkinson's diseases. However, research exploring olfaction and cognition in younger populations is limited. The aim of this review is to evaluate cognitive changes among non-elderly adults with non-COVID-19-related OD. METHODS We performed a structured comprehensive literature search of PubMed, Ovid Embase, Web of Science, and Cochrane Library in developing this scoping review. The primary outcome of interest was the association between OD and cognitive functioning in adults less than 60 years of age. RESULTS We identified 2878 studies for title and abstract review, with 167 undergoing full text review, and 54 selected for data extraction. Of these, 34 studies reported on populations of individuals restricted to the ages of 18-60, whereas the remaining 20 studies included a more heterogeneous population with the majority of individuals in this target age range in addition to some above the age of 60. The etiologies for smell loss among the included studies were neuropsychiatric disorders (37%), idiopathic cause (25%), type 2 diabetes (7%), trauma (5%), infection (4%), intellectual disability (4%), and other (18%). Some studies reported numerous associations and at times mixed, resulting in a total number of associations greater than the included number of 54 studies. Overall, 21/54 studies demonstrated a positive association between olfaction and cognition, 7/54 demonstrated no association, 25/54 reported mixed results, and only 1/54 demonstrated a negative association. CONCLUSION Most studies demonstrate a positive correlation between OD and cognition, but the data are mixed with associations less robust in this young adult population compared to elderly adults. Despite the heterogeneity in study populations and outcomes, this scoping review serves as a starting point for further investigation on this topic. Notably, as many studies in this review involved disorders that may have confounding effects on both olfaction and cognition, future research should control for these confounders and incorporate non-elderly individuals with non-psychiatric causes of smell loss.
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Affiliation(s)
- Patricia T Jacobson
- Department of Otolaryngology-Head and Neck Surgery, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | - Brandon J Vilarello
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Jeremy P Tervo
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Nicholas A Waring
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - David A Gudis
- Department of Otolaryngology-Head and Neck Surgery, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Terry E Goldberg
- Department of Psychiatry, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | - D P Devanand
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Department of Psychiatry, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | - Jonathan B Overdevest
- Department of Otolaryngology-Head and Neck Surgery, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
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Masala C, Solla P, Loy F. Gender-Related Differences in the Correlation between Odor Threshold, Discrimination, Identification, and Cognitive Reserve Index in Healthy Subjects. BIOLOGY 2023; 12:biology12040586. [PMID: 37106786 PMCID: PMC10136322 DOI: 10.3390/biology12040586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Many studies suggested that olfactory function could be associated with semantic memory, executive function, and verbal fluency. However, the gender-related association between olfactory function and the cognitive domain is not well investigated. The aim of this study was to estimate gender-related differences in the relationship between olfactory function and each specific cognitive domain of the Cognitive Reserve Index (CRI) questionnaire, such as education, working activity, and leisure time in healthy subjects. METHODS Two hundred and sixty-nine participants were recruited (158 women and 111 men), with a mean age of 48.1 ± 18.6 years. The CRI questionnaire and Sniffin' Sticks test were used to evaluate the cognitive reserve and the olfactory function, respectively. RESULTS In all subjects, significant associations between the odor threshold versus CRI-Education, between the odor discrimina-tion and identification versus CRI-Working activity and CRI-Leisure Time, were found. In women, odor threshold, discrimination, and identification were associated with CRI-Leisure Time, while in men, only a significant association between odor threshold and CRI-Education was observed. CONCLUSIONS Our data, showing significant gender-related associations between olfactory function and CRI scores, suggested the use of olfactory evaluation and cognitive reserve as an important screening tool for the early detection of mild cognitive impairment.
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Affiliation(s)
- Carla Masala
- Department of Biomedical Sciences, University of Cagliari, SP8 Cittadella Universitaria Monserrato, 09042 Cagliari, Italy
| | - Paolo Solla
- Department of Neurology, University of Sassari, Viale S. Pietro 10, 07100 Sassari, Italy
| | - Francesco Loy
- Department of Biomedical Sciences, University of Cagliari, SP8 Cittadella Universitaria Monserrato, 09042 Cagliari, Italy
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Neurons, Nose, and Neurodegenerative Diseases: Olfactory Function and Cognitive Impairment. Int J Mol Sci 2023; 24:ijms24032117. [PMID: 36768440 PMCID: PMC9916823 DOI: 10.3390/ijms24032117] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
Olfactory capacity declines with aging, but increasing evidence shows that smell dysfunction is one of the early signs of prodromal neurodegenerative diseases such as Alzheimer's and Parkinson's disease. The study of olfactory ability and its role in neurodegenerative diseases arouses much interest in the scientific community. In neurology, olfactory impairment is a potential early marker for the onset of neurodegenerative diseases, but the underlying mechanism is poorly understood. The loss of smell is considered a clinical sign of early-stage disease and a marker of the disease's progression and cognitive impairment. Highlighting the importance of biological bases of smell and molecular pathways could be fundamental to improve neuroprotective and therapeutic strategies. We focused on the review articles and meta-analyses on olfactory and cognitive impairment. We depicted the neurobiology of olfaction and the most common olfactory tests in neurodegenerative diseases. In addition, we underlined the close relationship between the olfactory and cognitive deficit due to nasal neuroepithelium, which is a direct extension of the CNS in communication with the external environment. Neurons, Nose, and Neurodegenerative diseases highlights the role of olfactory dysfunction as a clinical marker for early stages of neurodegenerative diseases when it is associated with molecular, clinical, and neuropathological correlations.
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Olfactory Impairment Correlates with Executive Functions Disorders and Other Specific Cognitive Dysfunctions in Parkinson's Disease. BIOLOGY 2023; 12:biology12010112. [PMID: 36671804 PMCID: PMC9855400 DOI: 10.3390/biology12010112] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/21/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Olfactory and cognitive disorders represent important non-motor symptoms in Parkinson's disease (PD). No clear evidence was reported about association of specific cognitive domains and olfactory impairment. OBJECTIVE The aim of this study was to evaluate the association between olfactory dysfunction and specific cognitive domains in PD patients compared to controls. METHODS 178 PD patients and 98 controls were enrolled and evaluated for odor threshold (OT), discrimination (OD), identification (OI), and TDI score using the Sniffin' Sticks test. Cognitive function was evaluated using the Montreal Cognitive Assessment scale with six sub-scores: Orientation (OIS), Attention (AIS), Language (LIS), Visuospatial (VIS), Memory (MIS), and Executive index scores (EIS). RESULTS Statistically significant correlations were observed between OT versus, LIS, and between TDI score versus EIS. Multivariate linear regression analysis, including age and sex which are well-known predictors of olfactory dysfunction, showed that, among specific cognitive domains, only LIS was significant predictor for OT, VIS was a significant predictor for OD, while both EIS and AIS were significant predictors for OI, and finally only EIS was significant predictor for TDI score. CONCLUSIONS Olfactory disorders in PD patients appear commonly related to dysfunction of specific cognitive domains, with strict association between global olfactory impairment and executive function deficits.
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Schlintl C, Schienle A. Reduced Olfactory Memory Performance Is Associated with Executive Function Deficits in Older Adults. Exp Aging Res 2022; 49:347-359. [PMID: 36100444 DOI: 10.1080/0361073x.2022.2122651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Previous research has identified an association between olfactory impairment (reduced odor sensitivity/ identification/ discrimination) and cognitive impairment in older adults. The present study focused on the relationship between olfactory memory performance and cognitive/affective functioning. METHOD Recognition performance for olfactory and visual stimuli (control condition) was tested through a matching task in older adults (n = 44; Mage = 76 years) and younger adults (n = 56; Mage = 24 years). Additionally, negative affect (anxiety, depression) and cognitive functioning were assessed via validated questionnaires and a neuropsychological test battery. RESULTS The older participants performed worse than the younger adults in the olfactory memory task. In older adults, difficulties in remembering odors were associated with reduced odor identification and executive functioning (reduced cognitive flexibility). Affective well-being was not related to olfactory memory performance. IMPLICATION Olfactory memory impairment in older adulthood might be a marker for cognitive decline in areas related to executive functions.
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Affiliation(s)
- Carina Schlintl
- Clinical Psychology, University of Graz, BioTechMed, Graz, Austria
| | - Anne Schienle
- Clinical Psychology, University of Graz, BioTechMed, Graz, Austria
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Bhattarai JP, Etyemez S, Jaaro-Peled H, Janke E, Leon Tolosa UD, Kamiya A, Gottfried JA, Sawa A, Ma M. Olfactory modulation of the medial prefrontal cortex circuitry: Implications for social cognition. Semin Cell Dev Biol 2022; 129:31-39. [PMID: 33975755 PMCID: PMC8573060 DOI: 10.1016/j.semcdb.2021.03.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
Olfactory dysfunction is manifested in a wide range of neurological and psychiatric diseases, and often emerges prior to the onset of more classical symptoms and signs. From a behavioral perspective, olfactory deficits typically arise in conjunction with impairments of cognition, motivation, memory, and emotion. However, a conceptual framework for explaining the impact of olfactory processing on higher brain functions in health and disease remains lacking. Here we aim to provide circuit-level insights into this question by synthesizing recent advances in olfactory network connectivity with other cortical brain regions such as the prefrontal cortex. We will focus on social cognition as a representative model for exploring and critically evaluating the relationship between olfactory cortices and higher-order cortical regions in rodent models. Although rodents do not recapitulate all dimensions of human social cognition, they have experimentally accessible neural circuits and well-established behavioral tests for social motivation, memory/recognition, and hierarchy, which can be extrapolated to other species including humans. In particular, the medial prefrontal cortex (mPFC) has been recognized as a key brain region in mediating social cognition in both rodents and humans. This review will highlight the underappreciated connectivity, both anatomical and functional, between the olfactory system and mPFC circuitry, which together provide a neural substrate for olfactory modulation of social cognition and social behaviors. We will provide future perspectives on the functional investigation of the olfactory-mPFC circuit in rodent models and discuss how to translate such animal research to human studies.
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Affiliation(s)
- Janardhan P Bhattarai
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Semra Etyemez
- Department of Psychiatry, John Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Hanna Jaaro-Peled
- Department of Psychiatry, John Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Emma Janke
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Usuy D Leon Tolosa
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Atsushi Kamiya
- Department of Psychiatry, John Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Jay A Gottfried
- Department of Psychology, University of Pennsylvania, School of Arts and Sciences, Philadelphia, PA 19104, USA; Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Akira Sawa
- Department of Psychiatry, John Hopkins University School of Medicine, Baltimore, MD 21287, USA; Departments of Neuroscience, Biomedical Engineering, and Genetic Medicine, John Hopkins University School of Medicine, Baltimore, MD 21287, USA; Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA.
| | - Minghong Ma
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.
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Torres LA, Paradela RS, Martino LM, da Costa DI, Irigoyen MC. Higher Perceived Stress as an Independent Predictor for Lower Use of Emotion-Focused Coping Strategies in Hypertensive Individuals. Front Psychol 2022; 13:872852. [PMID: 35686074 PMCID: PMC9171365 DOI: 10.3389/fpsyg.2022.872852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/03/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Individuals with high scores of perceived stress (PS) are more likely to develop arterial hypertension (AH) than those with low levels of stress. In addition to this, AH and stress are both independent risk factors for executive function (EF) impairment and worse quality of life (QoL). Therefore, strategies to control and cope with emotional stress are of paramount importance. However, less is known about the association of PS with EF, QoL, and coping in individuals with hypertension. This study aimed to evaluate the association of PS with EF performance, coping strategies use, and QoL in a sample of hypertensive patients. Methods We assessed a group of 45 hypertensive individuals (mean age = 58.42 ± 8.9 years, 71.11% female). The EF evaluation was: Frontal Assessment Battery; Controlled Oral Word Association Test—FAS; Letter-Number Sequencing subtest from the Wechsler Adult Intelligence Scale—Third Edition (WAIS-III); Digit Span subtest from the Wechsler Memory Scale-Revised (WMS-R) and Wisconsin Card Sorting Test. The type and frequency of coping strategies used were measured by the Brief Coping with Experienced Problems Scale (Brief-COPE). The World Health Organization Quality of Life Questionnaire Bref (WHOQOL-bref) was applied to measure QoL. The associations of the PS with EF performance, coping strategies, and QoL were investigated using univariate and multiple linear regression models adjusted for age, sex, education, systolic pressure, and depression symptoms. Results In the multivariate analyses, higher PS was an independent predictor for a lower frequency of emotion-focused strategy use (β = −0.23; p = 0.03). However, PS was not significantly related to EF and Qol in this sample. The lower the PS, the greater the use of emotion-focused coping. Conclusion Hypertensive individuals with high PS use less frequently positive emotion-focused coping strategies.
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Affiliation(s)
- Laura Aló Torres
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Regina Silva Paradela
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Luiza Menoni Martino
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Danielle Irigoyen da Costa
- Brain Institute (InsCer), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Maria Claudia Irigoyen
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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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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Olfactory capacity in anorexia nervosa: correlations with set-shifting ability. Eat Weight Disord 2022; 27:535-542. [PMID: 33860466 DOI: 10.1007/s40519-021-01188-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE The purpose of this study is to examine olfactory capacity in adults with anorexia nervosa (AN), in terms of odor identification and odor threshold and search for possible correlations between odor identification and cognitive flexibility in this population. METHODS Thirty-nine patients diagnosed with AN and 60 healthy participants, participated. Odor identification was assessed using the University Pennsylvania Smell Identification Test and a two alternative forced choice, ascending method with n-butanol was used to assess odor threshold. Cognitive flexibility was determined using the Intra/Extra-Dimensional Set-Shift test (IED), a subtest of the Cambridge Neuropsychological Test Automated Battery (CANTAB). RESULTS Patients with AN presented a poorer performance in odor identification compared with controls (p = 0.001). No differences were found in odor threshold, between the two groups. Patients with AN exhibited poor cognitive flexibility compared with controls (p = 0.003). A significant correlation between odor identification and cognitive flexibility was documented in AN (p = 0.01), but not in controls. CONCLUSION Our findings suggest that olfactory capacity is altered in AN: Qualitative characteristics of olfaction were affected in patients with AN (lower odor identification), while there was no difference in quantitative characteristics (odor threshold) compared with controls. Furthermore, odor identification in AN was correlated to cognitive flexibility. LEVEL OF EVIDENCE Level III: case-control analytic study.
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Henneghan AM, Lewis KA, Gill E, Kesler SR. Cognitive Impairment in Non-critical, Mild-to-Moderate COVID-19 Survivors. Front Psychol 2022; 13:770459. [PMID: 35250714 PMCID: PMC8891805 DOI: 10.3389/fpsyg.2022.770459] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/21/2022] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE Previous studies of post-acute COVID-19 syndrome have focused on critical cases with severe disease. However, most cases are mild to moderate in disease severity. OBJECTIVE We aimed to examine cognitive outcomes in cases of non-critical, mild-to-moderate COVID-19. Design, Setting, and Participants: In this cross-sectional study, we enrolled 72 adults aged 22 to 65 years in Central Texas who had non-critical, mild-to-moderate COVID-19 infection between 13 January 2021 and 20 April 2021. MAIN OUTCOMES AND MEASURES We remotely administered cognitive-behavioral testing to determine the frequency of cognitive impairment and examine demographic, clinical, and psychosocial contributors to impairment. RESULTS The frequency of objective cognitive impairment was 40%. The largest number of participants (24%) showed impairment on a measure of executive functioning. Attention and processing speed was more impaired in males (OR = 1.5, 95%CI = 0.23-2.9). Males endorsed lower adherence to social distancing guidelines (U = 590, p = 0.01), which was in turn associated with cognitive impairment across participants (r = -0.30, p = 0.01). Younger age was correlated with impairment (r = -0.26, p = 0.03) but was also associated with racial/ethnic minority status (r = -0.31, p = 0.01) and increased psychological symptoms (p < 0.04). Greater number of COVID-19 symptoms was correlated with lower subjective cognitive function (r = -0.38, p = 0.001) as well as psychosocial function (r > 0.24, p < 0.05). Moderate COVID-19 severity was associated with attention/processing speed impairment (r = 0.27, p = 0.03), increased pain (r = 0.31, p = 0.01), and higher number of COVID-19 symptoms (r = 0.32, p = 0.01). CONCLUSION AND RELEVANCE Mild or moderate COVID-19 infection may be associated with cognitive impairments, especially in the domain of executive functioning. A subgroup of younger individuals may be more vulnerable to cognitive and psychosocial effects of COVID-19. HIGHLIGHTS Question: How frequent is cognitive impairment among non-critical, mild-to-moderate COVID-19 survivors? FINDINGS In this cross-sectional study of 72 adults, 40% demonstrated cognitive impairment, particularly in executive function. MEANING Neurologic sequelae, such as cognitive impairment, may be common following COVID-19 infection.
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Affiliation(s)
- Ashley M. Henneghan
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
- Department of Oncology, Dell Medical School, The University of Texas at Austin, Austin, TX, United States
| | - Kimberly A. Lewis
- Ascension Seton Medical Center, Austin, TX, United States
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, United States
| | - Eliana Gill
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
- Ascension Seton Medical Center, Austin, TX, United States
| | - Shelli R. Kesler
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
- Department of Oncology, Dell Medical School, The University of Texas at Austin, Austin, TX, United States
- Department of Diagnostic Medicine, Dell Medical School, The University of Texas at Austin, Austin, TX, United States
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13
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Sabiniewicz A, Wrage F, Hummel T. The impact of cognitive and noncognitive factors on odor discrimination performance. J SENS STUD 2021. [DOI: 10.1111/joss.12683] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Agnieszka Sabiniewicz
- Department of Otorhinolaryngology, Smell and Taste Clinic TU Dresden Dresden Germany
- Institute of Psychology University of Wrocław Wrocław Poland
| | - Florian Wrage
- Department of Otorhinolaryngology, Smell and Taste Clinic TU Dresden Dresden Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic TU Dresden Dresden Germany
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Hyposmia may predict development of freezing of gait in Parkinson's disease. J Neural Transm (Vienna) 2021; 128:763-770. [PMID: 34014391 DOI: 10.1007/s00702-021-02347-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/30/2021] [Indexed: 10/21/2022]
Abstract
To explore the effect of olfactory dysfunction on treatment of motor manifestations in Parkinson's disease (PD). The current longitudinal retrospective cohort study consecutively recruited 108 de novo PD patients. Of whom 29 were normosmia and 79 were hyposmia, respectively, which was determined by the Korean Version of Sniffin' Sticks Test II at the time of diagnosis. All the participants underwent serial clinical examinations including Unified Parkinson's Disease Rating Scale (UPDRS), Mini-Mental State Examination, and Montreal Cognitive Assessment. The normosmic group demonstrated a significantly greater reduction of the UPDRS III score (30.3 ± 5.9 to 21.9 ± 5.1) than that of the hyposmic group (34.5 ± 9.3 to 28.5 ± 8.1) from baseline to 1-year later (p, 0.003; Bonferroni correction for p < 0.0045). Of subdomains in UPDRS III, the axial domain revealed a remarkable decrease in the normosmic group. Further, the hyposmic group exhibited a higher development rate of freezing of gait (FOG) compared to the normosmic group (29/79 (36.7%) vs 2/29 (6.9%); p, 0.002) during 33.9 ± 7.7 months of the mean follow-up period. A Cox proportional hazards model demonstrated the hyposmia to be a significant risk factor for the future development of FOG (HR, 4.23; 95% CI 1.180-17.801; p, 0.05). Our data demonstrated the olfactory dysfunction to be a significant risk factor for the development of the FOG in PD. Hyposmic PD patients should be paid more careful attention to the occurrence of FOG in the clinical practice.
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15
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Gellrich J, Sparing-Paschke LM, Hummel T, Schriever VA. The Influence of Cognitive Parameters on Olfactory Assessment in Healthy Children and Adolescents. Chem Senses 2020; 46:5943002. [PMID: 33119057 DOI: 10.1093/chemse/bjaa072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Olfactory threshold and odor identification tests are frequently used for assessment of olfactory function in children and adolescents. Whether olfactory test results are influenced by cognitive parameters or sex in children and adolescents is largely unknown. The aim of this study was to investigate the influence of cognition, age and sex on "Sniffin' Sticks" olfactory threshold and "U-Sniff" odor identification performance in a pediatric population. A total of 200 participants between age 6 and 17 years were included. Olfactory function (olfactory threshold and odor identification) was assessed using the "Sniffin' Sticks." In addition, age appropriate cognitive testing was applied. The results of this study indicate that odor identification test performance is positively correlated with age (r = 0.31) and verbal abilities of children (r = 0.24). Olfactory threshold results are only marginally influenced by age (r = 0.18) and are not associated with cognitive test performance. Olfactory assessment using olfactory threshold and "U-Sniff" odor identification testing is suitable for children and adolescents when considering age in the interpretation of test results.
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Affiliation(s)
- Janine Gellrich
- Abteilung Neuropädiatrie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany.,Klinik und Poliklinik für Kinder- und Jugendmedizin, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany
| | - Lisa-Marie Sparing-Paschke
- Smell and Taste Clinic, Department of Otorhinolaryngology, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany
| | - Valentin A Schriever
- Abteilung Neuropädiatrie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany
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16
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Brai E, Hummel T, Alberi L. Smell, an Underrated Early Biomarker for Brain Aging. Front Neurosci 2020; 14:792. [PMID: 32982661 PMCID: PMC7477331 DOI: 10.3389/fnins.2020.00792] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/06/2020] [Indexed: 12/11/2022] Open
Abstract
Olfaction is in addition to touch the most ancient of our senses, developing already in the womb it decays progressively from 65 years of age with a more pronounced impairment associated with dementia. Despite its clinical relevance and testing accessibility, smell remains an overlooked biomarker, which is rarely used by neurologists in the early screening phase. In this perspective article, we outline the reasons underlying the lack of awareness for this sense. In an attempt to put olfaction forward as an early biomarker for pathological brain aging, we draw a comparison with vision and hearing, regarded as more relevant for general health. This perspective article wants to encourage further studies aimed at understanding the mechanisms responsible for the early smell dysfunction in individuals a decade or more before the onset of cognitive symptoms.
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Affiliation(s)
- Emanuele Brai
- Center for Brain and Disease Research, Flanders Institute for Biotechnology (VIB) - Catholic University (KU) Leuven, Leuven, Belgium
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, University Hospital Dresden, Dresden, Germany
| | - Lavinia Alberi
- Swiss Integrative Centre for Human Health (SICHH), Fribourg, Switzerland.,Department of Oncology, Microbiology and Immunology, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
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17
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Carnemolla SE, Hsieh JW, Sipione R, Landis BN, Kumfor F, Piguet O, Manuel AL. Olfactory dysfunction in frontotemporal dementia and psychiatric disorders: A systematic review. Neurosci Biobehav Rev 2020; 118:588-611. [PMID: 32818582 DOI: 10.1016/j.neubiorev.2020.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 12/12/2022]
Abstract
Frontotemporal dementia (FTD) is a progressive neurodegenerative disease. Diagnosis of FTD, especially the behavioural variant, is challenging because of symptomatic overlap with psychiatric disorders (depression, schizophrenia, bipolar disorder). Olfactory dysfunction is common in both FTD and psychiatric disorders, and often appears years before symptom onset. This systematic review analysed 74 studies on olfactory function in FTD, depression, schizophrenia and bipolar disorder to identify differences in olfactory dysfunction profiles, focusing on the most common smell measures: odour identification and discrimination. Results revealed that FTD patients were severely impaired in odour identification but not discrimination; in contrast, patients diagnosed with schizophrenia showed impairments in both measures, while those diagnosed with depression showed no olfactory impairments. Findings in bipolar disorder were mixed. Therefore, testing odour identification and discrimination differentiates FTD from depression and schizophrenia, but not from bipolar disorder. Given the high prevalence of odour identification impairments in FTD, and that smell dysfunction predicts neurodegeneration in other diseases, olfactory testing seems a promising avenue towards improving diagnosis between FTD and psychiatric disorders.
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Affiliation(s)
| | - Julien Wen Hsieh
- Rhinology -Olfactology Unit, Department of Otorhinolaryngology- Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211 Geneva 14, Switzerland; Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Rebecca Sipione
- Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Basile N Landis
- Rhinology -Olfactology Unit, Department of Otorhinolaryngology- Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211 Geneva 14, Switzerland; Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Fiona Kumfor
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; The University of Sydney, School of Psychology, Sydney, Australia
| | - Olivier Piguet
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; The University of Sydney, School of Psychology, Sydney, Australia
| | - Aurélie L Manuel
- The University of Sydney, Brain & Mind Centre, Sydney, Australia.
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18
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Sandini TM, Marks WN, Tahir NB, Song Y, Greba Q, Howland JG. NMDA Receptors in Visual and Olfactory Sensory Integration in Male Long Evans Rats: A Role for the Orbitofrontal Cortex. Neuroscience 2020; 440:230-238. [PMID: 32497759 DOI: 10.1016/j.neuroscience.2020.05.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/20/2020] [Accepted: 05/23/2020] [Indexed: 11/28/2022]
Abstract
Sensory integration (SI) is a cognitive process whereby the brain uses unimodal or multimodal sensory features to create a comprehensive representation of the environment. Integration of sensory input is necessary to achieve a coherent perception of the environment, and to subsequently plan and coordinate action. The neural mechanisms mediating SI are poorly understood; however, recent studies suggest that the regulation of SI involves N-methyl-d-aspartate receptors (NMDARs) in orbitofrontal cortex (OFC). Thus, we tested this hypothesis directly in two experiments using object oddity tests that require SI for visual and olfactory stimuli. First, we blocked NMDARs with acute CPP treatment (i.p., 10 mg/kg) and tested rats in unimodal visual and olfactory SI tests, and respective control unimodal oddity tests that do not require SI. Second, we used intra-OFC infusions of AP5 (30 mM) to examine the role of NMDARs in the OFC in the oddity tests requiring SI. Systemic blockade of NMDARs impaired performance on the visual tests regardless of whether SI was required for determining oddity. In the olfactory tests, systemic treatment with CPP impaired the test requiring SI while sparing olfactory oddity, demonstrating a selective impairment in the olfactory SI. Intra-OFC blockade of NMDARs impaired olfactory SI, without effect on visual SI, demonstrating that intra-OFC NMDARs are essential for olfactory, but not visual SI. The present results are discussed in the context of the function of the OFC and its associated circuitry.
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Affiliation(s)
- Thaísa M Sandini
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E5, Canada
| | - Wendie N Marks
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E5, Canada
| | - Nimra B Tahir
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E5, Canada
| | - Yuanyi Song
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E5, Canada
| | - Quentin Greba
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E5, Canada
| | - John G Howland
- Department of Anatomy, Physiology, and Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E5, Canada.
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19
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Addicted to compulsion: assessing three core dimensions of addiction across obsessive-compulsive disorder and gambling disorder. CNS Spectr 2020; 25:392-401. [PMID: 31106718 PMCID: PMC6864250 DOI: 10.1017/s1092852919000993] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Several studies suggested that obsessive-compulsive disorder (OCD) patients display increased impulsivity, impaired decision-making, and reward system dysfunction. In a Research Domain Criteria (RDoC) perspective, these findings are prototypical for addiction and have led some authors to view OCD as a behavioral addiction. Thus, the aim of this study was to investigate similarities and differences on impulsivity, decision-making, and reward system, as core dimensions of addiction, across OCD and gambling disorder (GD) patients. METHODS Forty-four OCD patients, 26 GD patients, and 40 healthy controls (HCs) were included in the study. Impulsivity was assessed through the Barratt Impulsiveness Scale, decision-making through the Iowa Gambling Task, and reward system through a self-report clinical instrument (the Shaps-Hamilton Anhedonia Scale) assessing hedonic tone and through an olfactory test assessing hedonic appraisal to odors. RESULTS Both OCD and GD patients showed increased impulsivity when compared to HCs. More specifically, the OCD patients showed cognitive impulsivity, and the GD patients showed both increased cognitive and motor impulsivity. Furthermore, both OCD and GD patients showed impaired decision-making performances when compared to HCs. Finally, GD patients showed increased anhedonia and blunted hedonic response to pleasant odors unrelated to gambling or depression/anxiety symptoms, while OCD patients showed only increased anhedonia levels related to OC and depression/anxiety symptoms. CONCLUSION OCD patients showed several similarities and some differences with GD patients when compared to HCs on impulsivity, decision-making, and reward system, three core dimensions of addiction. These results could have relevant implications for the research of new treatment targets for OCD.
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20
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Chase BA, Markopoulou K. Olfactory Dysfunction in Familial and Sporadic Parkinson's Disease. Front Neurol 2020; 11:447. [PMID: 32547477 PMCID: PMC7273509 DOI: 10.3389/fneur.2020.00447] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/27/2020] [Indexed: 12/26/2022] Open
Abstract
This minireview discusses our current understanding of the olfactory dysfunction that is frequently observed in sporadic and familial forms of Parkinson's disease and parkinsonian syndromes. We review the salient characteristics of olfactory dysfunction in these conditions, discussing its prevalence and characteristics, how neuronal processes and circuits are altered in Parkinson's disease, and what is assessed by clinically used measures of olfactory function. We highlight how studies of monogenic Parkinson's disease and investigations in ethnically diverse populations have contributed to understanding the mechanisms underlying olfactory dysfunction. Furthermore, we discuss how imaging and system-level approaches have been used to understand the pathogenesis of olfactory dysfunction. We discuss the challenging, remaining gaps in understanding the basis of olfactory dysfunction in neurodegeneration. We propose that insights could be obtained by following longitudinal cohorts with familial forms of Parkinson's disease using a combination of approaches: a multifaceted longitudinal assessment of olfactory function during disease progression is essential to identify not only how dysfunction arises, but also to address its relationship to motor and non-motor Parkinson's disease symptoms. An assessment of cohorts having monogenic forms of Parkinson's disease, available within the Genetic Epidemiology of Parkinson's Disease (GEoPD), as well as other international consortia, will have heuristic value in addressing the complexity of olfactory dysfunction in the context of the neurodegenerative process. This will inform our understanding of Parkinson's disease as a multisystem disorder and facilitate the more effective use of olfactory dysfunction assessment in identifying prodromal Parkinson's disease and understanding disease progression.
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Affiliation(s)
- Bruce A. Chase
- Department of Biology, University of Nebraska at Omaha, Omaha, NE, United States
| | - Katerina Markopoulou
- Department of Neurology, NorthShore University HealthSystem, Evanston, IL, United States
- Department of Neurology, University of Chicago, Chicago, IL, United States
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21
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Association between olfactory function and inhibition of emotional competing distractors in major depressive disorder. Sci Rep 2020; 10:6322. [PMID: 32286450 PMCID: PMC7156747 DOI: 10.1038/s41598-020-63416-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 03/30/2020] [Indexed: 01/10/2023] Open
Abstract
We aimed to investigate the changes of olfaction of major depressive disorder (MDD) before and after medical treatment, and to preliminarily scrutinize the association between the olfactory function and the severity of depressive symptoms, response inhibition, and emotional responding. Forty-eight medicine-naïve MDD patients plus 33 healthy controls (HC) matched on gender, ages, and level of education, were recruited in the test group. The Chinese Smell Identification Test (CSIT), Self-reported Olfactory Scale (SROS), 17-item Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), and mean reaction time/accuracy rate (ΔMRT) of emotional Stroop test were measured. The patients were assessed before the treatment (baseline) and 3 months after the treatment (follow-up). The data at the baseline level were measured then associated using multiple linear regression stepwise analysis. The MDD patients had lower scores of the CSIT and SROS and longer ΔMRT at baseline level compared to HC while the ΔMRT of MDD patients remained longer after 3-month treatment (p’s < 0.05). At the baseline level, the regression equation including age and ΔMRT of negative word-color congruent (NEG-C), was finally observed as follows: y(CSIT) = 10.676–0.063 × 1–0.002 × 2, [x1 = the age(y), x2 = the NEG-C (ms)]. The olfactory function of MDD appears to be correlated negatively with the age and the ΔMRT of negative stimuli before treatment. After the remission of MDD, the olfactory dysfunction was improved, which might be regarded as a responding phenotype of brain function of MDD rather than the emotional responding.
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22
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Wang F, Wu X, Gao J, Li Y, Zhu Y, Fang Y. The relationship of olfactory function and clinical traits in major depressive disorder. Behav Brain Res 2020; 386:112594. [PMID: 32194189 DOI: 10.1016/j.bbr.2020.112594] [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: 09/06/2019] [Revised: 02/12/2020] [Accepted: 03/10/2020] [Indexed: 10/24/2022]
Abstract
People who have developed a good sense of smell could experience much more happiness and pleasure, which would trigger a discussion that olfactory disorder might correlate with the pathogenesis of major depressive disorder (MDD). Similar experiments conducted on rats have confirmed that nerve damage of olfactory pathway can induce a series of depression-like changes, including behavior, neurobiochemistry, and neuroimmunity. These changes will recover progressively with anti-depression treatment. While in similar studies on human beings, olfactory dysfunction has been found in people suffering from depression. This review briefly discusses the correlation between olfactory deficits and clinical traits of depression in different dimensions, such as the severity, duration and cognitive impairment of depression. Improving olfactory function may be expected to be a potential antidepressant therapy.
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Affiliation(s)
- Fang Wang
- Shanghai Yangpu Mental Health Center, Shanghai, 200093, China; Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Xiaohui Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Jerry Gao
- Yennora Public School, NSW, 2161, Australia
| | - Yongchao Li
- Shanghai Yangpu Mental Health Center, Shanghai, 200093, China
| | - Yuncheng Zhu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
| | - Yiru Fang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology, 200031, China; Shanghai Key Laboratory of Psychotic disorders, Shanghai, 201108, China.
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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]
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Solla P, Masala C, Liscia A, Piras R, Ercoli T, Fadda L, Hummel T, Haenher A, Defazio G. Sex-related differences in olfactory function and evaluation of possible confounding factors among patients with Parkinson's disease. J Neurol 2019; 267:57-63. [PMID: 31555978 DOI: 10.1007/s00415-019-09551-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 10/26/2022]
Abstract
The role of specific sex-related patterns in olfactory dysfunctions of Parkinson's disease (PD) patients is unclear. The aim of this study was to assess the presence of specific sex-related patterns in olfactory dysfunctions excluding the possibility of confounding effects in patients with Parkinson's disease. One hundred and sixty-eight participants (99 PD patients and 69 controls) were enrolled and evaluated using Sniffin' Sticks Extended test (SSET). There was no significant sex difference in the control group for the SSET parameters. By contrast, in the PD group male patients scored significantly lower on odor discrimination (OD), identification (OI), and Threshold-Discrimination-Identification (TDI) score than females. On multivariable linear regression analysis, the only significant predictors of TDI score were sex and apathy. Among PD patients, men showed a significantly greater impairment compared to women in OI, OD and TDI score, but not in odor threshold (OT). These findings highlighted the possible role of sex differences in the development of associated PD non-motor symptoms.
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Affiliation(s)
- P Solla
- Department of Neurology, Movement Disorders Center, Institute of Neurology, Azienda Ospedaliero Universitaria (A.O.U.), University of Cagliari, Cagliari, Italy.
| | - C Masala
- Section of Physiology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.
| | - A Liscia
- Section of Physiology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - R Piras
- Section of Physiology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - T Ercoli
- Department of Neurology, Movement Disorders Center, Institute of Neurology, Azienda Ospedaliero Universitaria (A.O.U.), University of Cagliari, Cagliari, Italy
| | - L Fadda
- Department of Neurology, Movement Disorders Center, Institute of Neurology, Azienda Ospedaliero Universitaria (A.O.U.), University of Cagliari, Cagliari, Italy
| | - T Hummel
- Department of Otorhinolaryngology, Medical Faculty Carl Gustav Carus, Interdisciplinary Center Smell and Taste, TU Dresden, Dresden, Germany
| | - A Haenher
- Department of Otorhinolaryngology, Medical Faculty Carl Gustav Carus, Interdisciplinary Center Smell and Taste, TU Dresden, Dresden, Germany
| | - G Defazio
- Department of Neurology, Movement Disorders Center, Institute of Neurology, Azienda Ospedaliero Universitaria (A.O.U.), University of Cagliari, Cagliari, Italy
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Herman AM, Critchley H, Duka T. Decreased olfactory discrimination is associated with impulsivity in healthy volunteers. Sci Rep 2018; 8:15584. [PMID: 30349020 PMCID: PMC6197201 DOI: 10.1038/s41598-018-34056-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 10/05/2018] [Indexed: 01/09/2023] Open
Abstract
In clinical populations, olfactory abilities parallel executive function, implicating shared neuroanatomical substrates within the ventral prefrontal cortex. In healthy individuals, the relationship between olfaction and personality traits or certain cognitive and behavioural characteristics remains unexplored. We therefore tested if olfactory function is associated with trait and behavioural impulsivity in nonclinical individuals. Eighty-three healthy volunteers (50 females) underwent quantitative assessment of olfactory function (odour detection threshold, discrimination, and identification). Each participant was rated for trait impulsivity index using the Barratt Impulsiveness Scale and performed a battery of tasks to assess behavioural impulsivity (Stop Signal Task, SST; Information Sampling Task, IST; Delay Discounting). Lower odour discrimination predicted high ratings in non-planning impulsivity (Barratt Non-Planning impulsivity subscale); both, lower odour discrimination and detection threshold predicted low inhibitory control (SST; increased motor impulsivity). These findings extend clinical observations to support the hypothesis that deficits in olfactory ability are linked to impulsive tendencies within the healthy population. In particular, the relationship between olfactory abilities and behavioural inhibitory control (in the SST) reinforces evidence for functional overlap between neural networks involved in both processes. These findings may usefully inform the stratification of people at risk of impulse-control-related problems and support planning early clinical interventions.
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Affiliation(s)
- Aleksandra M Herman
- Behavioural and Clinical Neuroscience, School of Psychology, University of Sussex, Brighton, BN1 9QH, UK.
| | - Hugo Critchley
- Psychiatry, Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Brighton, UK.,Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
| | - Theodora Duka
- Behavioural and Clinical Neuroscience, School of Psychology, University of Sussex, Brighton, BN1 9QH, UK.,Sussex Addiction and Intervention Centre, University of Sussex, Brighton, BN1 9QH, UK
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Cacciaglia R, Molinuevo JL, Sánchez-Benavides G, Falcón C, Gramunt N, Brugulat-Serrat A, Grau O, Gispert JD. Episodic memory and executive functions in cognitively healthy individuals display distinct neuroanatomical correlates which are differentially modulated by aging. Hum Brain Mapp 2018; 39:4565-4579. [PMID: 29972619 PMCID: PMC6220988 DOI: 10.1002/hbm.24306] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/22/2018] [Accepted: 06/25/2018] [Indexed: 11/21/2022] Open
Abstract
The neuroanatomical bases of episodic memory (EM) and executive functions (EFs) have been widely addressed in patients with brain damage and in individuals with neurologic disorders. These studies reported that larger brain structures support better outcomes in both cognitive domains, thereby supporting the “bigger is better” account. However, relatively few studies have explored the cerebral morphological properties underlying EM and EFs in cognitively healthy individuals and current findings indicate no unitary theoretical explanation for the structure–function relationship. Moreover, existing studies have typically restricted the analyses to a priori defined regions of interest. Here we conducted unbiased voxel‐wise analysis of the associations between regional gray as well as white matter volumes (GMv; WMv) and performance in both cognitive domains in a sample of 463 cognitively intact individuals. We found that efficiency in EM was predicted by lower GMv in brain areas belonging to the default‐mode network (DMN). By contrast, EFs performance was predicted by larger GMv in a distributed set of regions, which overlapped with the executive control network (ECN). Volume of white matter bundles supporting both cross‐cortical and interhemispheric connections was positively related to processing speed. Furthermore, aging modulated the relationship between regional volumes and cognitive performance in several areas including the hippocampus and frontal cortex. Our data extend the critical role of the DMN and ECN by showing that variability in their morphological properties, and not only their activation patterns, affects EM and EFs, respectively. Moreover, our finding that aging reverts these associations supports previously advanced theories of cognitive neurodevelopment.
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Affiliation(s)
- Raffaele Cacciaglia
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | | | - Carles Falcón
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Nina Gramunt
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.,CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Oriol Grau
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
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27
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Fadda R, Piras F, Doneddu G, Saba L, Masala C. Olfactory Function Assessment in Italian Subjects with Autism Spectrum Disorder. CHEMOSENS PERCEPT 2017. [DOI: 10.1007/s12078-017-9234-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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28
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Jackson C, Rai N, McLean CK, Hipolito MMS, Hamilton FT, Kapetanovic S, Nwulia EA. Overlapping Risky Decision-Making and Olfactory Processing Ability in HIV-Infected Individuals. CLINICAL AND EXPERIMENTAL PSYCHOLOGY 2017; 3:160. [PMID: 29057388 PMCID: PMC5648356 DOI: 10.4172/2471-2701.1000160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Given neuroimaging evidences of overlap in the circuitries for decision-making and olfactory processing, we examined the hypothesis that impairment in psychophysical tasks of olfaction would independently predict poor performances on Iowa Gambling Task (IGT), a laboratory task that closely mimics real-life decision-making, in a US cohort of HIV-infected (HIV+) individuals. METHOD IGT and psychophysical tasks of olfaction were administered to a Washington DC-based cohort of largely African American HIV+ subjects (N=100), and to a small number of demographically-matched non-HIV healthy controls (N=43) from a different study. Constructs of olfactory ability and decision-making were examined through confirmatory factor analysis (CFA). Structural equation models (SEMs) were used to evaluate the validity of the path relationship between these two constructs. RESULT The 100 HIV+ participants (56% female; 96% African Americans; median age = 48 years) had median CD4 count of 576 cells/μl and median HIV RNA viral load <48 copies per milliliter. Majority of HIV+ participants performed randomly throughout the course of IGT tasks, and failed to demonstrate a learning curve. Confirmatory factor analysis provided support for a unidimensional factor underlying poor performances on IGT. Nomological validity for correlations between olfactory ability and IGT performance was confirmed through SEM. Finally, factor scores of olfactory ability and IGT performance strongly predicted 6 months history of drug use, while olfaction additionally predicted hallucinogen use. CONCLUSION This study suggests that combination of simple, office-based tasks of olfaction and decision-making may identify those HIV+ individuals who are more prone to risky decision-making. This finding may have significant clinical, public health value if joint impairments in olfaction and IGT task correlates with more decreased activity in brain regions relevant to decision-making.
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Affiliation(s)
| | - Narayan Rai
- Department of Psychiatry, Howard University, Georgia Ave., NW, Washington, DC, USA
| | - Charlee K McLean
- Department of Psychiatry, Howard University, Georgia Ave., NW, Washington, DC, USA
| | | | | | - Suad Kapetanovic
- Department of Psychiatry, Keck School of Medicine, Los Angeles, CA, USA
| | - Evaristus A Nwulia
- Department of Psychiatry, Howard University, Georgia Ave., NW, Washington, DC, USA
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29
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Masala C, Saba L, Cecchini MP, Solla P, Loy F. Olfactory Function and Age: a Sniffin’ Sticks Extended Test Study Performed in Sardinia. CHEMOSENS PERCEPT 2017. [DOI: 10.1007/s12078-017-9233-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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30
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Khil L, Rahe C, Wellmann J, Baune BT, Wersching H, Berger K. Association between major depressive disorder and odor identification impairment. J Affect Disord 2016; 203:332-338. [PMID: 27318533 DOI: 10.1016/j.jad.2016.06.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 06/03/2016] [Accepted: 06/07/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is evidence of olfactory deficits in patients with major depressive disorder (MDD) but causes and mechanisms are largely unknown. METHODS We compared 728 patients with current MDD and 555 non-depressed controls regarding odor identification impairment taking into account the severity of acute symptoms and of the disease course. We assessed current symptom severity with the Hamilton Depression Rating Scale, and disease course severity based on admission diagnosis (ICD-10, F32/F33) and self-reported hospitalization frequency, defined as infrequent (<2) and frequent (≥2) depression-related hospitalizations under constant disease duration. A score of <10 on the Sniffin' Sticks-Screen-12 test determined the presence of odor identification impairment. RESULTS Compared to non-depressed controls patients with frequent (rapidly recurring) hospitalizations had an elevated chance of odor identification impairment, even after adjustment for smell-influencing factors, such as age and smoking, (OR=1.7; 95% CI 1.0-2.9). Patients with recurrent MDD (F33) also had an elevated odds of odor identification impairment compared to those with a first-time episode (F32, OR=1.5; 95% CI 1.0-2.4). In patients with a first-time episode the chance of odor identification impairment increased by 7% with each point increase in the Hamilton Score. LIMITATIONS Cross-sectional study. Variation in the use of psychotropic medication is a potential bias. CONCLUSION Odor identification impairment was evident in MDD patients with first-time high symptom severity and in patients with a severe disease course. Whether odor identification impairment is a marker or mediator of structural and functional brain changes associated with acute or active MDD requires further investigations in longitudinal studies.
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Affiliation(s)
- Laura Khil
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
| | - Corinna Rahe
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Jürgen Wellmann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Bernhard T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Heike Wersching
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
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