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Pieniak M, Tutar C, Jedryczka W, Benkhatar H, Debroise Blanchard-Dignac V, Haehner A, Hummel T. A practical test for retronasal odor identification based on aromatized tablets. J Neurosci Methods 2024; 406:110135. [PMID: 38583589 DOI: 10.1016/j.jneumeth.2024.110135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 03/17/2024] [Accepted: 04/03/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Olfactory perceptions elicited by odors originating from within the body (retronasal olfaction) play a crucial role in well-being and are often disrupted in various medical conditions. However, the assessment of retronasal olfaction in research and the clinical practice is impeded by the lack of commercially available tests and limited standardization of existing testing materials. NEW METHOD The novel ThreeT retronasal odor identification test employs 20 flavored tablets that deliver a standardized amount of odorous stimuli. The items represent common food- and non-food-related odors. RESULTS The ThreeT test effectively distinguishes patients with olfactory dysfunction from healthy controls, achieving a specificity of 86% and sensitivity of 73%. Its scores remain stable for up to 3 months (r=.79). COMPARISON WITH EXISTING METHOD ThreeT test exhibits a strong correlation with "Tasteless powders" measure of retronasal olfaction (r=.78) and classifies people into healthy and patient groups with similar accuracy. Test-retest stability of ThreeT is slightly higher than the stability of "Tasteless powders" (r=.79 vs r=.74). CONCLUSIONS ThreeT is suitable for integration into scientific research and clinical practice to monitor retronasal odor identification abilities.
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Affiliation(s)
- Michal Pieniak
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstrasse 74, Dresden 01307, Germany; Institute of Psychology, University of Wroclaw, Wroclaw, Poland
| | - Can Tutar
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstrasse 74, Dresden 01307, Germany
| | - Wiktoria Jedryczka
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstrasse 74, Dresden 01307, Germany; Institute of Psychology, University of Wroclaw, Wroclaw, Poland
| | - Hakim Benkhatar
- Centre Hospitalier de Versailles, Service ORL et Chirurgie Cervico-Faciale, Le Chesnay-Rocquencourt, France
| | | | - Antje Haehner
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstrasse 74, Dresden 01307, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstrasse 74, Dresden 01307, Germany.
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Hernandez AK, Uhl C, Haehner A, Cuevas M, Hummel T. Objective nasal airflow measures in relation to subjective nasal obstruction, trigeminal function, and olfaction in patients with chronic rhinosinusitis. Rhinology 2024; 0:3169. [PMID: 38507726 DOI: 10.4193/rhin23.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
BACKGROUND This study aimed to determine how nasal airflow measures and trigeminal function vary among patients with chronic rhinosinusitis (CRS) versus healthy controls and whether these measures are correlated with subjective nasal obstruction (SNO), olfactory function, and CRS control. METHODOLOGY Participants included CRS patients and healthy controls. After a structured medical history, nasal airflow (peak nasal inspiratory flow [PNIF]; active anterior rhinomanometry [AAR]), trigeminal function (trigeminal lateralization test, CO2 sensitivity), and olfactory ("Sniffin' Sticks" odor identification test) tests were performed. SNO ratings were also obtained. RESULTS Sixty-nine participants were included (37 men, 32 women, mean age 51 years). There was no significant difference for objective nasal airflow between patients and controls, but CRS patients had worse SNO, trigeminal function, and olfaction compared to controls. SNO, but not objective nasal airflow tests, was negatively correlated with CO2 sensitivity and odor identification. CONCLUSION The perception of nasal obstruction does not only depend on nasal airflow, but may also be modulated by trigeminal function and other factors. Thus, the role of objective nasal airflow measures as a sole method of functional nasal obstruction assessment in CRS remains limited.
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Affiliation(s)
- A K Hernandez
- Smell and Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Otorhinolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines - Manila, Manila, Philippines
- Department of Otorhinolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
| | - C Uhl
- Smell and Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M Cuevas
- Smell and Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Georgiopoulos C, Buechner MA, Falkenburger B, Engström M, Hummel T, Haehner A. Differential connectivity of the posterior piriform cortex in Parkinson's disease and postviral olfactory dysfunction: an fMRI study. Sci Rep 2024; 14:6256. [PMID: 38491209 PMCID: PMC10943068 DOI: 10.1038/s41598-024-56996-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/13/2024] [Indexed: 03/18/2024] Open
Abstract
Olfactory dysfunction is a common feature of both postviral upper respiratory tract infections (PV) and idiopathic Parkinson's disease (PD). Our aim was to investigate potential differences in the connectivity of the posterior piriform cortex, a major component of the olfactory cortex, between PV and PD patients. Fifteen healthy controls (median age 66 years, 9 men), 15 PV (median age 63 years, 7 men) and 14 PD patients (median age 70 years, 9 men) were examined with task-based olfactory fMRI, including two odors: peach and fish. fMRI data were analyzed with the co-activation pattern (CAP) toolbox, which allows a dynamic temporal assessment of posterior piriform cortex (PPC) connectivity. CAP analysis revealed 2 distinct brain networks interacting with the PPC. The first network included regions related to emotion recognition and attention, such as the anterior cingulate and the middle frontal gyri. The occurrences of this network were significantly fewer in PD patients compared to healthy controls (p = 0.023), with no significant differences among PV patients and the other groups. The second network revealed a dissociation between the olfactory cortex (piriform and entorhinal cortices), the anterior cingulate gyrus and the middle frontal gyri. This second network was significantly more active during the latter part of the stimulation, across all groups, possibly due to habituation. Our study shows how the PPC interacts with areas that regulate higher order processing and how this network is substantially affected in PD. Our findings also suggest that olfactory habituation is independent of disease.
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Affiliation(s)
- Charalampos Georgiopoulos
- Diagnostic Radiology, Department of Clinical Sciences, Medical Faculty, Lund University, Lund, Sweden.
- Department of Radiology, Section of Neuroradiology and Odontology, Skånes Universitetssjukhus, Entrégatan 7, 221 85, Lund, Sweden.
| | | | | | - Maria Engström
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Lötsch J, Brosig O, Slobodova J, Kringel D, Haehner A, Hummel T. Diagnosed and subjectively perceived long-term effects of COVID-19 infection on olfactory function assessed by supervised machine learning. Chem Senses 2024; 49:bjad051. [PMID: 38213039 DOI: 10.1093/chemse/bjad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Indexed: 01/13/2024] Open
Abstract
Loss of olfactory function is a typical acute coronavirus disease 2019 (COVID-19) symptom, at least in early variants of SARS-CoV2. The time that has elapsed since the emergence of COVID-19 now allows for assessing the long-term prognosis of its olfactory impact. Participants (n = 722) of whom n = 464 reported having had COVID-19 dating back with a mode of 174 days were approached in a museum as a relatively unbiased environment. Olfactory function was diagnosed by assessing odor threshold and odor identification performance. Subjects also rated their actual olfactory function on an 11-point numerical scale [0,…10]. Neither the frequency of olfactory diagnostic categories nor olfactory test scores showed any COVID-19-related effects. Olfactory diagnostic categories (anosmia, hyposmia, or normosmia) were similarly distributed among former patients and controls (0.86%, 18.97%, and 80.17% for former patients and 1.17%, 17.51%, and 81.32% for controls). Former COVID-19 patients, however, showed differences in their subjective perception of their own olfactory function. The impact of this effect was substantial enough that supervised machine learning algorithms detected past COVID-19 infections in new subjects, based on reduced self-awareness of olfactory performance and parosmia, while the diagnosed olfactory function did not contribute any relevant information in this context. Based on diagnosed olfactory function, results suggest a positive prognosis for COVID-19-related olfactory loss in the long term. Traces of former infection are found in self-perceptions of olfaction, highlighting the importance of investigating the long-term effects of COVID-19 using reliable and validated diagnostic measures in olfactory testing.
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Affiliation(s)
- Jörn Lötsch
- Goethe-University, Institute of Clinical Pharmacology, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Oskar Brosig
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Jana Slobodova
- Department of Otolaryngology, University of Pardubice, Faculty of Health Studies, Pardubice, Czech Republic
| | - Dario Kringel
- Goethe-University, Institute of Clinical Pharmacology, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - Antje Haehner
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
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Whitcroft KL, Altundag A, Balungwe P, Boscolo-Rizzo P, Douglas R, Enecilla MLB, Fjaeldstad AW, Fornazieri MA, Frasnelli J, Gane S, Gudziol H, Gupta N, Haehner A, Hernandez AK, Holbrook EH, Hopkins C, Hsieh JW, Huart C, Husain S, Kamel R, Kim JK, Kobayashi M, Konstantinidis I, Landis BN, Lechner M, Macchi A, Mazal PP, Miri I, Miwa T, Mori E, Mullol J, Mueller CA, Ottaviano G, Patel ZM, Philpott C, Pinto JM, Ramakrishnan VR, Roth Y, Schlosser RJ, Stjärne P, Van Gerven L, Vodicka J, Welge-Luessen A, Wormald PJ, Hummel T. Position paper on olfactory dysfunction: 2023. Rhinology 2023; 61:1-108. [PMID: 37454287 DOI: 10.4193/rhin22.483] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Since publication of the original Position Paper on Olfactory Dysfunction in 2017 (PPOD-17), the personal and societal burden of olfactory disorders has come sharply into focus through the lens of the COVID-19 pandemic. Clinicians, scientists and the public are now more aware of the importance of olfaction, and the impact of its dysfunction on quality of life, nutrition, social relationships and mental health. Accordingly, new basic, translational and clinical research has resulted in significant progress since the PPOD-17. In this updated document, we present and discuss currently available evidence for the diagnosis and management of olfactory dysfunction. Major updates to the current version include, amongst others: new recommendations on olfactory related terminology; new imaging recommendations; new sections on qualitative OD and COVID-19 OD; updated management section. Recommendations were agreed by all co-authors using a modified Delphi process. CONCLUSIONS We have provided an overview of current evidence and expert-agreed recommendations for the definition, investigation, and management of OD. As for our original Position Paper, we hope that this updated document will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency, and generalisability of work in this field.
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Affiliation(s)
- K L Whitcroft
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- and UCL Ear Institute, Faculty of Brain Sciences, University College London, London, UK
- and The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
| | - A Altundag
- Department of Otorhinolaryngology, Istanbul Surgery Hospital, Istanbul, Turkey
| | - P Balungwe
- Faculté de Médecine, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
- and Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - P Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - R Douglas
- Department of Otorhinolaryngology, University of Auckland, New Zealand
| | - M L B Enecilla
- Department of Otorhinolaryngology-Head and Neck Surgery, St. Luke's Medical Center, Global City, Philippines
- and Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
- and Department of Otorhinolaryngology, Medical Center Taguig, Taguig, Philippines
| | - A W Fjaeldstad
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
- and Department of Otorhinolaryngology, University Clinic for Flavour, Balance and Sleep, Regional Hospital Gødstrup, Herning, Denmark
- and Department of Clinical Medicine, Flavour Institute, Aarhus University, Aarhus, Denmark
- and Center for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK
| | - M A Fornazieri
- Department of Clinical Surgery, Universidade Estadual de Londrina and Pontifícia Universidade Católica do Paraná, Londrina, Brazil
| | - J Frasnelli
- Research Chair in Chemosensory Neuroanatomy, Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- and Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada
| | - S Gane
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
- and Royal National Throat Nose and Ear Hospital, UCLH, London
| | - H Gudziol
- Department of Otorhinolaryngology, University of Jena, Jena, Germany
| | - N Gupta
- Department of Otorhinolaryngology, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - A K Hernandez
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- and Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
- and Department of Otolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines - Manila, Manila, Philippines
| | - E H Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - C Hopkins
- Guys and St Thomas NHS Trust, London, United Kingdom
| | - J W Hsieh
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland
| | - C Huart
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium
- and Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - S Husain
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - R Kamel
- Department of Otorhinolaryngology, Cairo University, Cairo, Egypt
| | - J K Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University, College of Medicine, Seoul, Republic of Korea
| | - M Kobayashi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - I Konstantinidis
- Smell and Taste Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - B N Landis
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland
| | - M Lechner
- Division of Surgery and Interventional Science, University College London, London, UK
- and UCL Cancer Institute, University College London, London, UK
- and ENT Department, Homerton Healthcare NHS Foundation Trust, London, UK
| | - A Macchi
- ENT Clinic, University of Insubria, ASST Sette Laghi, Varese, Italy
| | - P P Mazal
- Servicio de Otorrinolaringología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - I Miri
- Service Médecine Physique Réadaptation fonctionnelle, Institut Mohamed Kassab d'Orthopédie, Mannouba, Tunisia
| | - T Miwa
- Department of Otorhinolaryngology, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan
| | - E Mori
- Department of Otorhinolaryngology, Jikei University, School of Medicine, Tokyo, Japan
| | - J Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona
- IDIBAPS
- CIBERES. Barcelona, Catalonia, Spain
| | - C A Mueller
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - G Ottaviano
- Department of Neurosciences DNS, Otolaryngology Section, University, Padua, Italy
| | - Z M Patel
- Department of Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK
- and The Smell and Taste Clinic, James Paget University Hospital, Gorleston, UK
| | - J M Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - V R Ramakrishnan
- Department of Otolaryngology-Head and Neck Surgery, Indiana University of School Medicine, Indianapolis, IN, USA
| | - Y Roth
- The Institute for Nose and Sinus Therapy and Clinical Investigations, Department of Otolaryngology - Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler Faculty of Medicine, Holon, Israel
| | - R J Schlosser
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - P Stjärne
- Section of Rhinology, Department of Otorhinolaryngology, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - L Van Gerven
- Department of Otorhinolaryngology, UZ Leuven, Belgium
- and Department of Neurosciences, Experimental Otorhinolaryngology, KU Leuven, Belgium
- and Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Unit, KU Leuven, Belgium
| | - J Vodicka
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Pardubice, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
| | - A Welge-Luessen
- University Hospital Basel - Otorhinolaryngology, Basel, Switzerland
| | - P J Wormald
- Department of Surgery-Otorhinolaryngology Head and Neck Surgery, University of Adelaide, Adelaide, SA, Australia
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Hernandez AK, Walke A, Haehner A, Cuevas M, Hummel T. Correlations between gustatory, trigeminal, and olfactory functions and nasal airflow. Eur Arch Otorhinolaryngol 2023; 280:4101-4109. [PMID: 37129608 PMCID: PMC10153028 DOI: 10.1007/s00405-023-07962-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 04/01/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE To determine the relationship of chemosensory screening and nasal airflow tests among the same set of participants, and to determine other factors that are related to the outcomes of these tests. METHODS Participants had no chemosensory complaints. Structured medical history was taken. Participants underwent 5 screening tests: q-sticks (orthonasal olfaction), q-powders (retronasal olfaction), trigeminal lateralization test, taste sprays, and peak nasal inspiratory flow (PNIF). Ratings of smell/taste ability and nasal airflow were obtained using visual analogue scales (VAS). Composite sinusitis symptoms and significance of olfaction questionnaire scores were also determined. RESULTS Four hundred participants were included in the study, 156 men, 244 women; aged 18-82 years (mean: 46). The q-powders and taste spray scores were weakly positively correlated with all the other chemosensory tests and PNIF. However, chemosensory test scores were not correlated with VAS, composite sinusitis symptoms, and significance of olfaction questionnaire scores. Various tests showed significant decrease starting at specific ages (in years, PNIF and trigeminal lateralization: 40, q-powders: 60, and q-sticks: 70). CONCLUSION Chemosensory screening tests and self-rated chemosensory function showed no correlation in participants without chemosensory complaints. In addition, gustatory function appeared to be correlated with olfactory and trigeminal function but also with nasal airflow, and nasal airflow was related not only to olfactory but also to trigeminal and taste function. Over all, the results suggest that chemosensory functions (orthonasal olfactory, trigeminal, retronasal olfactory, gustatory) and nasal airflow are correlated with each other, which we propose may be possibly mediated, at least in part, through central nervous system interactions.
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Affiliation(s)
- Anna Kristina Hernandez
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, 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.
| | - Antje Walke
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Mandy Cuevas
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, Dresden, Germany
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Mai Y, Klockow M, Haehner A, Hummel T. Self-assessment of olfactory function using the "Sniffin' Sticks". Eur Arch Otorhinolaryngol 2023; 280:3673-3685. [PMID: 36799976 PMCID: PMC10313570 DOI: 10.1007/s00405-023-07872-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/04/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND A precise and reliable test of the olfactory function is indispensable for the diagnosis of the olfactory disorder (OD). Despite of this, in a clinical context, often there is no place in daily routine for time-consuming procedures. This study aimed to examine if the assessment of olfactory function using the "Sniffin' Sticks" is suitable for self-assessment. METHODS Participants comprised 84 healthy control subjects (HC) and 37 OD patients. The "Sniffin' Sticks" test battery consisting of odor threshold (T), discrimination (D) and identification (I) tests was used for self- and assisted assessments. To save time, we applied the 8-item wide step version of the T test and the 8-item D test, whereas the I task remained the same as the original version. The whole test included two sessions, with each session comprising a self-assessment part performed by the participants themselves, and an assisted-assessment part performed by the examiner. RESULTS Sniffin' Sticks self-assessment was efficient in distinguishing between self-reported HC subjects and OD patients (p's < 0.01), and the scores did not differ significantly from the assisted-assessment (p's > 0.05). In the self-administered I and TDI tests, there was a moderate to excellent test-retest reliability (ICC = 0.51-0.93, p's < 0.01), and a strong to excellent correlation with the assisted assessment (r = 0.71-0.92, p's < 0.01). However, the self-administered T and D tests only exhibited low to moderate test-retest reliability (ICC = 0.30-0.72, p's < 0.05) and correlations with the assisted test (r = 0.31-0.62, p's < 0.05). CONCLUSIONS The Identification self-test is appropriate to be solely applied, and is therefore an easy-to-use alternative for olfactory screening in a larger segment of patients. The whole "Sniffin' Sticks" self-test also shows good measurement properties and is therefore a suitable backup in clinical practice, but improvement is needed due to the simplified D and T self-test.
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Affiliation(s)
- Yiling Mai
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
| | - Marie Klockow
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
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Faria V, Dulheuer J, Joshi A, Wahl H, Klimova A, Haehner A, Gossrau G. Impact of a 12-week olfactory training programme in women with migraine with aura: protocol for a double-blind, randomised, placebo-controlled trial. BMJ Open 2023; 13:e071443. [PMID: 37419649 PMCID: PMC10335595 DOI: 10.1136/bmjopen-2022-071443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 06/04/2023] [Indexed: 07/09/2023] Open
Abstract
INTRODUCTION Migraine is a leading cause of disability and suffering worldwide. However, conventional pharmacological migraine preventive therapies are often challenging and accompanied by adverse effects. Recently, structured odour exposure has shown to successfully increase pain thresholds in patients with chronic back pain. Despite the importance of the olfactory system in migraine, there are no studies investigating the impact of structured odour exposure in patients with migraine. METHODS AND ANALYSIS This double-blind randomised placebo-controlled trial will be conducted at the Headache Clinic of the University Pain Center at TU Dresden, Germany and aims at investigating the impact of a 12-week structured exposure to odours in women with migraine. Fifty-four women between 18 and 55 years with migraine with aura will be recruited and randomised to training with odours and odourless training. The primary outcomes are mechanical and electrical pain thresholds. Secondary outcomes comprise olfactory threshold and the number of headache days. Other exploratory measurements are headache associated pain intensity, acute analgesic intake, symptoms of anxiety and depression, and quality of life. Additionally, this protocol assesses neuroanatomical and neurofunctional changes associated with the 12-week olfactory training. Data analysis will be executed on the basis of the general linear model considering repeated measurements. ETHICS AND DISSEMINATION Ethical approvals were obtained from the Ethics Board of the TU Dresden (Protocol No. BO-EK-353082020). Participation will only be possible after written informed consent is provided. Findings will be disseminated through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER DRKS00027399.
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Affiliation(s)
- Vanda Faria
- Department of Otorhinolaryngology, TU Dresden Faculty of Medicine Carl Gustav Carus, Dresden, Germany
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jana Dulheuer
- Department of Otorhinolaryngology, TU Dresden Faculty of Medicine Carl Gustav Carus, Dresden, Germany
| | - Akshita Joshi
- Department of Otorhinolaryngology, TU Dresden Faculty of Medicine Carl Gustav Carus, Dresden, Germany
| | - Hannes Wahl
- Intitute of Neuroradiology, TU Dresden Faculty of Medicine Carl Gustav Carus, Dresden, Germany
| | - Anna Klimova
- NCT Partner Site Dresden, Institute for Medical Informatics and Biometrics, TU Dresden Faculty of Medicine Carl Gustav Carus, Dresden, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, TU Dresden Faculty of Medicine Carl Gustav Carus, Dresden, Germany
| | - Gudrun Gossrau
- Interdisciplinary Pain Center, University Hospital, and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
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Mignot C, Faria V, Hummel T, Frost M, Michel CM, Gossrau G, Haehner A. Migraine with aura: less control over pain and fragrances? J Headache Pain 2023; 24:55. [PMID: 37198532 DOI: 10.1186/s10194-023-01592-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/04/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Accumulating data emphasizes the importance of olfaction in migraine pathophysiology. However, there are only a few studies evaluating how the migraine brain processes olfactory stimulation, and virtually no studies comparing patients with and without aura in this context. METHODS This cross-sectional study recorded event-related potentials from 64 electrodes during a pure olfactory or pure trigeminal stimulus in females with episodic migraine with aura (n = 13) and without aura (n = 15), to characterize the central nervous processing of these intranasal stimuli. Patients were tested in interictal state only. Data were analyzed in the time domain and in the time-frequency domain. Source reconstruction analysis was also performed. RESULTS Patients with aura had higher event-related potentials amplitudes for left-sided trigeminal and left-sided olfactory stimulations, and higher neural activity for right-sided trigeminal stimulation in brain areas related to trigeminal and visual processing. Following olfactory stimulations patients with aura displayed decreased neural activity in secondary olfactory structures compared to patients without aura. Oscillations in the low frequency bands (< 8 Hz) differed between patient groups. CONCLUSIONS Altogether this may reflect hypersensitivity to nociceptive stimuli in patients with aura relative to patients without aura. Patients with aura have a bigger deficit in engaging secondary olfactory-related structures, possibly leading to distorted attention and judgements towards odors. The cerebral overlap between trigeminal nociception and olfaction might explain these deficits.
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Affiliation(s)
- Coralie Mignot
- Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Smell & Taste Clinic, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Vanda Faria
- Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Smell & Taste Clinic, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
- Department of Psychology, Uppsala University, 752 37, Uppsala, Sweden
- Brain and Eye Pain Imaging Lab, Pain and Affective Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, MA 02115, USA
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, MA 02115, USA
| | - Thomas Hummel
- Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Smell & Taste Clinic, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Marie Frost
- Comprehensive Pain Center, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Christoph M Michel
- Department of Basic Neurosciences, University of Geneva, CH-1211, Geneva 4, Switzerland
- CIBM Center for Biomedical Imaging, 1015, Lausanne, Switzerland
| | - Gudrun Gossrau
- Comprehensive Pain Center, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Antje Haehner
- Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Smell & Taste Clinic, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
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Sabiniewicz A, Lindner KK, Haehner A, Hummel T. Depression Severity Is Different in Dysosmic Patients Who Have Experienced Traumatic Brain Injury Compared with Those Who Have Not. Neurol Int 2023; 15:638-648. [PMID: 37218979 DOI: 10.3390/neurolint15020040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/24/2023] Open
Abstract
Traumatic brain injury (TBI) in humans can result in olfactory, cognitive, and affective changes. Surprisingly, research on the consequences of TBI often did not control for olfactory function in the investigated groups. Consequently, the affective or cognitive differences might be misleading as related rather to different olfactory performance than to a TBI experience. Hence, our study aimed to investigate whether TBI occurrence would lead to altered affective and cognitive functioning in two groups of dysosmic patients, one with TBI experience and one without. In total, 51 patients with TBI experience and 50 controls with varied causes of olfactory loss were thoroughly examined in terms of olfactory, cognitive, and affective performance. Student t-tests demonstrated that the only significant difference between the groups appeared in the depression severity, with TBI patients being more depressed (t = 2.3, p = 0.011, Cohen's d = -0.47). Regression analyses further showed that TBI experience was significantly associated with depression severity (R2 = 0.05, F [1, 96] = 5.5, p = 0.021, beta = 1.4). In conclusion, the present study showed that TBI experience is linked to depression, which is more pronounced compared to individuals with olfactory loss without TBI.
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Affiliation(s)
- Agnieszka Sabiniewicz
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
- Institute of Psychology, University of Wrocław, 50-527 Wrocław, Poland
| | - Kyri-Kristin Lindner
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Antje Haehner
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
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Gossrau G, Zaranek L, Klimova A, Sabatowski R, Koch T, Richter M, Haehner A. Olfactory training reduces pain sensitivity in children and adolescents with primary headaches. Front Pain Res (Lausanne) 2023; 4:1091984. [PMID: 36860330 PMCID: PMC9968932 DOI: 10.3389/fpain.2023.1091984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/13/2023] [Indexed: 02/15/2023] Open
Abstract
Objective Headache prevalence among children and adolescents has increased over the last few years. Evidence-based treatment options for pediatric headaches remain limited. Research suggests a positive influence of odors on pain and mood. We investigated the effect of repeated exposure to odors on pain perception, headache-related disability, and olfactory function in children and adolescents with primary headaches. Methods Eighty patients with migraine or tension-type headache (mean 13.1 ± 3.29 years) participated, of whom 40 underwent daily olfactory training with individually selected pleasant odors for 3 months and 40 received state-of-the-art outpatient therapy as a control group. At baseline and after a 3-month follow-up, olfactory function [odor threshold; odor discrimination; odor identification; comprehensive Threshold, Discrimination, Identification (TDI) score], mechanical detection and pain threshold (quantitative sensory testing), electrical pain threshold, patient-reported outcomes on headache-related disability [Pediatric Migraine Disability Assessment (PedMIDAS)], pain disability [Pediatric Pain Disability Index (P-PDI)], and headache frequency were assessed. Results Training with odors significantly increased the electrical pain threshold compared to the control group (U = 470.000; z = -3.177; p = 0.001). Additionally, olfactory training significantly increased the olfactory function (TDI score [t(39) = -2.851; p = 0.007], in particular, olfactory threshold, compared to controls (U = 530.500; z = -2.647; p = 0.008). Headache frequency, PedMIDAS, and P-PDI decreased significantly in both groups without a group difference. Conclusions Exposure to odors has a positive effect on olfactory function and pain threshold in children and adolescents with primary headaches. Increased electrical pain thresholds might reduce sensitization for pain in patients with frequent headaches. The additional favorable effect on headache disability without relevant side effects underlines the potential of olfactory training as valuable nonpharmacological therapy in pediatric headaches.
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Affiliation(s)
- Gudrun Gossrau
- Comprehensive Pain Center, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany,Correspondence: Gudrun Gossrau
| | - Laura Zaranek
- Comprehensive Pain Center, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany,Department of Pediatrics, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Anna Klimova
- NCT Partner Site Dresden, Institute for Medical Informatics and Biometrics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Rainer Sabatowski
- Comprehensive Pain Center, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany,Departement of Anesthesiology and Intensive Care Medicine, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Thea Koch
- Departement of Anesthesiology and Intensive Care Medicine, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Matthias Richter
- Department of Pediatrics, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Antje Haehner
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Abstract
BACKGROUND The sensation of nasal patency can be induced by inhaling menthol, which predominantly produces trigeminal stimulation. It remains unclear whether olfactory stimulation can also induce or modulate the sensation of nasal patency. METHODOLOGY A total of 118 participants (normosmia: n=67, olfactory dysfunction: n=51) were exposed to four odors in a randomized order: 1) phenylethanol (PEA), 2) menthol, 3) a mixture of PEA and menthol, 4) nearly odorless propylene glycol. The odors were presented by nasal clips. After the nasal clip had been removed, the participants rated relative nasal patency (RNP) from - 50 to +50, and their peak nasal inspiratory flow (PNIF) was measured. Repeated measures analysis of variance was used to examine the difference of RNP and PNIF among the four conditions and the influence of olfactory function. RESULTS The RNPs, other than PNIFs, differed between the four conditions. Menthol induced the highest RNP, followed by the mixed solution, PEA and the odorless condition. Normosmic participants, but not those with olfactory dysfunction, responded to PEA significantly higher than odorless condition with regard to RNP. The correlation analysis showed that the better the subjective or measured olfactory performance, the greater the PEA-induced sensation of nasal patency. CONCLUSIONS A specific olfactory stimulant that selectively induces olfactory perception can also evoke and modulate the sensation of nasal patency. Hence, patients might benefit from exposing themselves to odors in order to relieve the annoying nasal obstruction.
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Affiliation(s)
- Y-T Chao
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany; Division of Rhinology, Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - A Nakov
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - S Poletti
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany; Department of Otorhinolaryngology, Inselspital, Bern, Switzerland
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Haehner A, Gossrau G, Bock F, Hummel T, Iannilli E. Migraine Type-Dependent Patterns of Brain Activation After Facial and Intranasal Trigeminal Stimulation. Brain Topogr 2023; 36:52-71. [PMID: 36370239 PMCID: PMC9834371 DOI: 10.1007/s10548-022-00924-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/24/2022] [Indexed: 11/15/2022]
Abstract
In migraine, the trigeminal nerve is intimately involved in the pathophysiology of the disease. We hypothesized that alterations in the sensory trigeminal activation in migraine would be reflected by EEG-derived event-related potentials (ERP). We aimed to investigate differences in the temporal and spatial processing of trigeminal stimuli between interictal migraine patients and healthy subjects. ERP to trigeminal stimuli were recorded at 128-channels to allow localization of their cortical sources with high temporal resolution. Seventeen patients with episodic migraine without aura, 17 subjects with episodic migraine with aura, and 17 healthy subjects participated in the study. The first branch of the trigeminal nerve was stimulated using intranasal chemical (CO2), cutaneous electrical, and cutaneous mechanical (air puff) stimuli. Analyses were performed with regard to micro-state segmentation, ERP source localization, and correlation with the patients' clinical characteristics. Topographical assessments of EEG configurations were associated with the pathological condition. The source analysis revealed altered trigeminal-sensory response patterns in the precuneus, temporal pole, and cerebellum for both migraine groups during the interictal phase. The estimated current source density was positively correlated with migraine disease duration, indicating brain functional and structural changes as a consequence of the disease. Hyperactivity of the cerebellar posterior lobe was observed as a specific trigeminal response of migraine patients with aura. In conclusion, our results suggest the presence of brain changes accompanying the advancement of migraine as an expression of dysfunctional central pain processing. Hence, we identified EEG patterns in response to mechano-/chemosensory stimuli that can serve as biomarkers of migraine.
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Affiliation(s)
- Antje Haehner
- Smell & Taste Center, Deptartment of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Gudrun Gossrau
- Headache Outpatient Clinic, University Pain Center, University Hospital, TU Dresden, Dresden, Germany
| | - Franziska Bock
- Smell & Taste Center, Deptartment of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Center, Deptartment of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Emilia Iannilli
- Smell & Taste Center, Deptartment of Otorhinolaryngology, TU Dresden, Dresden, Germany. .,Deptartment of Biomed Sci, State Univ of New York at Albany, Albany, NY, USA. .,Deptartment of Psychology, K-F University of Graz, Graz, Austria.
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14
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Menzel S, Haehner A, Woosch D, Marquardt B, Ressel C, Draf J, Ottaviano G, Boscolo-Rizzo P, Kardashi R, de With K, Hackl Y, Hummel T. Parosmia as a predictor of a better olfactory function in COVID-19: a multicentric longitudinal study for upper respiratory tract infections. Eur Arch Otorhinolaryngol 2022; 280:2331-2340. [PMID: 36547711 PMCID: PMC9773662 DOI: 10.1007/s00405-022-07781-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aimed to evaluate the course of olfactory dysfunction [OD] due to upper respiratory tract infections [URTI] especially for COVID-19 [C19] in a multicentric design and to investigate possible predictors for the outcome. METHODS In a multicentric study, patients (n = 147, of which 96 were women) with OD due to URTI, including C19 and non-C19 were evaluated at two visits with a standardized medical history and "Sniffin' Sticks" extended psychophysical testing to examine the course and possible predictors for improvement of olfactory function. RESULTS C19 patients showed better overall olfactory function (p < 0.001) compared to non-C19. Olfactory function (p < 0.001) improved over 3.5 ± 1.2 months in a comparable fashion for C19 and non-C19 comparable over time (p = 0.20) except for a more pronounced improvement of odour threshold (p = 0.03) in C19. C19 patients with parosmia exhibited a higher probability of clinically relevant improvement of odour threshold, a better threshold in the second visit, and tended to have a better TDI-score at the second visit. Further possible predictors for an improving olfactory function were younger age, female gender, and had lower scores in olfactory tests at the first visit. CONCLUSIONS Patients with C19 and non-C19 URTI exhibit a similar improvement over 3-4 months except for the odour threshold, with a better TDI in both visits for C19. For C19 a better prognosis in terms of olfactory recovery was found for younger patients with parosmia and lower olfactory scores at the first visit. Still, for many patients with olfactory loss, an improvement that is experienced as complete may only occur over months and possibly years.
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Affiliation(s)
- Susanne Menzel
- Smell and Taste Clinic, Department of Otorhinolaryngology, University Hospital Carl Gustav Carus, Technische Universität Dresden, TU Dresden Faculty of Medicine Carl Gustav Carus: Technische Universitat Dresden Medizinische Fakultat Carl Gustav Carus, Fetscherstrasse 74, 01307, Dresden, Germany.
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, University Hospital Carl Gustav Carus, Technische Universität Dresden, TU Dresden Faculty of Medicine Carl Gustav Carus: Technische Universitat Dresden Medizinische Fakultat Carl Gustav Carus, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Dorothea Woosch
- Smell and Taste Clinic, Department of Otorhinolaryngology, University Hospital Carl Gustav Carus, Technische Universität Dresden, TU Dresden Faculty of Medicine Carl Gustav Carus: Technische Universitat Dresden Medizinische Fakultat Carl Gustav Carus, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Belinda Marquardt
- Smell and Taste Clinic, Department of Otorhinolaryngology, University Hospital Carl Gustav Carus, Technische Universität Dresden, TU Dresden Faculty of Medicine Carl Gustav Carus: Technische Universitat Dresden Medizinische Fakultat Carl Gustav Carus, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Cristina Ressel
- Smell and Taste Clinic, Department of Otorhinolaryngology, University Hospital Carl Gustav Carus, Technische Universität Dresden, TU Dresden Faculty of Medicine Carl Gustav Carus: Technische Universitat Dresden Medizinische Fakultat Carl Gustav Carus, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Julia Draf
- Smell and Taste Clinic, Department of Otorhinolaryngology, University Hospital Carl Gustav Carus, Technische Universität Dresden, TU Dresden Faculty of Medicine Carl Gustav Carus: Technische Universitat Dresden Medizinische Fakultat Carl Gustav Carus, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Giancarlo Ottaviano
- Department of Neurosciences-ENT Section, University-Hospital of Padova, Padua, Italy
| | - Paolo Boscolo-Rizzo
- Department of Medicine, Surgery and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Romina Kardashi
- Division of Infectious Diseases, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Katja de With
- Division of Infectious Diseases, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Yvonne Hackl
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Augsburg, Sauerbruchstraße 6, 86179, Augsburg, Germany
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, University Hospital Carl Gustav Carus, Technische Universität Dresden, TU Dresden Faculty of Medicine Carl Gustav Carus: Technische Universitat Dresden Medizinische Fakultat Carl Gustav Carus, Fetscherstrasse 74, 01307, Dresden, Germany
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Mai Y, Menzel S, Cuevas M, Haehner A, Hummel T. Well-being in patients with olfactory dysfunction. Physiol Behav 2022; 254:113899. [PMID: 35809697 DOI: 10.1016/j.physbeh.2022.113899] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/02/2022] [Accepted: 07/05/2022] [Indexed: 01/01/2023]
Abstract
This cross-sectional, retrospective study aimed to investigate the differences in well-being among patients with olfactory disorder (OD) with quantitative and/or qualitative olfactory dysfunctions, and to identify factors associated with well-being (WB). We included 470 OD patients. WB (WHO-5 questionnaire), quantitative olfactory function (Sniffin' Sticks) and qualitative dysfunction were assessed. Overall, 35% of the OD patients reported a poor WB, higher than 22% of the normative data in general population. For quantitative function, anosmia patients showed lower WB scores than hyposmia and normosmia patients (all p's < 0.03). For qualitative dysfunction, patients with severe parosmia showed lower WB scores than patients without and with less severe parosmia (p's < 0.01). Regarding OD causes in hyposmic patients, post-infectious patients showed poorer WB than idiopathic patients (p = 0.01); sinonasal patients had lower WB than post-traumatic and idiopathic patients (all p's < 0.04). There was a weak but significant positive correlation between WB score and Threshold test score (r = 0.11, p = 0.02). Hierarchical regression analyses showed that women gender, Threshold and overall Sniffin' Sticks scores (TDI) significantly predicted WB score in OD patients. Our results implied that quantitative and qualitative dysfunction is associated with WB. However, only patients with severe dysfunction showed significantly lower WB. While this needs to be better understood, in order to improve well-being, in these patients it appears to be highly important to improve olfactory function, and here especially olfactory sensitivity.
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Affiliation(s)
- Yiling Mai
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany.
| | - Susanne Menzel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany
| | - Mandy Cuevas
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany
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Hintschich CA, Dietz M, Haehner A, Hummel T. Topical Administration of Mometasone Is Not Helpful in Post-COVID-19 Olfactory Dysfunction. Life (Basel) 2022; 12:life12101483. [PMID: 36294918 PMCID: PMC9605508 DOI: 10.3390/life12101483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/29/2022] Open
Abstract
Persistent olfactory dysfunction is a major concern post-COVID-19, affecting up to 5% of all patients. Different therapeutic options, including mometasone nasal spray, have been recommended, only some of which have been validated for post-COVID-19 olfactory dysfunction. In this study we psychophysically assessed the effect of intranasally applied mometasone furoate on the recovery of olfaction. The spray was applied with a long applicator so that the olfactory cleft could be reached effectively. After olfactory dysfunction had been confirmed psychophysically using Sniffin’ Sticks, patients were randomly assigned to two different treatment arms: the study group (n = 40) underwent olfactory training and intranasal administration of mometasone furoate twice daily, whereas the control group (n = 46) performed olfactory training only. After a study duration of three months, psychophysical testing of olfaction was repeated using Sniffin’ Sticks. We found no benefit of an additional topical administration of mometasone furoate compared to olfactory training alone. These results psychophysically confirm two previous studies which were based on patients’ subjective self-ratings. Our findings are in contrast to current recommendations for the management of olfactory dysfunction post-COVID-19, which might have to be adapted accordingly.
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Affiliation(s)
- Constantin A. Hintschich
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, 01307 Dresden, Germany
- Department of Otorhinolaryngology, Regensburg University Hospital, 93053 Regensburg, Germany
- Correspondence: ; Tel.: +49-941-944-9401
| | - Melanie Dietz
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, 01307 Dresden, Germany
| | - Antje Haehner
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, 01307 Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, 01307 Dresden, Germany
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Li Z, Stolper S, Draf J, Haehner A, Hummel T. Smell, taste and trigeminal function: similarities and differences between results from home tests and examinations in the clinic. Rhinology 2022; 60:293-300. [PMID: 35926120 DOI: 10.4193/rhin21.430] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND This study aimed to examine an easy-to-conduct home chemosensory test as a screening tool prior to clinical testing and to investigate the associations between home and clinical tests. METHODS We examined 200 participants who performed a chemosensory test including subjective ratings as well as psychophysical smell, taste and trigeminal function tests at their homes. Following that, they were invited to the clinic for standardized testing using the Sniffin sticks test for assessment of olfactory function, taste sprays and strips for taste function, and a lateralization test for trigeminal function. RESULTS The home smell test correlated well with the Sniffin sticks test. The home test had acceptable sensitivity for detecting smell loss (sensitivity of 67% at a specificity of 92%). The home test could distinguish between patients with olfactory loss and healthy controls. In contrast, the home tests for taste and trigeminal function did not provide valid results. When comparing home and clinical smell and taste tests older age and olfactory loss were the most influencing confounders in various models, while participants who had olfactory loss and admitted to drink alcohol regularly were more likely to have consistency between home and clinical smell measurements. CONCLUSIONS Although the standardized psychophysical tests are valid and reliable and should be recommended, simple methods used at home could reflect the patients' information to some degree and provide useful data prior to clinical testing. The present home chemosensory test allows motivated individuals to screen their olfactory function in a simple way at home. Results from smell tests, but not from tests of taste or trigeminal function, obtained at home correlate with tests obtained at the clinic. Moreover, tests conducted at home or in the clinic have confounders that should be considered by researchers and clinicians.
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Affiliation(s)
- Z Li
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Univeristy Dresden, Dresden, Germany
| | - S Stolper
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Univeristy Dresden, Dresden, Germany
| | - J Draf
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Univeristy Dresden, Dresden, Germany
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Univeristy Dresden, Dresden, Germany
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Univeristy Dresden, Dresden, Germany
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Gossrau G, Frost M, Klimova A, Koch T, Sabatowski R, Mignot C, Haehner A. Interictal osmophobia is associated with longer migraine disease duration. J Headache Pain 2022; 23:81. [PMID: 35840888 PMCID: PMC9284850 DOI: 10.1186/s10194-022-01451-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/01/2022] [Indexed: 11/20/2022] Open
Abstract
Background Sensitization to sensory stimuli is an essential feature of migraine attacks. The relationship between the clinical course of migraine and increased sensitivity to olfactory stimuli has been little studied so far. Methods We analyzed the frequency and quality of osmophobia depending on the phase of migraine in patients with episodic and chronic migraine treated in an tertiary headache center with regard to gender, age, medical history and migraine disability assessment score (MIDAS). Standardized diagnostic questions were used for the assessment of osmophobia. Results In our cross-sectional investigation (n = 113), 38.1% of the patients showed an increased preictal hypersensitivity to odors, whereas 61.9% described ictal and 31.9% interictal hypersensitivity to odors, odor-triggered migraine was described in 30.1%. Median migraine disease duration has been statistically significantly longer in patients who suffered from interictal hypersensitivity to odors (28.5 years vs. 20 years; p = 0.012). There was a significant correlation between interictal hypersensitivity and higher age (54.50 vs. 45; p = 0.015). Patients with higher migraine disability in MIDAS experienced more frequently preictal and interictal olfactory sensitization and odor triggered migraine attacks. Conclusions In patients with longer migraine disease duration and higher migraine-related impairment, osmophobia was more frequently observed. These results might support the hypothesis of increasing sensitization with increasing burden of migraine.
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Affiliation(s)
- Gudrun Gossrau
- University Pain Center Dresden, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
| | - Marie Frost
- University Pain Center Dresden, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Anna Klimova
- NCT Partner Site Dresden, Institute for Medical Informatics and Biometrics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Thea Koch
- Department of Anesthesiology and Intensive Care Medicine, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Rainer Sabatowski
- University Pain Center Dresden, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany.,Department of Anesthesiology and Intensive Care Medicine, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Coralie Mignot
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany
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19
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Haehner A, Chen B, Espin M, Haussmann R, Matthes C, Desser D, Loessner L, Brandt MD, Donix M, Hummel T. Training with Odors Impacts Hippocampal Thickness in Patients with Mild Cognitive Impairment. J Alzheimers Dis 2022; 88:743-755. [DOI: 10.3233/jad-220248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The olfactory system is affected early in Alzheimer’s disease and olfactory loss can already be observed in patients with mild cognitive impairment (MCI). Olfactory training is effective for improving olfactory and cognitive function by stimulating the olfactory pathway, but its effect on patients with MCI remains unclear. Objective: The aim of this randomized, prospective, controlled, blinded study was to assess whether a 4-month period of olfactory training (frequent short-term sniffing various odors) may have an effect on olfactory function, cognitive function, and morphology of medial temporal lobe (MTL) subregions and olfactory bulb in MCI patients. Methods: A total of thirty-seven MCI patients were randomly assigned to the training group or a placebo group, which were performed twice a day for 4 months. Olfactory assessments, cognitive tests and magnetic resonance imaging were performed at the baseline and follow-up period. Results: After the training, there was an increase in odor discrimination, and increased cortical thickness of bilateral hippocampus (CA23DG and CA1) and mean MTL. Additionally, the change of olfactory score was positively associated with change of volume of olfactory bulb and hippocampus; the change of global cognition was positively associated with change of cortical thickness of hippocampus, entorhinal cortex and mean MTL; the change of cortical thickness of entorhinal cortex was positively associated with change of executive function. Conclusion: Olfactory training was associated with an increase in cortical thickness of the hippocampus but not olfactory bulb volume in patients with MCI. Olfactory training may serve as an early intervention of preventing hippocampal atrophy.
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Affiliation(s)
| | - Ben Chen
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Melanie Espin
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | | | | | - Dmitriy Desser
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | | | - Moritz D. Brandt
- Department of Neurology, TU Dresden, Dresden, Germany
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Markus Donix
- Department of Psychiatry, TU Dresden, Dresden, Germany
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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20
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Otte MS, Haehner A, Bork ML, Klussmann JP, Luers JC, Hummel T. Impact of COVID-19-Mediated Olfactory Loss on Quality of Life. ORL J Otorhinolaryngol Relat Spec 2022; 85:1-6. [PMID: 35413715 PMCID: PMC9148912 DOI: 10.1159/000523893] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/15/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION COVID-19 can be associated with a variety of longer-lasting impairments that can have a significant impact on patients' quality of life (QoL). While this is well described in the literature for limitations in lung capacity or permanent headaches, there is little research on the impact of olfactory dysfunction in the context of COVID-19 on patients' QoL. METHODS In 65 patients with a history of COVID-19, the present olfactory ability was assessed using the Sniffin' Sticks test. In addition, olfactory QoL was assessed by the Questionnaire of Olfactory Disorders. Self-assessment was performed with visual analogue scales. The data were compared with the results obtained in healthy individuals and in patients with hyposmia due to other viral infections. RESULTS The QoL of COVID-19 patients was significantly lower compared to the healthy control group. Even recovered subjects whose olfaction had already returned to the normal range still had a reduced QoL. The severity of the olfactory impairment correlated with the reduction in QoL. However, the olfactory QoL of COVID-19 patients was not worse than that of patients' olfactory loss due to other viral infections. Patients with parosmia had reduced QoL and rated their situation worse than patients without parosmia. CONCLUSION QoL appears to be impaired in patients with long-lasting COVID-19 olfactory disorders several months after overcoming acute symptoms, even if olfaction has normalized. However, the impairment is not more pronounced than in patients with other postviral olfactory disorders of the same duration.
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Affiliation(s)
- Martin Sylvester Otte
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany,*Martin Sylvester Otte,
| | - Antje Haehner
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technische Universität Dresden, Dresden, Germany
| | - Marie-Luise Bork
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Jan Christoffer Luers
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technische Universität Dresden, Dresden, Germany
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21
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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: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Loessner L, Matthes C, Haussmann R, Brandt MD, Sauer C, Espin M, Noppes F, Werner A, Linn J, Hummel T, Haehner A, Donix M. Predictors of subjective cognitive deficits in patients with mild cognitive impairment. Psychogeriatrics 2022; 22:210-217. [PMID: 34939254 DOI: 10.1111/psyg.12802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/12/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Detailed examination of cognitive deficits in patients with mild cognitive impairment (MCI) yields substantial diagnostic and prognostic value, specifically with respect to memory. Magnitude and characteristics of subjective cognitive deficits, however, often receive less attention in this population at risk for developing dementia. METHODS We investigated predictors of subjective cognitive deficits in patients with MCI, using a detailed assessment for such impairments associated with different cognitive domains, as well as demographic and clinical variables including magnetic resonance imaging data. RESULTS The strongest predictor for subjective memory deficits was depressed mood, whereas subjective performance issues associated with attention or executive functions also corresponded to measurable impairments in the respective cognitive domains. Reduced hippocampal thickness and hemispheric entorhinal cortex thickness asymmetry were associated with objective memory impairment but not with subjective deficits or symptoms of depression. CONCLUSIONS Whereas low objective memory performance and reduced cortical thickness within medial temporal lobe subregions could be associated with neurodegeneration, greater subjective memory deficits in patients with MCI may indicate psychological burden.
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Affiliation(s)
- Lorenz Loessner
- Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Claudia Matthes
- Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Robert Haussmann
- Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Moritz D Brandt
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Cathrin Sauer
- Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Melanie Espin
- Department of Otorhinolaryngology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Felix Noppes
- Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Annett Werner
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany.,Department of Neuroradiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Jennifer Linn
- Department of Neuroradiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Markus Donix
- Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
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23
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Mahmut MK, Rosbach M, Haehner A, Hummel T. Reactions received by smell loss patients after revealing their dysfunction. Rhinology 2022; 60:238-240. [PMID: 35229831 DOI: 10.4193/rhin21.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- M K Mahmut
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany.,Food, Flavour and Fragrance Lab, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - M Rosbach
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Abstract
BACKGROUND This study aimed to examine whether omega-3 supplementation would support olfactory recovery among postviral olfactory dysfunction patients. METHODOLOGY Patients with postviral olfactory dysfunction were included in this non-blinded, prospective pilot study. Structured medical history was taken from the patients, including the following: age, sex, history of COVID-19 infection, and duration of symptoms. Patients were randomly assigned to receive olfactory training only (control group) versus olfactory training with omega-3 supplementation (treatment group). All patients exposed themselves twice a day to four odours (phenyl ethyl alcohol [rose], eucalyptol [eucalyptus], citronellal [lemon], and eugenol [cloves]). Olfactory function was measured before and after training using "Sniffin' Sticks", comprised of tests for odour threshold, discrimination, and identification. The average interval between olfactory tests was 3 months. RESULTS Fifty-eight patients were included in the study, 25 men and 33 women. Generally, an improvement in olfactory scores was observed. Compared to the control group, the improvement in odour thresholds was more pronounced in the omega-3 group. Age, sex, and duration of symptoms had no effect on olfactory scores among both control and treatment groups. CONCLUSION Overall, the present results indicate that omega-3 supplementation may be an option for adjunct therapy with olfactory training in patients with postviral olfactory dysfunction.
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Affiliation(s)
- A K Hernandez
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - D Woosch
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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25
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Hernandez AK, Juratli L, Haehner A, Hsieh JW, Landis BN, Hummel T. Assessment of olfactory fluctuations in a clinical context. Eur Arch Otorhinolaryngol 2022; 279:5685-5690. [PMID: 35661914 PMCID: PMC9649505 DOI: 10.1007/s00405-022-07462-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/18/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE The aim of the study was to investigate whether olfactory fluctuations (OF) are pronounced in patients with sinonasal olfactory dysfunction (OD). METHODS The retrospective investigation included patients aged 18 years or older, who consulted a tertiary referral center for olfactory loss. Patients with normal smell function were excluded. Patients answered a structured questionnaire about their olfactory symptoms, with specific questions related to the presence of OF and its average frequency, amplitude, duration, time since most recent OF, and associated symptoms of self-reported OF. Patients also underwent clinical evaluation including a structured medical history and physical examination including nasal endoscopy. In addition, we assessed orthonasal olfactory function using Sniffin' Sticks, and gustatory function using "taste sprays". RESULTS Participants included 131 men and 205 women (n = 336), aged 18 to 86 years (mean 50, SD 16). Patient-reported fluctuations occurred most frequently in sinonasal (38%), idiopathic (29%), and postviral (29%) OD. Amplitude of OF was highest in postviral OD (p = 0.009). Average frequency, duration, and the time since the most recent fluctuation were not significantly different between groups (all p's > 0.42). Odor discrimination (p = 0.002) and identification (p = 0.017) scores were higher among those individuals with OF. CONCLUSION Amplitude of OF may help distinguish postviral from other causes of OD, especially in patients presenting with equivocal symptoms of sinonasal disease.
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Affiliation(s)
- Anna Kristina Hernandez
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Haus 5, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Lena Juratli
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Haus 5, Fetscherstrasse 74, 01307 Dresden, Germany ,University of Michigan Medical School, Ann Arbor, MI USA
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Haus 5, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Julien W. Hsieh
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology, University of Geneva, Geneva, Switzerland
| | - Basile N. Landis
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology, University of Geneva, Geneva, Switzerland
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Haus 5, Fetscherstrasse 74, 01307 Dresden, Germany
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Hernandez AK, Fuchss P, Haehner A, Hummel T. Olfactory function testing before and after anesthesia. Sci Rep 2021; 11:23857. [PMID: 34903794 PMCID: PMC8668874 DOI: 10.1038/s41598-021-03400-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/02/2021] [Indexed: 11/08/2022] Open
Abstract
This study aimed to determine whether anesthesia would affect olfactory function. Patients who were admitted for surgical intervention that did not include the nasal cavity and paranasal sinuses were included in this prospective cohort study. Structured medical history was taken from the patients, including the following: age, sex, smoking history, alcohol intake, current medications, and sleep deficits prior to surgery. Before surgery, patients were asked for a self-rating of their olfactory function. Olfactory function was also measured using Sniffin' Sticks comprising measures of odor threshold, discrimination, and identification. The mean interval between olfactory tests was 6 days (range 3-12 days). Seventy-three patients were included in the study, 34 men and 39 women. Olfactory scores were consistent before and after surgery as indicated by correlative analyses (p < 0.05). Odor thresholds, discrimination, identification, and composite TDI scores did not change significantly, whereas odor identification scores increased (p = 0.011) after surgery. In conclusion, post-operative olfactory scores remained stable. However, identification scores exhibited a slight increase which can be attributed to a retest effect. Overall, the present results indicate that surgery outside of the nasal and paranasal sinus region performed in general anesthesia has no major effect on the sense of smell.
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Affiliation(s)
| | - Patrick Fuchss
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Antje Haehner
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Chen B, Wang Q, Zhong X, Mai N, Zhang M, Zhou H, Haehner A, Chen X, Wu Z, Auber LA, Rao D, Liu W, Zheng J, Lin L, Li N, Chen S, Chen B, Hummel T, Ning Y. Structural and Functional Abnormalities of Olfactory-Related Regions in Subjective Cognitive Decline, Mild Cognitive Impairment, and Alzheimer's Disease. Int J Neuropsychopharmacol 2021; 25:361-374. [PMID: 34893841 PMCID: PMC9154279 DOI: 10.1093/ijnp/pyab091] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 11/11/2021] [Accepted: 12/09/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Odor identification (OI) dysfunction is an early marker of Alzheimer's disease (AD), but it remains unclear how olfactory-related regions change from stages of subjective cognitive decline (SCD) and mild cognitive impairment (MCI) to AD dementia. METHODS Two hundred and sixty-nine individuals were recruited in the present study. The olfactory-related regions were defined as the regions of interest, and the grey matter volume (GMV), low-frequency fluctuation, regional homogeneity (ReHo), and functional connectivity (FC) were compared for exploring the changing pattern of structural and functional abnormalities across AD, MCI, SCD, and normal controls. RESULTS From the SCD, MCI to AD groups, the reduced GMV, increased low-frequency fluctuation, increased ReHo, and reduced FC of olfactory-related regions became increasingly severe, and only the degree of reduced GMV of hippocampus and caudate nucleus clearly distinguished the 3 groups. SCD participants exhibited reduced GMV (hippocampus, etc.), increased ReHo (caudate nucleus), and reduced FC (hippocampus-hippocampus and hippocampus-parahippocampus) in olfactory-related regions compared with normal controls. Additionally, reduced GMV of the bilateral hippocampus and increased ReHo of the right caudate nucleus were associated with OI dysfunction and global cognitive impairment, and they exhibited partially mediated effects on the relationships between OI and global cognition across all participants. CONCLUSION Structural and functional abnormalities of olfactory-related regions present early with SCD and deepen with disease severity in the AD spectrum. The hippocampus and caudate nucleus may be the hub joining OI and cognitive function in the AD spectrum.
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Affiliation(s)
| | | | | | - Naikeng Mai
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Min Zhang
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Huarong Zhou
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
| | - Xinru Chen
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Zhangying Wu
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Lavinia Alberi Auber
- Department of Medicine, University of Fribourg, Fribourg, Switzerland,Swiss Integrative Center of Human Health, Fribourg, Switzerland
| | - Dongping Rao
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Wentao Liu
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Jinhong Zheng
- Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Lijing Lin
- Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Nanxi Li
- Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Sihao Chen
- Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Bingxin Chen
- Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
| | - Yuping Ning
- Correspondence: Yuping Ning, PhD, No. 13, Mingxin Road, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China ()
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Zou L, Haehner A, Menzel S, Gunder N, Hummel T. Reliability and validity of a brief version of the Questionnaire of Olfactory Disorders (brief QOD) in patients with olfactory dysfunction. Rhinology 2021; 60:56-62. [PMID: 34874020 DOI: 10.4193/rhin21.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to determine the reliability and validity of the brief version of Questionnaire of Olfactory Disorders (brief QOD). METHODS A total of 372 patients participated in this study. Olfactory function was examined using the Sniffin' Sticks test. The brief version of QOD, including 4 items concerning parosmia (QOD-P), 7 items concerning quality of life (QOD-QOL), and 3 visual analog scales to rate disease burden, awareness of the disorder and issues related to professional life (QOD-VAS), was used to assess subjective information on olfactory dysfunction. We evaluated the split-half reliability, internal consistency and validity of the brief QOD. RESULTS The split-half reliability was 0.60 (QOD-P), 0.87 (QOD-QOL), and 0.66 (QOD-VAS), respectively. The Cronbach's α coefficient was 0.63 (QOD-P), 0.87 (QOD-QOL), and 0.71 (QOD-VAS), respectively. Olfactory function was found to be associated with QOD-P, QOD-QOL and QOD-VAS. CONCLUSIONS The brief QOD is a suitable scale for the assessment of subjective severity of olfactory dysfunction for purposes such as treatment counseling, disability assessment, treatment control, and research in patients with olfactory disorder.
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Affiliation(s)
- L Zou
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany 2 Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China 3 Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
| | - S Menzel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
| | - N Gunder
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
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Chen B, Espin M, Haussmann R, Matthes C, Donix M, Hummel T, Haehner A. The Effect of Olfactory Training on Olfaction, Cognition, and Brain Function in Patients with Mild Cognitive Impairment. J Alzheimers Dis 2021; 85:745-754. [PMID: 34864678 DOI: 10.3233/jad-215257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The olfactory system is affected very early in Alzheimer's disease and olfactory loss can already be observed in patients with mild cognitive impairment (MCI), an early stage of AD. OBJECTIVE The aim of this randomized, prospective, controlled, blinded study was to evaluate whether olfactory training (OT) may have an effect on olfactory function, cognitive impairment, and brain activation in MCI patients after a 4-month period of frequent short-term exposure to various odors. METHODS A total of 38 MCI outpatients were randomly assigned to OT or a control training condition, which were performed twice a day for 4 months. Olfactory testing, comprehensive neuropsychological assessment, and magnetic resonance imaging were performed before and after training. RESULTS The results suggested that OT exhibited no significant effect on olfaction and cognitive function. However, OT exhibited a positive effect on frontal lobe activation (left middle frontal gyrus and orbital-frontal cortex) but exhibited no effect on grey matter volume. Moreover, the change of olfactory scores was positively associated with the change of frontal activation. CONCLUSION OT was found to have a limited effect on olfaction and cognition in patients with MCI compared to a non-OT condition but increased their functional response to odors in frontal area.
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Affiliation(s)
- Ben Chen
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany.,Department of Geriatric Psychiatry, Memory Clinic, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Melanie Espin
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany
| | - Robert Haussmann
- Department of Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany
| | - Claudia Matthes
- Department of Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany
| | - Markus Donix
- Department of Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany.,Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany
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Mahmut MK, Oelschlägel A, Haehner A, Hummel T. The impact of olfactory training using a nasal clip and extended periods of odor exposure. J SENS STUD 2021. [DOI: 10.1111/joss.12721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Mehmet K. Mahmut
- Smell and Taste Clinic, Department of Otorhinolaryngology TU Dresden Dresden Germany
- Food, Flavour and Fragrance Lab, School of Psychological Sciences Macquarie University Sydney Australia
| | - Annegret Oelschlägel
- Smell and Taste Clinic, Department of Otorhinolaryngology TU Dresden Dresden Germany
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology TU Dresden Dresden Germany
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology TU Dresden Dresden Germany
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Chen B, Masala C, Oleszkiewicz A, Englmaier V, Gunder N, Menzel S, Haehner A, Hummel T. Nonlinear association between chemosensory dysfunction and body mass index. J SENS STUD 2021. [DOI: 10.1111/joss.12715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Ben Chen
- Interdisciplinary Center Smell and Taste, Department of Otorhinolaryngology Medical Faculty Carl Gustav Carus, TU Dresden Dresden Germany
- Memory Clinic, Department of Geriatric Psychiatry The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou China
| | - Carla Masala
- Interdisciplinary Center Smell and Taste, Department of Otorhinolaryngology Medical Faculty Carl Gustav Carus, TU Dresden Dresden Germany
- Section of Physiology, Department of Biomedical Sciences University of Cagliari Cagliari Italy
| | - Anna Oleszkiewicz
- Interdisciplinary Center Smell and Taste, Department of Otorhinolaryngology Medical Faculty Carl Gustav Carus, TU Dresden Dresden Germany
- Institute of Psychology University of Wroclaw Wroclaw Poland
| | - Verena Englmaier
- Interdisciplinary Center Smell and Taste, Department of Otorhinolaryngology Medical Faculty Carl Gustav Carus, TU Dresden Dresden Germany
| | - Nadine Gunder
- Interdisciplinary Center Smell and Taste, Department of Otorhinolaryngology Medical Faculty Carl Gustav Carus, TU Dresden Dresden Germany
| | - Susanne Menzel
- Interdisciplinary Center Smell and Taste, Department of Otorhinolaryngology Medical Faculty Carl Gustav Carus, TU Dresden Dresden Germany
| | - Antje Haehner
- Interdisciplinary Center Smell and Taste, Department of Otorhinolaryngology Medical Faculty Carl Gustav Carus, TU Dresden Dresden Germany
| | - Thomas Hummel
- Interdisciplinary Center Smell and Taste, Department of Otorhinolaryngology Medical Faculty Carl Gustav Carus, TU Dresden Dresden Germany
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Wang Q, Chen B, Zhong X, Zhou H, Zhang M, Mai N, Wu Z, Huang X, Haehner A, Chen X, Auber LA, Peng Q, Hummel T, Ning Y. Olfactory Dysfunction Is Already Present with Subjective Cognitive Decline and Deepens with Disease Severity in the Alzheimer's Disease Spectrum. J Alzheimers Dis 2021; 79:585-595. [PMID: 33361601 DOI: 10.3233/jad-201168] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Odor identification dysfunction occurs early in Alzheimer's disease (AD) and is considered a preclinical symptom along with subjective cognitive decline (SCD). Nevertheless, whether subjects with SCD are co-symptomatic with odor identification dysfunction remains unclear. OBJECTIVE To compare the degree of odor identification dysfunction and assess the relation between odor identification and cognitive performance in the AD spectrum (including SCD, mild cognitive impairment (MCI), and AD). METHODS Patients (84 SCD, 129 MCI, 52 AD) and 35 controls underwent the Sniffin' Sticks Screen 16 test and comprehensive neuropsychological examination. RESULTS Odor identification scores were progressively lower moving from normal older adult to SCD, MCI, and AD. Additionally,the proportion of odor identification dysfunction were increasingly higher in the AD spectrum (p for trend <0.001), but no significant difference was found in the proportion of subjective olfactory dysfunction. No significant correlation was found between odor identification and cognition in the normal older adults and SCD subjects, but odor identification correlated with global cognition in the MCI (r = 0.199, p = 0.033) and in the AD (r = 0.300, p = 0.036) patients. Multiple linear regression showed that odor identification dysfunction was most strongly associated with memory among different cognitive subdomains and was most strongly associated with immediate verbal recall among different memory subdomains. CONCLUSION Odor identification dysfunction is already present with SCD and deepens with disease severity in the AD spectrum, and it may contribute to predicting cognitive decline and identifying SCD subjects who are at risk of developing AD.
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Affiliation(s)
- Qiang Wang
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China.,Department of Geriatric Psychiatry, The Second People's Hospital of Dali Bai Autonomous Prefecture, Dali, Yunnan Province, China
| | - Ben Chen
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Xiaomei Zhong
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Huarong Zhou
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Min Zhang
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Naikeng Mai
- Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Zhangying Wu
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Xingxiao Huang
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Germany
| | - Xinru Chen
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Lavinia Alberi Auber
- Department of Medicine, University of Fribourg, Fribourg, Switzerland.,Swiss Integrative Center of Human Health, Fribourg, Switzerland
| | - Qi Peng
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Germany
| | - Yuping Ning
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China.,The first School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
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Bogdanov V, Reinhard J, McGlone F, Haehner A, Simons CT, Hummel T. Oral Somatosensory Sensitivity in Patients With Taste Disturbance. Laryngoscope 2021; 131:2572-2577. [PMID: 34435674 DOI: 10.1002/lary.29843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/30/2021] [Accepted: 08/10/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The significance of the human sense of taste is typically underestimated until it is altered or even lost. Hypogeusia, a diminished capacity to taste, has an adverse influence on a patient's quality of life. Similar to interactions between the oral senses and between olfaction and intranasal trigeminal sensitivity, taste disturbance may also affect the mechanosensitivity of the tongue. In this study, we investigated the lingual tactile sensitivity of patients with subjective taste disturbance and people with normogeusia. STUDY DESIGN Prospective case-control study. METHODS Forty-six patients with subjective taste disturbance (mean age 60 years) and 43 participants with normogeusia (mean age 55 years) were enrolled and underwent a stereognostic test of edge and point sensitivity based on 3D-printed letters sized from 2 to 8 mm. Gustatory function and salivary production were also tested. RESULTS Patients with dysgeusia needed significantly bigger letters to recognize them compared with controls (P = .01). Apart from this, patients with dysgeusia had no significant association between gustatory function and salivary production. Duration of dysgeusia and age were not associated with the presently obtained measures of gustatory or oral mechanosensory function. CONCLUSIONS The results of this study indicate that taste dysfunction has a negative impact on oral mechanosensitivity and hence possibly on oral texture perception. LEVEL OF EVIDENCE 3 Laryngoscope, 131:2572-2577, 2021.
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Affiliation(s)
- Vasyl Bogdanov
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Carl-Thiem-Klinikum Cottbus gGmbH, Cottbus, Germany
| | - Jule Reinhard
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
| | - Francis McGlone
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Antje Haehner
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
| | - Chris T Simons
- CFAES Department of Food Science & Technology, Columbus, Ohio, U.S.A
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Oleszkiewicz A, Suhle P, Haehner A, Croy I. Prior exposure to Hedione, a model of pheromone, does not affect female ratings of male facial attractiveness or likeability. Physiol Behav 2021; 238:113458. [PMID: 34033848 DOI: 10.1016/j.physbeh.2021.113458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/20/2021] [Accepted: 05/09/2021] [Indexed: 10/21/2022]
Abstract
The existence of pheromones in humans is controversial, partly because of definitional difficulties and partly because of the question of possible chemical substances. The synthetic compound Methyl dihydrojasmonate (Hedione) is potent to bind to vomeronasal-type 1 receptors (VN1R1s) and activate limbic areas of the brain in a sex-specific manner. However, one of the most important definitional points for a human pheromone effect has not yet been investigated, i.e., whether smelling Hedione, a model of pheromone, has a behavioral effect. We tested in females whether Hedione leads to altered perception of male social stimuli. Each of the included women were sensitive to Hedione and were tested around the time of ovulation in three consecutive sessions, during each they were exposed to either Hedione or Phenylethyl alcohol or Odorless air. We measured the speed of male face recognition (implicit priming task) and collected ratings of facial attractiveness and likeability of men (explicit task). Only about half of the women tested were sensitive to Hedione. Those women did not show any effect of Hedione exposure in the implicit priming task and moderate, but non-significant effects in the explicit task. We therefore assume that Hedione is not a potent model of pheromone in humans and this observation may be due to the fact that the artificially produced substance is not suited for signaling the proximity of other humans. Furthermore, the high rate of Hedione-specific anosmia leads to the hypothesis that a substantial proportion of individuals has a poor V1NR1 receptor expression.
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Affiliation(s)
- Anna Oleszkiewicz
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Germany; Institute of Psychology, University of Wroclaw, Poland.
| | - Paulina Suhle
- Department of Psychotherapy and Psychosomatic Medicine, TU Dresden, Germany
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Germany
| | - Ilona Croy
- Department of Psychotherapy and Psychosomatic Medicine, TU Dresden, Germany; Department of Psychology, Friedrich Schiller University Jena, Germany
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Pieniak M, Oleszkiewicz A, Klockow M, Yoshino A, Haehner A, Hummel T. q-Powders: a quick test for screening retronasal olfactory disorders with tasteless powders. Eur Arch Otorhinolaryngol 2021; 279:779-784. [PMID: 33948681 PMCID: PMC8096134 DOI: 10.1007/s00405-021-06849-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/23/2021] [Indexed: 01/06/2023]
Abstract
Purpose To investigate the clinical utility of q-Powders—a retronasal identification screening test. Methods A total of 156 subjects (92 females, mean age: 54.5 years ± 17.3 years) completed a 3-item q-Powders retronasal identification test and a 16-items Sniffin’ Sticks orthonasal identification test. We analyzed whether the q-Powders test could differentiate between subjects with normosmia and subjects with an olfactory disorder. Results Our data indicated that subjects with an olfactory disorder scored lower in the q-Powders test than subjects with normosmia. The analyses revealed q-Powders test sensitivity of 84% and a test specificity of 64.9% with a score of 2 points taken as a cutoff for olfactory disorders. Conclusion The 3-item q-Powders retronasal test may be used for screening purposes in clinical research. Level of evidence 4
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Affiliation(s)
- Michal Pieniak
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
- Institute of Psychology, University of Wroclaw, ul. Dawida 1, 50-527, Wroclaw, Poland.
| | - Anna Oleszkiewicz
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
- Institute of Psychology, University of Wroclaw, ul. Dawida 1, 50-527, Wroclaw, Poland
| | - Marie Klockow
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Ayaho Yoshino
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
- Department of Otorhinolaryngology, Nippon Medical School Hospital, Tokyo, Japan
| | - Antje Haehner
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
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Melis M, Haehner A, Mastinu M, Hummel T, Tomassini Barbarossa I. Molecular and Genetic Factors Involved in Olfactory and Gustatory Deficits and Associations with Microbiota in Parkinson's Disease. Int J Mol Sci 2021; 22:ijms22084286. [PMID: 33924222 PMCID: PMC8074606 DOI: 10.3390/ijms22084286] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/14/2021] [Accepted: 04/17/2021] [Indexed: 12/11/2022] Open
Abstract
Deficits in olfaction and taste are among the most frequent non-motor manifestations in Parkinson’s disease (PD) that start very early and frequently precede the PD motor symptoms. The limited data available suggest that the basis of the olfactory and gustatory dysfunction related to PD are likely multifactorial and may include the same determinants responsible for other non-motor symptoms of PD. This review describes the most relevant molecular and genetic factors involved in the PD-related smell and taste impairments, and their associations with the microbiota, which also may represent risk factors associated with the disease.
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Affiliation(s)
- Melania Melis
- Department of Biomedical Sciences, University of Cagliari, Monserrato, 09042 Cagliari, Italy; (M.M.); (M.M.)
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, 01307 Dresden, Germany; (A.H.); (T.H.)
| | - Mariano Mastinu
- Department of Biomedical Sciences, University of Cagliari, Monserrato, 09042 Cagliari, Italy; (M.M.); (M.M.)
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, 01307 Dresden, Germany; (A.H.); (T.H.)
| | - Iole Tomassini Barbarossa
- Department of Biomedical Sciences, University of Cagliari, Monserrato, 09042 Cagliari, Italy; (M.M.); (M.M.)
- Correspondence: ; Tel.: +39-070-675-4144
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Zou LQ, Hummel T, Otte MS, Bitter T, Besser G, Mueller CA, Welge-Lussen A, Bulut OC, Goktas O, Negoias S, Li SB, Haehner A. Association between olfactory function and quality of life in patients with olfactory disorders: a multicenter study in over 760 participants. Rhinology 2021; 59:164-172. [PMID: 33395453 DOI: 10.4193/rhin20.403] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This cross-sectional, multi-centric study aimed to investigate the differences in quality of life among patients with olfactory dysfunction (OD) of different origin, and to identify factors associated with olfactory-related quality of life (QOL). METHODS Seven hundred sixty-three adults were recruited from 8 Smell & Taste clinics in Germany, Switzerland, and Austria. Olfactory-related QOL was assessed by the Questionnaire of Olfactory Disorders (QOD). Olfactory function was assessed with the "Sniffin' Sticks" test; self-assessment was performed with visual analog scales. RESULTS Patients with post-infectious and post-traumatic OD showed poorer olfactory-related QOL than patients with sinonasal and idiopathic OD. The olfactory-related QOL was positively associated with the "Sniffin' Sticks" test score, self-assessed olfactory function, disease duration, and age, with younger olfactory dysfunction patients showing lower QOL. Female patients presented with poorer olfactory-related QOL. In addition, the results showed that self-assessment of olfactory function explained more of the variance in olfactory-related QOL than olfactory function evaluated by the Sniffin’ Sticks test. CONCLUSIONS In addition to the psychophysical testing results, several factors such as disease cause, disease duration, sex, or self- assessed olfactory dysfunction should be taken into account when assessing the individual severity of the smell loss.
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Affiliation(s)
- L-Q Zou
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universitat Dresden, Dresden, Germany; Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universitat Dresden, Dresden, Germany
| | - M S Otte
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne,Germany
| | - T Bitter
- Department of Otorhinolaryngology, University Hospital Jena, Jena, Germany
| | - G Besser
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - C A Mueller
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - A Welge-Lussen
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitatsspital Basel, Basel, Switzerland
| | - O C Bulut
- Department of Otorhinolaryngology, SLK Kliniken Am Gesundbrunnen,Heilbronn, Germany; Department of Otorhinolaryngology, University Hospital Heidelberg, Heidelberg, Germany
| | - O Goktas
- HNO Zentrum am Kudamm, Berlin, Germany
| | - S Negoias
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitatsspital Basel, Basel, Switzerland; Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital, Bern, Bern, Switzerland
| | - S-B Li
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universitat Dresden, Dresden, Germany
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Chen B, Benzien C, Faria V, Ning Y, Cuevas M, Linke J, Croy I, Haehner A, Hummel T. Symptoms of Depression in Patients with Chemosensory Disorders. ORL J Otorhinolaryngol Relat Spec 2021; 83:135-143. [PMID: 33756467 DOI: 10.1159/000513751] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 12/13/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Patients with chemosensory dysfunction frequently report symptoms of depression. The current study aims to clarify whether the type (smell dysfunction, taste dysfunction, and mixed smell and taste dysfunction), severity, duration, or cause of dysfunction have differential impacts on the symptoms of depression. METHODS 899 patients with chemosensory disorders and 62 controls were included. Following a structured interview and an otorhinolaryngological examination, subjects underwent olfactory tests (Sniffin' Sticks), gustatory tests (taste sprays) and an assessment of depressive symptoms (Beck Depression Inventory). Information on the cause and duration of disorders was also collected. RESULTS Patients with combined olfactory/gustatory dysfunction had higher depression scores than patients with smell dysfunction only and controls, and no significant difference was found between the smell dysfunction and controls. Anosmia patients, but not hyposmia patients, exhibited higher depression scores than controls. Among various causes of chemosensory disorders, patients from the posttraumatic group had higher depression scores than patients with other causes of chemosensory dysfunction (sinonasal, idiopathic, or postinfectious). Multiple linear regression analyses suggested that reduced olfactory function was associated with enhanced depression scores in the olfactory disorders group (B = -0.326, t = -2.294, and p = 0.02) and in all patients with chemosensory disorders (B = -0.374, t = -2.550, p = 0.017). DISCUSSION/CONCLUSION Simultaneously decreased input of olfaction and gustation seems to have an additive effect on the exacerbation of emotional dysfunction. Early intervention should be considered for depression symptoms in patients with mixed olfactory/gustatory dysfunction in clinical practice.
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Affiliation(s)
- Ben Chen
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany, .,Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China,
| | - Cara Benzien
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany
| | - Vanda Faria
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany.,Department of Psychology, Uppsala University, Uppsala, Sweden.,Department of Anesthesiology, Center for Pain and the Brain, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Yuping Ning
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Mandy Cuevas
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany
| | - Jana Linke
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany
| | - Ilona Croy
- Department of Psychosomatic Medicine, TU Dresden, Dresden, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany
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Isenmann S, Haehner A, Hummel T. [Chemosensory disorders in Covid-19: Pathomechanisms and clinical relevance]. Fortschr Neurol Psychiatr 2021; 89:281-288. [PMID: 33621990 DOI: 10.1055/a-1375-0761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In this review article, current information on the frequency and relevance of chemosensory disorders in Covid-19 was recorded, assigned pathophysiologically and statements on prognostic significance were derived. The results are based on a comprehensive literature search of all literature on this topic and our own experience in the treatment of patients with smell and taste disorders since the beginning of the pandemic.Current study results indicate that clinically less affected Covid-19 patients without inpatient treatment and who do not require ventilation often have disorders of the chemosensory system. In young patients and women in particular, they seem to be an indicator of a favorable prognosis for the course of the disease. Smell disorders can appear early, as the sole symptom or together with other symptoms of Covid-19 disease. It has not yet been clarified whether ageusia can occur independently or whether it is also felt in the context of anosmia. In the pandemic, the new occurrence of anosmia without congestion / obstruction/runny nose is probably an expression of an infection with SARS-CoV-2 and should always give rise to quarantine and testing for SARS-CoV-2. The smell disorder in Covid-19 mostly seems to be temporary; It is not yet possible to conclusively assess whether there is usually a full restitution. The therapeutic approaches already established for other postviral olfactory disorders (e. g. olfactory training) are also used here.
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Affiliation(s)
- Stefan Isenmann
- Klinik für Neurologie und klinische Neurophysiologie, St. Josef Krankenhaus Moers
| | - Antje Haehner
- Interdisziplinäres Zentrum für Riechen und Schmecken, Klinik für HNO-Heilkunde, Universitätsklinikum Carl Gustav Carus, TU Dresden
| | - Thomas Hummel
- Interdisziplinäres Zentrum für Riechen und Schmecken, Klinik für HNO-Heilkunde, Universitätsklinikum Carl Gustav Carus, TU Dresden
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Chen B, Haehner A, Mahmut MK, Hummel T. Faster olfactory adaptation in patients with olfactory deficits: an analysis of results from odor threshold testing. Rhinology 2020; 58:489-494. [PMID: 32478337 DOI: 10.4193/rhin19.465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Patients with olfactory deficits often report rapid and lasting olfactory adaptation compared to the time when they had normal olfactory function. However, this phenomenon receives little scientific attention. This retrospective study aimed to compare the patterns of olfactory adaptation in normosmic controls and patients with olfactory impairment by analyzing the trajectory of turning points in odor threshold tests based on the staircase technique. METHODS 4120 subjects (1684 hyposmia, 1742 anosmia and 694 normosmic controls) were included in this study. Their odor threshold, odor discrimination and odor identification ability were assessed using the Sniffin’ Sticks. We analyzed the trajectory of turning points in the odor threshold test. RESULTS Current results suggested that patients with hyposmia needed significantly more trials to reach the final threshold scores than controls and anosmic group, and controls needed more trials than anosmic group. The difference between the first turning point and final threshold scores in the anosmic group was significantly larger than in the hyposmia group and in controls. CONCLUSION People with poor olfaction seem to adapt faster to olfactory stimuli. The trajectory of turning points in odor threshold test may serve as an indicator of olfactory adaptation and function of olfactory receptors. Olfactory adaptation may provide a new tool in the assessment of subtle olfactory loss.
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Affiliation(s)
- B Chen
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Germany; Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Germany
| | - M K Mahmut
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Germany; Food, Flavour and Fragrance Lab, Department of Psychology, Macquarie University, Sydney, Australia
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Germany
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Qiu C, Cui C, Hautefort C, Haehner A, Zhao J, Yao Q, Zeng H, Nisenbaum EJ, Liu L, Zhao Y, Zhang D, Levine CG, Cejas I, Dai Q, Zeng M, Herman P, Jourdaine C, de With K, Draf J, Chen B, Jayaweera DT, Denneny JC, Casiano R, Yu H, Eshraghi AA, Hummel T, Liu X, Shu Y, Lu H. Olfactory and Gustatory Dysfunction as an Early Identifier of COVID-19 in Adults and Children: An International Multicenter Study. Otolaryngol Head Neck Surg 2020; 163:714-721. [PMID: 32539586 PMCID: PMC7298561 DOI: 10.1177/0194599820934376] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/15/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate the prevalence and characteristics of olfactory or gustatory dysfunction in coronavirus disease 2019 (COVID-19) patients. STUDY DESIGN Multicenter case series. SETTING Five tertiary care hospitals (3 in China, 1 in France, 1 in Germany). SUBJECTS AND METHODS In total, 394 polymerase chain reaction (PCR)-confirmed COVID-19-positive patients were screened, and those with olfactory or gustatory dysfunction were included. Data including demographics, COVID-19 severity, patient outcome, and the incidence and degree of olfactory and/or gustatory dysfunction were collected and analyzed. The Questionnaire of Olfactory Disorders (QOD) and visual analog scale (VAS) were used to quantify olfactory and gustatory dysfunction, respectively. All subjects at 1 hospital (Shanghai) without subjective olfactory complaints underwent objective testing. RESULTS Of 394 screened subjects, 161 (41%) reported olfactory and/or gustatory dysfunction and were included. Incidence of olfactory and/or gustatory disorders in Chinese (n = 239), German (n = 39), and French (n = 116) cohorts was 32%, 69%, and 49%, respectively. The median age of included subjects was 39 years, 92 of 161 (57%) were male, and 10 of 161 (6%) were children. Of included subjects, 10% had only olfactory or gustatory symptoms, and 19% had olfactory and/or gustatory complaints prior to any other COVID-19 symptom. Of subjects with objective olfactory testing, 10 of 90 demonstrated abnormal chemosensory function despite reporting normal subjective olfaction. Forty-three percent (44/102) of subjects with follow-up showed symptomatic improvement in olfaction or gustation. CONCLUSIONS Olfactory and/or gustatory disorders may represent early or isolated symptoms of severe acute respiratory syndrome coronavirus 2 infection. They may serve as a useful additional screening criterion, particularly for the identification of patients in the early stages of infection.
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Affiliation(s)
- Chenghao Qiu
- Center of Stomatology, Shanghai Public Health Clinical Center, Shanghai, China
| | - Chong Cui
- ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Charlotte Hautefort
- Department of Head and Neck Surgery, Hopital Lariboisiere, University of Paris, Paris, France
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Jun Zhao
- Center of Pediatrics, Shanghai Public Health Clinical Center, Shanghai, China
| | - Qi Yao
- Department of Otorhinolaryngology, Chinese and Western Medicine Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Zeng
- Department of Cardiovascularology, The Third People’s Hospital of Shenzhen, Shenzhen, China
| | - Eric J. Nisenbaum
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Li Liu
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China
| | - Yu Zhao
- ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Di Zhang
- Department of Otolaryngology, The Third People’s Hospital of Shenzhen, Shenzhen, China
| | - Corinna G. Levine
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ivette Cejas
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Qi Dai
- ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Mei Zeng
- Department of Infectious Diseases, Children’s Hospital of Fudan University, Shanghai, China
| | - Philippe Herman
- Department of Head and Neck Surgery, Hopital Lariboisiere, University of Paris, Paris, France
| | - Clement Jourdaine
- Department of Head and Neck Surgery, Hopital Lariboisiere, University of Paris, Paris, France
| | - Katja de With
- Division of Infectious Diseases, University Hospital Carl Gustav Carus at the TU Dresden, Dresden, Germany
| | - Julia Draf
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Bing Chen
- ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Dushyantha T. Jayaweera
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - James C. Denneny
- American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
| | - Roy Casiano
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Hongmeng Yu
- ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Adrien A. Eshraghi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Xuezhong Liu
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Yilai Shu
- ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Hongzhou Lu
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China
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Negoias S, Meves B, Zang Y, Haehner A, Hummel T. Characteristics of Olfactory Disorder With and Without Reported Flavor Loss. Laryngoscope 2020; 130:2869-2873. [PMID: 32965693 DOI: 10.1002/lary.29070] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/07/2020] [Accepted: 07/07/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES/HYPOTHESIS Quality of life related to olfactory disorder (OD) depends on the perceived impairment. It is not known why some patients with OD report smell and flavor loss while others report smell loss only. In order to understand this, we compared the two clinical presentation forms in terms of demographics, clinical features, and orthonasal olfaction test results. STUDY DESIGN Observational, analytic, cross-sectional study. METHODS A total of 401 patients with measured orthonasal OD presenting at a tertiary referral center were divided in 2 groups according to their subjective reports (smell loss only = 129 patients vs. smell and flavor loss = 272 patients). Groups were compared in terms of demographic (age, sex), clinical features (duration of disease, type of onset, etiology, degree of impairment due to the disorder) and test results (taste and orthonasal olfaction). RESULTS Groups did not differ in terms of age, sex distribution, orthonasal olfactory, or taste function. Patients reporting smell and flavor loss were characterized by a mainly sudden onset of the disorder and a predominance of postinfectious olfactory loss. They also have a shorter disease duration and a higher disease impairment. For patients reporting smell loss only, disease duration is longer, they feel less impaired, the onset of the disorder is to a higher degree protracted and the main cause is idiopathic. CONCLUSIONS Patients with orthonasal OD reporting smell and flavor loss feel more impaired and present significant different clinical features compared to patients reporting smell loss only. Future studies measuring retronasal olfaction are necessary to fully understand flavor perception in OD. LEVEL OF EVIDENCE 4 Laryngoscope, 130:2869-2873, 2020.
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Affiliation(s)
- Simona Negoias
- Smell and Taste Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Dresden, Dresden, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Basel University Hospital, Basel, Switzerland
| | - Benjamin Meves
- Smell and Taste Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Dresden, Dresden, Germany
| | - Yunpeng Zang
- Smell and Taste Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Dresden, Dresden, Germany
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Dresden, Dresden, Germany
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Haehner A, Draf J, Dräger S, de With K, Hummel T. Predictive Value of Sudden Olfactory Loss in the Diagnosis of COVID-19. ORL J Otorhinolaryngol Relat Spec 2020; 82:175-180. [PMID: 32526759 PMCID: PMC7360503 DOI: 10.1159/000509143] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/03/2020] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Recent reports suggest that sudden smell loss might be a symptom of SARS-CoV-2 infection. The aim of this study was to investigate the frequency of olfactory loss in an outpatient population who presented to a coronavirus testing center during a 2-week period and to evaluate the diagnostic value of the symptom "sudden smell loss" for screening procedures. METHODS In this cross-sectional controlled cohort study, 500 patients who presented with symptoms of a common cold to a corona testing center and fulfilled corona testing criteria completed a standardized diagnostic questionnaire which included the patients' main symptoms, time course, and an additional self-assessment of the patients' current smell, taste function, and nasal breathing compared to the level before the onset of symptoms. RESULTS Out of the 500 patients, 69 presented with olfactory loss. Twenty-two of them subsequently tested positive for SARS-CoV-2. Only 12 out of the patients without olfactory loss tested positive, resulting in a frequency of 64.7% for the symptom "sudden smell loss" in COVID-19 patients. Compared to COVID-19 patients without smell loss, they were significantly younger and less severely affected. Changes in nasal airflow were significantly more pronounced in SARS-CoV-2 negative patients with olfactory complaints compared to the patients with smell loss who tested positive for SARS-CoV-2. By excluding patients with a blocked nose, the symptom "sudden smell loss" can be attested a high specificity (97%) and a sensitivity of 65% with a positive predictive value of 63% and negative predictive value of 97% for COVID-19. CONCLUSION Considering the high frequency of smell loss in non-hospitalized COVID-19 patients, acute olfactory impairment should be recognized as an early symptom of the disease and should be tested for on a regular basis. In contrast to other acute viral smell impairment, COVID-19-associated smell loss seems to be only rarely accompanied by a severely blocked nose.
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Affiliation(s)
- Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany,
| | - Julia Draf
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Sarah Dräger
- Division of Infectious Diseases, TU Dresden, Dresden, Germany
| | - Katja de With
- Division of Infectious Diseases, TU Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Qiu C, Cui C, Hautefort C, Haehner A, Zhao J, Yao Q, Zeng H, Nisenbaum EJ, Liu L, Zhao Y, Zhang D, Levine CG, Cejas I, Dai Q, Zeng M, Herman P, Jourdaine C, de With K, Draf J, Chen B, Jayaweera DT, Denneny JC, Casiano R, Yu H, Eshraghi AA, Hummel T, Liu X, Shu Y, Lu H. Olfactory and Gustatory Dysfunction as An Early Identifier of COVID-19 in Adults and Children: An International Multicenter Study. medRxiv 2020. [PMID: 32511546 DOI: 10.1101/2020.05.13.20100198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Evaluate the prevalence and characteristics of olfactory or gustatory dysfunction in COVID-19 patients Study Design: Multicenter Case Series Setting: 5 tertiary care hospitals (3 in China, 1 in France, 1 in Germany) Subjects and Methods: 394 PCR confirmed COVID-19 positive patients were screened, and those with olfactory or gustatory dysfunction were included. Data including demographics, COVID-19 severity, patient outcome, and the incidence and degree of olfactory and/or gustatory dysfunction were collected and analyzed. The Questionnaire of Olfactory Disorders (QOD) and Visual Analogue Scale (VAS) were used to quantify olfactory and gustatory dysfunction respectively. All subjects at one hospital (Shanghai) without subjective olfactory complaints underwent objective testing. RESULTS Of 394 screened subjects, 161 (41%) reported olfactory and/or gustatory dysfunction and were included. Incidence of olfactory and/or gustatory disorders in Chinese (n=239), German (n=39) and French (n=116) cohorts were 32%, 69%, and 49% 138 respectively. The median age of included subjects was 39 years old, 92/161 (57%) were male, and 10/161 (6%) were children. Of included subjects, 10% had only olfactory or gustatory symptoms, and 19% had olfactory and/or gustatory complaints prior to any other COVID-19 symptom. Of subjects with objective olfactory testing, 10/90 demonstrated abnormal chemosensory function despite reporting normal subjective olfaction. 43% (44/102) of subjects with follow-up showed symptomatic improvement in olfaction or gustation. CONCLUSIONS Olfactory and/or gustatory disorders may represent early or isolated symptoms of SARS-CoV-2 infection. They may serve as a useful additional screening criterion, particularly for the identification of patients in the early stages of infection.
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Gossrau G, Baum D, Koch T, Sabatowski R, Hummel T, Haehner A. Exposure to Odors Increases Pain Threshold in Chronic Low Back Pain Patients. Pain Medicine 2020; 21:2546-2551. [DOI: 10.1093/pm/pnaa072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Abstract
Objectives
Structured exposure to odors is an acknowledged therapy in patients with smell loss but has also been shown to be effective in depression. The latter might rely on connections between olfactory and emotional structures, suggesting possible effects of a similar approach in pain patients. Based on neuroanatomy, there are several interfaces between the “pain matrix” and olfactory system, such as the limbic system, hypothalamus, and mediodorsal thalamus. We aimed to investigate whether structured exposure to odors may impact perceived pain in patients with chronic low back pain.
Design
Randomized controlled parallel-group design. Subjects were tested on two occasions, at baseline and after four weeks.
Setting
Ambulatory.
Subjects
Forty-two patients with chronic low back pain
Methods
For all patients, olfactory function (using the “Sniffin’Sticks” test kit), detection, and pain thresholds for cutaneous electrical stimuli (applied to the forearm) were tested at baseline and after four weeks. Twenty-eight patients exposed themselves to four odors (rose, vanilla, chocolate, peach) every two hours over a period of four weeks (training group). Control patients (N = 14) underwent no such “olfactory training” (nontraining group).
Results
Pain thresholds were significantly increased in patients who performed olfactory training compared with patients who did not train with odors. Detection thresholds and olfactory function remained unchanged.
Conclusions
The present results indicate that regular exposure to odors increases pain thresholds in patients with chronic back pain and could be useful for general pain control in these patients. Furthermore, olfactory training in chronic pain patients might help to reduce chronification of pain by desensitization.
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Affiliation(s)
| | - Daniel Baum
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Thea Koch
- Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine Carl Gustav Carus, University Hospital, TU Dresden, Dresden, Germany
| | - Rainer Sabatowski
- University Pain Center, TU Dresden, Dresden, Germany
- Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine Carl Gustav Carus, University Hospital, TU Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Antje Haehner
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Tremblay C, Emrich R, Cavazzana A, Klingelhoefer L, Brandt MD, Hummel T, Haehner A, Frasnelli J. Specific intranasal and central trigeminal electrophysiological responses in Parkinson's disease. J Neurol 2019; 266:2942-2951. [PMID: 31451911 DOI: 10.1007/s00415-019-09517-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 08/13/2019] [Accepted: 08/16/2019] [Indexed: 01/20/2023]
Abstract
Olfactory dysfunction is a frequent early non-motor symptom of Parkinson's disease (PD). There is evidence that with regard to trigeminal perception, PD-related olfactory dysfunction is different from other olfactory disorders. More specifically, trigeminal sensitivity, when measured behaviorally, was unimpaired in PD patients as opposed to patients with non-Parkinsonian olfactory dysfunction (NPOD). We sought to investigate the trigeminal pathway by measuring electrophysiological recordings from the nasal epithelium and EEG-derived event-related potentials in response to a specific trigeminal stimulus in 21 PD patients and compare them to 23 patients with NPOD and 25 controls (C). The peripheral trigeminal response, as measured by the negative-mucosa potential, showed no difference between patients with PD and controls whereas PD patients showed faster responses than patients with NPOD, the latter having shown slower and larger responses than controls (18 PD, 14 NPOD, 20 C). The central trigeminal response, as measured by event-related potentials, revealed larger early component response in PD patients compared to patients with NPOD (15 PD, 21 NPOD, 23 C). As expected, psychophysical olfactory testing showed impaired olfactory function in both groups of patients as opposed to controls. Discriminant analysis revealed a model that could predict group membership for 80% of participants based on the negative-mucosa potential latency, olfactory threshold and discrimination tests. These results provide novel insights into the pattern of trigeminal activation in PD which will help to differentiate PD-related olfactory loss from NPOD, a crucial step towards establishing early screening batteries for PD including smell tests.
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Affiliation(s)
- Cécilia Tremblay
- Research Chair in Chemosensory Neuroanatomy, Department of Anatomy, Université du Québec à Trois-Rivières (UQTR), Trois-Rivières, QC, Canada.
| | - Rosa Emrich
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Dresden, Germany
| | - Annachiara Cavazzana
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Dresden, Germany
| | | | - Moritz D Brandt
- Department of Neurology, TU Dresden, Dresden, Germany.,German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Dresden, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Dresden, Germany
| | - Johannes Frasnelli
- Research Chair in Chemosensory Neuroanatomy, Department of Anatomy, Université du Québec à Trois-Rivières (UQTR), Trois-Rivières, QC, Canada.,Research Center of the Sacré-Cœur Hospital, Montréal, QC, Canada
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Haehner A, Masala C, Walter S, Reichmann H, Hummel T. Incidence of Parkinson’s disease in a large patient cohort with idiopathic smell and taste loss. J Neurol 2018; 266:339-345. [DOI: 10.1007/s00415-018-9135-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 10/27/2022]
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Hummel T, Stupka G, Haehner A, Poletti S. Olfactory training changes electrophysiological responses at the level of the olfactory epithelium. Rhinology 2018; 56:330-335. [DOI: 10.4193/rhin17.163] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Haehner A, Hummel T, Heinritz W, Krueger S, Meinhardt M, Whitcroft KL, Sabatowski R, Gossrau G. Mutation in Nav
1.7 causes high olfactory sensitivity. Eur J Pain 2018; 22:1767-1773. [DOI: 10.1002/ejp.1272] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2018] [Indexed: 12/11/2022]
Affiliation(s)
- A. Haehner
- Smell & Taste Clinic; Department of Otorhinolaryngology; TU Dresden; Germany
| | - T. Hummel
- Smell & Taste Clinic; Department of Otorhinolaryngology; TU Dresden; Germany
| | - W. Heinritz
- ÜBAG for Human Genetics Oberelbe/Spree; Cottbus/Dresden Germany
| | - S. Krueger
- ÜBAG for Human Genetics Oberelbe/Spree; Cottbus/Dresden Germany
| | | | - K. L. Whitcroft
- Smell & Taste Clinic; Department of Otorhinolaryngology; TU Dresden; Germany
- UCL Ear Institute; University College London; UK
- Centre for the Study of the Senses; School of Advanced Study; London UK
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