Odor Identification Across Time in Mutation Carriers and Non-Carriers in Autosomal-Dominant Alzheimer's Disease

BACKGROUND

Impaired odor identification is a characteristic of sporadic Alzheimer'sdisease(AD), but its presence in autosomal-dominantAD (adAD) remains uncertain.

OBJECTIVE

To investigate odor identification ability in mutation carriers (MC) and non-carriers (NC) of adAD in relation to years to estimated clinical onset clinical onset (YECO) of disease.

METHODS

Participants from six families with autosomal-dominant mutations (APP Swedish, APP Arctic, and PSEN1 mutations) included 20 MC and 20 NC. The groups were comparable in age, gender, education, number of APOE ɛ4 alleles, and YECO, but differed in global cognition (Mini-Mental State Examination). The MC group included individuals in asymptomatic, symptomatic cognitively unimpaired, mild cognitive impairment, and dementia stages of disease, spanning approximately 40 years of the AD continuum. All NC were asymptomatic. Olfactory function was assessed by means of free and cued identification of common odors summarized as total identification.

RESULTS

MC performed poorer than NC in free and total identification. Four MC and none of the NC were anosmic. Olfactory functions in MC and NC were significantly and inversely related to time course (YECO) for both free and total identification. The decline in free identification began approximately 10 years prior to the estimated clinical onset of AD in MC. Odor identification proficiency was associated with episodic memory and executive function in MC and NC.

CONCLUSIONS

Impaired odor identification is present well before the clinical diagnosis of AD in MC and is associated with disease progression. Odor identification ability may be a useful early biomarker for adAD.

Factors influencing olfactory function in an adult general population sample: the CHRIS study

The sense of smell allows for the assessment of the chemical composition of volatiles in our environment. Different factors are associated with reduced olfactory function, including age, sex, as well as health and lifestyle conditions. However, most studies that aimed at identifying the variables that drive olfactory function in the population suffered from methodological weaknesses in study designs and participant selection, such as the inclusion of convenience sample or only of certain age groups, or recruitment biases. We aimed to overcome these issues by investigating the Cooperative Health Research in South Tyrol (CHRIS) cohort, a population-based cohort, by using a validated odor identification test. Specifically, we hypothesized that a series of medical, demographic and lifestyle variables is associated with odor identification abilities. In addition, our goal was to provide clinicians and researchers with normative values for the Sniffin' Sticks identification set, after exclusion of individuals with impaired nasal patency. We included 6,944 participants without acute nasal obstruction and assessed several biological, social, and medical parameters. A basic model determined that age, sex, years of education, and smoking status together explained roughly 13% of the total variance in the data. We further observed that variables related to medical (positive screening for cognitive impairment and for Parkinson's disease, history of skull fracture, stage 2 hypertension) and lifestyle (alcohol abstinence) conditions had a negative effect on odor identification scores. Finally, we provide clinicians with normative values for both versions of the Sniffin' Sticks odor identification test, i.e. with 16 items and with 12 items.

"Mmm, Smells like Coffee!": How a Brief Odor Identification Test Could Help to Identify People with Mild Cognitive Impairment and Dementia

(1) Background: Dementia and mild cognitive impairment (MCI) are still underdiagnosed in the general population. Impaired odor identification has been identified as an early marker of MCI and dementia. We aimed to compare the additional diagnostic value of two odor identification tests to a cognitive screening test in detecting MCI or dementia. (2) Methods: The Sniffin' Sticks odor identification test (SS-OIT), a brief odor identification test (B-OIT) requiring the identification of coffee scent, and the Mini-Mental State Exam (MMSE) were administered to a consecutive series of 174 patients (93 with dementia, 42 with mild cognitive impairment, and 39 without cognitive impairment) referred for neuropsychological testing. (3) Results: Both participants with dementia and with MCI exhibited impairments in odor identification. The SS-OIT and the B-OIT were substantially correlated. Complementing MMSE scores with the SS-OIT or the B-OIT similarly improved the diagnostic accuracy of individuals with dementia and MCI. (4) Conclusions: People with suspected dementia or MCI may already benefit from brief odor identification tests. Although these tests require little additional time, they can notably increase sensitivity for dementia or MCI.

Odor Perception and Descriptions of Rose-Scented Geranium Pelargonium graveolens 'Dr. Westerlund'-Sensory and Chemical Analyses

A recent study found that the natural scent from the rose-scented geranium Pelargonium graveolens 'Dr. Westerlund' had positive effects on stress reduction. Essential oils from many pelargonium species are known to have phytochemical properties and pharmacological activities. No study has, so far, explored and identified the chemical compounds and the sensory perception of these compounds in 'Dr. Westerlund' plants. Such knowledge would be an important contribution to an increased understanding of the effects of plants' chemical odor properties on human well-being, and link this to the expressed perceived scents. This study aimed to identify the sensory profile and suggest responsible chemical compounds of Pelargonium graveolens 'Dr. Westerlund'. The sensory and chemical analysis results revealed sensory profiles of Pelargonium graveolens 'Dr. Westerlund's and provided suggestions for the chemical compounds attributed to the sensory profiles. Further studies are recommended to investigate the correlation between volatile compounds and possible stress reduction in humans.

Assessing how Age, Sex, Race, and Education Affect the Relationships Between Cognitive Domains and Odor Identification

BACKGROUND

The associations between cognitive domains and odor identification are well established, but how sociodemographic variables affect these relationships is less clear.

PURPOSE

Using the survey-adapted Montreal Cognitive Assessment instrument (MoCA-SA), we assess how age, sex, race, and education shape these relationships.

METHODS

We first used cluster analysis and multidimensional scaling to empirically derive distinct cognitive domains from the MoCA-SA as it is unclear whether the MoCA-SA can be disaggregated into cognitive domains. We then used ordinal logistic regression to test whether these empirically derived cognitive domains were associated with odor identification and how sociodemographic variables modified these relationships.

STUDY POPULATION

Nationally representative sample of community-dwelling US older adults.

RESULTS

We identified 5 out of the 6 theoretical cognitive domains, with the language domain unable to be identified. Odor identification was associated with episodic memory, visuospatial ability, and executive function. Stratified analyses by sociodemographic variables reveal that the associations between some of the cognitive domains and odor identification varied by age, sex, or race, but not by education.

CONCLUSIONS

These results suggest that (1) the MoCA-SA can be used to identify cognitive domains in survey research and (2) the performance of smell tests as a screener for cognitive decline may potentially be weaker in certain subpopulations.

Association Between Olfactory Dysfunction and Cognitive Impairment in Dementia-Free Older Adults: A Prospective Cohort Study in Taiwan

BACKGROUND

Previous studies assessing olfactory function and cognition have mostly been cross-sectional, and few have investigated the Asian geriatric population.

OBJECTIVE

To examine the relationships of olfaction with global or domain-specific cognitive function in Taiwanese community-dwelling older adults.

METHODS

This cohort study (2015-2019) is part of the Taiwan Initiative for Geriatric Epidemiological Research. The Taiwanese version of the Montreal Cognitive Assessment (MoCA-T) and a battery of neuropsychological tests were assessed at baseline and at a two-year follow-up. The cross-culture modified Sniffin' Sticks Identification Test (SSIT) was utilized to measure olfactory function. Generalized linear mixed models were used to examine the association of olfaction with cognitive performance over two years.

RESULTS

Data were collected from 376 participants (55.1% women), with a mean age of 75.6 years. A one-point decrease in the SSIT score (worsening of olfaction) was associated with worse global cognition (MoCA-T: βˆ= -0.13), memory (βˆ= -0.08 to -0.06), and verbal fluency (βˆ= -0.07). Compared with an SSIT score ≥ 11 (normosmia), an SSIT score < 8 (anosmia) was associated with worse global cognition (MoCA-T: βˆ= -0.99), memory (βˆ= -0.48 to -0.42), executive function (Trail Making Test A: βˆ= -0.36), attention (digit span backward: βˆ= -0.34), and verbal fluency (βˆ= -0.45). After stratified analyses, the associations remained in older adults ≥ 75 years, males, and non-carriers of apolipoprotein E ɛ4 in terms of global cognition, memory, and verbal fluency.

CONCLUSIONS

Odor identification deficits were associated with poor global or domain-specific cognitive function in a four-year cohort of community-dwelling older adults. Cognitive assessments should be conducted in dementia-free elderly individuals with impaired odor identification.

A mobile APP-based, customizable automated device for self-administered olfactory testing and an implementation of smell identification test

Olfactory tests are used for the evaluation of ability to detect and identify common odors in humans psychophysically. Olfactory tests are currently administered by professionals with a set of given odorants. Manual administration of such tests can be labor and cost intensive and data collected as such are confounded with experimental variables, which adds personnel costs and introduces potential errors and data variability. For large-scale and longitudinal studies, manually recorded data must be collected and compiled from multiple sites. It is difficult to standardize the way data are collected and recorded. There is a need for a computerized smell test system for psychophysical and clinical applications. A mobile digital olfactory testing system (DOTS) was developed, consisting of an odor delivery system (DOTS-ODD) and a mobile application program (DOTS-APP) connected wirelessly. The University of Pennsylvania Smell Identification Test was implemented in DOTS and compared to its commercial product on a cohort of 80 normosmic subjects and a clinical cohort of 12 Parkinson's disease patients. A test-retest was conducted on 29 subjects of the normal cohort. The smell identification scores obtained from the DOTS and standard UPSIT commercial test are highly correlated (r = 0.714, P < 0.001), and test-retest reliability coefficient was 0.807 (r = 0.807, P < 0.001). The DOTS is customizable and mobile compatible, which allows for the implementation of standardized olfactory tests and the customization of investigators' experimental paradigms. The DOTS-APP on mobile devices offers capabilities for a broad range of on-site, online, or remote clinical and scientific chemosensory applications.

Comparative Analysis of Acanthopanacis Cortex and Periplocae Cortex Using an Electronic Nose and Gas Chromatography-Mass Spectrometry Coupled with Multivariate Statistical Analysis

Chinese Herbal Medicines (CHMs) can be identified by experts according to their odors. However, the identification of these medicines is subjective and requires long-term experience. The samples of Acanthopanacis Cortex and Periplocae Cortex used were dried cortexes, which are often confused in the market due to their similar appearance, but their chemical composition and odor are different. The clinical use of the two herbs is different, but the phenomenon of being confused with each other often occurs. Therefore, we used an electronic nose (E-nose) to explore the differences in odor information between the two species for fast and robust discrimination, in order to provide a scientific basis for avoiding confusion and misuse in the process of production, circulation and clinical use. In this study, the odor and volatile components of these two medicinal materials were detected by the E-nose and by gas chromatography-mass spectrometry (GC-MS), respectively. An E-nose combined with pattern analysis methods such as principal component analysis (PCA) and partial least squares (PLS) was used to discriminate the cortex samples. The E-nose was used to determine the odors of the samples and enable rapid differentiation of Acanthopanacis Cortex and Periplocae Cortex. GC-MS was utilized to reveal the differences between the volatile constituents of Acanthopanacis Cortex and Periplocae Cortex. In all, 82 components including 9 co-contained components were extracted by chromatographic peak integration and matching, and 24 constituents could be used as chemical markers to distinguish these two species. The E-nose detection technology is able to discriminate between Acanthopanacis Cortex and Periplocae Cortex, with GC-MS providing support to determine the material basis of the E-nose sensors' response. The proposed method is rapid, simple, eco-friendly and can successfully differentiate these two medicinal materials by their odors. It can be applied to quality control links such as online detection, and also provide reference for the establishment of other rapid detection methods. The further development and utilization of this technology is conducive to the further supervision of the quality of CHMs and the healthy development of the industry.

Rapid olfactory decline during aging predicts dementia and GMV loss in AD brain regions

INTRODUCTION

Longitudinal multivariable analyses are needed to determine if the rate of olfactory decline during normal cognition predicts subsequent Alzheimer's disease (AD) diagnoses and brain dysmorphology.

METHODS

Older adults (n = 515) were assessed annually for odor identification, cognitive function and dementia clinical diagnosis (max follow-up 18 years). Regional gray matter volumes (GMV) were quantified (3T MRI) in a cross-sectional subsample (n = 121). Regression models were adjusted for APOE-ε4 genotype, dementia risk factors and demographics.

RESULTS

Faster olfactory decline during periods of normal cognition predicted higher incidence of subsequent MCI or dementia (OR 1.89, 95% CI: 1.26, 2.90, p < 0.01; comparable to carrying an APOE-ε4 allele) and smaller GMV in AD and olfactory regions (β = -0.11, 95% CI -0.21, -0.00).

DISCUSSION

Rapid olfactory decline during normal cognition, using repeated olfactory measurement, predicted subsequent cognitive impairment, dementia, and smaller GMVs, highlighting its potential as a simple biomarker for early AD detection.

HIGHLIGHTS

Rate of olfactory decline was calculated from olfactory testing over ≥3 time points. Rapid olfactory decline predicted impaired cognition and higher risk of dementia. Neurodegeneration on 3T magnetic resonance imaging was identical in those with olfactory decline and Alzheimer's disease.

Olfaction in pregnancy: systematic review and meta-analysis

Little attention has been paid to olfactory changes during pregnancy with contemporary studies limited in number and sample size. We examined whether pregnancy is associated with differences in olfactory performance and if there were any specific gestational ages at which these differences occur through a comprehensive systematic review and meta-analysis of the current literature. An initial electronic database search identified 234 citations, which were screened at the abstract level. Twenty-three citations were germane for full-text review, and 13 met criteria for inclusion. Our review assessed 5 olfactory measures of interest: odor identification (n = 11 articles), threshold (n = 8), discrimination (n = 5), hedonics (n = 6), and intensity (n = 5). Nine of these 13 studies contained sufficient data for meta-analysis, and these studies included a total of 523 pregnant women and 365 non-pregnant controls. Despite previous subjective and objective reports of odor intolerances and odor hypersensitivity, we did not find any significant differences between pregnant and non-pregnant women in odor discrimination, thresholds, or hedonics. However, meta-analysis of 506 cases and 333 controls showed worse odor identification in pregnant women compared to controls in a random-effects model. Thus, we demonstrate worse performance at odor identification during pregnancy. In this review, we discuss the current evidence (and lack thereof) regarding olfaction in pregnancy as well as highlight current knowledge gaps in this field.

Interactive Effects of Agitation and Cognitive Impairment on Odor Identification in Patients With Late-Life Depression

BACKGROUND

Late-life depression (LLD) is a risk factor for cognitive decline in older adults, and odor identification (OI) deficits are an early indicator of cognitive decline with LLD. However, neuropsychiatric symptoms (NPSs) are common in LLD and are associated with OI deficits. In subjects with LLD, when OI deficits forecast cognitive decline, whether and how NPS affects the relationship between OI and cognition still must be further explored.

OBJECTIVE

To comprehensively explore the potential effects of various NPSs on the relationship between OI and cognition in participants with LLD.

METHODS

There were 167 patients with LLD and 105 normal elderly (NE) participants. The odor identification test (Sniffin' Sticks), cognitive function assessments (global cognition, memory, executive function, attention, language, visual space), and an NPS assessment (the neuropsychiatric inventory questionnaire) were performed on the subjects. In patients with LLD, the relationship among OI, cognition and NPSs was examined using correlation analysis and moderation analysis.

RESULTS

In patients with LLD, OI was positively correlated with cognition (global cognition, memory, executive function, attention, language) and negatively associated with NPSs (agitation and aberrant motor behavior). In NE group, OI was correlated with executive function. Moderation analysis showed that there was an interactive effect of agitation and cognitive impairment (language deficit or attention deficit) on OI in patients with LLD.

CONCLUSION

The coexistence of agitation and language or attention deficit was associated with worse OI in subjects with LLD. Agitation should be considered since OI predicts cognitive decline in patients with LLD.

Structural and Functional Abnormalities of Olfactory-Related Regions in Subjective Cognitive Decline, Mild Cognitive Impairment, and Alzheimer's Disease

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.

Olfactory Measures as Predictors of Conversion to Mild Cognitive Impairment and Alzheimer's Disease

BACKGROUND

Early biomarkers of prodromal Alzheimer's disease (AD) are critical both to initiate interventions and to choose participants for clinical trials. Odor threshold, odor identification and odor familiarity are impaired in AD.

METHODS

We investigated the relative abilities of standard screening (MMSE) and olfactory measures to predict transitions from cognitively normal (CN) to mild cognitive impairment (MCI), from CN to AD, and MCI to AD. The archival sample of 497, from the UCSD ADRC, included participants who were CN, MCI, AD and converters to MCI or AD. Apoe ε4 status, a genetic risk factor, was available for 256 participants, 132 were ε4 carriers. A receiver operating characteristic curve (ROC) curve plots the trade-off between sensitivity and specificity. Area under the ROC curve (AUC) was used to determine diagnostic accuracy.

RESULTS

Different measures were better predictors at specific stages of disease risk; e.g., odor familiarity, odor identification and the combination showed higher predictive value for converting from MCI to AD in ε4 carriers than the MMSE. Combining odor familiarity and odor identification produced an AUC of 1.0 in ε4 carriers, MMSE alone was 0.58.

CONCLUSIONS

Olfactory biomarkers show real promise as non-invasive indicators of prodromal AD. The results support the value of combining olfactory measures in assessment of risk for conversion to MCI and to AD.

Odor Identification and Regional Gray Matter Atrophy in Patients with Alzheimer's Disease, Parkinson's Disease, and the Healthy Elderly: A Cross-Sectional Structural MRI Study

Multiple associations between impaired olfactory performance and regional cortical and deep gray matter atrophy have been reported in separate studies of patients with Alzheimer’s disease (AD), Parkinson’s disease (PD), and of the healthy elderly. We aimed to evaluate such possible associations among these populations in a unified manner. Twenty AD, twenty PD patients’ and twenty healthy age- and sex-matched controls’ odor identification performance was assessed with the Lithuanian adaptation of the Sniffin’ Sticks 12 odor identification test, followed by morphometric gray matter analysis by MRI using FreeSurfer. AD patients had significantly lower cognitive performance than both PD patients and the healthy elderly, as evaluated with the Mini-Mental State Examination (MMSE). Odor identification performance was significantly worse in AD and PD patients compared with the healthy elderly; AD patients performed slightly worse than PD patients, but the difference was not statistically significant. Among patients with AD, worse odor identification performance was initially correlated with atrophy of multiple cortical and deep gray matter regions known to be involved in olfactory processing, however, only two measures—decreased thicknesses of the right medial and left lateral orbitofrontal cortices—remained significant after adjustment for possible confounders (age, MMSE score, and global cortical thickness). Among patients with PD and the healthy elderly we found no similar statistically significant correlations. Our findings support the key role of the orbitofrontal cortex in odor identification among patients with AD, and suggest that correlations between impaired odor identification performance and regional gray matter atrophy may be relatively more pronounced in AD rather than in PD.

Odor Sensitivity Versus Odor Identification in Older US Adults: Associations With Cognition, Age, Gender, and Race

The ability to identify odors predicts morbidity, mortality, and quality of life. It varies by age, gender, and race and is used in the vast majority of survey and clinical literature. However, odor identification relies heavily on cognition. Other facets of olfaction, such as odor sensitivity, have a smaller cognitive component. Whether odor sensitivity also varies by these factors has not been definitively answered. We analyzed data from the National Social Life, Health, and Aging Project, a nationally representative study of older US adults (n = 2081). Odor identification was measured using 5 validated odors presented with Sniffin' Stick pens as was odor sensitivity in a 6-dilution n-butanol constant stimuli detection test. Multivariate ordinal logistic regression modeled relationships between olfaction and age, gender, race, cognition, education, socioeconomic status, social network characteristics, and physical and mental health. Odor sensitivity was worse in older adults (P < 0.01), without gender (P = 0.56) or race (P = 0.79) differences. Odor identification was also worse in older adults, particularly men (both P ≤ 0.01), without differences by race. Decreased cognitive function was associated with worse odor identification (P ≤ 0.01) but this relationship was weaker for odor sensitivity (P = 0.02) in analyses that adjusted for other covariates. Odor sensitivity was less strongly correlated with cognitive ability than odor identification, confirming that it may be a more specific measure of peripheral olfactory processing. Investigators interested in associations between olfaction and health should consider both odor sensitivity and identification when attempting to understand underlying neurosensory mechanisms.

Odor identification impairment and cholinesterase inhibitor treatment in Alzheimer's disease

INTRODUCTION

This study evaluated acute change in odor identification following atropine nasal spray challenge, and 8-week change in odor identification ability, as a predictor of long-term improvement in patients with mild to moderate Alzheimer's disease (AD) who received open-label cholinesterase inhibitor treatment.

METHODS

In patients with clinical AD, the University of Pennsylvania Smell identification Test (UPSIT) was administered before and after an anticholinergic atropine nasal spray challenge. Patients were then treated with donepezil for 52 weeks.

RESULTS

In 21 study participants, acute atropine-induced decrease in UPSIT was not associated with change in the Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-Cog) or Selective Reminding Test (SRT). Decline in odor identification performance from baseline to week 8 was indicative of a future decline in cognitive performance over 52 weeks.

DISCUSSION

Change in odor identification with atropine challenge is not a useful predictor of treatment response to cholinesterase inhibitors. Short-term change in odor identification performance needs further investigation as a potential predictor of cognitive improvement with cholinesterase inhibitor treatment.

Improved Odor Identification Ability and Increased Regional Gray Matter Volume After Olfactory Training in Patients With Idiopathic Olfactory Loss

Idiopathic olfactory loss (IOL) is thought as an early marker for neurodegenerative disease. This study investigated the effect of olfactory training (OT) on regional gray matter volume (GMV) among patients with IOL. A total of 24 patients (mean age 64.6 years, 11 male) with IOL and 30 control participants with normal olfaction (mean age 62.6 years, 13 males) were included in the study. Voxel-based morphometry was performed to compare the GMV between patient and control groups. Only the patients received OT (averaged duration 7 months), and a longitudinal approach was used to examine the GMV change from pre- to post-OT. Moreover, the effect of OT on GMV change was explored for patients with different severity of olfactory loss (anosmia vs. hyposmia). Olfactory performance was measured alongside using the "Sniffin' Sticks." Patients had improved odor identification and larger GMV in the bilateral cerebellum, bilateral thalamus, left precentral gyrus, right gyrus rectus, and medial orbitofrontal cortex after OT. However, no correlation was found between changes of odor identification and increased regional GMV. Besides, patients with anosmia, compared with patient with hyposmia, demonstrated increased GMV in the left precuneus, left superior frontal medial cortex, and left midcingulate cortex after OT. The study showed improved odor identification ability among patients with IOL after OT, which is unlikely related to spontaneous recovery. In this specific patient group, the GMV alterations may be associated with factors not directly predicted by the currently performed measurements, but possibly higher order olfactory-related functional changes.

FPGA Implementation for Odor Identification with Depthwise Separable Convolutional Neural Network

The integrated electronic nose (e-nose) design, which integrates sensor arrays and recognition algorithms, has been widely used in different fields. However, the current integrated e-nose system usually suffers from the problem of low accuracy with simple algorithm structure and slow speed with complex algorithm structure. In this article, we propose a method for implementing a deep neural network for odor identification in a small-scale Field-Programmable Gate Array (FPGA). First, a lightweight odor identification with depthwise separable convolutional neural network (OI-DSCNN) is proposed to reduce parameters and accelerate hardware implementation performance. Next, the OI-DSCNN is implemented in a Zynq-7020 SoC chip based on the quantization method, namely, the saturation-flooring KL divergence scheme (SF-KL). The OI-DSCNN was conducted on the Chinese herbal medicine dataset, and simulation experiments and hardware implementation validate its effectiveness. These findings shed light on quick and accurate odor identification in the FPGA.

Comparative Effects of Repetitive Odor Identification and Odor Memory Tasks on Olfactory Engagement in Older Populations - A Pilot fMRI Study

OBJECTIVE

This study evaluated human Blood Oxygen Level-Dependent (BOLD) responses in primary and higher-order olfactory regions of older adults, using odor memory and odor identification tasks. The goal was to determine which olfactory and memory regions of interest are more strongly engaged in older populations comparing these two odor training tasks.

METHODS

Twelve adults 55-75 years old (75% females) without intranasal or major neurological disorders performed repetitive odor memory and identification tasks using a 3-tesla magnetic resonance scanner. Odors were presented intermittently at 10-second bursts separated by 20-second intervals of odorless air. Paired t-tests were used to compare differences in the degree of activation between odor identification and odor memory tasks within individuals. An FDR cluster-level correction of p<0.05 was used for multiplicity of tests (with a cluster-defining threshold set at p<0.01 and 10 voxels).

RESULTS

Odor identification compared to memory (ie, odor identification > odor memory) contrasts had several areas of significant activation, including many of the classical olfactory brain regions as well as the hippocampus. The opposite contrast (odor memory > odor identification) included the piriform cortex, though this was not significant. Both tasks equally activated the piriform cortex, and thus when the two tasks are compared to each other this area of activation appears to be either absent (OI > OM) or only weakly observed (OM > OI).

CONCLUSION

These findings from a predominantly African American sample suggest that odor identification tasks may be more potent than memory tasks in targeted olfactory engagement in older populations. Furthermore, repetitive odor identification significantly engaged the hippocampus - a region relevant to Alzheimer's disease - more significantly than did the odor memory task. If validated in larger studies, this result could have important implications in the design of olfactory training paradigms.

Evaluation of Olfactory Function in Children With Vernal Keratoconjunctivitis

BACKGROUND

Vernal keratoconjunctivitis (VKC) is a chronic, severe allergic disease of the conjunctiva, which mostly affects young males in early to mid-childhood. There is a high incidence of asthma, allergic rhinitis (AR) and eczema among patients with VKC. It is unknown if VKC patients have abnormal olfactory dysfunction, and if so, whether this is related to AR.

OBJECTIVE

Our aim was to evaluate olfactory function in children with VKC, with and without comorbid AR, in comparison to healthy children without VKC.

MATERIALS AND METHODS

Thirty-nine VKC patients and 32 healthy children were included in the study. After eye and ear, nose and throat (ENT) examination, acoustic rhinometry and modified Connecticut Chemosensory Clinical Research Center (CCCRC) tests were performed and the test results were compared between VKC and control groups and between VKC children with or without AR. A p value <0.05 was regarded as statistically significant.

RESULTS

The VKC group included 25 males (64.1%) with a mean age of 11.13 ± 3.22 years, while the control group included 26 males (81.3%) with a mean age of 12.50 ± 2.13 years (p > 0.05 for both age and gender). Fourteen VKC patients (35.9%) had either positive prick test or elevated serum specific IgE levels against house dust mites and pollens. Mean odor thresholds did not differ between the two groups (p = 0.084), while mean odor identification and CCCRC score were statistically significantly lower in VKC group (6.00 ± 1.02 and 6.81 ± 0.75, respectively) compared to control group (7.06 ± 0.77 and 7.5 ± 0.41, respectively) (p < 0.05, both). Thirteen VKC patients had co-associated AR (33.3%). In VKC patients with AR, mean odor threshold and identification scores were even lower (5.31 ± 0.95 and 6.23 ± 0.78, respectively) (p < 0.05, both).

CONCLUSION

Olfactory function was found to be mildly impaired in children with VKC, especially when co-associated with AR. Therefore, loss of smell should be asked as an extraocular symptom.

Impaired Odor Identification of Culturally Familiar Odorants Associated with Dementia in South Korean Older Adults

Among olfactory functions, odor identification is the most studied predictor of dementia. We aimed to verify whether patients with dementia are less aware of specific odors than cognitively normal individuals using an odor identification test, which includes odorants that are culturally familiar to South Koreans. We divided 139 older adults aged 57–79 years into the dementia and normal cognition groups. Odor identification function was assessed in all participants. We conducted hierarchical logistic regression analyses with the diagnosis of dementia as a dependent variable and three demographic characteristics, as well as 12 odor identification items, as independent variables. Impaired odor identification for herbal medicine (odds ratio (OR) = 9.420; p = 0.012) and Korean grilled meat (OR = 5.361; p = 0.019) and older age (OR = 1.176; p = 0.005) were significant predictors of dementia. Impaired odor identification of culturally familiar odorants was associated with dementia risk. This may be explained by the fact that compared with culturally non-specific universal odorants, familiar odorants are more related to episodic memory, which is impaired in the early stages of dementia. Thus, an optimal combination of odor identification items should be used for screening individuals with cognitive decline requiring further neurocognitive function tests.

The Influence of Cognitive Parameters on Olfactory Assessment in Healthy Children and Adolescents

Olfactory threshold and odor identification tests are frequently used for assessment of olfactory function in children and adolescents. Whether olfactory test results are influenced by cognitive parameters or sex in children and adolescents is largely unknown. The aim of this study was to investigate the influence of cognition, age and sex on "Sniffin' Sticks" olfactory threshold and "U-Sniff" odor identification performance in a pediatric population. A total of 200 participants between age 6 and 17 years were included. Olfactory function (olfactory threshold and odor identification) was assessed using the "Sniffin' Sticks." In addition, age appropriate cognitive testing was applied. The results of this study indicate that odor identification test performance is positively correlated with age (r = 0.31) and verbal abilities of children (r = 0.24). Olfactory threshold results are only marginally influenced by age (r = 0.18) and are not associated with cognitive test performance. Olfactory assessment using olfactory threshold and "U-Sniff" odor identification testing is suitable for children and adolescents when considering age in the interpretation of test results.

Long-Term Test-Retest Reliability of the UPSIT in Cognitively Intact Older Adults

The objective of this study was to determine the long-term test-retest reliability of the University of Pennsylvania Smell Identification Test (UPSIT), and its individual items, in cognitively intact older adults. A community sample of older adults received a neuropsychological test battery, including the 12-item, 6-trial Selective Reminding Test (SRT). The UPSIT was administered at baseline and follow-up that occurred between 1 and 4 years after baseline. UPSIT scores of participants who were cognitively intact and did not decline cognitively were examined for test-retest reliability. In 92 older adults with mean age 77.6 years followed for 2.79 (standard deviation [SD] 0.69) years, mean UPSIT score declined from 30.29 (SD 5.83) to 27.80 (SD 5.50). In linear mixed models that adjusted for time, age, sex, and education, intraclass correlation coefficients for UPSIT were 0.65, SRT delayed recall 0.59, and SRT total immediate recall 0.49. Among 4 possible response combinations, the largest proportion of participants had correct responses at both visits for 35 out of 40 items. Consistency of item responses ranged from 50% to 90% across the 2 time points. The long-term test-retest reliability of the UPSIT was moderately strong without practice effects over long periods of time in older adults. These results provide indirect support to prior findings on odor identification impairment predicting cognitive decline and dementia, and suggest potential use of olfactory testing as a biomarker in prevention and treatment trials of cognitive enhancers.

Odor identification predicts postoperative seizure control following magnetic resonance-guided laser interstitial thermal therapy

OBJECTIVE

Olfactory dysfunction has been well documented in individuals with temporal lobe epilepsy, but its use in presurgical planning has yet to be examined. We assessed the role of preoperative odor identification in mesial onset seizure localization utilizing stereoelectroencephalography (S-EEG) and magnetic resonance-guided laser interstitial thermal therapy (MRgLiTT) outcome.

METHODS

We identified 30 patients who had typical seizures captured during S-EEG monitoring or MRgLiTT of mesial temporal structures (n = 17 S-EEG, n = 13 MRgLiTT); seizure onset zone was classified as unilateral mesial seizure onset, or multifocal with unilateral mesial onset and nonmesial onset. Odor identification ability was assessed using the Sniffin' Sticks Odor Identification Test (SSOIT). Patients also completed measures of confrontation naming and auditory-verbal learning/memory using the Boston Naming Test and Hopkins Verbal Learning Test-Revised, respectively.

RESULTS

Overall, patients with intractable focal epilepsy exhibited poor olfactory performance (median [M] = 10.4, interquartile range [IQR] = 9.4-11.8). Of 19 patients who underwent MRgLiTT, 10 patients (52.6%) were seizure-free at last follow-up (M = 13 months, IQR =10-18). Patients who were seizure-free after MRgLiTT (n = 10) had poorer odor identification scores (M = 9, IQR = 7-13) compared to patients with seizure reoccurrence (M = 13, IQR = 12.5-15). Odor identification score was inversely associated with seizure freedom, with odds ratio = 0.60 (95% confidence interval [CI] = 0.38-0.95, P = .03). Receiver operating characteristic analysis revealed that an SSOIT score of 12 was the ideal cutoff for predicting favorable seizure outcome (area under the curve = 0.84, 95% CI = 0.64-1.0). Sensitivity was 88.9% and specificity was 78.9%, with a likelihood ratio of 2.9 of seizure failure in patients who had an odor identification score ≥ 12.

SIGNIFICANCE

Interictal olfactory dysfunction is commonly seen in patients with intractable focal epilepsy. Odor identification is a novel, noninvasive presurgical biomarker to distinguish who may or may not benefit from MRgLiTT of mesial temporal structures.

Prevalence and reversibility of smell dysfunction measured psychophysically in a cohort of COVID-19 patients

Background

Considerable evidence suggests that smell dysfunction is common in coronavirus disease‐2019 (COVID‐19). Unfortunately, extant data on prevalence and reversibility over time are highly variable, coming mainly from self‐report surveys prone to multiple biases. Thus, validated psychophysical olfactory testing is sorely needed to establish such parameters.

Methods

One hundred severe acute respiratory syndrome‒coronavirus‐2 (SARS‐CoV‐2)‐positive patients were administered the 40‐item University of Pennsylvania Smell Identification Test (UPSIT) in the hospital near the end of the acute phase of the disease. Eighty‐two were retested 1 or 4 weeks later at home. The data were analyzed using analysis of variance and mixed‐effect regression models.

Results

Initial UPSIT scores were indicative of severe microsmia, with 96% exhibiting measurable dysfunction; 18% were anosmic. The scores improved upon retest (initial test: mean, 21.97; 95% confidence interval [CI], 20.84‐23.09; retest: mean, 31.13; 95% CI, 30.16‐32.10; p < 0.0001); no patient remained anosmic. After 5 weeks from COVID‐19 symptom onset, the test scores of 63% of the retested patients were normal. However, the mean UPSIT score at that time continued to remain below that of age‐ and sex‐matched healthy controls (p < 0.001). Such scores were related to time since symptom onset, sex, and age.

Conclusion

Smell loss was extremely common in the acute phase of a cohort of 100 COVID‐19 patients when objectively measured. About one third of cases continued to exhibit dysfunction 6 to 8 weeks after symptom onset. These findings have direct implications for the use of olfactory testing in identifying SARS‐CoV‐2 carriers and for counseling such individuals with regard to their smell dysfunction and its reversibility.

Early-Onset Schizophrenia Showed Similar but More Severe Olfactory Identification Impairment Than Adult-Onset Schizophrenia

BACKGROUND

"Early-onset schizophrenia" (EOS) is defined as disease with onset before the age of 18 years. This subset of schizophrenia exhibits worse cognitive function and carries a worse prognosis than adult-onset schizophrenia (AOS). Olfactory impairment has been found in patients with schizophrenia-spectrum disorders. However, most research has focused on olfactory impairment in patients with AOS: olfactory function in EOS is not known. The aim of this study was to investigate the olfactory identification ability in EOS, and its relationship with negative symptoms.

METHODS

We compared olfactory function between two independent samples: 40 patients with EOS and 40 age- and sex-matched healthy controls (HCs); as well as 40 patients with AOS and 40 age- and sex-matched HCs. The University of Pennsylvania Smell Identification Test was administered.

RESULTS

The EOS group and AOS group exhibited worse olfactory identification ability than HCs; impairment correlated significantly with negative symptoms. Olfactory identification was worse in patients suffering EOS compared with those suffering AOS.

CONCLUSION

Olfactory identification impairment may be a trait marker of schizophrenia.

Olfactory assessment in the Chinese pediatric population

Young children with olfactory disturbance are sometimes encountered in ENT clinics. We investigated the clinical applicability of olfactory testing to the pediatric population in China.One hundred and ninety-three healthy children aged 6 to 17 years were enrolled. All participants were asked for demographic information (age, sex, body mass index [BMI], and rating of olfactory function) in a structured questionnaire and underwent olfactory testing including T&T Olfactometer (T&T), odor discrimination (OD), and odor identification (OI) tests of Sniffin' Sticks.Age had a significant influence on the outcome of olfactory testing, sex, BMI, or self-rating had no influence. Children had better performance on T&T than OI and OD tests of Sniffin' Sticks.T&T and Sniffin' Sticks can be completed by Chinese children. Performance on olfactory tests increased with increasing age. T&T may be more suitable to assess olfactory function in the Chinese pediatric population.

Odor Identification Screening Improves Diagnostic Classification in Incipient Alzheimer's Disease

BACKGROUND

Measurements of olfaction may serve as useful biomarkers of incipient dementia. Here we examine the improvement in diagnostic accuracy of Alzheimer's disease (AD) and mild cognitive impairment (MCI) when assessing both cognitive functioning and odor identification.

OBJECTIVE

To determine the utility of odor identification as a supplementary screening test in incipient AD.

METHODS

Sniffin' Sticks Odor Identification Test (SS-OIT) and the Montreal Cognitive Assessment (MoCA) were administered in 262 AD, 174 MCI [150 amnestic (aMCI), and 24 non-amnestic (naMCI)], and 292 healthy older adults (HOA).

RESULTS

Odor identification scores were higher in HOA relative to MCI or AD groups, and MCI outperformed AD. Odor identification scores were higher in aMCI single domain than aMCI multiple domain. Complementing MoCA scores with the SS-OIT significantly improved diagnostic accuracy of individuals with AD and MCI, including within MCI subgroups.

DISCUSSION

Odor identification is a useful supplementary screening tool that provides additional information relevant for clinical categorization of AD and MCI, including those who are at highest risk to convert to AD.

Do Visually Impaired People Develop Superior Smell Ability?

It is well known that visually impaired people perform better in orientation by sound than sighted individuals, but it is not clear whether this enhanced awareness also extends to other senses. Therefore, the aim of this study was to observe whether visually impaired subjects develop superior abilities in olfactory perception to compensate for their lack of vision. We investigated the odor perception of visually impaired individuals aged 7 to 89 ( n = 99; 52 women, 47 men) and compared them with subjects of a control group aged 8 to 82 years ( n = 100; 45 women, 55 men) without any visual impairment. The participants were evaluated by Sniffin' Sticks odor identification and discrimination test. Identification ability was assessed for 16 common odors presented in felt-tip pens. In the odor discrimination task, subjects had to determine which of three pens in 16 triplets had a different odor. The median number of correctly identified odorant pens in both groups was the same, 13 of the offered 16. In the discrimination test, there was also no significant difference observed. Gender did not influence results. Age-related changes were observed in both groups with olfactory perception decreasing after the age of 51. We could not confirm that visually impaired people were better in smell identification and discrimination ability than sighted individuals.

A Meta-Analysis of Odor Thresholds and Odor Identification in Autism Spectrum Disorders

Autism Spectrum Disorders (ASD) are often accompanied by atypical visual, auditory, and tactile sensory behavior. Evidence also suggests alterations of the olfactory system, but the pattern of findings appears mixed. To quantify this pattern systematically, we conducted a meta-analysis. Studies were included if they examined olfactory function (i.e., odor threshold, or odor identification) in ASD compared with healthy age-matched control groups. We also coded for the potential moderators gender, age, and IQ. Articles were identified through computerized literature search using Web of Science, PubMed, and Scopus databases. A total of 11 articles compared odor threshold and/or odor identification between cases and controls (for threshold, n = 143 ASD and 148 controls; and for identification, n = 132 ASD and 139 controls). Effects sizes showed a substantial heterogeneity. As a result, the 95% prediction intervals were wide and ranged between a large negative and a large positive effect size for odor threshold, [-1.86, 2.05], and for odor identification, [-1.51, 2.52]. Exploratory analyses suggested that age and IQ may be potential moderators. To conclude, the large heterogeneity is consistent with the notion of both hyposensitivity and hypersensitivity in individuals with ASD. However, future research needs to predict and test the specific direction of the effect to provide convincing evidence for atypical olfactory functions in ASD.

Identification of Chinese Herbal Medicines with Electronic Nose Technology: Applications and Challenges

This paper provides a review of the most recent works in machine olfaction as applied to the identification of Chinese Herbal Medicines (CHMs). Due to the wide variety of CHMs, the complexity of growing sources and the diverse specifications of herb components, the quality control of CHMs is a challenging issue. Much research has demonstrated that an electronic nose (E-nose) as an advanced machine olfaction system, can overcome this challenge through identification of the complex odors of CHMs. E-nose technology, with better usability, high sensitivity, real-time detection and non-destructive features has shown better performance in comparison with other analytical techniques such as gas chromatography-mass spectrometry (GC-MS). Although there has been immense development of E-nose techniques in other applications, there are limited reports on the application of E-noses for the quality control of CHMs. The aim of current study is to review practical implementation and advantages of E-noses for robust and effective odor identification of CHMs. It covers the use of E-nose technology to study the effects of growing regions, identification methods, production procedures and storage time on CHMs. Moreover, the challenges and applications of E-nose for CHM identification are investigated. Based on the advancement in E-nose technology, odor may become a new quantitative index for quality control of CHMs and drug discovery. It was also found that more research could be done in the area of odor standardization and odor reproduction for remote sensing.

The Impact of Stress on Odor Perception

The olfactory system and emotional systems are highly intervened and share common neuronal structures. The current study investigates whether emotional (e.g., anger and fear) and physiological (saliva cortisol) stress responses are associated with odor identification ability and hedonic odor judgments (intensity, pleasantness, and unpleasantness). Nineteen men participated in the modified Trier Social Stress Test (TSST) and a control session (cycling on a stationary bike). The physiological arousal was similar in both sessions. In each session, participants' odor identification score was assessed using the University of Pennsylvania Smell Identification Test, and their transient mood was recorded on the dimensions of valence, arousal, anger, and anxiety. Multivariate regression analyses show that an increase of cortisol in the TSST session (as compared with the control session) is associated with better odor identification performance (β = .491) and higher odor intensity ratings (β = .562). However, increased anger in the TSST session (as compared with the control session) is associated with lower odor identification performance (β = -.482). The study shows divergent effects of the emotional and the physiological stress responses, indicating that an increase of cortisol is associated with better odor identification performance, whereas increased anger is associated with poorer odor identification performance.

Odor Familiarity and Identification Abilities in Adolescents

Olfactory identification abilities in adolescents have been reported inferior compared with adults. Though this seems to be the case when comparing identification abilities using tests validated on-and for-adults, odor familiarity has been hypothesized to affect identification abilities in younger participants. However, this has never been thoroughly tested. The aims of this study were to investigate patterns in odor familiarity differences between adolescents and adults, and to investigate if an adolescent familiarity-based modification of an identification test could lead to similar identification scores in adolescents and adults. In total, 411 adolescent participants and 320 adult participants were included in the study. Odor familiarity ratings were obtained for 125 odors. A modified version of the "Sniffin' Sticks" identification test was created and validated on 72 adolescents based on adolescent familiarity scores. This test was applied to 82 normosmic adults and 167 normosmic adolescents. Results show a lower familiarity for spices and environmental odors, and a higher familiarity for candy odors in adolescents. The identification abilities in adults and adolescents were equal after familiarity-based modification. We conclude that changes in odor familiarity from adolescence to adulthood do not develop evenly for all odors, but are dependent on odor-object category.

The Impact of Stress on Odor Perception

The olfactory system and emotional systems are highly intervened and share common neuronal structures. The current study investigates whether emotional (e.g., anger and fear) and physiological (saliva cortisol) stress responses are associated with odor identification ability and hedonic odor judgments (intensity, pleasantness, and unpleasantness). Nineteen men participated in the modified Trier Social Stress Test (TSST) and a control session (cycling on a stationary bike). The physiological arousal was similar in both sessions. In each session, participants' odor identification score was assessed using the University of Pennsylvania Smell Identification Test, and their transient mood was recorded on the dimensions of valence, arousal, anger, and anxiety. Multivariate regression analyses show that an increase of cortisol in the TSST session (as compared with the control session) is associated with better odor identification performance (β = .491) and higher odor intensity ratings (β = .562). However, increased anger in the TSST session (as compared with the control session) is associated with lower odor identification performance (β = -.482). The study shows divergent effects of the emotional and the physiological stress responses, indicating that an increase of cortisol is associated with better odor identification performance, whereas increased anger is associated with poorer odor identification performance.

Olfactory Functions in Adults With Autism Spectrum Disorders

Autism spectrum disorders (ASD) are often characterized by atypical sensory behavior (hyper- or hyporeactivity) although evidence is scarce regarding olfactory abilities in ASD; 16 adults with high-functioning ASD (mean age: 38.2, SD: 9.7) and 14 healthy control subjects (mean age: 42.0 years, SD: 12.5) were assessed in odor threshold, free and cued odor identification, and perceived pleasantness, intensity, and edibility of everyday odors. Although results showed no differences between groups, the Bayes Factors (close to 1) suggested that the evidence for no group differences on the threshold and identification tests was inconclusive. In contrast, there was some evidence for no group differences on perceived edibility (BF₀₁ = 2.69) and perceived intensity (BF₀₁ = 2.80). These results do not provide conclusive evidence for or against differences between ASD and healthy controls on olfactory abilities. However, they suggest that there are no apparent group differences in subjective ratings of odors.

Odor Emotional Quality Predicts Odor Identification

It is commonly agreed upon a strong link between emotion and olfaction. Odor-evoked memories are experienced as more emotional compared with verbal, visual, and tactile stimuli. Moreover, the emotional quality of odor cues increases memory performance, but contrary to this, odors are poor retrieval cues for verbal labels. To examine the relation between the emotional quality of an odor and its likelihood of identification, this study evaluates how normative emotion ratings based on the 3-dimensional affective space model (that includes valence, arousal, and dominance), using the Self-Assessment Manikin by Bradley and Lang (Bradley MM, Lang PJ. 1994. Measuring emotion: the Self-Assessment Manikin and the Semantic Differential. J Behav Ther Exp Psychiatry. 25(1):49-59.) and the Positive and Negative Affect Schedule (Watson D, Clark LA, Tellegen A. 1988. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 54(6):1063-1070.) predict the identification of odors in a multiple choice condition. The best fitting logistic regression model includes squared valence and dominance and thus, points to a significant role of specific emotional features of odors as a main clue for odor identification.

Sniffin' Sticks and olfactory system imaging in patients with Kallmann syndrome

BACKGROUND

The relationship between olfactory function, rhinencephalon and forebrain changes in Kallmann syndrome (KS) have not been adequately investigated. We evaluated a large cohort of male KS patients using Sniffin' Sticks and MRI in order to study olfactory bulb (OB) volume, olfactory sulcus (OS) depth, cortical thickness close to the OS, and olfactory phenotype.

METHODS

Olfaction was assessed administering Sniffin' Sticks®, in 38 KS patients and 17 controls (by means of Screening 12 test®). All subjects underwent magnetic resonance imaging (MRI) to study OB volume, sulcus depth, and cortical thickness.

RESULTS

Compared to controls, KS patients showed smaller OB volume (p<0.0001), reduced sulcus depth (p<0.0001), and thicker cortex in the region close to the OS (p<0.0001). Anosmic KS patients had smaller OB than controls and hyposmic KS patients; there was no difference between hyposmic KS patients and controls. OB volume correlated with Sniffin' Sticks score (r = 0.64; p < 0.001), OS depth (p<0.0001) and, inversely, with cortical thickness changes (p<0.0001). Sniffin' Sticks showed an inverse correlation with cortical thickness (r = -0.5; p<0.0001) and a trend toward a statistically significant correlation with OS depth.

CONCLUSION

The present study provides further evidence of the strict relationship between olfaction and OB volume. The strong correlation between OB volume and the overlying cortical changes highlights the key role of rhinencephalon in forebrain embryogenesis.

Development of normative data for the Brazilian adaptation of the University of Pennsylvania Smell Identification Test

It is well established that olfactory dysfunction has significant implications for safety, nutrition, and quality of life. The more reliable standardized tests of olfactory function, such as the University of Pennsylvania Smell Identification Test (UPSIT), assess odor identification ability. Unfortunately, cultural factors can influence such tests, as a number of odors are not universally recognized. In this study, a Portuguese language version of the UPSIT was administered to an age- and sex-stratified prospective sample of 1820 Brazilian subjects. Normative data were developed for a subset of 1578 subjects who reported having no difficulties smelling or tasting. Individuals with a history of head trauma or, in the case of those over the age of 64 years, Mini-Mental State Examination Scores <24, were excluded from analysis. As in other populations, the test scores were significantly influenced by age and sex. The median overall difference between the North American and Brazilian UPSIT scores was 2.2 points for men and 0.8 points for women, although subtle age-related differences were also apparent. This research represents that largest clinical study of olfaction ever performed in South America. Correction factors based upon age and sex are provided to allow for direct comparisons of Brazilian test scores to those based upon North American norms.

Odor identification in frontotemporal lobar degeneration subtypes

Odor identification impairment is a feature of several neurodegenerative disorders. Although neurodegenerative changes in the frontotemporal lobar degeneration (FTLD) subtypes involve areas important for olfactory processing, data on olfactory function in these patients are limited. An 18-item, multiple-choice odor identification test developed at our memory clinic, the Motol Hospital smell test, was administered to 9 patients with behavioral variant frontotemporal dementia, 13 patients with the language variants, primary nonfluent aphasia (n = 7) and semantic dementia (n = 6), and 8 patients with progressive supranuclear palsy. Compared to the control group (n = 15), all FTLD subgroups showed significant impairment of odor identification (P < .05). The differences between the FTLD subgroups were not significant. No correlation between odor identification and neuropsychological tests results was found. Our data suggest that odor identification impairment is a symptom common to FTLD syndromes, and it seems to be based on olfactory structure damage rather than cognitive decline.

Field Survey Measures of Olfaction: The Olfactory Function Field Exam (OFFE)

Population-based field research on human olfaction has been limited by a lack of feasible assessment tools. Previous olfactory survey research has measured only odor identification, with no research being done on odor detection (i.e., a person's sensitivity to detect a particular odor). Laboratory studies suggest that deficits in both aspects of olfactory function may be related to physical health, mental health and cognition, social function, including overall quality of life, and even mortality. However, field studies are needed to validate and extend these findings in large representative samples. Here we describe the olfactory function field exam, an instrument that can be deployed in field environments by lay interviewers to evaluate both odor identification and odor detection rapidly, practically, and accurately. Use of this new survey tool in future field-based population health studies will elucidate the impact of olfactory function on a myriad of health and social conditions.

Subthalamic deep brain stimulation effects on odor identification in Parkinson's disease

BACKGROUND AND PURPOSE

Olfactory dysfunction is common in Parkinson's disease (PD) and it is one of the earliest non-motor symptoms. A few studies have suggested that deep brain stimulation of the subthalamic nucleus (STN-DBS) could improve olfactory function. Our aim was to evaluate the acute effect of bilateral STN-DBS on a commonly used smell test in PD patients.

METHODS

Fifteen PD patients who underwent bilateral STN-DBS and 15 controls were recruited. Patients and controls were tested for odor identification.

RESULTS

No statistical differences were documented between ON and OFF STN-DBS acute stimulation concerning olfaction. Controls presented a better performance for olfactory identification than patients.

CONCLUSIONS

Our exploratory study did not support that bilateral STN-DBS could have an acute effect on olfactory function in PD patients.

Food neophobia and its relation with olfaction

Food neophobia, that is the reluctance to try novel foods, is an attitude that dramatically affects human feeding behavior in many different aspects among which food preferences and food choices appear to be the most thoroughly considered. This attitude has an important evolutionary meaning since it protects the individual from ingesting potentially dangerous substances. On the other hand, it fosters an avoidance behavior that can extend even toward useful food elements. A strong link exists between food neophobia and both the variety in one person’s diet and previous exposures to different foods. In this review, the more recent findings about food neophobia will be concisely described. Given the suggested connection between the exposure to different foods and food neophobia, this review will focus on the relation between this attitude and human chemosensory abilities. Olfaction, in particular, is a sensory modality that has a central role in flavor perception and in food preference acquisition. Therefore, the latest evidences about its relation with food neophobia will be discussed along with the applied and cognitive implications.

Pregnancy and olfaction: a review

Many women report a heightened sense of smell during pregnancy. Accounts of these anecdotes have existed for over 100 years, but scientific evidence has been sparse and inconclusive. In this review, I examine the literature on olfactory perception during pregnancy including measures of self-report, olfactory thresholds, odor identification, intensity and hedonic ratings, and disgust. Support for a general decrease in olfactory thresholds (increase in sensitivity) is generally lacking. There is limited evidence that some suprathreshold measures of olfactory perception, such as hedonic ratings of odors, are affected by pregnancy, but these effects are idiosyncratic. In this review, I explore the hypotheses that have been put forth to explain changes in olfactory perception during pregnancy and provide suggestions for further research.

Olfactory functions are not associated with autism severity in autism spectrum disorders

BACKGROUND

Changes in olfactory functions have been found in many neurodegenerative and psychiatric disorders, including autism spectrum disorders (ASDs). The aim of the present study was to evaluate the relationship between olfactory functions (odor-detection thresholds, odor identification, and odor preference) and autism severity and sensory-related behavior in children and adolescents with ASD.

SUBJECTS AND METHODS

Our sample consisted of 35 high-functioning patients with ASD (mean age 10.8±3.6 years, 31 boys). Olfactory testing (threshold and identification) used the Sniffin' Sticks test. Odor pleasantness was assessed on a 5-point scale using the Identification part of the Sniffin' Sticks test. The severity of autistic psychopathology was measured using the Childhood Autism Rating Scale (CARS).

RESULTS

Using Spearman's correlation, we found no significant correlations between autism severity (as expressed by total CARS score) and odor-detection thresholds (R=0.144, P=0.409), odor identification (R=0.07, P=0.966), or odor pleasantness (R=-0.046, P=0.794). There was also no significant relationship between CARS item 9 ("Taste, smell, and touch response and use") and odor-detection thresholds (R=0.170, P=0.330), odor identification (R=0.282, P=0.100), or odor pleasantness (R=0.017, P=0.923).

CONCLUSION

We did not find any significant relationship between the severity of autistic psychopathology and olfactory functions.

Both odor identification and ApoE-ε4 contribute to normative cognitive aging

Research indicates that apoliprotein E (ApoE) plays a role in the development of Alzheimer's disease (AD) and possibly in the cognitive decline associated with normative aging. More recently, researchers have shown that ApoE is expressed in olfactory brain structures, and a relationship among ApoE, AD, and olfactory function has been proposed. In the current analyses, we investigated the contribution of ApoE and odor identification in decline trajectories associated with normative cognitive aging in various domains, using longitudinal data on cognitive performance available from the Swedish Adoption/Twin Study of Aging. Data on both ApoE status and olfactory functioning were available from 455 individuals ranging in age from 50 to 88 years at the first measurement occasion. Odor identification was measured via a mailed survey. Cognitive performance was assessed in up to 5 waves of in-person testing covering a period of 16 years. Latent growth curve analyses incorporating odor identification and ApoE status indicated a main effect of odor identification on the performance level in three cognitive domains: verbal, memory, and speed. A main effect of ApoE on rates of decline after age 65 was found for verbal, spatial, and speed factors. The consistency of results across cognitive domains provides support for theories that posit central nervous system-wide origins of the olfaction-cognition-ApoE relationship; however, olfactory errors and APOE ε4 show unique and differential effects on cognitive trajectory features.

Lewy bodies and olfactory dysfunction in old age

As part of a clinical-pathologic project, older people completed a standard odor identification test at study entry. During a mean of 3.5 years of observation, 201 people died and underwent brain autopsy and neuropathologic examination (6 with a history of Parkinson's disease were excluded). Lewy bodies were identified with antibodies to alpha-synuclein and classified as nigral, limbic, or neocortical based on their distribution in 6 brain regions. Plaques and tangles in 5 regions were summarized with a previously established composite measure, and neuron loss in the substantia nigra was rated on 6-point scale. Odor identification scores ranged from 0 to 12 correct (mean = 8.0, standard deviation = 2.6). On neuropathologic examination, 26 persons had Lewy bodies (13 neocortical, 9 limbic, and 4 nigral). In an analysis adjusted for age, sex, education, and time from olfactory testing to death, limbic (estimate = -2.47, standard error [SE] = 0.73, P < 0.001) and neocortical (estimate = -4.36, SE = 0.63, P < 0.001) Lewy body subgroups were associated with impaired olfaction. Results were comparable in analyses that controlled for dementia or parkinsonism during the study or postmortem measures of plaques and tangles or nigral cell loss. A final set of analyses suggested that impaired olfactory performance may aid detection of underlying Lewy body disease. The findings indicate that Lewy body disease impairs late life olfactory function even in otherwise asymptomatic individuals.

Age-Related Olfactory Decline is Associated with the BDNF Val66met Polymorphism: Evidence from a Population-Based Study

The present study investigates the effect of the brain-derived neurotrophic factor (BDNF) val66met polymorphism on change in olfactory function in a large scale, longitudinal population-based sample (n = 836). The subjects were tested on a 13 item force-choice odor identification test on two test occasions over a 5-year-interval. Sex, education, health-related factors, and semantic ability were controlled for in the statistical analyses. Results showed an interaction effect of age and BDNF val66met on olfactory change, such that the magnitude of olfactory decline in the older age cohort (70–90 years old at baseline) was larger for the val homozygote carriers than for the met carriers. The older met carriers did not display larger age-related decline in olfactory function compared to the younger group. The BDNF val66met polymorphism did not affect the rate of decline in the younger age cohort (45–65 years). The findings are discussed in the light of the proposed roles of BDNF in neural development and maintenance.

Odor identification, eye tracking and deficit syndrome schizophrenia

BACKGROUND

Deficit syndrome (DS) schizophrenia patients have smooth pursuit eye movement (SPEM) dysfunction. We examined if they also had smell identification deficits, since social affiliation is related to olfaction in other mammals.

METHODS

Sixty-seven patients had DS assessments: 31 patients had SPEM and 50 had Smell Identification Test (SIT) assessments, and 14 patients had both measurements.

RESULTS

DS patients had worse SPEM and SIT performance than the non-DS patients. Areas under the receiver-operator characteristic (ROC) curves for SIT and SPEM were both fairly accurate in identifying the DS. The odds ratio (OR) for the DS for impaired versus normal SPEM was 6.21 (95% confidence interval [CI]: 1.21, 32.25) and for microsmia versus normosmia was 10.4 (95% CI: 1.23, 88.18). Further analyses showed that the association of SIT with both SPEM and the DS could account for the SPEM-DS association.

CONCLUSIONS

We found a strong association between the DS and SIT scores suggesting that the neural substrates of olfaction may be related to social affiliation in humans, as they are in other mammals. These data further support the notion that the DS defines a homogeneous subgroup of schizophrenia patients and further suggest that dysfunction in the neural circuitry of olfaction may contribute to its pathophysiology.