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Sekine R, Hernandez AK, Overbeck C, Hofer MK, Mori E, Hähner A, Hummel T. Comparison of Patient Characteristics and Olfactory Sensitivity for Trigger Odorants in Parosmia and Phantosmia. Laryngoscope 2024; 134:3277-3285. [PMID: 38578016 DOI: 10.1002/lary.31379] [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: 11/04/2023] [Revised: 01/30/2024] [Accepted: 02/21/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES This study aimed to determine the characteristics of patients with qualitative olfactory dysfunction (qualOD) and whether individuals with parosmia exhibit increased olfactory sensitivity to previously reported odorous triggers of parosmia. METHODS This study included individuals aged ≥18 years, divided into quantitative OD only, parosmia, and phantosmia groups. Data collected included: clinical-demographic data, "Sniffin' Sticks" scores, questionnaires (depression scale, importance of olfaction), and information about parosmia and phantosmia. A proportion of patients underwent trigger odor threshold testing for 2-Furfurylthiol [FFT] found in coffee and 2,6-nonadienal [Nonadienal] found in cucumber. RESULTS Those with parosmia were typically younger women, with shorter OD duration due to post-viral OD (PVOD), hyposmic/normosmic, and experienced parosmia more severely. Parosmia was 3.5 times more likely in PVOD. Those with phantosmia were older, with longer OD duration due to idiopathic OD, hyposmic/anosmic, and experienced phantosmia less severely. There were no significant differences between FFT and Nonadienal threshold scores in patients with parosmia, phantosmia, or only quantitative OD, but all groups had significantly increased olfactory sensitivity for trigger odors compared to phenyl ethyl alcohol (PEA). CONCLUSION Parosmia and phantosmia patients have distinct characteristics. This may provide clinicians with a better understanding of possible olfactory outcomes in these patients. The higher olfactory sensitivity of all groups to trigger odors compared to PEA raises interesting points about parosmia triggers and odors in the context of warning for danger, in relation to the pathophysiology of parosmia that may be worth exploring in future studies. LEVEL OF EVIDENCE 3 Laryngoscope, 134:3277-3285, 2024.
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Affiliation(s)
- Rumi Sekine
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Anna Kristina Hernandez
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Otolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines - Manila, Manila, Philippines
- Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
| | - Clara Overbeck
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Marlise K Hofer
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eri Mori
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Antje Hähner
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Hintschich CA, Wege-Lüssen A, Göktas Ö, Stuck BA, Müller CA, Hummel T. [Persistent olfactory impairment after COVID-19-recommendations of the Working Group on Olfactology and Gustology of the German Society of Oto-rhino-laryngology, Head and Neck Surgery]. HNO 2023; 71:739-743. [PMID: 37801102 PMCID: PMC10589143 DOI: 10.1007/s00106-023-01368-w] [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] [Accepted: 08/17/2023] [Indexed: 10/07/2023]
Abstract
This article does not intend to comprehensively review the existing literature on coronavirus disease 2019 (COVID-19)-associated smell disorders, but aims to summarize scientific evidence for otorhinolaryngological practice and provide recommendations for diagnosis and treatment of persistent smell disorders following COVID-19.
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Affiliation(s)
- Constantin A Hintschich
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
| | | | | | - Boris A Stuck
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Marburg, Philipps-Universität Marburg, Marburg, Deutschland
| | - Christian A Müller
- Universitätsklinik für Hals‑, Nasen- und Ohrenkrankheiten, Kopf- und Halschirurgie, Medizinische Universität Wien, Wien, Österreich
| | - Thomas Hummel
- Interdisziplinäres Zentrum für Riechen und Schmecken, Universitätsklinikum Carl Gustav Carus, Dresden, Deutschland
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3
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Hernandez AK, Landis BN, Altundag A, Fjaeldstad AW, Gane S, Holbrook EH, Huart C, Konstantinidis I, Lechner M, Macchi A, Portillo Mazal P, Miwa T, Philpott CM, Pinto JM, Poletti SC, Vodicka J, Welge-Luessen A, Whitcroft KL, Hummel T. Olfactory Nomenclature: An Orchestrated Effort to Clarify Terms and Definitions of Dysosmia, Anosmia, Hyposmia, Normosmia, Hyperosmia, Olfactory Intolerance, Parosmia, and Phantosmia/Olfactory Hallucination. ORL J Otorhinolaryngol Relat Spec 2023; 85:312-320. [PMID: 37062268 PMCID: PMC10711772 DOI: 10.1159/000530211] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 03/10/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND Definitions are essential for effective communication and discourse, particularly in science. They allow the shared understanding of a thought or idea, generalization of knowledge, and comparison across scientific investigation. The current terms describing olfactory dysfunction are vague and overlapping. SUMMARY As a group of clinical olfactory researchers, we propose the standardization of the terms "dysosmia," "anosmia," "hyposmia," "normosmia," "hyperosmia," "olfactory intolerance," "parosmia," and "phantosmia" (or "olfactory hallucination") in olfaction-related communication, with specific definitions in this text. KEY MESSAGES The words included in this paper were determined as those which are most frequently used in the context of olfactory function and dysfunction, in both clinical and research settings. Despite widespread use in publications, however, there still exists some disagreement in the literature regarding the definitions of terms related to olfaction. Multiple overlapping and imprecise terms that are currently in use are confusing and hinder clarity and universal understanding of these concepts. There is a pressing need to have a unified agreement on the definitions of these olfactory terms by researchers working in the field of chemosensory sciences. With the increased interest in olfaction, precise use of these terms will improve the ability to integrate and advance knowledge in this field.
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Affiliation(s)
- Anna Kristina Hernandez
- Smell and Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Otolaryngology – Head and Neck Surgery, Philippine General Hospital, University of the Philippines – Manila, Manila, Philippines
- Department of Otolaryngology – Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
| | - Basile N. Landis
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology, University Hospital of Geneva, Geneva, Switzerland
| | - Aytug Altundag
- Department of Otolaryngology, Head and Neck Surgery, Biruni University Medical School, Istanbul, Turkey
| | - Alexander Wieck Fjaeldstad
- Department of Otorhinolaryngology, University Clinic for Flavour, Balance and Sleep, Regional Hospital Gødstrup, Herning, Denmark
- Department of Clinical Medicine, Flavour Institute, Aarhus University, Aarhus, Denmark
- Center for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Study, University of London, London, UK
| | - Simon Gane
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Study, University of London, London, UK
- Royal National Throat Nose and Ear Hospital, UCLH, London, UK
| | - Eric H. Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, USA
| | - Caroline Huart
- Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Iordanis Konstantinidis
- Smell and Taste Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Matt Lechner
- Division of Surgery and Interventional Science, University College London, London, UK
- UCL Cancer Institute, University College London, London, UK
- ENT Department, Homerton Healthcare NHS Foundation Trust, London, UK
| | - Alberto Macchi
- ENT Clinic, University of Insubria, ASST Sette Laghi, Varese, Italy
| | - Patricia Portillo Mazal
- Servicio de Otorrinolaringología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Takaki Miwa
- Department of Otorhinolaryngology, Kanazawa Medical University, Uchinada, Japan
| | - Carl M. Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK
- The Smell and Taste Clinic, James Paget University Hospital, Gorleston, UK
| | - Jayant M. Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - Sophia C. Poletti
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jan Vodicka
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Pardubice, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
| | - Antje Welge-Luessen
- Department of Otorhinolaryngology, University Hospital Basel, Basel, Switzerland
| | - Katherine L. Whitcroft
- Smell and Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Study, University of London, London, UK
- UCL Ear Institute, Faculty of Brain Sciences, University College London, London, UK
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Li Z, Chen L, Xu C, Chen Z, Wang Y. Non-invasive sensory neuromodulation in epilepsy: Updates and future perspectives. Neurobiol Dis 2023; 179:106049. [PMID: 36813206 DOI: 10.1016/j.nbd.2023.106049] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Epilepsy, one of the most common neurological disorders, often is not well controlled by current pharmacological and surgical treatments. Sensory neuromodulation, including multi-sensory stimulation, auditory stimulation, olfactory stimulation, is a kind of novel noninvasive mind-body intervention and receives continued attention as complementary safe treatment of epilepsy. In this review, we summarize the recent advances of sensory neuromodulation, including enriched environment therapy, music therapy, olfactory therapy, other mind-body interventions, for the treatment of epilepsy based on the evidence from both clinical and preclinical studies. We also discuss their possible anti-epileptic mechanisms on neural circuit level and propose perspectives on possible research directions for future studies.
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Affiliation(s)
- Zhongxia Li
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China; Zhejiang Rehabilitation Medical Center Department, The Third Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Liying Chen
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Cenglin Xu
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zhong Chen
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yi Wang
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China; Zhejiang Rehabilitation Medical Center Department, The Third Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China.
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Gavid M, Coulomb L, Thomas J, Aouimeur I, Verhoeven P, Mentek M, Dumollard JM, Forest F, Prades JM, Thuret G, Gain P, He Z. Technique of flat-mount immunostaining for mapping the olfactory epithelium and counting the olfactory sensory neurons. PLoS One 2023; 18:e0280497. [PMID: 36649285 PMCID: PMC9844923 DOI: 10.1371/journal.pone.0280497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/02/2023] [Indexed: 01/18/2023] Open
Abstract
The pathophysiology underlying olfactory dysfunction is still poorly understood, and more efficient biomolecular tools are necessary to explore this aspect. Immunohistochemistry (IHC) on cross sections is one of the major tools to study the olfactory epithelium (OE), but does not allow reliable counting of olfactory sensory neurons (OSNs) or cartography of the OE. In this study, we want to present an easy immunostaining technique to compensate for these defects of IHC. Using the rat model, we first validated and pre-screened the key OSN markers by IHC on cross sections of the OE. Tuj-1, OMP, DCX, PGP9.5, and N-cadherin were selected for immunostaining on flat-mounted OE because of their staining of OSN dendrites. A simple technique for immunostaining on flat-mounted septal OE was developed: fixation of the isolated septum mucosa in 0.5% paraformaldehyde (PFA) preceded by pretreatment of the rat head in 1% PFA for 1 hour. This technique allowed us to correctly reveal the olfactory areas using all the 5 selected markers on septum mucosa. By combining the mature OSN marker (OMP) and an immature OSN marker (Tuj-1), we quantified the mature (OMP+, Tuj-1-), immature (OMP-, Tuj-1+), transitory (OMP+, Tuj-1+) and total OSN density on septal OE. They were respectively 42080 ± 11820, 49384 ± 7134, 14448 ± 5865 and 105912 ± 13899 cells per mm2 (mean ± SD). Finally, the same immunostaining technique described above was performed with Tuj-1 for OE cartography on ethmoid turbinates without flat-mount.
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Affiliation(s)
- Marie Gavid
- Laboratory BIIO (EA2521), Jean Monnet University, Saint-Etienne, France
- Department of Otorhinolaryngology, CHU of Saint-Etienne, Saint-Etienne, France
| | - Louise Coulomb
- Laboratory BIIO (EA2521), Jean Monnet University, Saint-Etienne, France
| | - Justin Thomas
- Laboratory BIIO (EA2521), Jean Monnet University, Saint-Etienne, France
| | - Inès Aouimeur
- Laboratory BIIO (EA2521), Jean Monnet University, Saint-Etienne, France
| | - Paul Verhoeven
- CIRI, GIMAP Team, INSERM U1111, CNRS UMR5308, University of Lyon, University of Saint-Etienne, Saint-Etienne, France
| | - Marielle Mentek
- Laboratory BIIO (EA2521), Jean Monnet University, Saint-Etienne, France
| | - Jean-Marc Dumollard
- Laboratory BIIO (EA2521), Jean Monnet University, Saint-Etienne, France
- Department of Pathology, CHU of Saint-Etienne, Saint-Etienne, France
| | - Fabien Forest
- Laboratory BIIO (EA2521), Jean Monnet University, Saint-Etienne, France
- Department of Pathology, CHU of Saint-Etienne, Saint-Etienne, France
| | - Jean-Michel Prades
- Department of Otorhinolaryngology, CHU of Saint-Etienne, Saint-Etienne, France
| | - Gilles Thuret
- Laboratory BIIO (EA2521), Jean Monnet University, Saint-Etienne, France
| | - Philippe Gain
- Laboratory BIIO (EA2521), Jean Monnet University, Saint-Etienne, France
| | - Zhiguo He
- Laboratory BIIO (EA2521), Jean Monnet University, Saint-Etienne, France
- * E-mail:
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6
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Gary JB, Gallagher L, Joseph PV, Reed D, Gudis DA, Overdevest JB. Qualitative Olfactory Dysfunction and COVID-19: An Evidence-Based Review with Recommendations for the Clinician. Am J Rhinol Allergy 2023; 37:95-101. [PMID: 35957578 PMCID: PMC9379596 DOI: 10.1177/19458924221120117] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Nearly 40% of patients who experience smell loss during SARS-CoV-2 infection may develop qualitative olfactory dysfunction, most commonly parosmia. Our evidence-based review summarizes the evolving literature and offers recommendations for the clinician on the management of patients experiencing parosmia associated with COVID-19. METHODS We performed a systematic search using independent queries in PubMed, Embase, Ovid, and Cochrane databases, then categorized articles according to themes that emerged regarding epidemiology, effect on quality of life, disease progression, prognosis, pathophysiology, diagnosis, and treatment of parosmia. RESULTS We identified 123 unique references meeting eligibility and performed title and abstract review with 2 independent reviewers, with 74 articles undergoing full-text review. An inductive approach to thematic development provided 7 central themes regarding qualitative olfactory dysfunction following COVID-19. CONCLUSIONS While other respiratory viruses are known to cause qualitative olfactory disturbances, the incidence of parosmia following COVID-19 is notable, and correlates negatively with age. The presence of parosmia predicts persistent quantitative olfactory dysfunction. Onset can occur months after infection, and symptoms may persist for well over 7 months. Affected patients report increased anxiety and decreased quality of life. Structured olfactory training with essential oils is the preferred treatment, where parosmia predicts recovery of aspects of quantitative smell loss when undergoing training. There is limited evidence that nasal corticosteroids may accelerate recovery of olfactory function. Patients should be prepared for the possibility that symptoms may persist for years, and providers should guide them to resources for coping with their psychosocial burden.
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Affiliation(s)
- Joseph B. Gary
- Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA
| | - Liam Gallagher
- Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA
| | - Paule V. Joseph
- National Institute on Alcohol Abuse and
Alcoholism, Bethesda, MD, USA
- National Institute of Nursing Research,
Bethesda, MD, USA
| | - Danielle Reed
- Monell Chemical Senses
Center, Philadelphia, PA, USA
| | - David A. Gudis
- Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA
- Department of Otolaryngology–Head and
Neck Surgery, Columbia University Irving Medical
Center, New York–Presbyterian Hospital, New York, NY, USA
| | - Jonathan B. Overdevest
- Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA
- Department of Otolaryngology–Head and
Neck Surgery, Columbia University Irving Medical
Center, New York–Presbyterian Hospital, New York, NY, USA
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7
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Shahid E, Nasir M, Khan F, Fasih U. Phantosmia: A neglected symptom after Dacryocystorhinostomy with intubation (A case report). Oman J Ophthalmol 2023; 16:145-147. [PMID: 37007265 PMCID: PMC10062087 DOI: 10.4103/ojo.ojo_318_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 06/13/2022] [Accepted: 06/29/2022] [Indexed: 02/23/2023] Open
Abstract
A 62-year-old female presented with complaints of persistent phantosmia (foul smell) for the last 4 months. She has a past history of right-sided dacryocystorhinostomy (DCR) 18 months back and left-sided DCR 12 months back. In the initial follow-up period, the patient had frequent visits to her otolaryngologist and ophthalmologist. She experienced phantosmia often but was reassured. The patient presented to us and was examined in an operation theater. It was discovered that the foul-smelling foreign body was present in her right nasal cavity above the middle turbinate. It was removed. A retained gauze piece was revealed to be a cause of phantosmia. The purpose of reporting is to create awareness among ophthalmologists and otolaryngologists. Retained gauze piece following DCR surgery presenting as phantosmia is a new symptom after DCR surgery previously not reported in the literature. Repeated complaints of a postoperative patient, should be dealt with vigilantly and timely.
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Abstract
The German Society of Pneumology initiated 2021 the AWMF S1 guideline Long COVID/Post-COVID. In a broad interdisciplinary approach, this S1 guideline was designed based on the current state of knowledge.The clinical recommendations describe current Long COVID/Post-COVID symptoms, diagnostic approaches, and therapies.In addition to the general and consensus introduction, a subject-specific approach was taken to summarize the current state of knowledge.The guideline has an explicit practical claim and will be developed and adapted by the author team based on the current increase in knowledge.
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Krämer G. Riech- und Schmeckstörungen bei Epilepsien und anderen neurologischen Erkrankungen. DGNEUROLOGIE 2022. [PMCID: PMC9336133 DOI: 10.1007/s42451-022-00464-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- G. Krämer
- Neurozentrum Bellevue, Theaterstr. 8, 8001 Zürich, Schweiz
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10
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Olfactory and gustatory disorders in COVID-19. ALLERGO JOURNAL INTERNATIONAL 2022; 31:243-250. [PMID: 35755859 PMCID: PMC9208356 DOI: 10.1007/s40629-022-00216-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/28/2022] [Indexed: 12/05/2022]
Abstract
Loss of olfaction is one of the symptoms most commonly reported by patients with coronavirus disease 2019 (COVID-19). Although the spontaneous recovery rate is high, recent studies have shown that up to 7% of patients remain anosmic for more than 12 months after the onset of infection, leaving millions of people worldwide suffering from severe olfactory impairment. Olfactory training remains the first recommended treatment. With the continued lack of approved drug treatments, new therapeutic options are being explored. This article reviews the current state of science on COVID-19-related olfactory disorders, focusing on epidemiology, pathophysiology, cure rates, currently available treatment options, and research on new treatments.
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Moeini Z, Seraj Z, Zohoorian Abootorabi T, Ashrafi-Kooshk M, Riazi G, Saboury AA, Seyedarabi A. Unravelling the Novel Effects of Three Volatile Compounds in Preventing Fibril Formation of Disease Related Tau and α-Synuclein Proteins- Towards Identifying Candidate Aromatic Substances for Treating Neurodegenerative Diseases. Front Pharmacol 2022; 13:793727. [PMID: 35392564 PMCID: PMC8980687 DOI: 10.3389/fphar.2022.793727] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/28/2022] [Indexed: 11/15/2022] Open
Abstract
Background: The aggregation of tau and α-synuclein into fibrillary assemblies in nerve cells is the molecular hallmark of Alzheimer’s and Parkinson’s diseases, respectively. In our previous studies, we investigated the anti-amyloidogenic effects of three different aroma-producing (volatile) compounds including cinnamaldehyde, phenyl ethyl alcohol, and TEMED on the fibrillation process of HEWL, as a model protein. Our previous results showed that while TEMED was able to completely stop the process of fibril formation, cinnamaldehyde and phenyl ethyl alcohol gave rise to oligomeric/protofibrillar forms and were involved in the entrapment of intermediate species of HEWL. In this study, we investigated the anti-amyloidogenic effect of the same three volatile compounds on recombinantly produced tau and α-synuclein proteins. Methods: The thioflavin T fluorescence assay, circular dichroism, SDS-PAGE/native-PAGE, dynamic light scattering, and atomic force microscopy were used, where necessary, to further our understanding of the inhibitory effects of the three volatile compounds on the fibril formation of tau and α-synuclein proteins and allow for a comparison with previous data obtained for HEWL. Results: Our results revealed that contrary to the results obtained for HEWL (a globular protein), the volatile compound TEMED was no longer able to prevent fibril formation in either of the natively unstructured tau or α-synuclein proteins, and instead, cinnamaldehye and phenyl ethyl alcohol, in particular, had the role of preventing fibril formation of tau or α-synuclein. Conclusion: The results of this study further emphasized the exclusion of HEWL as a model protein for fibrillation studies and highlighted the importance of studying brain-related proteins such as tau or α-synuclein and the need to assess the effects of volatile compounds such as cinnamaldehye and phenyl ethyl alcohol as potential substances in the treatment of neurodegenerative diseases.
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Affiliation(s)
- Zahra Moeini
- Department of Biochemistry, Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Zahra Seraj
- Department of Biochemistry, Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | | | | | - Gholamhossein Riazi
- Department of Biochemistry, Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Ali Akbar Saboury
- Department of Biochemistry, Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Arefeh Seyedarabi
- Department of Biochemistry, Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
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12
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Vasconcelos CCF, Hammerle MB, Sales DS, Rueda Lopes FC, Pinheiro PG, Gouvea EG, Alves MCDF, Pereira TV, Schmidt SL, Alvarenga RMP, Pires KL. Post-COVID-19 olfactory dysfunction: carbamazepine as a treatment option in a series of cases. J Neurovirol 2022; 28:312-318. [PMID: 35366736 PMCID: PMC8976535 DOI: 10.1007/s13365-022-01066-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 12/24/2022]
Abstract
Olfactory dysfunction is reported frequently in patients with coronavirus disease 2019. However, an effective treatment for this dysfunction is unknown. The present study evaluated carbamazepine as a treatment option for olfactory dysfunction based on its use in cases of neuralgia, especially of the V cranial nerve. The study included 10 patients with coronavirus disease with olfactory complaints who were part of a cohort of 172 coronavirus disease patients monitored for late neurological manifestations. Carbamazepine was administered for 11 weeks. The adverse effects reported were drowsiness (9/10) and dizziness (2/10); 9 of the 10 patients reported improved olfactory function after carbamazepine treatment. While the role of carbamazepine in the control of post-coronavirus disease olfactory dysfunction could not be confirmed in this study, the satisfactory response observed in most patients in this series suggests that further studies are warranted.
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Affiliation(s)
- Claudia Cristina Ferreira Vasconcelos
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Mariana Beiral Hammerle
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil.
| | - Deborah Santos Sales
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Fernanda Cristina Rueda Lopes
- Departamento de Radiologia, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil
- Diagnósticos da América S/A (DASA), São Paulo, Brazil
| | - Patricia Gomes Pinheiro
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Elisa Gutman Gouvea
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Manuella Caroline Dutra Frazão Alves
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Tayane Vasconcellos Pereira
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Sergio Luis Schmidt
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Regina Maria Papais Alvarenga
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Karina Lebeis Pires
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
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13
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Patel ZM, Holbrook EH, Turner JH, Adappa ND, Albers MW, Altundag A, Appenzeller S, Costanzo RM, Croy I, Davis GE, Dehgani-Mobaraki P, Doty RL, Duffy VB, Goldstein BJ, Gudis DA, Haehner A, Higgins TS, Hopkins C, Huart C, Hummel T, Jitaroon K, Kern RC, Khanwalkar AR, Kobayashi M, Kondo K, Lane AP, Lechner M, Leopold DA, Levy JM, Marmura MJ, Mclelland L, Miwa T, Moberg PJ, Mueller CA, Nigwekar SU, O'Brien EK, Paunescu TG, Pellegrino R, Philpott C, Pinto JM, Reiter ER, Roalf DR, Rowan NR, Schlosser RJ, Schwob J, Seiden AM, Smith TL, Soler ZM, Sowerby L, Tan BK, Thamboo A, Wrobel B, Yan CH. International consensus statement on allergy and rhinology: Olfaction. Int Forum Allergy Rhinol 2022; 12:327-680. [PMID: 35373533 DOI: 10.1002/alr.22929] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/01/2021] [Accepted: 11/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O). METHODS Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus. RESULTS The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies. CONCLUSION This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.
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Affiliation(s)
- Zara M Patel
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Eric H Holbrook
- Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Justin H Turner
- Otolaryngology, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Nithin D Adappa
- Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark W Albers
- Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Aytug Altundag
- Otolaryngology, Biruni University School of Medicine, İstanbul, Turkey
| | - Simone Appenzeller
- Rheumatology, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Richard M Costanzo
- Physiology and Biophysics and Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Ilona Croy
- Psychology and Psychosomatic Medicine, TU Dresden, Dresden, Germany
| | - Greg E Davis
- Otolaryngology, Proliance Surgeons, Seattle and Puyallup, Washington, USA
| | - Puya Dehgani-Mobaraki
- Associazione Naso Sano, Umbria Regional Registry of Volunteer Activities, Corciano, Italy
| | - Richard L Doty
- Smell and Taste Center, Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Valerie B Duffy
- Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | | | - David A Gudis
- Otolaryngology, Columbia University Irving Medical Center, New York, USA
| | - Antje Haehner
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | - Thomas S Higgins
- Otolaryngology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Claire Hopkins
- Otolaryngology, Guy's and St. Thomas' Hospitals, London Bridge Hospital, London, UK
| | - Caroline Huart
- Otorhinolaryngology, Cliniques universitaires Saint-Luc, Institute of Neuroscience, Université catholgique de Louvain, Brussels, Belgium
| | - Thomas Hummel
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | | | - Robert C Kern
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ashoke R Khanwalkar
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Masayoshi Kobayashi
- Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Kenji Kondo
- Otolaryngology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Andrew P Lane
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matt Lechner
- Otolaryngology, Barts Health and University College London, London, UK
| | - Donald A Leopold
- Otolaryngology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Joshua M Levy
- Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael J Marmura
- Neurology Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lisha Mclelland
- Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Takaki Miwa
- Otolaryngology, Kanazawa Medical University, Ishikawa, Japan
| | - Paul J Moberg
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Sagar U Nigwekar
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Erin K O'Brien
- Otolaryngology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Teodor G Paunescu
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Carl Philpott
- Otolaryngology, University of East Anglia, Norwich, UK
| | - Jayant M Pinto
- Otolaryngology, University of Chicago, Chicago, Illinois, USA
| | - Evan R Reiter
- Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - David R Roalf
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nicholas R Rowan
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rodney J Schlosser
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - James Schwob
- Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Allen M Seiden
- Otolaryngology, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - Timothy L Smith
- Otolaryngology, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Zachary M Soler
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - Leigh Sowerby
- Otolaryngology, University of Western Ontario, London, Ontario, Canada
| | - Bruce K Tan
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andrew Thamboo
- Otolaryngology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bozena Wrobel
- Otolaryngology, Keck School of Medicine, USC, Los Angeles, California, USA
| | - Carol H Yan
- Otolaryngology, School of Medicine, UCSD, La Jolla, California, USA
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14
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Parker JK, Methven L, Pellegrino R, Smith BC, Gane S, Kelly CE. Emerging Pattern of Post-COVID-19 Parosmia and Its Effect on Food Perception. Foods 2022; 11:foods11070967. [PMID: 35407054 PMCID: PMC8997629 DOI: 10.3390/foods11070967] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/14/2022] [Accepted: 03/24/2022] [Indexed: 01/05/2023] Open
Abstract
Olfactory dysfunction is amongst the many symptoms of Long COVID. Whilst most people that experience smell loss post COVID-19 recover their sense of smell and taste within a few weeks, about 10% of cases experience long-term problems, and their smell recovery journey often begins a few months later when everyday items start to smell distorted. This is known as parosmia. The aim of this study was to identify the key food triggers of parosmic distortions and investigate the relationship between distortion and disgust in order to establish the impact of parosmia on diet and quality of life. In this cross-sectional study (n = 727), respondents experiencing smell distortions completed a questionnaire covering aspects of smell loss, parosmia and the associated change in valence of everyday items. There was a significant correlation between strength and disgust (p < 0.0001), and when the selected items were reported as distorted, they were described as either unpleasant or gag-inducing 84% of the time. This change in valence associated with loss of expected pleasure and the presence of strange tastes and burning sensations must certainly lead to changes in eating behaviours and serious longer-term consequences for mental health and quality of life.
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Affiliation(s)
- Jane K. Parker
- Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (L.M.); (C.E.K.)
- Correspondence:
| | - Lisa Methven
- Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (L.M.); (C.E.K.)
| | | | - Barry C. Smith
- Centre for the Study of the Senses, Institute of Philosophy, School of Advanced Study, University of London, London WC1E 7HU, UK;
| | - Simon Gane
- Royal National Ear, Nose and Throat and Eastman Dental Hospitals, University College London Hospital, 47-49 Huntley St., London WC1E 6DG, UK;
| | - Christine E. Kelly
- Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (L.M.); (C.E.K.)
- AbScent, 14 London Road, Andover SP10 2PA, UK
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15
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Klimek L, Hagemann J, Döge J, Koll L, Cuevas M, Klimek F, Hummel T. Störungen des Riech- und Schmeckvermögens bei COVID-19. ALLERGO JOURNAL 2022; 31:35-43. [PMCID: PMC9618349 DOI: 10.1007/s15007-022-5602-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Der Verlust des Riechvermögens ist eines der Symptome, die von Patienten mit COVID-19 mit am häufigsten angegeben werden. Obwohl die Spontanheilungsrate hoch ist, haben neuere Studien gezeigt, dass bis zu 7 % der Patienten mehr als zwölf Monate nach Beginn der Infektion anosmisch bleiben, sodass weltweit Millionen von Menschen unter schweren Riechstörungen leiden. Riechtraining ist nach wie vor die erste empfohlene Behandlungsform. Angesichts weiterhin fehlender zugelassener medikamentöser Behandlungsmöglichkeiten werden neue therapeutische Optionen erforscht. Dieser Artikel gibt einen Überblick über den aktuellen Stand der Wissenschaft zu COVID-19-bedingten Riechstörungen, wobei der Schwerpunkt auf der Epidemiologie, der Pathophysiologie, den Heilungsraten, den derzeit verfügbaren Behandlungsmöglichkeiten und der Forschung zu neuen Behandlungsmethoden liegt. Zitierweise: Klimek L, Hagemann J, Döge J, Freudelsperger L, Cuevas M, Klimek F, Hummel T. Olfactory and gustatory disorders in COVID-19. Allergo J Int 2022;31:243-50 https://doi.org/10.1007/s40629-022-00216-7
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Affiliation(s)
- Ludger Klimek
- FA für Dermatologie u. Allergologie, Zentrum f. Rhinologie und Allergologie, An den Quellen 10, 65183 Wiesbaden, Germany
| | - Jan Hagemann
- Klinik f. Hals-Nasen-Ohrenheilkunde, Universitätsmedizin Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Julia Döge
- Klinik f. Hals-Nasen-Ohrenheilkunde, Universitätsmedizin Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Laura Koll
- Hals-, Nasen-, Ohrenklinik und Poliklinik, Universitätsmedizin Mainz, Mainz, Germany
| | - Mandy Cuevas
- Klinik u. Poliklinik für Hals- Nasen- und Ohrenheilkunde, Univ.-Klinikum Carl Gustav Carus, Fetscherstr. 74, 01307 Dresden, Germany
| | - Felix Klimek
- Zentrum für Rhinologie und Allergologie Wiesbaden, An den Quellen 10, 65183 Wiesbaden, Germany
| | - Thomas Hummel
- Klinik und Poliklinik für HNO-Heilkunde, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
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16
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Kandemir S, Pamuk AE, Habipoğlu Y, Özel G, Bayar Muluk N, Kılıç R. Olfactory acuity based on Brief Smell Identification Test (BSIT Ⓡ) in migraine patients with and without aura: A cross-sectional, controlled study. Auris Nasus Larynx 2021; 49:613-617. [PMID: 34930631 DOI: 10.1016/j.anl.2021.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate olfactory acuity in migraine patients with and without aura (MwA and MwoA) MATERIAL AND METHODS: The study included 30 MwA patients, 30 MwoA patients, and 30 age- and gender-matched controls. Demographic features and odor-related symptoms (osmophobia, odor offensiveness, and odor-triggered attack status) were noted. Olfactory acuity was measured using the Brief Smell Identification Test (BSIT®), a 12-item derivative of the University of Pennsylvania Smell Identification Test (UPSIT®). BSIT® scores were compared between the migraine patients and controls. RESULTS The mean BSIT® score did not differ significantly between the MwA patients (8.7 ± 0.9) and MwoA (9.17 ± 0.9) patients (P = 0.094); however, the mean score in the control group was higher (10.4 ± 0.6) than in the MwA and MwoA patients (P < 0.001). The mean BSIT® score did not differ significantly between patients with and without odor-triggered migraine attacks (9 ± 0.9 and 8.8 ± 0.8, respectively) (P = 0.4). Osmophobia and odor-triggered attacks were more common in the MwA patients than in the MwoA patients (odor-triggered attacks: 66% vs. 40% [P = 0.04]; osmophobia: 76.6% vs. 60% [P = 0.16]) CONCLUSION: Olfactory acuity is lower during attack-free periods in migraine patients, as compared to controls. Migraine aura status does not affect olfactory acuity. Odor-triggered attacks, osmophobia, and offensive odors between attacks were more common in the MwA patients than in the MwoA patients.
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Affiliation(s)
- Süheyla Kandemir
- Kırıkkale Yüksek İhtisas Hospital, Department of Otorhinolaryngology, Kırıkkale 71400, Turkey
| | - A Erim Pamuk
- Kırıkkale Yüksek İhtisas Hospital, Department of Otorhinolaryngology, Kırıkkale 71400, Turkey.
| | - Yasin Habipoğlu
- Kırıkkale Yüksek İhtisas Hospital, Department of Neurology, Kırıkkale, Turkey
| | - Gökçe Özel
- Kırşehir Ahi Evran University , Faculty of Medicine, Department of Otorhinolaryngology, Kırşehir, Turkey
| | - Nuray Bayar Muluk
- Kırıkkale University, Faculty of Medicine, Department of Otorhinolaryngology, Kırıkkale, Turkey
| | - Rahmi Kılıç
- Ankara Training and Research Hospital, Department of Otorhinolaryngology, Ankara, Turkey
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17
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Schambeck SE, Crowell CS, Wagner KI, D’Ippolito E, Burrell T, Mijočević H, Protzer U, Busch DH, Gerhard M, Poppert H, Beyer H. Phantosmia, Parosmia, and Dysgeusia Are Prolonged and Late-Onset Symptoms of COVID-19. J Clin Med 2021; 10:jcm10225266. [PMID: 34830550 PMCID: PMC8618742 DOI: 10.3390/jcm10225266] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 12/28/2022] Open
Abstract
Deficiencies in smell and taste are common symptoms of COVID-19. Quantitative losses are well surveyed. This study focuses on qualitative changes such as phantosmia (hallucination of smell), parosmia (alteration of smell), and dysgeusia (alteration of taste) and possible connections with the adaptive immune system. Subjective experience of deficiency in taste and smell was assessed by two different questionnaires after a median of 100 and 244 days after first positive RT-PCR test. SARS-CoV-2-specific antibody levels were measured with the iFlash-SARS-CoV-2 assay. After 100 days a psychophysical screening test for olfactory and gustatory dysfunction was administered. 30 of 44 (68.2%) participants reported a chemosensory dysfunction (14 quantitative, 6 qualitative, 10 quantitative, and qualitative) during COVID-19, eleven (25.0%) participants (1 quantitative, 7 qualitative, 3 quantitative, and quantity) after 100 days, and 14 (31.8%) participants (1 quantitative, 10 qualitative, 3 quantitative and qualitative) after 244 days. Four (9.1%) participants, who were symptom-free after 100 days reported now recently arisen qualitative changes. Serological and T-cell analysis showed no correlation with impairment of taste and smell. In conclusion, qualitative changes can persist for several months and occur as late-onset symptoms months after full recovery from COVID-19-induced quantitative losses in taste and smell.
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Affiliation(s)
- Sophia E. Schambeck
- Helios Klinikum München West, Steinerweg 5, 81241 München, Germany; (H.P.); (H.B.)
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675 München, Germany; (C.S.C.); (K.I.W.); (E.D.); (T.B.); (D.H.B.); (M.G.)
- Correspondence:
| | - Claudia S. Crowell
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675 München, Germany; (C.S.C.); (K.I.W.); (E.D.); (T.B.); (D.H.B.); (M.G.)
- German Center for Infection Research (DZIF), Partner Site Munich, 81675 Munich, Germany;
| | - Karolin I. Wagner
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675 München, Germany; (C.S.C.); (K.I.W.); (E.D.); (T.B.); (D.H.B.); (M.G.)
| | - Elvira D’Ippolito
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675 München, Germany; (C.S.C.); (K.I.W.); (E.D.); (T.B.); (D.H.B.); (M.G.)
| | - Teresa Burrell
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675 München, Germany; (C.S.C.); (K.I.W.); (E.D.); (T.B.); (D.H.B.); (M.G.)
| | - Hrvoje Mijočević
- Institute of Virology, School of Medicine, Technical University of Munich, Trogerstr. 30, 81675 München, Germany;
| | - Ulrike Protzer
- German Center for Infection Research (DZIF), Partner Site Munich, 81675 Munich, Germany;
- Institute of Virology, School of Medicine, Technical University of Munich, Trogerstr. 30, 81675 München, Germany;
| | - Dirk H. Busch
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675 München, Germany; (C.S.C.); (K.I.W.); (E.D.); (T.B.); (D.H.B.); (M.G.)
- German Center for Infection Research (DZIF), Partner Site Munich, 81675 Munich, Germany;
| | - Markus Gerhard
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675 München, Germany; (C.S.C.); (K.I.W.); (E.D.); (T.B.); (D.H.B.); (M.G.)
- German Center for Infection Research (DZIF), Partner Site Munich, 81675 Munich, Germany;
| | - Holger Poppert
- Helios Klinikum München West, Steinerweg 5, 81241 München, Germany; (H.P.); (H.B.)
- Klinik und Poliklinik für Neurologie im Neuro-Kopf-Zentrum, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 München, Germany
| | - Henriette Beyer
- Helios Klinikum München West, Steinerweg 5, 81241 München, Germany; (H.P.); (H.B.)
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18
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Nørgaard HJ, Fjaeldstad AW. Differences in Correlation between Subjective and Measured Olfactory and Gustatory Dysfunctions after Initial Ear, Nose and Throat Evaluation. Int Arch Otorhinolaryngol 2021; 25:e563-e569. [PMID: 34737828 PMCID: PMC8558951 DOI: 10.1055/s-0040-1722249] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/08/2020] [Indexed: 11/09/2022] Open
Abstract
Introduction
Subjective chemosensory function can differ from measured function. Previous studies on olfactory assessment have found a positive correlation between subjective and measured scores. However, information on gustatory correlation between measured and subjective functions is sparse in patients who have undergone an initial ear, nose and throat (ENT) evaluation.
Objectives
To evaluate the correlation between subjective and measured olfactory and gustatory dysfunctions in a population complaining of taste and/or smell dysfunction after an initial ENT evaluation without chemosensory testing. Furthermore, we aimed to assess the need for chemosensory testing depending on the type of subjective chemosensory dysfunction.
Methods
A case series in which subjective chemosensory function was assessed through a questionnaire and measured chemosensory function was assessed by validated clinical tests.
Results
In total, 602 patients with complaints of olfactory and/or gustatory dysfunction were included. We found that 50% of the patients with normal gustatory function and an olfactory impairment classified their olfactory impairment as a subjective taste disorder. Furthermore, 98% of the patients who rated their olfactory function as absent did have a measurable olfactory impairment, but only 64% were anosmic.
Conclusion
Subjective gustatory dysfunction was poorly correlated with measured gustatory dysfunction, and was often found to reflect olfactory dysfunction. Contrarily, subjective olfactory dysfunction was positively correlated with measurable olfactory dysfunction. Although subjective anosmia was a strong indicator of measured anosmia or hyposmia, the existence of remaining olfactory function was frequently found in these patients. Validated chemosensory testing should be performed in patients with perceived olfactory or gustatory deficits, as this could help ensure increased diagnostic precision and a relevant treatment.
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Affiliation(s)
- Hans Jacob Nørgaard
- Department of Otorhinolaryngology, Flavour Clinic, West Hospital Unit, Central Denmark Region, Holstebro, Denmark.,Flavour Institute, Aarhus University, Palle Juul-Jensens, Aarhus N, Denmark
| | - Alexander Wieck Fjaeldstad
- Department of Otorhinolaryngology, Flavour Clinic, West Hospital Unit, Central Denmark Region, Holstebro, Denmark.,Flavour Institute, Aarhus University, Palle Juul-Jensens, Aarhus N, Denmark.,Department of Psychiatry, Center for Eudaimonia and Human Flourishing, University of Oxford, Oxford, United Kingdom
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19
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Koczulla AR, Ankermann T, Behrends U, Berlit P, Böing S, Brinkmann F, Franke C, Glöckl R, Gogoll C, Hummel T, Kronsbein J, Maibaum T, Peters EMJ, Pfeifer M, Platz T, Pletz M, Pongratz G, Powitz F, Rabe KF, Scheibenbogen C, Stallmach A, Stegbauer M, Wagner HO, Waller C, Wirtz H, Zeiher A, Zwick RH. [S1 Guideline Post-COVID/Long-COVID]. Pneumologie 2021; 75:869-900. [PMID: 34474488 DOI: 10.1055/a-1551-9734] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The German Society of Pneumology initiated the AWMFS1 guideline Post-COVID/Long-COVID. In a broad interdisciplinary approach, this S1 guideline was designed based on the current state of knowledge.The clinical recommendation describes current post-COVID/long-COVID symptoms, diagnostic approaches, and therapies.In addition to the general and consensus introduction, a subject-specific approach was taken to summarize the current state of knowledge.The guideline has an expilcit practical claim and will be continuously developed and adapted by the author team based on the current increase in knowledge.
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Affiliation(s)
| | | | - Uta Behrends
- Klinikum rechts der Isar der Technischen Universität München, Chronisches Fatigue Centrum
| | | | | | | | | | - Rainer Glöckl
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP)
| | - Christian Gogoll
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP)
| | - Thomas Hummel
- Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V
| | | | - Thomas Maibaum
- Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM)
| | - Eva M J Peters
- Deutsche Gesellschaft für Psychosomatische Medizin und Ärztliche Psychotherapie (DGPM)
| | - Michael Pfeifer
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP)
| | - Thomas Platz
- Deutsche Gesellschaft für Neurorehabilitation (DGNR) und Redaktionskomitee S2k-LL SARS-CoV-2, COVID-19 und (Früh-) Rehabilitation
| | - Matthias Pletz
- Paul Ehrlich Gesellschaft für Chemotherapie e. V. (PEG)/Sektion Infektiologie
| | - Georg Pongratz
- Deutsche Schmerzgesellschaft, Deutsche Migräne- und Kopfschmerzgesellschaft und Deutsche Gesellschaft für Rheumatologie
| | | | - Klaus F Rabe
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP)
| | | | - Andreas Stallmach
- Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselerkrankungen (DGVS), Deutsche Gesellschaft für Infektiologie (DGI)
| | | | - Hans Otto Wagner
- Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM)
| | | | - Hubert Wirtz
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP)
| | - Andreas Zeiher
- Deutsche Gesellschaft für Kardiologie- Herz- und Kreislaufforschung (DGK)
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20
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Huart C, Philpott CM, Altundag A, Fjaeldstad AW, Frasnelli J, Gane S, Hsieh JW, Holbrook EH, Konstantinidis I, Landis BN, Macchi A, Mueller CA, Negoias S, Pinto JM, Poletti SC, Ramakrishnan VR, Rombaux P, Vodicka J, Welge‐Lüessen A, Whitcroft KL, Hummel T. Systemic corticosteroids in coronavirus disease 2019 (COVID-19)-related smell dysfunction: an international view. Int Forum Allergy Rhinol 2021; 11:1041-1046. [PMID: 33728824 PMCID: PMC8251281 DOI: 10.1002/alr.22788] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 02/06/2023]
Abstract
The frequent association between coronavirus disease 2019 (COVID-19) and olfactory dysfunction is creating an unprecedented demand for a treatment of the olfactory loss. Systemic corticosteroids have been considered as a therapeutic option. However, based on current literature, we call for caution using these treatments in early COVID-19-related olfactory dysfunction because: (1) evidence supporting their usefulness is weak; (2) the rate of spontaneous recovery of COVID-19-related olfactory dysfunction is high; and (3) corticosteroids have well-known potential adverse effects. We encourage randomized placebo-controlled trials investigating the efficacy of systemic steroids in this indication and strongly emphasize to initially consider smell training, which is supported by a robust evidence base and has no known side effects.
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Affiliation(s)
- Caroline Huart
- Department of OtorhinolaryngologyCliniques universitaires Saint‐LucBrusselsBelgium
- Institute of NeuroscienceUniveristé catholique de LouvainBrusselsBelgium
| | - Carl M. Philpott
- The Norfolk Smell and Taste ClinicNorfolk and Waveney ENT ServiceGorlestonUK
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
| | - Aytug Altundag
- Department of OtorhinolaryngologyBiruni UniversityIstanbulTurkey
| | - Alexander W. Fjaeldstad
- Flavour ClinicDepartment of OtorhinolaryngologyRegional Hospital West JutlandHolstebroDenmark
- Flavour InstituteAarhus UniversityAarhusDenmark
| | - Johannes Frasnelli
- Department of AnatomyUniversité du Québec à Trois‐RivièresTrois‐RivièresQuebecCanada
| | - Simon Gane
- Department of RhinologyRoyal National ENT Hospital, University College London Hospitals NHS Foundation TrustLondonUK
- UCL Ear Institute, University College LondonLondonUK
| | - Julien W. Hsieh
- Department of Otorhinolaryngology–Head and Neck Surgery, Rhinology‐Olfactory UnitGeneva University HospitalsGenevaSwitzerland
| | | | | | - Basile N. Landis
- Department of Otorhinolaryngology–Head and Neck Surgery, Rhinology‐Olfactory UnitGeneva University HospitalsGenevaSwitzerland
| | - Alberto Macchi
- ENT clinic Asst‐Settelaghi‐University of InsubriaeVareseItaly
| | | | - Simona Negoias
- Department of OtorhinolaryngologyHead and Neck SurgeryUniversity Hospital BaselCH‐4051BaselSwitzerland
| | - Jayant M. Pinto
- Section of Otolaryngology–Head and Neck SurgeryThe University of ChicagoChicagoIllinois
| | - Sophia C. Poletti
- Department of OtorhinolaryngologyInselspital University Hospital BernBernSwitzerland
| | - Vijay R. Ramakrishnan
- Department of Otolaryngology–Head and Neck SurgeryUniversity of Colorado Anschutz Medical CampusAuroraColorado
| | - Philippe Rombaux
- Department of OtorhinolaryngologyCliniques universitaires Saint‐LucBrusselsBelgium
- Institute of NeuroscienceUniveristé catholique de LouvainBrusselsBelgium
| | - Jan Vodicka
- Department of Otorhinolaryngology and Head and Neck SurgeryHospital of PardubicePardubiceCzech Republic
| | - Antje Welge‐Lüessen
- Department of OtorhinolaryngologyHead and Neck SurgeryUniversity Hospital BaselCH‐4051BaselSwitzerland
| | - Katherine L. Whitcroft
- UCL Ear Institute, University College LondonLondonUK
- The Centre for Olfactory Research and ApplicationsInstitute of PhilosophySchool of Advanced StudyLondonUK
| | - Thomas Hummel
- Smell and Taste ClinicDepartment of OtorhinolaryngologyTU DresdenDresdenGermany
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21
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Pellegrino R, Mignot C, Georgiopoulos C, Haehner A, Hummel T. Consequences of gaining olfactory function after lifelong anosmia. Neurocase 2021; 27:238-242. [PMID: 34003718 DOI: 10.1080/13554794.2021.1921221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We present a rare case in which a patient has gained her smell after lifelong anosmia. The patient was objectively tested and diagnosed with functional anosmia at age 13 and reported they were experiencing a new sensation of smell at age 22. Our results show an electrophysiological signal for two unimodal odorants. The patient had a retronasal score in the hyposmic range and self-reported the ability to smell non-trigeminal odors, but reported being disturbed by the presence of the new sense and co-occurrence of phantosmia. We discuss our case in routes of neurogenesis and non-forming memory association with odors.
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Affiliation(s)
- Robert Pellegrino
- Department of Otorhinolaryngology, Smell & Taste Clinic, University of Dresden Medical School, Dresden, Germany
| | - Coralie Mignot
- Department of Otorhinolaryngology, Smell & Taste Clinic, University of Dresden Medical School, Dresden, Germany
| | - Charalampos Georgiopoulos
- Department of Otorhinolaryngology, Smell & Taste Clinic, University of Dresden Medical School, Dresden, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, Smell & Taste Clinic, University of Dresden Medical School, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell & Taste Clinic, University of Dresden Medical School, Dresden, Germany
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22
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Drews T, Hummel T, Rochlitzer B, Hauswald B, Hähner A. Acupuncture is associated with a positive effect on odour discrimination in patients with postinfectious smell loss-a controlled prospective study. Eur Arch Otorhinolaryngol 2021; 279:1329-1334. [PMID: 34032906 PMCID: PMC8897321 DOI: 10.1007/s00405-021-06872-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/04/2021] [Indexed: 01/05/2023]
Abstract
Introduction Smell disorders are common in the general population and occur e.g., after infections, trauma or idiopathically Treatment strategies for smell loss range from surgery, medication to olfactory training, depending on the pathology, but they are limited This study examined the effect of acupuncture on olfactory function. Methods Sixty patients with smell loss following infections of the upper respiratory tract were included in this investigation Half of the study group were randomly assigned to verum acupuncture and the other half to sham acupuncture Olfaction was measured by means of the “Sniffin’ Sticks” test battery (odour threshold, discrimination and identification). Results Compared to sham acupuncture, verum was associated with an improvement of smell function as measured by the TDI score (p = 0.039) The improvement was largely determined by improvement in odour discrimination, and was significantly better in patients with a shorter duration of the disorder. Conclusion The present results suggest that acupuncture is an effective supplementary treatment option for patients with olfactory loss.
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Affiliation(s)
- Tanja Drews
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technische Universität Dresden, Technical University of Dresden Medical School, Fetscherstrasse 74, 01307, Dresden, Germany. .,Department of Otorhinolaryngology, Bundeswehrkrankenhaus Berlin, Scharnhorststr 13, 10115, Berlin, Germany.
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technische Universität Dresden, Technical University of Dresden Medical School, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Bettina Rochlitzer
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technische Universität Dresden, Technical University of Dresden Medical School, Fetscherstrasse 74, 01307, Dresden, Germany.,Klinik Für Augenheilkunde, Städtisches Klinikum Görlitz, Girbigsdorfer Str 1-3, Görlitz, Germany
| | - Bettina Hauswald
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technische Universität Dresden, Technical University of Dresden Medical School, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Antje Hähner
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technische Universität Dresden, Technical University of Dresden Medical School, Fetscherstrasse 74, 01307, Dresden, Germany
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23
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Sabiniewicz A. Smells Influence Perceived Pleasantness but Not Memorization of a Visual Virtual Environment. Iperception 2021; 12:2041669521989731. [PMID: 33868626 PMCID: PMC8020408 DOI: 10.1177/2041669521989731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 01/04/2021] [Indexed: 12/20/2022] Open
Abstract
The present study aimed to investigate whether the perception of still scenes in a virtual environment in congruent versus incongruent condition can be influenced by odors. Ninety healthy participants were divided into three groups, including two experimental virtual reality (VR) environments: a rose garden, an orange basket, and a control condition. In each VR condition, participants were exposed to a rose odor, an orange odor, or no odor, resulting in congruent, incongruent, and control conditions. Participants were asked to describe (a) the content of the VR scene and rate its overall pleasantness and (b) the smell and to rate its intensity and pleasantness. For each condition, participants were tested twice. During the second test, participants provided ratings and descriptions of the content of the VR scenes without being exposed to odors or VR environments. Virtual scenarios tended to be remembered as more pleasant when presented with congruent odors. Furthermore, participants used more descriptors in congruent scenarios than in incongruent scenarios. Eventually, rose odor appeared to be remembered as more pleasant when presented within congruent scenarios. These findings show that olfactory stimuli in congruent versus incongruent conditions can possibly modulate the perception of the pleasantness of visual scenes but not the memorization.
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Affiliation(s)
- Agnieszka Sabiniewicz
- Interdisciplinary Center “Smell & Taste”, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany Institute of Psychology, University of Wrocław, Wrocław, Poland
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24
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Pellegrino R, Mainland JD, Kelly CE, Parker JK, Hummel T. Prevalence and correlates of parosmia and phantosmia among smell disorders. Chem Senses 2021; 46:bjab046. [PMID: 34698820 PMCID: PMC8633731 DOI: 10.1093/chemse/bjab046] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Among those many individuals who experience a reduced odor sensitivity (hyposmia/anosmia), some individuals also have disorders that lead to odor distortion, such as parosmia (i.e. distorted odor with a known source), or odor phantoms (i.e. odor sensation without an odor source). We surveyed a large population with at least one olfactory disorder (N = 2031) and found that odor distortions were common (46%), with respondents reporting either parosmia (19%), phantosmia (11%), or both (16%). In comparison to respondents with hyposmia or anosmia, respondents with parosmia were more likely to be female, young, and suffering from post-viral olfactory loss (P < 0.001), while respondents with phantosmia were more likely to be middle-aged (P < 0.01) and experiencing symptoms caused by head trauma (P < 0.01). In addition, parosmia, compared to phantosmia or anosmia/hyposmia, was most prevalent 3 months to a year after olfactory symptom onset (P < 0.001), which coincides with the timeline of physiological recovery. Finally, we observed that the frequency and duration of distortions negatively affects the quality of life, with parosmia showing a higher range of severity than phantosmia (P < 0.001). Previous research often grouped these distortions together, but our results show that they have distinct patterns of demographics, medical history, and loss in quality of life.
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Affiliation(s)
- Robert Pellegrino
- Monell Chemical Senses Center, Philadelphia, PA, USA
- Department of Food Science, University of Tennessee, Knoxville, TN, USA
| | - Joel D Mainland
- Monell Chemical Senses Center, Philadelphia, PA, USA
- Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Jane K Parker
- Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, UK
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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25
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Ciurleo R, De Salvo S, Bonanno L, Marino S, Bramanti P, Caminiti F. Parosmia and Neurological Disorders: A Neglected Association. Front Neurol 2020; 11:543275. [PMID: 33240192 PMCID: PMC7681001 DOI: 10.3389/fneur.2020.543275] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 10/07/2020] [Indexed: 11/30/2022] Open
Abstract
Parosmia is a distorted olfactory sensation in the presence of an odor. This olfactory disorder can affect the quality of life of most patients who experience it. Qualitative olfactory dysfunctions, such as parosmia and phantosmia, may be clinical conditions secondary to neurological diseases. The incidence of parosmia is underestimated, as well as its association with neurological diseases, due to poor self-reporting of patients and lack of objective methods for its measure. In this paper, we show selected clinical cases of parosmia associated with neurological disorders, such as traumatic brain injury and multiple sclerosis. These clinical cases show how the correct diagnosis of parosmia can represent the tip of the iceberg of important underlying neurological disorders and be a good prognostic indicator of their progression or recovery.
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Affiliation(s)
- Rosella Ciurleo
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | - Simona De Salvo
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | - Lilla Bonanno
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | - Silvia Marino
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | - Placido Bramanti
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | - Fabrizia Caminiti
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino-Pulejo", Messina, Italy
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26
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Liu DT, Welge-Lüssen A, Besser G, Mueller CA, Renner B. Assessment of odor hedonic perception: the Sniffin' sticks parosmia test (SSParoT). Sci Rep 2020; 10:18019. [PMID: 33093474 PMCID: PMC7581750 DOI: 10.1038/s41598-020-74967-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/11/2020] [Indexed: 11/24/2022] Open
Abstract
Qualitative olfactory dysfunction is characterized as distorted odor perception and can have a profound effect on quality of life of affected individuals. Parosmia and phantosmia represent the two main subgroups of qualitative impairment and are currently diagnosed based on patient history only. We have developed a test method which measures qualitative olfactory function based on the odors of the Sniffin' Sticks Identification subtest. The newly developed test is called Sniffin' Sticks Parosmia Test (SSParoT). SSParoT uses hedonic estimates of two oppositely valenced odors (pleasant and unpleasant) to assess hedonic range (HR) and hedonic direction (HD), which represent qualitative olfactory perception. HR is defined as the perceivable hedonic distance between two oppositely valenced odors, while HD serves as an indicator for overall hedonic perception of odors. This multicenter study enrolled a total of 162 normosmic subjects in four consecutive experiments. Cluster analysis was used to group odors from the 16-item Sniffin' Sticks Identification test and 24-additional odors into clusters with distinct hedonic properties. Eleven odor pairs were found to be suitable for estimation of HR and HD. Analysis showed agreement between test-retest sessions for all odor pairs. SSparoT might emerge as a valuable tool to assess qualitative olfactory function in health and disease.
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Affiliation(s)
- David T Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Antje Welge-Lüssen
- Department of Otorhinolaryngology, University Hospital, University of Basel, Basel, Switzerland
| | - Gerold Besser
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Christian A Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
| | - Bertold Renner
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- Institute of Clinical Pharmacology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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27
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Han AY, Mukdad L, Long JL, Lopez IA. Anosmia in COVID-19: Mechanisms and Significance. Chem Senses 2020; 45:bjaa040. [PMID: 32556089 PMCID: PMC7449368 DOI: 10.1093/chemse/bjaa040] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Indexed: 12/13/2022] Open
Abstract
The global pandemic of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 remains a challenge for prevention due to asymptomatic or paucisymptomatic patients. Anecdotal and preliminary evidence from multiple institutions shows that these patients present with a sudden onset of anosmia without rhinitis. We aim to review the pathophysiology of anosmia related to viral upper respiratory infections and the prognostic implications. Current evidence suggests that SARS-CoV-2-related anosmia may be a new viral syndrome specific to COVID-19 and can be mediated by intranasal inoculation of SARS-CoV-2 into the olfactory neural circuitry. The clinical course of neuroinvasion of SARS-CoV-2 is yet unclear, however an extended follow up of these patients to assess for neurological sequelae including encephalitis, cerebrovascular accidents and long-term neurodegenerative risk may be indicated.
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Affiliation(s)
- Albert Y Han
- Department of Head and Neck Surgery, University of California, Los Angeles, Rehabilitation Center 35–64, Los Angeles, CA, USA
| | - Laith Mukdad
- Department of Head and Neck Surgery, University of California, Los Angeles, Rehabilitation Center 35–64, Los Angeles, CA, USA
| | - Jennifer L Long
- Department of Head and Neck Surgery, University of California, Los Angeles, Rehabilitation Center 35–64, Los Angeles, CA, USA
- Greater Los Angeles VA Healthcare System, Los Angeles, CA, USA
| | - Ivan A Lopez
- Department of Head and Neck Surgery, University of California, Los Angeles, Rehabilitation Center 35–64, Los Angeles, CA, USA
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28
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Delfino-Pereira P, Berti Dutra P, Cortes de Oliveira JA, Casanova Turatti IC, Fernandes A, Peporine Lopes N, Garcia-Cairasco N. Are Predator Smell (TMT)-Induced Behavioral Alterations in Rats Able to Inhibit Seizures? Chem Senses 2020; 45:347-357. [DOI: 10.1093/chemse/bjaa023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Abstract
We aimed to evaluate the chemical and behavioral effects of 2,5-dihydro-2,4,5-trimethylthiazoline (TMT) after olfactory exposure and to verify their influence in the expression of acute audiogenic seizures in the Wistar Audiogenic Rat (WAR) strain. PROTOCOL 1: TMT gas chromatography was applied to define odor saturation in a chamber to different concentrations, time required for saturation and desaturation, and if saturation was homogeneous. Also, male Adult Wistar rats were exposed to saline (SAL) or to different TMT concentrations and their behaviors were evaluated (neuroethology). PROTOCOL 2: Male adult WARs were exposed for 15 s to SAL or TMT, followed by sound stimulation for 1 min or until tonic–clonic convulsion. Behavioral analysis included latencies (wild running and tonic–clonic convulsion), seizure severity indexes, and neuroethology. Gas chromatography established a saturation homogeneous to different concentrations of TMT, indicating that saturation and desaturation occurred in 30 min. TMT triggered fear-like or aversion-like reactions associated with reduction in motor activity and in grooming behavior, in the 2 highest concentrations. Pure TMT presented anticonvulsant properties, such as less-severe seizure phenotype, as well as a decrease in tonic–clonic convulsion expression. TMT elicited fear-like or aversion-like behaviors in Wistar and WAR and can be utilized in a quantifiable and controllable way. Our results suggested possible antagonism between “fear-related” or “aversion-related” and “seizure-related” networks.
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Affiliation(s)
- Polianna Delfino-Pereira
- Neurosciences and Behavioral Sciences Departament, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Poliana Berti Dutra
- Neurosciences and Behavioral Sciences Departament, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Physiology Departament, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Izabel Cristina Casanova Turatti
- Physics and Chemistry Departament, Ribeirão Preto School of Pharmaceutical Sciences, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Artur Fernandes
- Physiology Departament, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Norberto Peporine Lopes
- Physics and Chemistry Departament, Ribeirão Preto School of Pharmaceutical Sciences, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Norberto Garcia-Cairasco
- Neurosciences and Behavioral Sciences Departament, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Physiology Departament, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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29
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Iannilli E, Leopold D, Hornung D, Hummel T. Advances in Understanding Parosmia: An fMRI Study. ORL J Otorhinolaryngol Relat Spec 2019; 81:185-192. [DOI: 10.1159/000500558] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 04/23/2019] [Indexed: 11/19/2022]
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30
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Abstract
BACKGROUND Photophobia is commonly associated with migraine, meningitis, concussion, and a variety of ocular diseases. Advances in our ability to trace multiple brain pathways through which light information is processed have paved the way to a better understanding of the neurobiology of photophobia and the complexity of the symptoms triggered by light. PURPOSE The purpose of this review is to summarize recent anatomical and physiological studies on the neurobiology of photophobia with emphasis on migraine. RECENT FINDINGS Observations made in blind and seeing migraine patients, and in a variety of animal models, have led to the discovery of a novel retino-thalamo-cortical pathway that carries photic signal from melanopsinergic and nonmelanopsinergic retinal ganglion cells (RGCs) to thalamic neurons. Activity of these neurons is driven by migraine and their axonal projections convey signals about headache and light to multiple cortical areas involved in the generation of common migraine symptoms. Novel projections of RGCs into previously unidentified hypothalamic neurons that regulate parasympathetic and sympathetic functions have also been discovered. Finally, recent work has led to a novel understanding of color preference in migraine-type photophobia and of the roles played by the retina, thalamus, and cortex. SUMMARY The findings provide a neural substrate for understanding the complexity of aversion to light in patients with migraine and neuro-ophthalmologic other disorders.
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Affiliation(s)
- Rami Burstein
- Department of Anesthesia and Critical Care (RB, RN), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology (ABF), Children's Hospital Boston, Boston, Massachusetts
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31
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Schofield PW, Doty RL. The influence of head injury on olfactory and gustatory function. HANDBOOK OF CLINICAL NEUROLOGY 2019; 164:409-429. [PMID: 31604560 DOI: 10.1016/b978-0-444-63855-7.00023-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Head injury, particularly that resulting in brain injury, is a significant public health concern. For example, annual incidence rates of traumatic brain injury, a common consequence of head injury, range from 54 to 60 million people worldwide, including 2.2-3.6 million people whose trauma is moderate to severe. Trauma to the face and brain, including blast injuries common in modern warfare, can result in alterations in the ability to both smell and taste. In the case of smell, these include total loss of function (anosmia), decreased sensitivity (hyposmia), alterations in odor quality (dysosmia), and hallucination (phantosmia). Although taste dysfunction, i.e., altered perception of such basic taste-bud-mediated sensations as sweet, sour, bitter, salty, and savory (umami), can be similarly influenced by head trauma, the effects are typically more subtle and less studied. The present review provides an up-to-date assessment of what is known about the impact of head injury on quantitative measures of taste and smell function, including the influences of severity, type of injury, location of insults, prognosis, and approaches to therapy.
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Affiliation(s)
- Peter W Schofield
- Neuropsychiatry Service, Hunter New England Local Health District and Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle, NSW, Australia.
| | - Richard L Doty
- Smell and Taste Center and Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Abstract
Despite garnering minimal attention from the medical community overall, olfaction is indisputably critical in the manner in which we as humans interact with our surrounding environment. As the initial anatomical structure in the olfactory pathway, the nasal airway plays a crucial role in the transmission and perception of olfactory stimuli. The goal of this chapter is to provide a comprehensive overview of olfactory disturbances as it pertains to the sinonasal airway. This comprises an in-depth discussion of clinically relevant nasal olfactory anatomy and physiology, classification systems of olfactory disturbance, as well as the various etiologies and pathophysiologic mechanisms giving rise to this important disease entity. A systematic clinical approach to the diagnosis and clinical workup of olfactory disturbances is also provided in addition to an extensive review of the medical and surgical therapeutic modalities currently available.
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Affiliation(s)
- Joseph S. Schwartz
- Department of Otolaryngology—Head & Neck Surgery, McGill University, Montreal, QC, Canada
| | - Bobby A. Tajudeen
- Department of Otolaryngology—Head & Neck Surgery, Rush University, Chicago, IL, United States
| | - David W. Kennedy
- Department of Otorhinolaryngology—Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States,Correspondence to: David W. Kennedy, M.D., Department of Otorhinolaryngology—Head and Neck Surgery, Hospital of the University of Pennsylvania, 3400 Spruce St Ravdin 5, Philadelphia, PA 19104, United States. Tel: +1-215-662-6971, Fax: +1215-349-5977
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Holbrook EH, Puram SV, See RB, Tripp AG, Nair DG. Induction of smell through transethmoid electrical stimulation of the olfactory bulb. Int Forum Allergy Rhinol 2018; 9:158-164. [PMID: 30480384 DOI: 10.1002/alr.22237] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/07/2018] [Accepted: 10/12/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Anosmia has an estimated prevalence of 5% of the general population. Outside of inflammatory causes, therapeutic options are limited despite research advances. Bypassing peripheral neuronal damage through central stimulation is a potential therapeutic option that has shown success in other sensory systems, most notably with hearing. We performed a pilot study to determine the feasibility of inducing smell through artificial electrical stimulation of the olfactory bulbs in humans. METHODS Subjects with a history of sinus surgery, including total ethmoidectomy, with intact ability to smell were enrolled. The ability to smell was confirmed with a 40-item smell identification test. Awake subjects underwent nasal endoscopy and either a monopolar or bipolar electrode was positioned at 3 areas along the lateral lamella of the cribriform plate within the ethmoid sinus cavity. A graded stimulation current of 1-20 mA at 3.17 Hz was administered while cortical evoked potential (CEP) recordings were collected. Subjective responses of perceived smell along with reports of discomfort were recorded. Subjects with artificially induced smell underwent repeat stimulation after medically induced anosmia. RESULTS Five subjects (age, 43-72 years) were enrolled. Three subjects reported smell perception smell with electrical stimulation. This was reproducible after inducing anosmia, but CEP recordings could not provide objective support. All subjects tolerated the study with minimal discomfort. CONCLUSION This is the first report of induced smell through transethmoid electrical stimulation of the olfactory bulb. These results provide a proof of concept for efforts in development of an olfactory implant system.
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Affiliation(s)
- Eric H Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA
| | - Sidharth V Puram
- Department of Otolaryngology and Department of Genetics, Washington University School of Medicine, St Louis, MO
| | - Reiner B See
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Aaron G Tripp
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Dinesh G Nair
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Daramola OO, Chandra RK. Chronic rhinosinusitis and endoscopic sinus surgery. World J Otorhinolaryngol Head Neck Surg 2018; 4:29-32. [PMID: 30035258 PMCID: PMC6051306 DOI: 10.1016/j.wjorl.2018.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 03/07/2018] [Indexed: 11/30/2022] Open
Abstract
Olfactory dysfunction is a major symptom reported by patients with chronic rhinosinusitis (CRS). Surgical treatment of this disease requires close surveillance of such dysfunction because of wide ranging implications for safety, quality of life, and impact on the flavor of foods and beverages. This review highlights key findings regarding the influences of endoscopic sinus surgery (ESS) on olfactory function across the unique presentations of CRS. Such findings provide information useful for informing patients of potential complications and for obtaining informed consent prior to surgical intervention. ESS has been shown to improve olfaction across all types of CRS as assessed through quantitative testing and subjective reports. The presence of nasal polyposis (NP) and eosinophilia have been identified as predictors of significant postoperative olfactory improvement. When indicated, judicious partial resection of the middle turbinate may result in improved olfactory function without a risk of long term complication. Careful attention to the olfactory cleft and frontal sinus recess are important in limiting olfactory complications by avoiding indiscriminate disruption of olfactory epithelium. Given the chronic nature of the disease, surveillance of olfactory function in patients with CRS is a lifelong activity that will evolve as emerging technologies become available.
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Affiliation(s)
- Opeyemi O Daramola
- Rhinology, Sinus and Skull Base Surgery, Division of Otolaryngology-Head and Neck Surgery, Crystal Run Healthcare, 2 Centerock Rd, West Nyack, NY 10994, USA
| | - Rakesh K Chandra
- Rhinology, Sinus & Skull Base Surgery, Vanderbilt University, 1215 21st Ave S, #7209 MCE S Tower, Nashville, TN 37232-8605, USA
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Saltagi MZ, Rabbani CC, Ting JY, Higgins TS. Management of long-lasting phantosmia: a systematic review. Int Forum Allergy Rhinol 2018; 8:790-796. [PMID: 29485754 DOI: 10.1002/alr.22108] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/23/2018] [Accepted: 02/06/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND Interest in the pathophysiology and management of phantom smells has increased rapidly over the last decade. A PubMed search for the term "phantosmia" demonstrated a near-doubling of articles published on phantosmia within the past 7 years. We aimed to systematically review the literature on the management of phantosmia. METHODS The PubMed, EMBASE, and Cochrane databases were searched for articles published since January 1990, using terms combined with pertinent Boolean search operators. We included articles evaluating management of phantosmia written in the English language, with original data and a minimum of 6 months of follow-up, on at least 2 patients and with well-defined and measurable outcomes. RESULTS A total of 2151 unique titles were returned upon the initial search. Of these, 146 abstracts were examined, yielding 7 articles meeting the inclusion criteria. All articles were predominantly level 4 evidence. One prospective level 3 study was included. The studies included a total of 96 patients, with follow-up ranging from 6 months to 11 years. Endpoints were primarily based on subjective patient responses. Management options included observation and medical and surgical therapy. Olfactory mucosa excision was the only surgical intervention studied, with short-term symptomatic improvement in 10 of 11 patients. Forty-one patients were treated medically, which included antipsychotic, antimigraine, and antiseizure medications, transcranial stimulation, and topical cocaine application. CONCLUSION Despite increasing interest in the treatment of phantosmia and reports of successful therapies, there remains a paucity of data and lack of consensus regarding optimal management of this difficult condition.
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Affiliation(s)
| | - Cyrus C Rabbani
- Indiana University School of Medicine, Indianapolis, IN.,Department of Otolaryngology-Head and Neck Surgery, Indiana University Health, Indianapolis, IN
| | - Jonathan Y Ting
- Indiana University School of Medicine, Indianapolis, IN.,Department of Otolaryngology-Head and Neck Surgery, Indiana University Health, Indianapolis, IN
| | - Thomas S Higgins
- Department of Otolaryngology-Head and Neck Surgery, University of Louisville, Louisville, KY.,Kentuckiana Ear, Nose & Throat, Louisville, KY
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36
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Delfino-Pereira P, Bertti-Dutra P, de Lima Umeoka EH, de Oliveira JAC, Santos VR, Fernandes A, Marroni SS, Del Vecchio F, Garcia-Cairasco N. Intense olfactory stimulation blocks seizures in an experimental model of epilepsy. Epilepsy Behav 2018; 79:213-224. [PMID: 29346088 DOI: 10.1016/j.yebeh.2017.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/11/2017] [Accepted: 12/11/2017] [Indexed: 10/18/2022]
Abstract
There are reports of patients whose epileptic seizures are prevented by means of olfactory stimulation. Similar findings were described in animal models of epilepsy, such as the electrical kindling of amygdala, where olfactory stimulation with toluene (TOL) suppressed seizures in most rats, even when the stimuli were 20% above the threshold to evoke seizures in already kindled animals. The Wistar Audiogenic Rat (WAR) strain is a model of tonic-clonic seizures induced by acute acoustic stimulation, although it also expresses limbic seizures when repeated acoustic stimulation occurs - a process known as audiogenic kindling (AK). The aim of this study was to evaluate whether or not the olfactory stimulation with TOL would interfere on the behavioral expression of brainstem (acute) and limbic (chronic) seizures in the WAR strain. For this, animals were exposed to TOL or saline (SAL) and subsequently exposed to acoustic stimulation in two conditions that generated: I) acute audiogenic seizures (only one acoustic stimulus, without previous seizure experience before of the odor test) and II) after AK (20 acoustic stimuli [2 daily] before of the protocol test). We observed a decrease in the seizure severity index of animals exposed only to TOL in both conditions, with TOL presented 20s before the acoustic stimulation in both protocols. These findings were confirmed by behavioral sequential analysis (neuroethology), which clearly indicated an exacerbation of clusters of specific behaviors such as exploration and grooming (self-cleaning), as well as significant decrease in the expression of brainstem and limbic seizures in response to TOL. Thus, these data demonstrate that TOL, a strong olfactory stimulus, has anticonvulsant properties, detected by the decrease of acute and AK seizures in WARs.
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Affiliation(s)
- Polianna Delfino-Pereira
- Neurosciences and Behavioral Sciences Department, Ribeirão Preto School of Medicine, Universiy of São Paulo, Hospital das Clínicas, Campus Universitário S/N, 4° Andar, Ribeirão Preto, SP CEP: 14048-900, Brazil
| | - Poliana Bertti-Dutra
- Neurosciences and Behavioral Sciences Department, Ribeirão Preto School of Medicine, Universiy of São Paulo, Hospital das Clínicas, Campus Universitário S/N, 4° Andar, Ribeirão Preto, SP CEP: 14048-900, Brazil; Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, Prédio Central, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP: 14049-900, Brazil
| | - Eduardo Henrique de Lima Umeoka
- Neurosciences and Behavioral Sciences Department, Ribeirão Preto School of Medicine, Universiy of São Paulo, Hospital das Clínicas, Campus Universitário S/N, 4° Andar, Ribeirão Preto, SP CEP: 14048-900, Brazil; Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, Prédio Central, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP: 14049-900, Brazil
| | - José Antônio Cortes de Oliveira
- Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, Prédio Central, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP: 14049-900, Brazil
| | - Victor Rodrigues Santos
- Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, Prédio Central, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP: 14049-900, Brazil
| | - Artur Fernandes
- Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, Prédio Central, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP: 14049-900, Brazil; Genetics Department, Ribeirão Preto School of Medicine, University of São Paulo, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP: 14049-900, Brazil
| | - Simone Saldanha Marroni
- Neurosciences and Behavioral Sciences Department, Ribeirão Preto School of Medicine, Universiy of São Paulo, Hospital das Clínicas, Campus Universitário S/N, 4° Andar, Ribeirão Preto, SP CEP: 14048-900, Brazil; Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, Prédio Central, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP: 14049-900, Brazil
| | - Flávio Del Vecchio
- Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, Prédio Central, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP: 14049-900, Brazil
| | - Norberto Garcia-Cairasco
- Neurosciences and Behavioral Sciences Department, Ribeirão Preto School of Medicine, Universiy of São Paulo, Hospital das Clínicas, Campus Universitário S/N, 4° Andar, Ribeirão Preto, SP CEP: 14048-900, Brazil; Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, Prédio Central, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP CEP: 14049-900, Brazil.
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Sjölund S, Larsson M, Olofsson JK, Seubert J, Laukka EJ. Phantom Smells: Prevalence and Correlates in a Population-Based Sample of Older Adults. Chem Senses 2017; 42:309-318. [PMID: 28334095 PMCID: PMC5863552 DOI: 10.1093/chemse/bjx006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Loss of olfactory function is common in old age, but evidence regarding qualitative olfactory dysfunction in the general older population is scarce. The current study investigates the prevalence and correlates of phantom smell experiences (phantosmia) in a population-based study (Swedish National Study on Aging and Care in Kungsholmen [SNAC-K]) of Swedish adults (n = 2569) aged between 60 and 90 years. Phantosmia was assessed through a standardized interview and defined as reporting having experienced an odor percept in the absence of any stimuli in the surrounding environment that could emit the odor. The relationships between phantosmia and demographic, genetic, health-related, and behavioral variables were analyzed with hierarchical logistic regression analyses. The overall prevalence of phantom smells was 4.9%, and was associated with female gender, carrying the met allele of the BDNF gene, higher vascular risk burden, and reporting distorted smell sensations (parosmia). Olfactory dysfunction was, however, not related to phantosmia. The most frequently reported phantom smell was smoky/burnt. A novel finding was that some individuals reported phantom smells with an autobiographical connotation. The results from this study indicate that the prevalence of phantosmia in the general older population is not negligible and that some factors that are beneficial for preserved olfactory function, such as female gender and the BDNF met allele, are also associated with the occurrence of phantom smells.
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Affiliation(s)
- Sara Sjölund
- Gösta Ekman's Laboratory, Department of Psychology, Stockholm University, Frescati Hagväg 9 A, 10691 Stockholm, Sweden
| | - Maria Larsson
- Gösta Ekman's Laboratory, Department of Psychology, Stockholm University, Frescati Hagväg 9 A, 10691 Stockholm, Sweden
| | - Jonas K Olofsson
- Gösta Ekman's Laboratory, Department of Psychology, Stockholm University, Frescati Hagväg 9 A, 10691 Stockholm, Sweden
| | - Janina Seubert
- Department of Clinical Neuroscience, Psychology Division, Karolinska Institutet, Nobels väg 9, 17165 Stockholm, Sweden.,Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Gävlegatan 16, 11330 Stockholm, Sweden
| | - Erika J Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Gävlegatan 16, 11330 Stockholm, Sweden
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Venteicher AS, Kumar JI, Murphy EA, Gray ST, Holbrook EH, Curry WT. Phantosmia and Dysgeusia following Endoscopic Transcribriform Approaches to Olfactory Groove Meningiomas. J Neurol Surg B Skull Base 2017; 78:245-250. [PMID: 28593111 DOI: 10.1055/s-0036-1597925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 11/29/2016] [Indexed: 10/20/2022] Open
Abstract
The endoscopic, endonasal transcribriform approach (EETA) is an important technique used to directly access the anterior skull base and is increasingly being used in the management of olfactory groove meningiomas (OGMs). As this approach requires removal of the cribriform plate and olfactory epithelium en route to the tumor, patients are anosmic postoperatively. Here, we report the development of phantosmia and dysgeusia in two patients who underwent EETAs for OGMs, which has not yet been reported in the literature. We hypothesize that phantosmia and dysgeusia may result from aberrant neuronal signals or misinterpretation centrally from the remaining distal portions of the olfactory and taste pathways. Since EETAs are newer than traditional open craniotomy-based techniques, reporting these outcomes will be important to appropriately counsel patients preoperatively.
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Affiliation(s)
- Andrew S Venteicher
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Jay I Kumar
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Emma A Murphy
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Stacey T Gray
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
| | - Eric H Holbrook
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
| | - William T Curry
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
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39
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Sarnat HB, Flores-Sarnat L, Wei XC. Olfactory Development, Part 1: Function, From Fetal Perception to Adult Wine-Tasting. J Child Neurol 2017; 32:566-578. [PMID: 28424010 DOI: 10.1177/0883073817690867] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Discrimination of odorous molecules in amniotic fluid occur after 30 weeks' gestation; fetuses exhibit differential responses to maternal diet. Olfactory reflexes enable reliable neonatal testing. Olfactory bulbs can be demonstrated reliably by MRI after 30 weeks' gestation, and their hypoplasia or aplasia also documented by late prenatal and postnatal MRI. Olfactory axons project from nasal epithelium to telencephalon before olfactory bulbs form. Fetal olfactory maturation remains incomplete at term for neuronal differentiation, synaptogenesis, myelination, and persistence of the transitory fetal ventricular recess. Immaturity does not signify nonfunction. Olfaction is the only sensory system without thalamic projection because of its own intrinsic thalamic equivalent. Diverse malformations of the olfactory bulb can be diagnosed by clinical examination, imaging, and neuropathology. Some epileptic auras might be primarily generated in the olfactory bulb. Cranial nerve 1 should be tested in all neonates and especially in patients with brain malformations, endocrinopathies, chromosomopathies, and genetic/metabolic diseases.
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Affiliation(s)
- Harvey B Sarnat
- 1 Department of Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,2 Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,3 Department of Pathology and Laboratory Medicine (Neuropathology), University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,5 Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Laura Flores-Sarnat
- 1 Department of Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,2 Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,3 Department of Pathology and Laboratory Medicine (Neuropathology), University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,5 Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Xing-Chang Wei
- 4 Department of Radiology and Diagnostic Imaging, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,5 Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
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40
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Abstract
The ability to scrutinize our surroundings remains heavily dependent on the sense of smell. From the ability to detect dangerous situations such as fires to the recollection of a fond memory triggered by an odor, the advantages of an intact olfactory system cannot be overstated. Outcomes studies have highlighted the profound negative impact of anosmia and parosmia on the overall quality of life. The National Institute on Deafness and Other Communication Disorders estimates that ∼1.4% of the United States population experiences chronic olfactory dysfunction and smell loss. Efforts have focused on improving both the diagnosis of olfactory dysfunction through olfactory testing and improved reporting of treatment outcomes of olfactory training. The purpose of this article was to review the differential diagnosis, workup, and current treatment strategies of anosmia and smell disorders.
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Affiliation(s)
- George A Scangas
- Department of Otolaryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
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41
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Gunzer W. Changes of Olfactory Performance during the Process of Aging - Psychophysical Testing and Its Relevance in the Fight against Malnutrition. J Nutr Health Aging 2017; 21:1010-1015. [PMID: 29083442 DOI: 10.1007/s12603-017-0873-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Olfactory performance plays a vital role in several aspects of everyday life. A decrease in olfactory function leading to reduced appetite and inadequate food intake could contribute to higher risk of malnutrition and has a significant impact on quality of life. Early detection of olfactory impairment may help to maintain normal, or - through early training - to improve olfactory function and could thus contribute to the prevention of malnutrition. This review summarizes recent findings on the association between decreased olfactory performance in older adults, its implication for overall health and discusses issues regarding the assessment of olfactory performance in older people. METHODS A non-systematic literature search using databases (PubMed, ScienceDirect, Google Scholar) was conducted up to March 2016 to review recent findings on the topics of olfactory impairment, age, malnutrition and issues in psychophysical testing. RESULTS Although the association of olfactory impairment and malnutrition is widely accepted strong evidence is scarce. This could be because existing psychophysiological olfactory performance tests are not suitable and inefficient for older adults or people with cognitive impairment due to their required time and concentration. Since prevalence of olfactory impairment remains poorly documented in European regions and varies from 13.9% to >60% depending on age and due to considerable methodological diversity in studies there is need to develop rapid and efficient screening tools which are suitable for this target group. CONCLUSION Due to numerous causes and health consequences of olfactory impairment in older people, early detection of olfactory malfunction by rapid, inexpensive but valid tests, which could be used by geriatricians and other healthcare professionals, might be useful in patient counselling by identifying individuals at nutritional risk.
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Affiliation(s)
- W Gunzer
- W. Gunzer, FH JOANNEUM University of Applied Sciences, Department of Health Studies, Insitute of Dietetics and Nutrition, Graz, Austria,
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42
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Jion YI, Grosberg BM, Evans RW. Phantosmia and Migraine With and Without Headache. Headache 2016; 56:1494-1502. [DOI: 10.1111/head.12890] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2016] [Indexed: 01/03/2023]
Affiliation(s)
| | - Brian M. Grosberg
- Hartford Healthcare Headache Center; Wethersfield CT USA (B.M. Grosberg)
| | - Randolph W. Evans
- Department of Neurology; Baylor College of Medicine; Houston TX USA (R.W. Evans)
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43
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Radiological appearances in olfactory dysfunction: pictorial review. The Journal of Laryngology & Otology 2016; 129:529-34. [PMID: 26074255 DOI: 10.1017/s0022215115001097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Olfactory dysfunction is a common condition that may in some cases require imaging to investigate a potential underlying cause. OBJECTIVES This review describes the anatomy of normal olfaction and illustrates the pathological substrates of olfactory dysfunction amenable to imaging.
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44
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Posttraumatic olfactory dysfunction. Auris Nasus Larynx 2015; 43:137-43. [PMID: 26441369 DOI: 10.1016/j.anl.2015.08.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 07/30/2015] [Accepted: 08/26/2015] [Indexed: 11/20/2022]
Abstract
Impairment of smell may occur following injury to any portion of the olfactory tract, from nasal cavity to brain. A thorough understanding of the anatomy and pathophysiology combined with comprehensively obtained history, physical exam, olfactory testing, and neuroimaging may help to identify the mechanism of dysfunction and suggest possible treatments. Although most olfactory deficits are neuronal mediated and therefore currently unable to be corrected, promising technology may provide novel treatment options for those most affected. Until that day, patient counseling with compensatory strategies and reassurance is essential for the maintenance of safety and QoL in this unique and challenging patient population.
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45
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Morrissey DK, Pratap U, Brown C, Wormald PJ. The role of surgery in the management of phantosmia. Laryngoscope 2015; 126:575-8. [PMID: 26422113 DOI: 10.1002/lary.25647] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 07/19/2015] [Accepted: 08/10/2015] [Indexed: 11/05/2022]
Affiliation(s)
- David K Morrissey
- School of Medicine, The University of Queensland, Brisbane, Queensland.,The Queen Elizabeth Hospital, Woodville, South Australia
| | - Upasna Pratap
- The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria
| | | | - Peter-John Wormald
- The Queen Elizabeth Hospital, Woodville, South Australia.,Department of Surgery-Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, Australia
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46
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Thompson CF, Kern RC, Conley DB. Olfaction in Endoscopic Sinus and Skull Base Surgery. Otolaryngol Clin North Am 2015; 48:795-804. [PMID: 26117298 DOI: 10.1016/j.otc.2015.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Olfactory dysfunction is a common complaint for patients with chronic rhinosinusitis, because smell loss decreases a patient's quality of life. Smell loss is caused by obstruction from polyps, nasal discharge, and mucosal edema, as well as inflammatory changes within the olfactory epithelium. Addressing olfaction before endoscopic sinus and skull base surgery is important in order to set postoperative expectations, because an improvement in smell is difficult to predict. Several commercially available olfactory testing measures are available and can easily be administered in clinic. During surgery, careful dissection within the olfactory cleft is recommended in order to optimize postoperative olfactory function.
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Affiliation(s)
| | - Robert C Kern
- Department of Otolaryngology, Northwestern University, Chicago, IL, USA
| | - David B Conley
- Department of Otolaryngology, Northwestern University, Chicago, IL, USA
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Whiting AC, Marmura MJ, Hegarty SE, Keith SW. Olfactory acuity in chronic migraine: a cross-sectional study. Headache 2014; 55:71-5. [PMID: 25385519 DOI: 10.1111/head.12462] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE/BACKGROUND This study aims to measure olfactory acuity in chronic migraine subjects, at baseline and on migraine days, and compare to age- and sex-matched controls. Olfactory impairment is common in neurological disorders. While smell hypersensitivity has been established with chronic migraine, olfactory acuity has not been well studied. METHODS We recruited 50 subjects with chronic migraine from the Jefferson Headache Center and 50 age- and sex-matched controls. Using the University of Pennsylvania Smell Identification Test (UPSIT), a validated test of olfaction, olfactory acuity was measured at baseline and during a migraine for subjects, and compared to controls at baseline and at home 2 weeks later. All subjects were additionally screened for odor sensitivity and allodynia. RESULTS The mean UPSIT score for migraine subjects was 34.5 on non-migraine days and 34.7 on migraine days (mean difference=-0.4, 95% confidence interval [CI; -1.3, 0.6] P=.45). Controls had a mean of 35.9 and 36.1 for each test day (mean difference = -0.1, 95% CI [-0.9, 0.7] P=.87). On average, migraineurs performed worse than their matched control counterparts in both test sittings (test 1: P=.047; test 2: P=.01). The great majority of subjects were allodynic (42/50) compared with only 9 of 50 controls, and the majority of subjects (41/50) found more than one listed odor to be bothersome, compared with only 10/50 controls. On non-migraine days, 18/48 chronic migraine subjects had abnormal olfaction and on migraine days 14/42 had abnormal olfaction, compared with only 9/50 controls who had abnormal olfaction on their first UPSIT. CONCLUSIONS While chronic migraine patients do not appear to have a significant change in olfactory acuity between migrainous and non-migrainous periods, they do appear to be more likely to have abnormal olfactory acuity at baseline compared to age- and sex-matched controls.
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Affiliation(s)
- Alexander C Whiting
- Department of Neurology, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, PA, USA
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Restrepo D, Hellier JL, Salcedo E. Complex metabolically demanding sensory processing in the olfactory system: implications for epilepsy. Epilepsy Behav 2014; 38:37-42. [PMID: 24113565 PMCID: PMC3979506 DOI: 10.1016/j.yebeh.2013.08.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 08/26/2013] [Indexed: 12/23/2022]
Abstract
Although the olfactory system is not generally associated with seizures, sharp application of odor eliciting activity in a large number of olfactory sensory neurons (OSNs) has been shown to elicit seizures. This is most likely due to increased ictal activity in the anterior piriform cortex-an area of the olfactory system that has limited GABAergic interneuron inhibition of pyramidal output cell activity. Such hyperexcitability in a well-characterized and highly accessible system makes olfaction a potentially powerful model system to examine epileptogenesis.
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Affiliation(s)
- Diego Restrepo
- Department of Cell and Developmental Biology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Rocky Mountain Taste and Smell Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
| | - Jennifer L. Hellier
- Department of Cell and Developmental Biology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045,Rocky Mountain Taste and Smell Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045,Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045
| | - Ernesto Salcedo
- Department of Cell and Developmental Biology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045,Rocky Mountain Taste and Smell Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045
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Does imaging of the olfactory tract change the clinical management of patients with olfactory disturbance? A case series of 100 consecutive patients. The Journal of Laryngology & Otology 2014; 128:810-3. [DOI: 10.1017/s0022215114001625] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground:Isolated olfactory dysfunction is a common complaint; the vast majority of cases are benign and untreatable. A common dilemma is whether to image the olfactory tract of affected patients.Methods:A case review of 100 consecutive patients who underwent magnetic resonance imaging for the primary complaint of olfactory dysfunction was performed. Patients with a diagnosis of chronic rhinosinusitis, with or without nasal polyps, were excluded.Results:Magnetic resonance imaging abnormalities that were considered clinically relevant to the presentation of olfactory dysfunction were found in only seven patients (7 per cent). Of these, only one patient (1 per cent) had an abnormality found that altered their clinical management. A comparison of the findings for children (less than 16 years old,n = 5) with those for adults (equal to or more than 16 years old,n = 95) revealed that 4 per cent of adults scanned had olfactory-related pathology diagnosed, as opposed to 60 per cent of children.Conclusion:Cross-sectional imaging may not be necessary in most patients with olfactory dysfunction. Imaging adds little to the patient history and clinical examination findings.
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Henkin RI, Potolicchio SJ, Levy LM. Olfactory Hallucinations without Clinical Motor Activity: A Comparison of Unirhinal with Birhinal Phantosmia. Brain Sci 2013; 3:1483-553. [PMID: 24961619 PMCID: PMC4061890 DOI: 10.3390/brainsci3041483] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 10/11/2013] [Accepted: 10/12/2013] [Indexed: 01/14/2023] Open
Abstract
Olfactory hallucinations without subsequent myoclonic activity have not been well characterized or understood. Herein we describe, in a retrospective study, two major forms of olfactory hallucinations labeled phantosmias: one, unirhinal, the other, birhinal. To describe these disorders we performed several procedures to elucidate similarities and differences between these processes. From 1272, patients evaluated for taste and smell dysfunction at The Taste and Smell Clinic, Washington, DC with clinical history, neurological and otolaryngological examinations, evaluations of taste and smell function, EEG and neuroradiological studies 40 exhibited cyclic unirhinal phantosmia (CUP) usually without hyposmia whereas 88 exhibited non-cyclic birhinal phantosmia with associated symptomology (BPAS) with hyposmia. Patients with CUP developed phantosmia spontaneously or after laughing, coughing or shouting initially with spontaneous inhibition and subsequently with Valsalva maneuvers, sleep or nasal water inhalation; they had frequent EEG changes usually ipsilateral sharp waves. Patients with BPAS developed phantosmia secondary to several clinical events usually after hyposmia onset with few EEG changes; their phantosmia could not be initiated or inhibited by any physiological maneuver. CUP is uncommonly encountered and represents a newly defined clinical syndrome. BPAS is commonly encountered, has been observed previously but has not been clearly defined. Mechanisms responsible for phantosmia in each group were related to decreased gamma-aminobutyric acid (GABA) activity in specific brain regions. Treatment which activated brain GABA inhibited phantosmia in both groups.
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Affiliation(s)
- Robert I Henkin
- Center for Molecular Nutrition and Sensory Disorders, The Taste and Smell Clinic, 5125 MacArthur Blvd, NW, Suite 20, Washington, DC 20016, USA.
| | - Samuel J Potolicchio
- Department of Neurology, The George Washington University Medical Center, 2150 Pennsylvania Avenue, NW, 7th Floor, Washington, DC 20037, USA.
| | - Lucien M Levy
- Department of Radiology, The George Washington University Medical Center, 900 23rd Street, NW, Washington, DC 20037, USA.
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