Gustatory Test Research Articles

The taste of the pandemic-contemporary review on the current state of research on gustation in coronavirus disease 2019 (COVID-19).

Subjectively perceived impairment of taste is a common and distinct symptom of coronavirus disease 2019 (COVID‐19). Large meta‐analyses identified this symptom in approximately 50% of cases. However, this high prevalence is not supported by blinded and validated psychophysical gustatory testing, which showed a much lower prevalence in up to 26% of patients. This discrepancy may be due to misinterpretation of impaired retronasal olfaction as gustatory dysfunction. In addition, we hypothesized that COVID‐19–associated hyposmia is involved in the decrease of gustatory function, as found for hyposmia of different origin. This indirect mechanism would be based on the central‐nervous mutual amplification between the chemical senses, which fails in COVID‐19–associated olfactory loss. However, further research is necessary on how severe acute respiratory syndrome‐coronavirus‐2 (SARS‐CoV‐2) may directly impair the gustatory pathway as well as its subjective perception.

Zinc supplementation during chemotherapy for gynecological malignancy.

To determine the significance of zinc supplementation for zinc deficiency during chemotherapy for gynecologic malignancies. Twenty-eight patients suspected of zinc deficiency before chemotherapy were prospectively evaluated. Gustatory test, serum zinc, blood count, and biochemical examinations were made pre-chemotherapy at 3- and 6-week intervals. Patients with serum zinc levels <70 μg were prescribed oral zinc acetate hydrate (167.8mg/day) for 3 weeks. The primary outcome was efficacy of zinc supplementation, the secondary outcomes were zinc deficiency rates and adverse effects of the zinc supplement. Fifteen (mean serum zinc level: 67.4 ± 6.2μg/dL) out of 28 patients were administered zinc supplementation pre-chemotherapy, and subsequent serum zinc levels reached 83.2 ± 15.3μg/dL in 3 weeks. Factors associated with chemotherapy (vs. chemoradiation, p=0.041) and taxane + platinum (p=0.048) were significant risk factors for decreasing zinc levels following chemotherapy. Although patients that required zinc supplementation showed decreased serum zinc levels after chemotherapy and tended to experience taste alteration (sour: p=0.041), zinc supplementation for zinc deficiency during chemotherapy did not alter taste perception. Zinc supplementation promptly increased serum levels without major complications and may prevent an alteration in taste perception.

Novel risperidone orally disintegrating minitablets for pediatric use: patient acceptance and dose adjustment

Objective Risperidone is a potent psychotropic agent has been approved for symptomatic treatment of irritability in children and adolescents with autism spectrum disorders. However, its bitter taste and dose adjustment of liquid dosage forms are a main hurdle for patient acceptance. Significance Thus, this recent study investigate the formulation of taste masked risperidone orally disintegration minitablets (ODMT) as a way of enhancing patient acceptance. Methods Taste masked risperidone hydrogenated castor oil or Cetyl alcohol based granules were prepared using a simple melt granulation technique in different drug to lipid ratios; drug release, bitterness score of the prepared granular formulations were evaluated. DSC was also performed to detect the possible drug lipid interaction. The selected lipid-based granules were further compressed into ODMT formulations. Bitterness score was assessed by gustatory sensation test and results were compared to marketed liquid formulations of risperidone. Results All the prepared ODMT formulations showed high content uniformity, with minimum dose fluctuation compared to marketed oral liquid preparations. Conclusion In conclusion, risperidone lipid-based granules could be formulated in different ratios by simple techniques and commonly used excipients into taste masked risperidone ODMT with accurate and flexible doses suitable for pediatric use with high taste preference and acceptability.

Symptoms of Depression in Patients with Chemosensory Disorders

Introduction: Patients with chemosensory dysfunction frequently report symptoms of depression. The current study aims to clarify whether the type (smell dysfunction, taste dysfunction, and mixed smell and taste dysfunction), severity, duration, or cause of dysfunction have differential impacts on the symptoms of depression. Methods: 899 patients with chemosensory disorders and 62 controls were included. Following a structured interview and an otorhinolaryngological examination, subjects underwent olfactory tests (Sniffin’ Sticks), gustatory tests (taste sprays) and an assessment of depressive symptoms (Beck Depression Inventory). Information on the cause and duration of disorders was also collected. Results: Patients with combined olfactory/gustatory dysfunction had higher depression scores than patients with smell dysfunction only and controls, and no significant difference was found between the smell dysfunction and controls. Anosmia patients, but not hyposmia patients, exhibited higher depression scores than controls. Among various causes of chemosensory disorders, patients from the posttraumatic group had higher depression scores than patients with other causes of chemosensory dysfunction (sinonasal, idiopathic, or postinfectious). Multiple linear regression analyses suggested that reduced olfactory function was associated with enhanced depression scores in the olfactory disorders group (B = −0.326, t = −2.294, and p = 0.02) and in all patients with chemosensory disorders (B = −0.374, t = −2.550, p = 0.017). Discussion/Conclusion: Simultaneously decreased input of olfaction and gustation seems to have an additive effect on the exacerbation of emotional dysfunction. Early intervention should be considered for depression symptoms in patients with mixed olfactory/gustatory dysfunction in clinical practice.

Isolated taste disorders in patients referred to a flavor clinic with taste and smell loss.

Background and AimApproximately five percent of the general population are suffering from taste disorders. Usually, subjective loss of taste is caused by smell disorders; thus, isolated loss of the sense of taste is relatively rare. Despite the influence on quality of life, isolated taste disorders (ITD) are sparsely represented in literature and clinical research. In particular, there is need for sufficient diagnostic and treatment algorithms. Aim of study is to add further information to the sparse literature on ITD and suggest an appropriate diagnostic algorithm for ITD.MethodsWe present a retrospective study on patients with ITD diagnosed at the Flavour clinic, ENT department, Regional Hospital West Jutland, between 2017 and 2020. All patients underwent a thorough rhinolaryngological and otoneurologic examination, including olfactory and gustatory assessment, and a wide spectrum of biochemical, microbiological, and radiological examinations.ResultsIn total, 522 patients referred due to smell and/or taste disorders, 423 (81%) complained of a subjective taste disorder, only 19 (3.4%) patients were diagnosed with ITD. According to etiology, the patients were categorized in following groups: medicine‐related (25%), mixed (21%), iatrogenic (21%), idiopathic (11%), radiotherapy‐related (11%), and autoimmune/inflammatory (11%). Based on etiology, individualized treatment was recommended with very discouraging results.InterpretationDiagnostics of taste disorders is a delicate and expertise demanding task. The mechanisms underlying isolated loss of taste are heterogeneous. ENT and otoneurologic examination, and specific olfactory and gustatory testing are required in all patients, whereas biochemical, microbiological, and radiological examinations are only necessary on an individual basis.

The Loss of Smell and Taste in the COVID-19 Outbreak: a Tale of Many Countries.

Purpose of ReviewOlfactory dysfunction in upper airway viral infections (common cold, acute rhinosinusitis) is common (> 60%). During the COVID-19 outbreak, frequency of sensory disorders (smell and/or taste) in affected patients has shown a high variability from 5 to 98%, depending on the methodology, country, and study.Recent FindingsA sudden, severe, isolated loss of smell and/or taste, in the absence of other upper airway inflammatory diseases (allergic rhinitis, chronic rhinosinusitis, nasal polyposis), should alert individuals and physicians on being potentially affected by COVID-19. The evaluation of smell/taste disorders with a visual analogue scale or an individual olfactory or gustatory test, at the hospital or by telemedicine, to prevent contamination might facilitate an early detection of infected patients and reduce the transmission of SARS-CoV-2.SummaryDuring the COVID-19 outbreak, patients with sudden loss of smell should initiate social distancing and home isolation measures and be tested for SARS-CoV-2 diagnostic test when available. Olfactory training is recommended when smell does not come back after 1 month but can be started earlier.

Olfactory and gustatory abnormalities in COVID-19 cases.

PurposeAt the time of writing, there is a pandemic affecting virtually every country on Earth. There is considerable discussion amongst clinicians as well as lay people about anosmia and ageusia in COVID-19 sufferers. We aimed to report the results from comprehensive olfactory and gustatory testing in a series of hospital in-patients.MethodsThe prospective study evaluated 81 individuals with a COVID-19 infection, as confirmed by 2019 n-cov Real-Time PCR laboratory testing. The control group consisted of forty individuals with COVID-19 negative. Olfactory and gustatory testings were carried out by an examiner utilizing stringent safety standards and wearing full personal protective equipment. The results obtained in the case group were then compared with those obtained for the controls.ResultsIn the case group, 41(50.6%) of patients were male and 40 (49.4%) were female, mean age of 54.16 ± 16.98 years (18–95). In the control group, 21 (52.5%) of subjects were male and 19 (47.5%) were female, and mean age was 55 ± 15.39 years (18–90). Fifty (61.7%) COVID-19-positive patients had complaints related to olfaction. The distribution of olfactory symptoms in the case group differed at the level of statistical significance from the control group (p < 0.001). Turning to gustatory abnormalities, within the case group, 22 individuals (27.2%) had taste malfunction. A statistically significant difference was found in the distribution of gustatory abnormalities between cases and controls (p < 0.001).ConclusionsOlfactory and gustatory dysfunctions are strongly associated with SARS-CoV-2 infection. Hyposmia with or without hypogeusia is potentially a reliable indicator of latent COVID-19.

Prospective assessment of gustatory function after radiotherapy for head and neck cancers.

Taste disorders are major causes of morbidity in patients undergoing head and neck irradiation. We quantitatively assessed the gustatory function of patients with head and neck cancers who underwent radiotherapy using recently developed standardised tools for measuring taste. Twenty patients undergoing head and neck irradiation responded to a specific questionnaire and were assessed by olfactory and gustatory function tests. To assess changes over time, testing was performed before, immediately after, and at 2- and 4-week intervals following the start of radiotherapy. Concurrently, patients were evaluated for xerostomia from radiotherapy. A decrease in the taste recognition threshold was observed in the second week after the beginning of radiotherapy. The taste detection threshold improved within the 14th-18th week. Most affected patients demonstrated that their gustatory function primarily decreased independent of the olfactory function. Disturbances in taste were exponentially worsened beyond an accumulated dose of 30Gy and involved all tastants. According to a multivariate analysis, radiation-induced taste impairment was not influenced by the degree of xerostomia. However, there was an association between the dose of irradiation and the severity of taste disturbance. In this preliminary study, we found that the taste function was worse 2weeks after the start of radiotherapy and returned to pretreatment levels within 4.5months. Taste disturbances were exponentially worse beyond an accumulated dose of 20Gy. Taste dysfunction after radiotherapy was not influenced by the degree of xerostomia, whereas only the dose of irradiation was associated with the severity of taste dysfunction.

Validation of a self-administered olfactory and gustatory test for the remotely evaluation of COVID-19 patients in home quarantine.

BackgroundChemosensitive disorders are very frequent in the early stages of COVID‐19 and in paucisymptomatic cases. These patients are typically placed in home quarantine. This study has the aim of validating a new olfactory and gustatory objective evaluation test in these patients.MethodsThirty‐three home‐quarantined COVID‐19 patients have undergone a self‐administered chemosensitive test the day before the control swab. On this occasion, the patients underwent operator‐administered already validated tests. The results were finally compared.ResultsThe differences between the results of the two tests were not significant for both the olfaction (P =.201) and the taste (P =.180).ConclusionThe olfactory and gustatory evaluation by self‐administered test can be considered a valid tool, fundamental for obtaining objective qualitative and quantitative data on the extent of chemosensitive disorders in home‐quarantined COVID‐19 patients.

Detection and recognition thresholds for five basic tastes in patients with mild cognitive impairment and Alzheimer\u2019s disease dementia

BackgroundPatients with Alzheimer’s disease dementia (ADD) are thought to exhibit taste disorders; however, this has not been extensively studied. We investigated gustatory functions and factors affecting taste in patients with ADD or mild cognitive impairment (MCI) and in non-demented controls (NDCs) and evaluated associations between cognitive impairment and gustatory functions.MethodsWe recruited 29 patients with ADD, 43 with MCI, and 14 with NDCs. We obtained medical and medication history, measured salivary secretion volumes, and performed cognitive function tests, blood tests, whole-mouth gustatory tests, and dietary and gustatory questionnaires.ResultsPatients with ADD showed significantly higher recognition threshold values than NDCs (p < 0.05). Many individuals did not recognize umami at the maximum concentration, and this happened more frequently in patients with ADD or MCI than in NDCs. Evaluation items other than cognitive function tests did not show significant differences among the groups, but many individuals had decreased salivation, low serum zinc levels, and were on multiple medications. We found a significant correlation between recognition threshold and age (r = 0.229, p < 0.05) and cognitive function test score (r = 0.268, p < 0.05).ConclusionsPatients with ADD showed impairment of gustatory function. Gustatory impairment in patients with MCI could not be confirmed. However, many individuals with MCI did not recognize umami, either. Our results suggest that taste disorders in elderly people with cognitive decline occur independently of factors affecting taste such as salivation, zinc levels, or prescription drugs.Trial registrationThe study was registered in the UMIN Clinical Trials Registry on February 10, 2017, with reference number UMIN000026087.

Chemosensory function is decreased in rheumatoid arthritis.

Research indicates that rheumatic disorders are accompanied by decreased chemosensory function. The present study aimed to specifically evaluate this issue in patients with rheumatoid arthritis (RA). 212 RA patients (43 men, 169 women, mean age 59 ± 13.3years), and 30 healthy controls (10 men, 20 women, mean age 40 ± 15.3years), were included in this study. Chemosensory measurements consisted of olfactory testing using the "Sniffin' Sticks" test battery (with odor thresholds, odor discrimination and odor identification; OT, OD, OI) and gustatory testing on a suprathreshold and a quasi-threshold level using "taste sprays" and "taste strips", respectively. In addition, inflammatory markers (erythrocyte sedimentation rate, C-reactive protein) and RA autoantibodies (anti-cyclic citrullinated peptides, RA factors) were evaluated. Olfactory measurements showed 4% of the RA patients functionally anosmic and 40% hyposmic. RA patients scored significantly lower in suprathreshold olfactory tests (OD, OI) compared to controls (OI: 12.5 ± 2.5 vs. 14.1 ± 1.3; OD: 11.3 ± 2.7 vs. 12.9 ± 1.7). In addition, RA patient had decreased taste function compared to healthy individuals (10.4 ± 2.6 vs. 11.7 ± 1.7). Chemosensory function did not correlate with parameters related to the severity of disease. Chemosensory function (taste, OD and OI) appears to be decreased in RA patients. In contrast, OT was not affected. Changes in chemosensory function seem to be independent of disease parameters such as duration of disease or disease activity.

Gustatory function in persons with cerebral palsy.

Gustatory function is closely related to chewing and swallowing; however, there are currently no reports regarding gustatory function in persons with cerebral palsy (CP). The aim of this study was to compare the gustatory function between persons with CP and healthy controls. We investigated sweet, salty, sour and bitter tastes using the whole-mouth method and measured the electrogustometric thresholds in the chorda tympani nerve area. Twelve participants with CP (6 women and 6 men) for whom gustatory testing was possible at our facilities, and 17 age-matched controls (9 women and 8 men) were included. The mean age±standard deviation was 58.6±8.1years and 58.5±8.7years in subjects with CP and controls, respectively. Taste detection and identification were significantly worse in persons with CP compared with the controls. Taste identification was more impaired than taste detection. At the highest concentration, taste identification was impossible 11 times out of 48 (12 persons×4 kinds of tastes) in persons with CP but such a deficit was not observed in 68 attempts (17 persons×4 kinds of tastes) involving controls. The electrogustometric thresholds were not significantly different between the groups. Gustatory function associated with chewing and swallowing is worse in persons with CP compared to the controls.

To Assess the Influence of Habitual Mouth Breathing and its Associated Taste Alterations

Background: If the sense of taste is impaired, it may often negatively affect patient’s food intake, nutritional status and consequently health condition because it provides information about the food we eat. Aim and Objective: To study the influence of habitual mouth breathing and its associated taste alterations and also investigate the cause of this influence. Method and Methodology: Total eighty subjects were taken out of which forty healthy volunteers (male-26; female14) participated in this study. The mean age of these subjects was 25.6± 1.9 (SD) years (age range, 19-36 years). Furthermore forty subjects (male-21; female-19) with a habit of mouth breathing (MB) were taken. The mean age of these subjects was 29.5± 3.4 (SD) years (age range, 19-40 years). A taste threshold is the minimum concentration at which taste sensitivity to a particular substance or food can be perceived. The subjects were told to avoid eating or drinking anything, with the exception of water for 3 hours before evaluation. In addition, a complete Ear, Nose, Throat examination was performed. We carried out the chemical method of gustatory testing by using filter paper taste strips. This is a validated gustatory test, used to measure the gustatory sensitivity of the tongue for 5 tastants; sweet, sour, salty, bitter, and umami. We measured the recognition thresholds only on one side on the tongue either left or right. There are many factors that can alter taste senstivity. Considering these factors can help us better understand and ensure accurate sensory taste perception. Although there are a variety of factors but some that influence taste perception more than others are discussed in this study. These various effects are brought about by the many organic and inorganic constituents of saliva. In response to these variations in saliva, taste sensitivity may also fluctuate widely. Conclusion: Relationships between individual salivary constituents and certain taste substances have been explored in human psychophysical and animal experiments. However, there are many organic and inorganic salivary constituents whose effects on taste acuity have not yet been fully elucidated

Electronic Tongues for Inedible Media.

“Electronic tongues”, “taste sensors”, and similar devices (further named as “multisensor systems”, or MSS) have been studied and applied mostly for the analysis of edible analytes. This is not surprising, since the MSS development was sometimes inspired by the mainstream idea that they could substitute human gustatory tests. However, the basic principle behind multisensor systems—a combination of an array of cross-sensitive chemical sensors for liquid analysis and a machine learning engine for multivariate data processing—does not imply any limitations on the application of such systems for the analysis of inedible media. This review deals with the numerous MSS applications for the analysis of inedible analytes, among other things, for agricultural and medical purposes.

A Comparative Study of Whole-Mouth Taste Thresholds between North Korean Refugees and South Koreans

Background and Objectives Since Korea has been divided into two countries over 60 years ago and differences has gradually developed between the two, an influx of North Korean refugees to South Korea have soared over the past 20 years. Their complaints regarding taste intensity, particularly about strong sweetness of foods, are common after entry into South Korea. Because a long-term over-exposure or restriction to some taste stimuli causes profound alterations in corresponding taste sensitivity in humans, we hypothesized that sugar restriction, which remains common in North Korea, has influenced sweet sensitivity of North Koreans. Subjects and Method To test this hypothesis, we assessed the taste stimuli recognition and detection thresholds of both young adults North refugees and South Koreans using a 1-mL whole-mouth gustatory test applied to a series of sweet, bitter, sour, and salty solutions. Results As expected, the cumulative curve of the recognition threshold for sucrose shifted to the left and the mean recognition threshold for sucrose was significantly lower (0.5357% vs. 0.7393%, p=0.044) for North refugees than for South participants. On the other hand, the recognition threshold for salt was significantly higher (0.2174% vs. 0.1212%, p=0.027) in North refugees. No differences on the recognition taste sensitivity for quinine hydrochloride and citric acid were observed. Conclusion The findings documented in the present study indicate that a prolonged food deficit seems to have changed the taste sensitivity of healthy North Korean refugees. The altered taste sensitivity was most pronounced for sweet and salty tastes, and lasted up to 3.5 years after the refugees left North Korea. Key words: Refugees ㆍ Taste perception ㆍ Taste threshold

Association of olfactory impairment with indexes of sarcopenia and frailty in community-dwelling older adults.

Individuals with olfactory or gustatory impairment often have associated difficulties with food-related activities. As both functions decline in older adults, we investigated the association of these impairments with sarcopenia/frailty indexes in community-dwelling older adults. A total of 141 participants (69 men and 72 women, mean age 73.0 years) were enrolled. Odor identification was examined using the Open Essence test. Salty and sweet tastes were assessed using a whole-mouth gustatory test. Participants underwent evaluation of the appendicular skeletal muscle mass index (ASMI) by InBody720 and grip strength, and determination of the Study of Osteoporotic Fractures frailty index. Participants with olfactory impairment (Open Essence ≤7), but not with gustatory impairment, showed a significantly higher prevalence of ASMI and grip strength less than the cut-off values recommended by the Asian Working Group for Sarcopenia, and Study of Osteoporotic Fractures frailty and/or pre-frailty status, compared with those without impairment. Multivariate logistic regression analysis showed a significant association of olfactory impairment with ASMI less than the cut-off value, grip strength less than the cut-off value, Asian Working Group for Sarcopenia sarcopenia and pre-frailty/frailty in the Study of Osteoporotic Fractures index in the whole population, and with ASMI less than the cut-off value and Asian Working Group for Sarcopenia sarcopenia in women, after adjustment. Three (Japanese cypress, wood and roasted garlic) and four (Japanese orange, India ink, menthol and curry) Open Essence odorants were elucidated as the "sarcopenia subset" and "frailty subset," respectively, and showed higher ability to identify sarcopenia and frailty status, compared with the remaining five odorants. These findings suggest that olfactory impairment is closely associated with sarcopenia and/or frailty in community-dwelling older adults. Geriatr Gerontol Int 2019; 19: 384-391.

Clinical investigation of gustatory and neurosensory alterations following mandibular third molar surgery: an observational prospective study.

This study aimed to prospectively observe gustatory and neurosensory alterations following surgical removal of mandibular third molars. A prospective clinical study was conducted with patients who required mandibular third molar extraction, recruited from the Division of Oral and Maxillofacial Surgery at the Federal University of Ceará (Brazil). Age, sex, and radiographic signs were recorded. The outcome variables were the presence or absence of gustatory and neurosensory alterations. The patients were observed preoperatively and at 7, 30, 90, and 180days postoperatively by using gustatory and neurosensory tests. The response to sweet (p = 0.509) and sour (p = 0.078) stimulus did not alter significantly over time. The salty threshold significantly increased from the preoperative to 7- and 30-day postoperative periods, returning to baseline values at 90days postoperatively (p = 0.038). The bitter threshold increased significantly from the preoperative to 7-day postoperative period, returning to baseline values at 30days after surgery (p < 0.001). Regarding neurosensory evaluation, there was an altered response to stimulus at 7days postoperatively in specific studied areas, returning to baseline values 30days after surgery (p < 0.05). The present study shows that mandibular third molar removal was associated with slight sensory disturbances related to mechanical, tactile, and gustatory perception. Regarding the recovery period, all patients returned to normal function without intervention, over a period ranging from 30 to 90days. This study highlighted the importance of a sensory evaluation following removal of third molars, notably regarding mechanical perception and gustatory threshold assessment.

Proton Pump Inhibitor Ameliorates Taste Disturbance among Patients with Laryngopharyngeal Reflux: A Randomized Controlled Study.

Patients with laryngopharyngeal reflux (LPR) were reported to suffer from hypogeusia that affects quality of life. Proton pump inhibitor (PPI) is a useful drug in the treatment of LPR, but its effect on hypogeusia is not known. We therefore assessed the effects of PPI or a histamine H2 receptor antagonist (H2 blocker) on hypogeusia among patients with LPR. Both PPI and H2 blocker could inhibit acid reflux. LPR was diagnosed with reflux finding score and reflux symptom index. The visual analogue scale (VAS) of taste disturbance symptoms and the gustatory tests were assessed before and 8 weeks after treatment with esomeprazole, a PPI (20 patients, aged 50.0 ± 1.7 years) or famotidine, a H2 blocker (20 patients, aged 47.1 ± 1.8 years). There were no significant differences in VAS scores and recognition thresholds for four basic tastes between the two groups before treatment. Only PPI therapy significantly decreased the VAS scores, suggesting the improvement of taste perception. Moreover, PPI therapy significantly decreased recognition thresholds for bitter taste in the anterior tongue (chorda tympani nerve area) and the thresholds in the posterior tongue (glossopharyngeal nerve area) for salty, sour, and bitter tastes. By contrast, H2-blocker therapy caused no significant changes of thresholds in the anterior tongue, but improved the threshold only for bitter in the posterior tongue, the value of which was however significantly higher than that in PPI group. In conclusion, PPI could ameliorate hypogeusia by improving bitter, salty, and sour tastes among patients with LPR.

P.115 Association of phantogeusia with Parkinson Disease

Background: Phantogeusia associated with Parkinson Disease has not heretofore been reported. Methods: A 59 year old right handed female presented with a four year history of a bitter, sour and sweet taste on her entire tongue and roof of her mouth, 8/10 intensity, constant, persistent, without any external stimuli. Drinking water tasted bitter and sour. The phantogeusia was unresponsive to dietary changes, gabapentine, and allergy medications. Results: Abnormalities in Neurological examination: Decreased blink frequency. Hypokinetic. Hypomimetic face. Mood appears sad. Cranial Nerve (CN) examination: CN lll, lV, Vl: Saccadization of horizontal eye movements. Motor Examination: Pill rolling tremor in right hand. 1+ cogwheel rigidity in left upper extremity. Gait: 2+ retropulsion. Chemosensory testing: Olfactory: Alcohol Sniff Test: 6 (anosmia). SNAP Phenylethyl Alcohol Threshold Testing left -2.5 (hyposmia) &amp; right &gt; -2.0 (anosmia). Gustatory testing: Propylthiouracil Disc Taste test: 10 (normogeusia). Taste Testing Threshold: normogeusia to NaCl, Sucrose, HCl, Urea, and PTC. Other: DOPAPET: positive for Parkinson disease. Upper endoscopy: normal. Conclusions: Investigation for the presence of parkinsonian features in those with phantogeusia is warranted and chemosensory dysfunction including phantogeusia in those who presents with Parkinson’s disease is worthy of exploration.

Awareness of dysgeusia and gustatory tests in patients undergoing chemotherapy for breast cancer.

We analyzed the prevalence of gustatory test abnormalities in breast cancer (BC) patients undergoing chemotherapy. We enrolled 43 BC patients undergoing chemotherapy and 38 BC patients who had never undergone chemotherapy (control group). Two gustatory tests were conducted: an instillation method examining the threshold for four basic taste stimuli and an electrogustometry method measuring the threshold for perception with electric stimulation at the front two-thirds of the tongue (cranial nerve VII) and at the back third of the tongue (cranial nerve IX). The results of the two gustatory tests and clinicopathological factors were compared between the chemotherapy and control groups and between patients with and without awareness of dysgeusia in the chemotherapy group. In the chemotherapy group, 19 (44%) patients were aware of dysgeusia and 8 (19%) had hypogeusia using the instillation method. Although more patients had parageusia in the chemotherapy than control group, no significant differences in the results of the two gustatory tests were observed. Patients with dysgeusia awareness had a higher threshold at cranial nerve IX using the electrogustometry method than those without dysgeusia awareness; no significant differences in hypogeusia were observed using the instillation method. In fact, 74% (14/19) of patients with dysgeusia awareness could identify the four tastes accurately using the instillation method. Similar results were observed for the instillation and electrogustometry methods at cranial nerve VII. While approximately half of the chemotherapy patients were aware of dysgeusia, 81% (35/43) of them could accurately identify the four basic tastes using the instillation method.