Mometasone furoate nasal spray improves olfactory performance in seasonal allergic rhinitis.
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Adult↗
Biomedical subjects
T Hummel
Publications and source records attributed to T Hummel.
[Therapy of olfactory loss].
BACKGROUND: Apart from olfactory loss due to sino-nasal disease therapy of olfactory dysfunction is a difficult task. METHODS: Own investigations were carried out using alpha-lipoic acid (Hummel et al. 2002) and caroverine (Quint et al. 2002) in both patients with posttraumatic olfactory dysfunction and patients with olfactory loss following viral infections. Both studies were designed as unblinded trials; the study using caroverine contained an arm where patients received zinc. RESULTS: While data from these investigations are preliminary both studies indicated a beneficial effect of the medication on olfactory loss. Therapeutic principles may involve the release of nerve growth factors through alpha-lipoic acid and the NMDA-antagonistic action of caroverine which might act at higher order centers of olfactory processing. CONCLUSIONS: These studies and other work indicate that olfactory loss may be treated through different pharmacological approaches. However, only double-blind, randomized, controlled trials will tell whether these effects are due to the potential pharmacological activity of these drugs, or, whether they merely reflect spontaneous recovery as it is seen in a relatively large percentage of patients suffering from olfactory dysfunction.
Antioxidants↗
Ratings of overall olfactory function.
The aim of this study was to investigate the accuracy of self-reported ratings of olfactory function in 83 healthy subjects. Such ratings were compared with quantitative measures of olfactory function, as well as with ratings of nasal patency. In experiment 1 subjects rated olfactory function and nasal patency before olfactory testing, whereas in experiment 2 the reverse was the case. No feedback regarding test results were provided until after completion of the testing. The principal findings were: (i) when ratings preceded measurements of olfactory function, there was no significant correlation between the two parameters. However, ratings of olfactory function correlated significantly with ratings of nasal airway patency. (ii) In contrast, when measurements of olfactory function preceded the ratings, this constellation switched. Now ratings of olfactory function correlated significantly with measured olfactory function, whereas there was no significant correlation between ratings of nasal airway patency and ratings of olfactory function. In conclusion, these data suggest that ratings of olfactory function are unreliable in healthy, untrained subjects. The ratings seem to reflect changes of nasal airway patency to a larger degree than measurable olfactory function. The results further indicate that this is mainly due to the limited attention the sense of smell receives in daily life.
Adult↗
Quantitative assessment of gustatory function in a clinical context using impregnated "taste strips".
Assessment of gustatory sensitivity in a clinical setting is the prerequisite for correct diagnosis and adequate treatment of taste dysfunction. Despite of this, no taste test has been established for the routine clinical testing. The aim of the present study was to create a protocol which is easy to administer. The presently used technique is based on strips made from filter paper which were impregnated with different taste solutions (four concentrations each for sweet, sour, salty and bitter). These strips are placed on the tongue and subjects are asked to identify the taste quality. After establishing the concentration range of the taste solutions, the test was tried in 69 subjects. Each subject received eighteen taste strips (four concentrations of each taste quality plus two blanks) in a pseudo-randomized sequence. Results from this new procedure correlated significantly with the results of the well established extensive three-drop-technique (r69 = 0.67). Repeated measures indicated good reproducibility of the results for the taste strips (r69 = 0.68). These data suggest the usefulness of this new technique in routine clinical practice. Major advantages are long shelf-life, convenience of administration, short time needed for testing (approximately 8 min), and the possibility to test each side of the tongue separately.
Adolescent↗
On the chemosensory nature of the vomeronasal epithelium in adult humans.
In contrast to many lower vertebrates, the vomeronasal epithelium (VNE) in humans has long been regarded as absent or functionally irrelevant. For example, the neural connection between the VNE and the accessory olfactory bulb has been reported to degenerate during the second half of pregnancy and its presence has not been demonstrated in adults. Further, reports on the organ's occurrence in adult humans have been contradictory. The aims of this study were to collect immunohistochemical data on the neurogenic or epithelial character of the VNE [for example, with antibodies against protein gene product 9.5 (PGP 9.5), olfactory marker protein (OMP), beta-tubulin, and cytokeratin], determine its proliferative capacity (for example, proliferating cell nuclear antigen), as well as to examine the differentiation activity of VNE cells and their interactions with extracellular matrix components (for example, hyaluronan receptor CD44, galectins, and caveolin). To this end, we studied the vomeronasal organs (VNOs) of 22 human cadavers, three adult biopsies, one embryo (week 8) and one fetus (week 13) by means of immunohistochemistry. The histology of the VNE appeared extremely heterogeneous. There were sections of stratified, respiratory, and typical "pseudostratified" vomeronasal epithelia consisting of slender bipolar cells. Mostly negative immunohistochemical results for OMP indicated that the human VNE does not function like the mature olfactory epithelium. In addition, the investigations did not support the hypothesis that neural connections between the VNE and central brain structures might be present. On the other hand, the presence of some bipolar cells positive for both PGP 9.5 and soybean lectin (SBA) pointed to a neuron-like activity of a small subset of VNE cells. Proliferation antigens located in the nuclei of basally located cells of the VNE were not regularly expressed. However, positive reactions for CD44 demonstrated a high activity of VNE cells in terms of differentiation and migration. Some bipolar cells showed immunoreactivity for caveolin indicating its possible role in signal transduction and differentiation. In summary, the reaction patterns of most antibodies in the adult human VNE are different from those obtained in the olfactory epithelium and the VNO of the rat. However, the VNE shows a specific pattern of activity unique to the mucosa of the nasal cavity. Considering the histologically well differentiated epithelium and its steady maintenance, the VNE of the adult human appears to be a highly differentiated structure the function of which remains unclear.
Adult↗
Olfactory function in idiopathic Parkinson's disease (IPD): results from cross-sectional studies in IPD patients and long-term follow-up of de-novo IPD patients.
Olfactory loss is a prominent symptom in idiopathic Parkinson's disease (IPD). Experiment 1 re-investigated the diagnostic value of psychophysical testing in the differentiation between idiopathic Parkinson disease (IPD) from non-IPD; 50 consecutive PS patients participated. In Experiment 2 five de-novo patients received 3 olfactory tests spread over a period of approximately one year. Nineteen IPD patients were anosmic, and 18 were hyposmic. All but one patient with MSA and PSP had mild/moderate hyposmia. Normosmia was found in CBD/misdiagnosed PS/psychogenic movement disorder. In Experiment 2, one of the de-novo patients was normosmic, 3 hyposmic, and 1 anosmic. Follow up investigations indicated decreased olfactory function in 3 patients while it improved in one. The normosmic patient retained olfactory abilities. This patient failed to respond to pharmacological treatment. In summary, olfactory tests differentiate IPD from non-IPD. Furthermore, tests of olfactory function may also be of interest in investigations related to treatment of PS.
Adult↗
Olfactory modulation of nausea during early pregnancy?
OBJECTIVES: To investigate whether nausea and vomiting and olfactory sensitivity are correlated, we determined whether subjects with little or no nausea and vomiting are less sensitive to odours than subjects who indicate a high degree of nausea and vomiting, and whether subjects with relatively low olfactory sensitivity are less prone to nausea and vomiting than subjects with relatively higher olfactory sensitivity. DESIGN: Cross sectional study. SETTING: The Unit of Perinatal Physiology, Department of Obstetrics, University Hospital, Zurich, Switzerland. POPULATION: Fifty-three women in early pregnancy. METHODS: Following a detailed history related to olfaction and nausea and vomiting, subjects filled in a nausea profile which provided a 'general nausea score' comprised of the factors 'somatic distress', 'gastrointestinal distress', and 'emotional distress'. Olfactory function was assessed using pen-like odour dispensing devices ('sniffin' sticks'). Tests included n-butanol odour threshold, odour discrimination and odour identification. MAIN OUTCOME MEASURES: Olfactory function assessed by means of the sniffing sticks nausea profile. RESULTS: Correlational analyses between results of olfactory sensitivity and scores from the nausea questionnaire were not significant. Further, when subjects were divided into groups with relatively low or relatively high overall scores in the nausea profile, olfactory sensitivity did not differ between groups. Similarly, other analyses did not indicate a modulation of nausea and vomiting through olfactory sensitivity. CONCLUSIONS: These findings do not support the hypothesis that higher olfactory sensitivity relates to an increase of nausea. However, they do support the idea that olfactory-induced nausea is independent of subjectively perceived intensity. Olfactory-induced nausea appears to be due to the cognitive processing of olfactory information which, in early pregnancy, is reported to be altered in an unsystematic fashion.
Adolescent↗
Olfactory function in Parkinsonian syndromes.
The study aimed to compare olfactory function in idiopathic Parkinson's disease (IPD) and nonidiopathic Parkinson's syndrome (PS). At their first visit 50 PS patients (age 38-80 years) received testing for odor threshold, olfactory discrimination and identification. All patients underwent extensive neurological diagnostics including PET scans. Patients were followed up for 6-12 months. Most of IPD patients were functionally anosmic (n=19), the remaining IPD patients had severe/moderate hyposmia (n=18). PS patients diagnosed with multiple system atrophy had less severe olfactory deficits (7 hyposmia, 1 normosmia). With the exception of 1 hyposmic patient, other PS patients had no olfactory deficits (progressive supranuclear palsy, corticobasal degeneration, psychogenic PS, essential tremor). This study added to previous findings: (1) there was no major difference betwesen olfactory function in IPD subtypes; (2) all olfactory tests differentiated IPD from nonIPD. These data suggest that olfactory probes improve the diagnostic armamentarium in IPD.
Adult↗
[Basics, methods and indications for objective olfactometry].
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Chemoreceptor Cells↗
Olfactory function in HIV-positive subjects.
The aim of this study was to reinvestigate previous reports of chemosensory dysfunction in HIV-positive subjects. Odor thresholds, odor discrimination and odor identification were assessed using the Sniffin' Sticks test battery. Seventy-four HIV-positive patients were tested. According to CDC criteria, 38 subjects were classified as stage A, 10 as stage B and 26 as stage C. None of the subjects exhibited severe cognitive impairment. Compared to normative data all subjects had normal odor identification and discrimination. However, odor thresholds were well below the median of a normal population. There were no significant differences between stage A, B or C subjects. This may be interpreted as indicating that olfactory dysfunction is among the primary deficits of HIV infection and occurs independently of disease stage. These results confirm previous work suggesting that odor thresholds are elevated early in HIV infection whereas a decline in identification and discrimination abilities is correlated with reduced cognitive abilities.
AIDS-Related Opportunistic Infections↗
Comparison of lateralized and binasal olfactory thresholds.
We investigated whether dirhinal olfactory thresholds differ from monorhinal ones. Experiments 1 and 2 investigated butanol, Experiment 3 phenylethylalcohol. In Experiments 2 and 3 pen-like odor dispensing devices were used, in Experiment 1 odors were presented in glass bottles. Participants were in excellent health (Experiment 1: 14 female [f], 15 m [m], mean age [ma] 24 years; Experiment 2: 12 f, 19 m, ma 24 years; Experiment 3: 19 f, 19 m, ma 32 years). Thresholds were assessed for left, right, and both nostrils. No significant difference was found between dirhinal results and results for the best of two nostrils. Apart from this, thresholds were found to improve with repeated testing. In conclusion, using two odorants with different techniques of administration in studies performed at different sites, the present results indicated that there is no major difference between odor detection thresholds obtained for the best and both nostrils.
Adult↗
Gustatory and olfactory function in the first trimester of pregnancy.
OBJECTIVE: To investigate gustatory and olfactory sensitivity in the first trimester of pregnancy using validated test kits. DESIGN: Prospective study. SETTING: Department of Obstetrics, University Hospital Zurich, Switzerland. POPULATION: Total 53 pregnant women and 59 controls in a known phase of the menstrual cycle. METHOD: Gustatory sensitivity was assessed by requiring subjects to discriminate between four basic-taste tablets ('sweet', 'salty', 'sour', and 'bitter'). Olfactory testing was performed using the 'Sniffin' sticks' kit. Subjects rated the intensity and hedonic tone of the four tastants and of 10 common odors. RESULTS: Pregnant women had significantly lower overall gustatory sensitivity scores. There were no differences in olfactory sensitivity. However, pregnant women rated the odors 'rum', 'cigarette' and 'coffee' as more aversive than did non-pregnant women. CONCLUSION: Our data do not support the hypothesis of a generalized increase in chemosensitivity in early pregnancy. In terms of adaptive changes of the olfactory system may act as a sentinel to potentially harmful chemicals. In contrast, the gustatory system appears to retreat to allow a greater intake of electrolytes and a more widely sourced diet.
Adult↗
Effects of the opioid remifentanil on olfactory function in healthy volunteers.
The effects of opioids on human subjective olfactory function have rarely been investigated. This is despite the fact that opioid receptors are widely distributed throughout the olfactory systems. Using an established validated test of subjective olfactory function, olfactory threshold, odor discrimination and odor identification performance were tested in 16 healthy volunteers before opioid administration and at steady state after 3 hours remifentanil infusion. Each one man and one women were assigned randomly to one out of eight predefined remifentanil target plasma concentrations: 0, 1.2, 1.8, 2.4, 3, 3.6, 4.8, and 6 ng/ml. In the thirteen subjects that had completed the tests, olfactory thresholds were elevated with increasing remifentanil dose, and this correlated statistically significant with the remifentanil dose. Remifentanil plasma concentrations were linearly related to changes in olfactory thresholds. In contrast, effects of remifentanil on odor discrimination and identification were not statistically significant. However, remifentanil target plasma concentrations were also significantly correlated with the subjects' ratings of tiredness and drowsiness, although only drowsiness was significantly correlated with the differences in odor thresholds. We conclude that opioid administration leads to impaired olfactory function expressed in raised olfactory thresholds. This is compatible with previously reported opioidergic effects at the level of the olfactory bulb.
Adult↗
[Current diagnosis and therapy of postoperative delirium].
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Delirium↗
Oral mucosal blood flow in patients with burning mouth syndrome.
The pathophysiology of burning mouth syndrome (BMS) is largely unknown. Thus, the aim was to study oral mucosal blood flow in BMS-patients using laser Doppler flowmetry (LDF). Thirteen BMS patients (11 female, two male; mean age+/-SD 64.3+/-7.9 years, mean disease duration 18.9+/-6.2 months) and 13 healthy non-smoking controls matched for age and gender (11 female, two male; mean age 64.7+/-8.1 years) were investigated. Using the LDF technique mucosal blood flow (mBF) was measured at the hard palate, the tip of the tongue, on the midline of the oral vestibule, and on the lip. Measurements were made at rest and over 2 min following dry ice application of 10 s duration using a pencil shaped apparatus. In addition, blood pressure (BP), heart rate (HR), peripheral cutaneous blood flow, and transcutaneous pCO(2) were continuously recorded. Mucosal blood flow (mBF) increased at all measurement sites in response to dry ice application (P<0.001) with peak flow at 0.5--1.5 min after stimulation onset. During the following 1.5--2 min, blood flow decreased at all sites with a tendency to return to baseline towards the end of the observation period. Except for BP and peripheral blood flow, all of the cardiovascular changes exhibited significant changes during the observation period; no differences between groups were detected. When compared to healthy controls BMS patients generally exhibited larger changes in mBF. These changes were significant for recordings made on the hard palate (F[1,24]=13.9, P<0.001). Dry ice stimulation appears to be an effective, non-invasive and reasonably tolerable means to investigate mucosal blood flow at different mucosal sites. In general, vasoreactivity in BMS patients was higher than in healthy controls. BMS patients exhibited a higher response on the hard palate compared to controls. These changes in oral blood flow appear to be specifically related to BMS symptoms indicating a disturbed vasoreactivity.
Aged↗
Plasma homocysteine and MTHFR C677T genotype in levodopa-treated patients with PD.
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Genotype↗
Patterns of non-conductive olfactory disorders in eastern Austria: a study of 120 patients from the Department of Otorhinolaryngology at the University of Vienna.
BACKGROUND: About 1% of the population suffer from disorders of the chemosensory system. In the United States at least two million people have problems related to smell and taste. The sense of smell enables the individual to determine the flavour of food and beverages and is most important as a sophisticated warning system. For the present investigation, we collected data on the age pattern and causes of olfactory disorders in eastern Austria. METHODS: 120 patients with non-conductive olfactory disorders were examined over a 9-month period starting from July 1998 at the outpatient clinic of the Ear Nose and Throat Department of the University of Vienna. Data concerning the underlying population taken from the 1998 population census in Vienna were used for comparison, in order to gain a more representative estimation of the distribution of these disorders. The diagnosis was based on thorough history taking, physical examination, CT scan, and olfactory testing for sensitivity by means of so-called "sniffin' sticks". RESULTS: The patients' ages ranged from 16 to 86 years (mean, 54.5 years; 74 females, 46 males). Those older than 50 years seem to have a higher risk of developing olfactory disorders. Only 15 of the female patients were pre-menopausal. Olfactory disorders were most frequently caused by viral infections in the upper respiratory tract (n = 51). Fifteen patients reported head trauma as a cause of olfactory loss, and 45 causes were idiopathic. Most of those in whom the olfactory disorder had been in existence for less than 3 months were anosmic (84%), very few were hyposmic (16% of a total of 19 patients). In contrast, 38% (of a total of 29 patients) in whom the disease had been in existence for 3 and 6 months were hyposmic. Parosmia was reported in 16 cases. Most parosmias appeared after viral infection (56%). Eight of the 120 patients reported dysgeusia. CONCLUSIONS: The present study is a first step towards an assessment of olfactory disorders in Austria. We found similar causes of non-conductive olfactory disorders as have been reported in the literature for other countries, namely upper respiratory infection leading to postviral olfactory disorders, and head trauma. With increasing age women seem to suffer more often from chemosensory dysfunction than men, which may be related to hormonal factors.
Adolescent↗
Qualitative and quantitative olfactometric evaluation of different concentrations of ethanol peppermint oil solutions.
Selection of an adequate placebo is a major problem in clinical trials of Euminz(R) (10% peppermint oil/ethanol) which is used topically for the treatment of tension-type headache. This randomized, controlled, double-blind, cross-over study was performed to investigate whether there are qualitative differences between 10%, 1%, 0.5%, 0.1%, and 0% peppermint oil. Forty-one healthy subjects participated (age range 21-28 years); they rated both intensity, and hedonic tone of the stimuli. Verbal descriptions were combined to multiple response sets (MRS). In addition, the trigeminal impact of odorants was determined. Intensity ratings and MRS "menthol like" and "alcohol/solvent" changed with stimulus concentration. However, intensity had no significant effect on hedonics, trigeminal impact, or the number of descriptive items used. When MRS "menthol like" and "alcohol/solvent" were analysed after being weighted with intensity ratings, changes in relation to stimulus concentration were lost. Thus, the differences between the five concentrations of peppermint oil were--to their largest part--due to changes in stimulus intensity. Considering the large day-to-day variability of olfactory sensitivity the present data support the hypothesis that the odour quality of 10% peppermint oil cannot be discriminated from the odour of 0.1%, 0.5%, or 1% peppermint oil when tested on separate days.
Adult↗