Abstract

Nowadays, depression is a major issue in public health. Because of the partial overlap between the brain structures involved in depression, olfaction and emotion, the study of olfactory function could be a relevant way to find specific cognitive markers of depression. This study aims at determining whether the olfactory impairments are state or trait markers of major depressive episode (MDE) through the study of the olfactory parameters involving the central olfactory pathway. In a pilot study, we evaluated prospectively 18 depressed patients during acute episodes of depression and 6 weeks after antidepressant treatment (escitalopram) against 54 healthy volunteers, matched by age, gender and smoking status. We investigated the participants’ abilities to identify odors (single odors and in binary mixture), to evaluate and discriminate the odors’ intensity, and determine the hedonic valence of odors. The results revealed an “olfactory anhedonia” expressed by decrease of hedonic score for high emotional odorant as potential state marker of MDE. Moreover, these patients experienced an “olfactory negative alliesthesia”, during the odor intensity evaluation, and failed to identify correctly two odorants with opposite valences in a binary iso-mixture, which constitute potential trait markers of the disease. This study provides preliminary evidence for olfactory impairments associated with MDE (state marker) that are persistent after the clinical improvement of depressive symptoms (trait marker). These results could be explained by the chronicity of depression and/or by the impact of therapeutic means used (antidepressant treatment). They need to be confirmed particularly the ones obtained in complex olfactory environment which corresponds a more objective daily life situation.

Highlights

  • There is increasing interest in literature to understand the olfactory deficits of depression

  • The three groups of subjects were able to discriminate the studied odorants according to their hedonic valence

  • Concerning the discrimination of odor intensity (Table 4), we found that for both pleasant (PHE) and unpleasant (ISO) odorants, patients were unable to discriminate correctly the three different concentration levels during the major depressive episode (MDE) (PHE: Q = 14.74, p = 0.001; isovaleric acid (ISO): Q = 6.85, p = 0.03) and after 6 weeks of antidepressant treatment (PHE: Q = 11.41, p = 0.003; ISO: Q = 2.94, p = 2.23), whereas controls succeeded in this discrimination task (PHE: Q = 58.80, p,0.001; ISO: Q = 59.70, p,0.001)

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Summary

Introduction

There is increasing interest in literature to understand the olfactory deficits of depression. An overview of this literature shows conflicting results regarding impairment of all olfactory parameters (i.e., odor threshold, odor identification, discrimination, intensity, familiarity and pleasantness). Different studies found no significant difference between patients suffering from MDE and healthy controls concerning the odor pleasantness [6,7,8,9], the odor identification [5,7,10,11,12,13,14] and the evaluation of odor intensity [5,6,9,15]

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