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Alfaro R, Nicanor-Carreón JG, Doty T, Lugar H, Hershey T, Pepino MY. Enhancement of taste by retronasal odors in patients with Wolfram syndrome and decreased olfactory function. Chem Senses 2023; 48:bjad004. [PMID: 36798000 PMCID: PMC9992935 DOI: 10.1093/chemse/bjad004] [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: 07/15/2022] [Indexed: 02/18/2023] Open
Abstract
Wolfram syndrome is a rare disease characterized by diabetes, neurodegeneration, loss of vision, and audition. We recently found, in a young sample of participants (mean age 15 years), that Wolfram syndrome was associated with impairment in smell identification with normal smell sensitivity and whole-mouth taste function. However, these senses were assessed separately, and it is unknown whether smell-taste interactions are altered in Wolfram syndrome, which was the focus of this study. Participants with Wolfram syndrome (n = 36; 18.2 ± 6.8 years) and sex-age-equivalent healthy controls (n = 34) were assessed with a battery of sensory tests. Using sip-and-spit methods, participants tasted solutions containing gustatory and olfactory stimuli (sucrose with strawberry extract, citric acid with lemon extract, sodium chloride in vegetable broth, and coffee) with and without nose clips, and rated perceived taste and retronasal smell intensities using the generalized Labeled Magnitude Scale. Participants also completed n-butanol detection thresholds and the University of Pennsylvania Smell Identification Test (UPSIT). Retronasal smell increased taste intensity of sucrose, sodium chloride, and coffee solutions similarly in both groups (P values <0.03). Compared with the control group, participants in the Wolfram group had lower UPSIT scores and reduced smell sensitivity, retronasal intensity, and saltiness (P values <0.03), but rated other taste intensities similarly when wearing the nose clip. Despite impairments in orthonasal smell identification, odor-induced taste enhancement was preserved in participants with Wolfram syndrome who still had some peripheral olfactory function. This finding suggests that odor-induced taste enhancement may be preserved in the presence of reduced olfactory intensity.
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Affiliation(s)
- Raul Alfaro
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Jessica G Nicanor-Carreón
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Tasha Doty
- Department of Psychiatry, School of Medicine, Washington University, St. Louis, MO, United States
| | - Heather Lugar
- Department of Psychiatry, School of Medicine, Washington University, St. Louis, MO, United States
| | - Tamara Hershey
- Department of Psychiatry, School of Medicine, Washington University, St. Louis, MO, United States
- Department of Radiology, School of Medicine, Washington University, St. Louis, MO, United States
| | - Marta Yanina Pepino
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Department of Biomedical and Translational Sciences, Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, United States
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Liu DT, Prem B, Besser G, Renner B, Mueller CA. Olfactory-related Quality of Life Adjustments in Smell Loss during the Coronavirus-19 Pandemic. Am J Rhinol Allergy 2021; 36:253-260. [PMID: 34704454 DOI: 10.1177/19458924211053118] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 01/08/2023]
Abstract
BACKGROUND Previous studies provided the first evidence that the importance of olfaction decreases with the duration of olfactory dysfunction (OD). OBJECTIVE To evaluate differences in olfactory-related quality of life (QoL) between patients with new-onset and persistent smell loss (>4 weeks) during the coronavirus-19 (COVID-19) pandemic and patients with persistent postinfectious OD (PIOD) that were recruited before the pandemic. METHODS This was a retrospective study that included 149 patients with self-reported OD. The olfactory-related QoL was measured using the questionnaire of OD (QOD). The QOD measures the degree to which patients (i) adjust and cope with smell loss (QOD-positive statement [QOD-PS]), (ii) suffer from distorted odor perceptions (QOD-parosmia [QOD-PAR]), and (iii) suffer from smell loss in general (QOD-negative statement [QOD-NS]). Self-perceived chemosensory function, demographics, olfactory function, and duration of smell loss were evaluated. Analyses of variance were used to depict differences in QoL-outcomes between different OD groups. RESULTS All patients included during the COVID-19 pandemic reported an extensive loss of chemosensory functions of smell, taste, and flavor perception. Psychophysical retronasal screening testing showed olfactory impairments in more than half of these patients. One-way analysis of variance and posthoc tests revealed that the QOD-NS was significantly higher in the new-onset OD group than the PIOD group. At the same time, the QOD-PS score was significantly higher in the PIOD and the persistent COVID-19 OD group than in the new-onset OD group. CONCLUSION We showed that patients with persistent OD experienced better olfactory-related adjustment and lower QoL-impairment scores than those with recent-onset smell loss, suggesting that the olfactory-related QoL might change as a function of time after symptom onset.
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Affiliation(s)
- David T Liu
- 27271Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Bernhard Prem
- 27271Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Gerold Besser
- 27271Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Bertold Renner
- 9171Institute of Experimentals and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,9169Institute of Clinical Pharmacology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian A Mueller
- 27271Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
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Pellegrino R, Hörberg T, Olofsson J, Luckett CR. Duality of Smell: Route-Dependent Effects on Olfactory Perception and Language. Chem Senses 2021; 46:6278057. [PMID: 34007980 DOI: 10.1093/chemse/bjab025] [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] [Indexed: 11/13/2022] Open
Abstract
Olfactory research in humans has largely focused on odors perceived via sniffing, orthonasal olfaction, whereas odors perceived from the mouth, retronasal olfaction, are less well understood. Prior work on retronasally presented odors involves animal models and focus mainly on odor sensitivity, but little is known about retronasal olfactory perception and cognition in humans. In this study, we compared orthonasal and retronasal odor presentation routes to investigate differences in odor descriptions and evaluations. Thirty-six individuals participated in a within-subjects study using twelve odors (varying in pleasantness and edibility) in perceptual and semantic tasks. Orthonasal presentation was associated with a better ability to identify odors, and with more concrete (and source-based) language. Exploratory analyses revealed that whereas orthonasal odors were described with words that had visual associations, retronasal odors were described with words that had interoceptive associations. Interestingly, these route-dependent differences in descriptor usage were not explained by differences in sensitivity and intensity, suggesting instead a cognitive and linguistic processing difference between odors presented orthonasally and retronasally. Our results indicate that olfaction is, in fact, a dual sense, in which the routes change the perception of an odor.
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Affiliation(s)
- Robert Pellegrino
- Department of Food Science, University of Tennessee, 2510 River Drive, Knoxville, Tennessee, USA
| | - Thomas Hörberg
- Gösta Ekman Laboratory, Department of Psychology Stockholm University, Frescati hagväg 9, Stockholm, Sweden.,Department of Linguistics, Stockholm University, Universitetsvägen 10C, 114 18 Stockholm, Sweden
| | - Jonas Olofsson
- Gösta Ekman Laboratory, Department of Psychology Stockholm University, Frescati hagväg 9, Stockholm, Sweden
| | - Curtis R Luckett
- Department of Food Science, University of Tennessee, 2510 River Drive, Knoxville, Tennessee, USA
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Oleszkiewicz A, Park D, Resler K, Draf J, Schulze A, Zang Y, Hähner A, Hummel T. Quality of Life in Patients With Olfactory Loss Is Better Predicted by Flavor Identification Than by Orthonasal Olfactory Function. Chem Senses 2020; 44:371-377. [PMID: 31046120 DOI: 10.1093/chemse/bjz027] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
To date, most studies on the relationship between chemosensory performance and quality of life have focused on orthonasal measures of olfactory function. In the current investigation, we examined the predictive value of orthonasal and flavor identification indices of olfactory function on a wide spectrum of health and sociopsychological factors, including quality of life, life satisfaction, overall health, and depressive symptoms. Participants were 178 ENT patients (Mage = 58 ± 1), representing various causes of olfactory loss: idiopathic smell loss (n = 51; Mage = 63 ± 2), sinunasal disease (n = 27; Mage = 56 ± 3), head trauma (n = 33; Mage = 51 ± 2), and infections of the upper respiratory tract (n = 67; Mage = 59 ± 2). They completed self-report questionnaires and underwent olfactory testing using Sniffin' Sticks (orthonasal olfactory testing) and "Taste Powder" (intraorally applied flavors for retronasal olfactory testing, additionally inducing taste sensation). Data were analyzed with hierarchical regression models wherein the first step included subjects' sex, age, and orthonasal olfaction score. In the second step, we included the "Taste Powder" score. Tested models revealed that the first step was not significantly predicting variables of interest; however, there was an improvement of the model's predictive value when the "Taste Powder" score was added. Results of this study suggest that flavor identification significantly improves predictions of health and sociopsychological functioning of ENT patients with various etiologies.
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Affiliation(s)
- Anna Oleszkiewicz
- Smell and Taste Centre, Technische Universitat Dresden, Dresden, Germany.,Institute of Psychology, University of Wroclaw, Wrocław, Poland
| | - Dahae Park
- Smell and Taste Centre, Technische Universitat Dresden, Dresden, Germany
| | - Katarzyna Resler
- Department and Clinic of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wrocław, Poland
| | - Julia Draf
- Smell and Taste Centre, Technische Universitat Dresden, Dresden, Germany
| | - Anja Schulze
- Smell and Taste Centre, Technische Universitat Dresden, Dresden, Germany
| | - Yunpeng Zang
- Smell and Taste Centre, Technische Universitat Dresden, Dresden, Germany
| | - Antje Hähner
- Smell and Taste Centre, Technische Universitat Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell and Taste Centre, Technische Universitat Dresden, Dresden, Germany
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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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Blankenship ML, Grigorova M, Katz DB, Maier JX. Retronasal Odor Perception Requires Taste Cortex, but Orthonasal Does Not. Curr Biol 2018; 29:62-69.e3. [PMID: 30581018 DOI: 10.1016/j.cub.2018.11.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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: 09/25/2018] [Revised: 10/31/2018] [Accepted: 11/02/2018] [Indexed: 12/16/2022]
Abstract
Smells can arise from a source external to the body and stimulate the olfactory epithelium upon inhalation through the nares (orthonasal olfaction). Alternatively, smells may arise from inside the mouth during consumption, stimulating the epithelium upon exhalation (retronasal olfaction). Both ortho- and retronasal olfaction produce highly salient percepts, but the two percepts have very different behavioral implications. Here, we use optogenetic manipulation in the context of a flavor preference learning paradigm to investigate differences in the neural circuits that process information in these two submodalities of olfaction. Our findings support a view in which retronasal, but not orthonasal, odors share processing circuitry commonly associated with taste. First, our behavioral results reveal that retronasal odors induce rapid preference learning and have a potentiating effect on orthonasal preference learning. Second, we demonstrate that inactivation of the insular gustatory cortex selectively impairs expression of retronasal preferences. Thus, orally sourced (retronasal) olfactory input is processed by a brain region responsible for taste processing, whereas externally sourced (orthonasal) olfactory input is not.
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Affiliation(s)
| | - Maria Grigorova
- Department of Psychology, Brandeis University, Waltham, MA, USA
| | - Donald B Katz
- Program in Neuroscience, Brandeis University, Waltham, MA, USA; Department of Psychology, Brandeis University, Waltham, MA, USA; Volen National Center for Complex Systems, Brandeis University, Waltham, MA, USA.
| | - Joost X Maier
- Department of Neurobiology & Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Ganjaei KG, Soler ZM, Storck KA, Rowan NR, Othieno FA, Schlosser RJ. Variability in Retronasal Odor Identification Among Patients With Chronic Rhinosinusitis. Am J Rhinol Allergy 2018; 32:424-431. [PMID: 30103620 DOI: 10.1177/1945892418793540] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 12/12/2022]
Abstract
Background Retronasal olfaction is important in flavor detection and enjoyment. The ability to identify specific individual retronasal odors may play a role in quality of life for patients with chronic rhinosinusitis (CRS). Objective To identify patterns and improve understanding of retronasal identification of individual odors in CRS patients. Methods Patients diagnosed with CRS underwent retronasal and orthonasal (Sniffin' Sticks) olfactory testing and taste testing (taste strips). Retronasal identification was tested with presentation of flavored powders on the posterior tongue. Retronasal identification for individual odors was compared with results of orthonasal and taste testing. Results Seventy participants were evaluated. Retronasal identification correlated with orthonasal identification and discrimination for most individual odors. Among all patients, cinnamon and apple were identified better retronasally and banana better orthonasally ( P < .05). Anosmics identified retronasal orange, cinnamon, mushroom, coffee, smoked ham, peach, ginger, grape, and cheese more than would be expected by chance for a forced-choice paradigm with 3 distractor items ( P < .05), and this was independent of objective taste function for most odors. Conclusion Retronasal and orthonasal identification of most odors correlate in CRS patients; however, patients with anosmia can still identify certain retronasal odors more often than expected. These odors do not appear to stimulate gustatory pathways and may involve trigeminal stimulation. Understanding preserved retronasal neural stimuli may allow providers to improve eating-related quality of life in these patients.
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Affiliation(s)
- Kimia G Ganjaei
- 1 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.,2 Rutgers-Robert Wood Johnson Medical School, Piscataway, New Jersey
| | - Zachary M Soler
- 1 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Kristina A Storck
- 1 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Nicholas R Rowan
- 1 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Florence A Othieno
- 1 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Rodney J Schlosser
- 1 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.,3 Department of Surgery, Ralph H. Johnson VA Medical Center, Charleston, South Carolina
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