Changes In Olfaction Research Articles

OLFACTION AND DEMENTIA RISK IN THE ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY

Abstract We examined the association of olfaction with incident dementia and characterized this relationship by key demographic subgroups and APOE-ε4 genotype in the ARIC study. We further examined how change in olfaction was associated with dementia incidence. Olfaction was evaluated using the 12-item Sniffin’ Sticks test in 4470 ARIC participants in 2011-2013 (visit 5) and in 2658 participants in 2016-2017 (visit 6). We defined olfaction as good (score 11-12), moderate (9-10), hyposmia (7-8), and anosmia (0-6). Dementia status was ascertained from 2011-2013 through 2020. Of the 4470 participants at baseline (age:75±5 years, 21% Black race, 60% women), 17% developed dementia over 10 years. In multivariable Cox models, moderate olfaction (hazard ratio (HR):1.5, 95%CI:1.3-1.9), hyposmia (HR:2.2, 95%CI:1.8-2.8), and anosmia (HR:3.5, 95%CI:2.8-4.3) were associated with higher dementia rate in a linear, monotonic manner relative to good olfaction. Findings were similar across subgroups of age, sex, race, and APOE-ε4 genotype. We also used logistic regression to estimate marginal dementia probability. We found that, on the risk difference scale, the absolute risk difference between anosmia and good olfaction was higher in APOE-ε4 carriers (0.29, 95%CI:0.20-0.37) compared to that in non-carriers (0.16, 95%CI:0.11-0.21); jointly, APOE-ε4 carriers with anosmia had the greatest cumulative dementia probability. Further, compared to participants who maintained good olfaction from visit 5 to visit 6, those with stable anosmia (HR:5.6, 95%CI:2.7-11.6) and a decline from good to anosmia (HR:4.5, 95%CI:2.2-9.4)) showed comparable associations with dementia incidence. Our study provides important data about how simple noninvasive olfaction tests may inform future dementia risk.

Endoscopic trans-sphenoidal pituitary surgery does not impact postoperative nasal quality of life

PurposeThe aim of this prospective longitudinal study was to assess both subjective quality of life using questionnaires and objective examination of nasal function with regard to olfaction, nasal air flow and mucociliary clearance in patients after minimally invasive, turbinate-preserving endoscopic transnasal trans-sphenoidal pituitary surgery.MethodsPatients undergoing endoscopic transnasal pituitary surgery were recruited prospectively and examined during three study visits, preoperatively and 3 and 6 months postoperatively. We examined nasal function using sniffin' sticks test, rhinomanometry, saccharin transit time test, and endoscopic and radiological scores. In addition, the influence on subjective quality of life and mental health was recorded using the Sinonasal-Outcome-Test-20 (SNOT-20) and the Hospital-Anxiety-and-Depression-Scale (HADS).Results20 patients undergoing endoscopic pituitary tumor resections were included. No significant changes in olfaction or mucociliary clearance were noted. Nasal air flow showed a tendency to increase in the postoperative course lacking significance. Both the endoscopy and the radiological scores showed a significant deterioration, especially after 3 months, with a trend towards improvement over time. However, neither the SNOT-20 nor the HADS showed significant changes compared to baseline.ConclusionsOur concept of minimally invasive endoscopic tumor resections on the pituitary gland with preservation of nasal turbinates shows low morbidity for the patient. Despite objectifiable surgery-associated changes in the nose, nasal physiology in terms of smell, airflow and mucociliary clearance can be preserved and the subjective quality of life of our patients remains stable.

Sequential change in olfaction and (non) motor symptoms: the difference between anosmia and non-anosmia in Parkinson's disease.

Hyposmia is a common prodrome in patients with Parkinson's disease (PD). This study investigates whether olfactory changes in PD differ according to the degree of olfactory dysfunction and whether there are changes in motor and non-motor symptoms. The 129 subjects with PD were divided into two groups: anosmia and non-anosmia. All cases were reassessed within 1-3 years after the initial assessment. The assessment included the MDS-Unified PD Rating Scale (MDS-UPDRS), the University of Pennsylvania Smell Identification Test (UPSIT), Beck's Depression Inventory-II (BDI-II), Montreal Cognitive Assessment (MoCA), and equivalence dose of daily levodopa (LEDD). The generalized estimating equation (GEE) model with an exchangeable correlation structure was used to analyze the change in baseline and follow-up tracking and the disparity in change between these two groups. The anosmia group was older and had a longer disease duration than the non-anosmia group. There was a significant decrease in UPSIT after follow-up in the non-anosmia group (β = -3.62, p < 0.001) and a significant difference in the change between the two groups (group-by-time effect, β = 4.03, p < 0.001). In the third part of the UPDRS motor scores, there was a tendency to increase the score in the non-anosmia group compared to the anosmia group (group-by-time effect, β = -4.2, p < 0.038). There was no significant difference in the group-by-time effect for UPDRS total score, LEDD, BDI-II, and MoCA scores. In conclusion, this study found that olfactory sensation may still regress in PD with a shorter disease course without anosmia, but it remains stable in the anosmia group. Such a decline in olfaction may not be related to cognitive status but may be associated with motor progression.

Changes in olfaction & quality of life following standard medical therapy in patients with intermittent & persistent allergic rhinitis.

Allergic rhinitis (AR) is an inflammatory disease prevalent worldwide which can affect both olfaction and quality of life (QoL). The objective of the present study was to assess olfaction and QoL changes in patients with AR before and after medical therapy. Adult participants (>18 yr) with AR were recruited for this study. These patients prospectively underwent olfaction testing using the modified Connecticut Chemosensory Clinical Research Centre Test and QoL assessment using Rhinoconjunctivitis QoL Questionnaire (RQLQ) before and after standard medical therapy with topical steroids and/antihistaminics. Of the 150 patients recruited, 72 per cent had intermittent AR. The symptom of hyposmia was present in 34 patients (22.7%) and was more prevalent in patients with moderate-to-severe type of AR (P<0.001). However, olfaction testing revealed hyposmia/anosmia in 44 patients (29.3%). Mean composite olfaction scores were significantly higher in patients with mild AR compared to moderate/severe AR (P=0.026). The pre-therapy mean composite olfaction score in the 34 patients with olfaction disturbances was 3.1 standard deviation (±1.06 SD). Following therapy, the mean composite olfaction score rose to 4.3 (±1.34 SD) and this change was found to be significant (P<0.001). Mean pre-therapy RQLQ scores were 2.87 (0.06-5.33) overall. Significant improvement was also found in RQLQ scores following therapy (P<0.001). Mean RQLQ scores were significantly lower in those with moderate-to-severe AR (P<0.001) as well as those with intermittent AR (P=0.004). Nine patients had persistently high RQLQ scores after medical therapy. Both olfaction and QoL showed significant improvement after medical therapy in Indian adults with AR. In those patients who do not improve, other causes must be sought for the persistent symptoms.

Olfaction after endoscopic surgery for sellar and parasellar disease: an updated systematic review and meta-analysis.

Whether endoscopic surgery for sellar/parasellar disease causes significant deficits in olfactory function remains unclear. We aimed to systematically review the olfactory outcomes in such settings based on the evidence up to date. PubMed, EMBASE, and CENTRAL were searched through February 1, 2021. Included studies were limited to endoscopic surgery for sellar/parasellar disease with follow-up olfactory function measured by standardized olfactory testing methods or subjective assessment. The primary outcome was the change in olfactory function after surgery assessed by standardized olfactory testing methods. The secondary outcome was the change in subjective olfactory function. Random-effects model was used in obtaining combine effects. Study quality was assessed using the Newcastleâ€"Ottawa scale. Sensitivity analysis was carried out using the leave-one-out approach, and publication bias was assessed using Egger's test. The results show no significant difference in olfaction assessed by standardized olfactory testing methods at 1-3 months post-surgery (880 patients in 16 studies) or at 6-12 months post-surgery (1320 patients in 16 studies) compared to pre-surgery, whereas a significantly lower subjective olfaction at 3 months was observed. In addition, the lack of significant change in olfaction as assessed by standardized olfactory testing methods was observed regardless of whether patients were treated with or without the nasoseptal flap (NSF) harvesting. Heterogeneity and publication bias were observed, whereas sensitivity analysis showed the meta-analysis results are robust. The findings of this updated systematic review and meta-analysis support the conclusion that endoscopic surgery for sellar and parasellar pathology may pose no greater risk of olfactory dysfunction. In addition, the current evidence does not support there is an increased risk of diminished olfaction among patients treated with NSF during surgery.

Changes in olfaction and taste in patients hospitalized for COVID-19 and their relationship to patient evolution during hospitalization

ObjectivesDuring the COVID-19 pandemic, several cases of changes in olfaction and taste associated with the infection have been reported. Therefore, otolaryngologists are frequently the first medical professionals sought by patients. The aim of this study was to evaluate the frequency of olfaction and taste disorders in patients hospitalized with COVID-19, and their association with other clinical manifestations and patient evolution during hospitalization. Methods248 patients, admitted to three public hospitals in Belo Horizonte, Minas Gerais, Brazil, were prospectively included: Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG), Hospital Júlia Kubitschek (HJK) and Hospital Eduardo de Menezes (HEM), who, upon admission to hospital, presented with Severe Acute Respiratory Syndrome due to COVID-19. Clinical and laboratory variables and outcomes during hospitalization were prospectively collected from the electronic medical records. The collection of sociodemographic and symptomatology data during the acute phase was carried out prospectively in electronic medical records and confirmed with the patients at a subsequent outpatient visit. ResultsThe most frequently reported symptoms were dyspnea (77.4%), cough (69.8%) and fever (55.2%). During the acute phase of the disease, 95 (38.3%) and 87 (35.1%) patients reported taste and olfaction disorders, respectively. There was a lower prevalence of dysosmia among patients with previous comorbidities (p < 0.05). Both symptoms were associated with less need for intensive care admission (p = 0.001 for dysgeusia and p = 0.021 for dysosmia) and a negative correlation with length of hospital stay (dysosmia: r = −0.175, p < 0.05; dysgeusia: r = −0.29, p < 0.001) and length of stay in the ICU (dysosmia: r = −0.136, p < 0.05; dysgeusia: r = −0.215, p < 0.05). The absence of taste disorders was also associated with a greater need for mechanical ventilation (p < 0.001). ConclusionChanges in taste and olfaction were reported by a large number of patients in the acute phase of COVID-19. In this study, both were markers of better clinical patient evolution. Level of evidence1B.

Morphological changes in nasal mucosa in patients with sarcoidosis.

•Changes in the microvascular network of the nasal mucosa may be accompanied by changes in olfaction. •Contact endoscopic changes in the microvascular network of the nasal mucosa may be used as a marker of sinonasal sarcoidosis. •A modified version of the Negoro's classification, in use for the tongue mucosa, may be used for the classification of contact endoscopic microvascular patterns of the nasal mucosa in patients with sarcoidosis •The validation of the use of the vascular patterns of nasal mucosa on contact endoscopy as a marker of nasal disease activity is a major future research challenge •Contact endoscopy emerges as a promising technique for on-site diagnosis of early, advanced or late inflammatory mucosal spots or generalized mucosal affection in sarcoidosis.

Radiofrequency ablation turbinoplasty improves the sense of smell in pediatric patients: A prospective study

IntroductionThe olfactory sense is of paramount importance for the adequate development of a child. Olfactory loss in children might have different origins. One of the most common is conductive, when nasal obstruction prevents odorants from reaching the olfactory epithelium. Rhinitis and turbinate enlargement have been proven to diminish the sense of smell in pediatric patients. A common treatment for resistant rhinitis in these patients is turbinate radiofrequency ablation (TRA). However, despite an increasing research effort in this field, there are no studies instrumentally assessing olfaction in children undergoing turbinate surgery to date. This study was designed with the aim of assessing changes in olfaction through validated instrumental tools in pediatric patients undergoing TRA for the first time. MethodsA prospective uncontrolled intervention clinical trial design was conducted. Two cohorts of children ranging 4–15 years old were consecutively selected from a third level referral Hospital and subjected to the universal sniff test (U-Sniff), alcohol sniff test (AST), and sniffin sticks threshold test (SST) before and 1, 3 and 6 months after surgery. Cohort A consisted of children solely undergoing TRA. Cohort B consisted of children on whom adenoidectomy and TRA had been performed. Additionally, a cohort of Spanish healthy controls, paired by sex and age, were asked to perform the U-Sniff. ResultsA total of 81 participants with a mean age of 10.31 ± 2.56 years were included. Fifty-three patients underwent TRA exclusively and 28 were subjected to associated adenoidectomy. Despite a tendency toward improvement in the U-sniff scores, there were no statistically significant differences after surgery. However, statistically significant differences were obtained for threshold tasks measured with SST and AST, revealing differences at 1, 3 and 6 months after surgery compared to preoperative scores. ConclusionsIn summary, this research demonstrated adequate levels in the sense of smell regarding identification tasks, but decreased olfactory threshold scores in pediatric patients suffering from TE. TRA, alone or with adenoidectomy, improved smell threshold scores, but had no significant effect on identification tasks.

Outcomes of olfaction in patients with empty nose syndrome after submucosal implantation

BackgroundOlfactory dysfunction, such as hyposmia, is a significant symptom of empty nose syndrome (ENS). The efficacy of surgical intervention in olfaction improvements for ENS has not been investigated extensively. ObjectiveThe aim of this study was to evaluate changes in olfaction after surgical treatment for ENS. MethodsThis prospective cohort study at a tertiary medical center enrolled patients with ENS indicated for surgical treatment between June 2015 and June 2019. The Sniffin’ Sticks 12-items odor identification test (SS-12) and subjective olfaction rating were completed by patients before and after surgery to assess olfaction. ResultsA total of 40 patients completed the survey both before and after surgical treatment. Prior to surgery, 25% of the patients had olfactory dysfunction detected by SS-12, whereas 80% of the patients reported a reduction in olfactory function by subjective rating. The degree of olfactory dysfunction by both assessments significantly improved following surgery. The age was a significant predictor of postoperative improvement. ConclusionSurgical treatment is helpful in improving olfaction in patients with ENS who commonly suffer from olfactory dysfunction. Younger patients may benefit more from surgical intervention in aspect of olfaction.

Alteration in Status of Olfaction amongst COVID 19 Patients: A Descriptive Study in a Dedicated COVID Hospital of Eastern India

Introduction COVID 19 patients present with symptoms of respiratory tract infection as it is caused by SARS Cov-2 which is a β corona virus. A significant number of patients may complain of changes in olfaction either at the onset or later. The incidence, severity and recovery from anosmia/hyposmia varies in different patients. This study was done to investigate the effect of COVID 19 on olfactory dysfunction in the Indian population. Materials &amp; Methods 100 patients admitted with RT-PCR positive reports for SARS Cov-2, in a dedicated COVID hospital in eastern India, were included in this study. Their olfactory function was estimated by pocket smell test (4 items) during ENT examination at bed side. Recovery from anosmia/hyposmia were noted during follow up visits. Results In our study 36% of patients had some alteration in smell. Out of the 36%, 12% had anosmia and 24% had hyposmia. Chances of complete recovery is more in patients suffering from anosmia than hyposmia. Conclusion Changes in smell sensation is a significant marker for screening and diagnosis of cases of COVID 19. Most of the patients recover completely.

Predictive Value of Olfactory and Taste Symptoms in the Diagnosis of COVID-19: A Systematic Review and Meta-Analysis.

ObjectivesThis study evaluated the diagnostic value of various symptoms of coronavirus disease 2019 (COVID-19) in screening for this disease.MethodsTwo authors (working independently) comprehensively reviewed six databases (PubMed, Cochrane Database, Embase, Web of Science, Scopus, and Google Scholar) from their dates of inception until November 2020. The predictive value of patient-reported symptoms, including otolaryngologic and general symptoms, was evaluated in adults who underwent testing for COVID-19. True-positive, true-negative, false-positive, and false-negative data were extracted from each study. The methodological quality of the included studies was evaluated using the quality assessment of diagnostic accuracy studies tool (ver. 2).ResultsTwenty-eight prospective and retrospective studies were included in the meta-analysis. The diagnostic odds ratio (DOR) of a change in olfaction and/or taste was 10.20 (95% confidence interval [CI], 8.43–12.34). The area under the summary receiver operating characteristic curve was 0.8. Olfactory and/or taste changes had a low sensitivity (0.57; 95% CI, 0.47–0.66) but moderate negative (0.78; 95% CI, 0.69–0.85] and positive (0.78; 95% CI, 0.66–0.87) predictive values and a high specificity (0.91; 95% CI, 0.83–0.96). Olfactory and/or taste changes had a higher diagnostic value than the other otolaryngologic symptoms, a higher DOR and specificity, and a similar or higher diagnostic value than the other general symptoms.ConclusionAmong otolaryngologic symptoms, olfactory and/or taste dysfunction was the most closely associated with COVID-19 and its general symptoms, and should therefore be considered when screening for the disease.

Olfactory Outcomes after Resection of Tuberculum Sella and Planum Sphenoidale Meningiomas via a Transcranial Approach.

Objectives Controversy exists surrounding the optimal approaches to tuberculum sella meningioma (TSM) and planum meningioma (PM). Olfaction is infrequently considered within this context but is nonetheless an important quality of life measure. The evolution of olfactory outcomes following contemporary transcranial surgery remains unclear. This study reviews olfactory outcomes after supraorbital craniotomy for TSM or PM and defines temporal trends in its recovery. Study Design A prospective study of a patients who underwent a minimally invasive supraorbital craniotomy for TSM or PM was conducted at a single neurosurgical center. Participants & Main Outcome Measures All patients were questioned about olfaction at presentation 3 months postoperatively, 12 months postoperatively, and annually thereafter (median follow-up = 37 months). The olfactory status of patients was categorized as normosmia, anosmia, hyposmia, parosmia, (altered perception of odours), or phantosmia, (olfactory hallucinations). Results Twenty-two patients were included in the study analysis, (range = 27-76). Precisely, 3 months after surgery, seven patients had normal olfaction (32%). Six patients were anosmic, (27%) four hyposmic, (18%), three parosmic, (14%), and two were phantosmic (9%). At 1-year follow-up, almost half of patients (10; 48%) were normosmic, while two patients (9.5%) were anosmic. There were no further improvements in olfaction between 1 year and long-term follow-up. Conclusion Subfrontal transcranial approaches for TSM or PM appear to be associated with changes in olfaction that can improve with time; these improvements occur within the first year after surgery. Impacts upon olfaction should be considered when selecting a surgical approach and patients counseled appropriately.

Change in olfactory function after septoplasty. A systematic review and meta-analysis.

Septoplasty is one of the most frequently performed surgeries. However, there remains a question as to the effect of such intervention on the sense of smell. This study aims to examine the available evidence regarding the effect of septoplasty on the sense of smell. A database search was performed using PubMed, ScienceDirect, Google Scholar and The Cochrane Library databases from January 1990 to February 2020. Search terms included smell, olfaction, odor, septum, septoplasty, and septorhinoplasty. A meta-analysis was performed with 12 studies that provided sufficient data on change in olfaction. 14 studies met the inclusion criteria, and 2 additional studies were included manually; comprising a total of 996 patients and 25 controls. Significant improvement in olfactory test scores was observed in all tests. Pre- and postoperative differences in means were 0.63 for BSIT, 0.80 for CCCRC test, 1.16 for odor threshold, 1.43 for odor discrimination, and 1.18 for odor identification. Septoplasty seems to improve olfactory function. However, the outcome of this intervention is discrete and not equal for all patients, so further randomized trials are needed to confirm current findings.

Olfactory changes after endoscopic sinus surgery for chronic rhinosinusitis: A meta‐analysis

Endoscopic sinus surgery (ESS) is an important treatment modality for chronic rhinosinusitis (CRS). However, its effect on olfaction remains controversial. To assess the olfactory impact of ESS in patients with CRS. A meta-analysis. A systematic literature search in the PubMed, EMBASE and Cochrane Library databases was conducted to identify studies that assessed change in olfaction after ESS in patients with CRS. Search terms were related to paranasal sinus diseases, smell and endoscopy. The extracted data included authors, publication year, study type, age, sex, diagnostic criteria, surgical mode, sample size, follow-up time, olfaction measurement tool and outcome.We analysed the olfactory changes as continuous variables. Thirty-five studies including 3164 patients with CRS were eligible for the meta-analysis.Among patients having CRS with nasal polyps, olfactory dysfunction improved, as assessed by the Sniffin' Sticks total score (P=.000), Sniffin' Sticks discrimination score (P=.023), Sniffin' Sticks identification score (P=.005), University of Pennsylvania Smell Identification Test (P=.046) and Visual Analogue Scale (P=.000). However, the threshold score of the Sniffin' Sticks test did not improve significantly (P=.361). Olfactory dysfunction did not improve in patients having CRS without nasal polyps according to the University of Pennsylvania Smell Identification Test (P=.404). In non-classified CRS patients, improvement in olfactory dysfunction was observed according to the University of Pennsylvania Smell Identification Test (P=.000), Visual Analogue Scale (P=.001) and Questionnaire of Olfactory Disorders-Negative Statements (P=.001). However, there were no significant improvements according to the Brief Smell Identification Test (P=.325), Sniffin' Sticks threshold score (P=.160) and Sniffin' Sticks identification score (P=.079). Endoscopic sinus surgery may be beneficial for improvement in olfactory conditions in patients with CRS. Further thorough and comprehensive studies need to be conducted.

Individual importance of olfaction decreases with duration of smell loss.

The personal importance of a lost neurologic - motor or sensory - function in several conditions has been shown to decrease as the afflicted patient becomes accustomed to not having that function. It is unknown how the importance of olfaction changes with duration of olfactory dysfunction (OD). The aim of this study was to evaluate the association between duration of smell loss and individual significance of olfaction, and whether this relationship would be modulated by other factors, such as etiology of smell loss. This is a retrospective study including a total 163 subjects with different degrees of olfactory function. Individual significance of olfaction was measured using the Importance of Olfaction Questionnaire (IOQ). Demographics, olfactory function, duration and etiology of OD were evaluated. Group comparisons, bivariate correlations, analyses of variance and multivariate linear regression were applied to detect differences and associations with the outcome measure of IOQ. A significant negative correlation was found between duration of OD and the IOQ. Other important findings include a significantly higher IOQ in patients with posttraumatic- compared to idiopathic OD and in patients with higher aggravation scores compared to the lower aggravation group. Multivariate regression analysis further confirmed that duration of smell loss was independently associated with IOQ. The duration of smell loss is negatively correlated with the individual importance of olfaction, suggesting that patients develop coping mechanisms for adjusting to OD.

Olfactory testing does not predict \u03b2-amyloid, MRI measures of neurodegeneration or vascular pathology in the British 1946 birth cohort

ObjectiveTo explore the value of olfactory identification deficits as a predictor of cerebral β-amyloid status and other markers of brain health in cognitively normal adults aged ~ 70 years.MethodsCross-sectional observational cohort study. 389 largely healthy and cognitively normal older adults were recruited from the MRC National Survey of Health and Development (1946 British Birth cohort) and investigated for olfactory identification deficits, as measured by the University of Pennsylvania Smell Identification Test. Outcome measures were imaging markers of brain health derived from 3 T MRI scanning (cortical thickness, entorhinal cortex thickness, white matter hyperintensity volumes); 18F florbetapir amyloid-PET scanning; and cognitive testing results. Participants were assessed at a single centre between March 2015 and January 2018.ResultsMean (± SD) age was 70.6 (± 0.7) years, 50.8% were female. 64.5% had hyposmia and 2.6% anosmia. Olfaction showed no association with β-amyloid status, hippocampal volume, entorhinal cortex thickness, AD signature cortical thickness, white matter hyperintensity volume, or cognition.Conclusion and relevanceIn the early 70s, olfactory function is not a reliable predictor of a range of imaging and cognitive measures of preclinical AD. Olfactory identification deficits are not likely to be a useful means of identifying asymptomatic amyloidosis. Further studies are required to assess if change in olfaction may be a proximity marker for the development of cognitive impairment.

0770 &amp;lt;Olfactory Disorders In Individuals With Diagnosis Of Narcolepsy&amp;gt;

Abstract Introduction Narcolepsy is a sleep disorder characterized mainly by excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic-hypnopompic hallucinations and sleep fragmentation. Besides those most known manifestations, other findings may be present in patients with narcolepsy, such as weight gain, reduction in eating satiety and psychological alterations. It is also observed that part of the hypocretin-producing cells projections are present in the olfactory bulb, and the conditions appears to be related to changes in olfaction. Methods a cross sectional study was performed in patients diagnosed with narcolepsy followed up by the excessive daytime sleepiness outpatient clinic of the discipline o Sleep Biology and Medicine of the Department of Psychobiology of the Federal University of São Paulo, Brazil. Olfaction was assessed by the University of Pennsylvania Smell Identification Test (UPSIT) following an interview and nasal cavity examination. Patients with conditions and disorders that may cause hyposmia were excluded. Results 77 patients were assessed, of which 56 had type-1 narcolepsy and 21 with type-2 narcolepsy. The results were compared with the test’s reference data. Most patients with type-1 and type-2 narcolepsy presented scores compatible with some degree of olfactory impairment. No significant difference was observed between the scores of patients with type-1 and type-2 narcolepsy. Conclusion The present study shows most patients with narcolepsy have some degree of olfactory impairment. This impairment doesn’t appear to be explained by alterations in the hypocretineric cells as pointed out in previous studies. The changes in olfaction in people with narcolepsy may cause the satiety alterations often observed in them. Other mechanisms involved with the genesis of hyposmia in those patients should be studied further. Support AFIP - Associação Fundo de Incentivo à Pesquisa

Social recognition deficits after developmental exposure to indoor flame retardants are correlated with an altered amygdala‐prefrontal cortex circuit and expression of social neuropeptides

Polybrominated diphenyl ethers (PBDEs) are indoor flame retardant pollutants with adverse neurobehavioral effects. In humans, PBDEs are associated with hyperactivity and impairments in executive function, psychomotor and mental development, attention and social competence. There is evidence showing that early‐life PBDE exposure, coinciding with critical developmental periods can permanently alter brain processes and behavior. Our lab has found that perinatal exposure to DE‐71, an industrial mixture of PBDEs, produces a behavior phenotype displaying altered social recognition ability and anxiety. This study further evaluates long‐term social recognition ability, and correlative changes in olfaction, gene expression of prosocial peptides, oxytocin and vasopressin and their receptors, and connectivity in the basolateral amygdala‐prefrontal cortex (BLA‐PFC), a critical component of the social brain network. C57BL/6 dams were dosed with DE‐71 for 10 wk (pre‐conception: 4 wk; gestation: 3 wk; lactation: 3 wk). Dosing consisted of low dose (LD, 0.1 mg/kg/d), high dose (HD, 0.4 mg/kg/d), or corn oil vehicle control (OD) administered via ingestion of infused corn flakes. Exposed progeny were subjected to behavioral testing for short‐ and long‐term social memory (social recognition task‐SRT, social memory recognition test‐SMRT), social novelty (sociability‐SOC), olfaction and anxiety (elevated plus maze‐EPM, Suok). When compared to OD controls, LD and HD male and female offspring exhibited deficits in short‐term SRT ability relative to OD, showing no preference to investigate a novel versus familiar mouse. LD males and females also showed long‐term social recognition memory deficits. In LD males and females this may be due to altered ability to discriminate two social odors as measured by an olfactory habituation/dishabituation (OHT). On EPM, LD males showed significantly more time spent in open arm indicating less anxiety while the opposite was found in HD female. Adult exposure in LD and HD dams did not produce altered SRT or OHT behavior. Gene markers of central vasopressin (Avp, Avp1ar) and oxytocin system (Oxt, Oxtr) were examined in offspring brains using qRT‐PCR. In HD females we found reduced Avp in the paraventricular (PVN) and supraoptic nuclei (SON) of the hypothalamus and reduced Avp1ar expression in the SON.To investigate potential alterations to the BLA‐PFC circuit that may underlie DE‐71‐induced deficits in social recognition, Cholera Toxin B was injected into the prelimbic cortex at PND30 and labeled PFC‐projecting BLA neurons were stereologically quantified. Significantly more labeled neurons (normalized to total cells) were found in the BLA of LD and HD males. In summary, perinatal exposure to DE‐71 may reprogram forebrain neurodevelopment and hypothalamic neurochemistry of “social” peptides possibly leading to altered prosocial and anxiogenic behavior phenotypes relevant to neurodevelopmental disorders.Support or Funding InformationSigma Xi GIAR (EK, KR), UC MEXUS (EK), UC Minigrant (VC, GL, KR), UCR RISE (MD), APS STRIDE (AB)

Quality-of-life and olfaction changes observed with short-term medical management of chronic rhinosinusitis.

Patients with chronic rhinosinusitis (CRS) commonly experience both reduced quality of life (QOL) and olfactory dysfunction (OD). Literature on the impacts of appropriate medical therapy (AMT) for CRS on QOL and OD is limited, and the focused design of these studies may limit their applicability to usual clinical practice. Adults with symptomatic CRS were prospectively enrolled (November 2016 to October 2018) into an observational, multi-institutional study. Individualized AMT was initiated using standard practice according to evidence-based guidelines. Endoscopy examination (Lund-Kennedy), olfactory function (Sniffin' Sticks) testing, and QOL survey responses (22-item Sino-Nasal Outcome Test [SNOT-22], Questionnaire of Olfactory Disorders-Negative Statements [QOD-NS]) were obtained at enrollment and follow-up. Baseline measures demonstrated heterogeneity of QOL and OD. After an average of 7.8 weeks, within-subject median SNOT-22 total improved by 39.5% (n = 39, p < 0.001) relative to baseline, including 50% (p = 0.014) improvement for item #21, "Sense of smell/taste." QOD-NS improvement was also statistically significant (p = 0.044). Sniffin' Sticks score relative improvement of 10.9% (n = 33, p = 0.109) was not statistically significant and lacked correlation with SNOT-22 total scores (R = -0.247, p = 0.165) or QOD-NS total scores (R = -0.016, p = 0.930), but correlated moderately with endoscopy score (R = -0.436, p = 0.018). Participants with varied impacts of CRS, treated with individualized short-term AMT, demonstrated significant improvements in CRS- and olfactory-specific QOL measures, without corresponding improvement in clinically measured olfactory function. Olfactory function changes moderately correlated with endoscopy score changes, but lacked an association with QOL measurements.

Jordan smell test: a pilot study

Objective An objective smell test is essential to identify the level of smelling sensation and provide information on changes in olfaction after treatment. The aim of this study is to describe a simple, portable, inexpensive, and reliable olfaction identification test in the Arab population (Jordan smell test). Patients and methods Seven odorants that are familiar to Arab people were selected for this smell test. In academic tertiary medical center setting, odor discrimination testing in patients with sinonasal disease and in nonsmoker healthy volunteers was performed, and the results were compared with appropriate statistical formulas. Results A total of 25 healthy volunteers and another 25 age-matched and sex-matched patients with sinonasal pathology were evaluated with our smell test. Volunteers scored 13.2 in Jordan smell test, whereas the score was 9.2 in the patients (P Conclusion Jordan smell test is a novel, office-based, and easy administrable method to objectively assess olfaction sensation in the Arab population. The test is flexible to changes in its different variables, such as the type or number of odors. Further studies with a larger number of participants in different Arab countries are needed to validate our results.