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Biomedical subjects

Thomas Hummel

Publications and source records attributed to Thomas Hummel.

At least 55 records · Page 3Linked to original sources
PubMed2006

Assessment of olfactory function.

Numerous techniques are available for the investigation of chemosensory functions in humans. They include psychophysical measures of chemosensory function, e.g. odor identification, odor discrimination, odor thresholds, odor memory, and retronasal perception of odors. In order to assess changes related to the patients' quality of life or effects of qualitative olfactory dysfunction, questionnaires are being used. Measures relying to a lesser degree on the subjects' cooperation are e.g. chemosensory event-related potentials, odor-induced changes of the EEG, the electroolfactogram, imaging techniques, or measures of respiration. In a clinical context, however, psychophysical techniques are most frequently used, e.g. tests for odor identification, and odor thresholds. Interpretation of results from these measures is frequently supported by the assessment of chemosensory event-related potentials. Other techniques await further standardization before they will become useful in a clinical context.

Brain↗
PubMed2006

Increased olfactory sensitivity in euthymic patients with bipolar disorder with event-related episodes compared with patients with bipolar disorder without such episodes.

OBJECTIVE: Some patients with bipolar disorder experience mood episodes following emotional life events, whereas others do not. There is evidence that orbitofrontal hypoactivity may be related to this, because the orbitofrontal cortex is involved in the regulation of emotional and behavioural responses to external events. The close anatomical and functional connection between the orbitofrontal cortex and olfactory processing suggests that patients with bipolar disorder and heightened emotional reactivity may exhibit altered olfactory function compared with patients with bipolar disorder who do not exhibit this sensitivity. METHODS: In this pilot study, olfactory function was assessed in patients with bipolar disorder and a history of event-triggered episodes (n = 7) and in patients with bipolar disorder without such a history (n = 9) at the Department of Psychiatry and the Taste and Smell Clinic of the University of Dresden, Germany. Each patient's bipolar disorder was in remission at study entry, and they were on monotherapy with mood stabilizers. Assessment included olfactory event-related potentials (ERP) and psychophysical tests for odour threshold, odour identification and olfactory quality discrimination. RESULTS: Odour thresholds were lower in patients with bipolar disorder and event-triggered episodes compared with the other patient group. In addition, patients with event-triggered episodes exhibited shorter N1 peak latencies of the olfactory ERP. CONCLUSIONS: Our findings indicate disinhibition of orbitofrontal areas involved in the processing of emotional events in a subset of patients with bipolar illness.

Adult↗
PubMed2005

Mechanical obstruction of the olfactory cleft reveals differences between orthonasal and retronasal olfactory functions.

Following up on recent observations in patients with nasal polyposis (NP), the present study aimed to investigate whether a mechanical obstruction of the anterior olfactory cleft (OC) would produce differential effects on orthonasal and retronasal olfactory functions. To this end, we studied 33 healthy subjects in a randomized trial. Sponges with high content of saline were either placed in the OC or on the respiratory epithelium, such that this was blinded to both subject and observer. The results indicated that orthonasal (P = 0.04) but not retronasal (P = 0.15) olfactory identification ability was lower when the OC was blocked. This confirms the idea that differences between orthonasal and retronasal olfactory functions, as observed in NP patients, are, at least to some degree, due to mechanical obstruction of the anterior portion of the OC. The present data also suggest that mechanical obstruction is a means to induce reversible hyposmia void of side effects which can be performed in a blinded fashion. This might become a valuable model of hyposmia for future investigations.

Adult↗
PubMed2005

Effects of radiotherapy on olfactory function.

BACKGROUND AND PURPOSE: Changes in olfactory function have been reported in patients receiving significant doses of radiation to the olfactory epithelium. Aim of this study was to investigate severity and time course of changes in olfactory function in patients irradiated for tumours of the head and neck region. MATERIAL AND METHODS: Forty-four patients receiving radiotherapy (RT) for tumours in the area of the head and neck participated (16 women, 28 men; age 11-81 y; mean 55 y). Olfactory function was measured before and bi-weekly during RT for 6 weeks. A subgroup (25 patients) was followed for 12 months. Patients were divided into two groups according to the dose to the olfactory epithelium. Twenty-two patients ('OLF group') had radiation doses to the olfactory epithelium between 23.7 and 79.5 Gy (median 62.2 Gy). In the 22 patients of the 'non-OLF group' the dose applied to the olfactory epithelium was significantly lower (2.9-11.1 Gy, median 5.9 Gy). Total tumour dose (30-76.8 Gy), age, sex distribution, and baseline chemosensory function were not significantly different between groups. Testing was performed for odour identification, odour discrimination, and olfactory thresholds. RESULTS: Odour discrimination, but not odour identification or odour threshold, was significantly decreased 2-6 weeks after begin of therapy in the OLF group. In addition, a significant effect of the radiation dose was observed for odour discrimination. More than 6 months after therapy, OLF group patients had significantly lower odour identification scores compared to the non-OLF group. CONCLUSION: As indicated through the non-significant change of olfactory thresholds, the olfactory epithelium is relatively resistant against effects of radiation. It is hypothesized that RT has additional effects on the olfactory bulb/orbitofrontal cortex responsible for the observed changes of suprathreshold olfactory function.

Adolescent↗
PubMed2005

Sex-specific hemispheric differences in cortical activation to a bimodal odor.

Most odorants we experience in every day life are bimodal in that they activate both the main olfactory and the intranasal trigeminal system. Few studies have investigated whether true bimodal odorants are processed differently than unimodal odorants. The aim of the study was to address sex-dependent hemispheric differences in olfactory event-related potentials. Event-related potentials (ERP) of the bimodal stimulant peppermint oil were recorded in 34 healthy subjects (17 women). No sex-related differences in olfactory sensitivity, trigeminal sensitivity or hedonic ratings of the stimuli were found. Although perceived similarly by men and women, results indicated a sex-differentiated hemispheric response to bimodal odors. Women generally expressed larger amplitudes and longer latencies over their left hemisphere, whereas men demonstrated a similar pattern over their right hemisphere. This effect was most evident for the early sensory derived ERP components indicating a sex-dependent difference in the sensory processing of bimodal odors.

Adult↗
PubMed2005

Intranasal concentrations of orally administered flavors.

The odorants emanating from the oral cavity during eating and drinking reach the olfactory mucosa via the pharynx (retronasal olfaction). It is unclear which variables influence the perception of intraorally applied substances. The aim of the present study was to determine the temporal profiles of volatile odor concentrations at different locations in the nasal cavity during consumption of liquid and solid custard samples using proton transfer reaction mass spectrometry. Intranasal odor concentrations were measured at least twice in nine subjects (six female, three male) at four nasal positions during the consumption of liquid and solid custards. The low-viscosity custard was swallowed earlier than the more solid one. The compounds were found to reach the nose in different concentrations. Largest maximal amplitudes were measured in the nasopharynx, whereas lowest concentrations were found in the region of the olfactory cleft. In addition, different odorants reached the different regions in the nasal cavity in varying concentrations, indicated by a significant interaction between factors "position" and "compound". Furthermore, the compounds were found to reach the positions within the nasal cavity with different latencies. These results indicate that different volatile flavor compounds exhibit different temporal and spatial profiles in terms of their intranasal distribution.

Administration, Oral↗
PubMed2005

Differential neural responses evoked by orthonasal versus retronasal odorant perception in humans.

Odors perceived through the mouth (retronasally) as flavor are referred to the oral cavity, whereas odors perceived through the nose (orthonasally) are referred to the external world. We delivered vaporized odorants via the orthonasal and retronasal routes and measured brain response with fMRI. Comparison of retronasal versus orthonasal delivery produced preferential activity in the mouth area at the base of the central sulcus, possibly reflecting olfactory referral to the mouth, associated with retronasal olfaction. Routes of delivery produced differential activation in the insula/operculum, thalamus, hippocampus, amygdala, and caudolateral orbitofrontal cortex in orthonasal > retronasal and in the perigenual cingulate and medial orbitofrontal cortex in retronasal > orthonasal in response to chocolate, but not lavender, butanol, or farnesol, so that an interaction of route and odorant may be inferred. These findings demonstrate differential neural recruitment depending upon the route of odorant administration and suggest that its effect is influenced by whether an odorant represents a food.

Appetite↗
PubMed2005

Taste disorders in acute stroke: a prospective observational study on taste disorders in 102 stroke patients.

BACKGROUND AND PURPOSE: The aim of the study was to assess whether and how frequently patients with acute first-ever stroke exhibit gustatory dysfunction. METHODS: We performed a 1-year prospective observational study. Gustatory function was assessed using the standardized "taste strips" test. In addition, we assessed olfactory function, swallowing, stroke location, comorbidities, and the patients' medication. RESULTS: A total of 102 consecutive patients were enrolled (45 female, 57 male; mean age, 63 years); 31 of them (30%) exhibited gustatory loss and 7 (6%) had lateralized impairment of taste function. Predictors of impaired taste function were male gender (P=0.003), high National Institutes of Health Stroke Scale (NIHSS) score at admission (P=0.009), coexisting swallowing dysfunction (P=0.026), and a stroke of partial anterior circulation subtype (PACS) (P=0.008). In particular, in hypogeusic patients the lesion was most frequently localized in the frontal lobe (P=0.009). Follow-up examinations in 14 patients indicated improvement of taste sensitivity. CONCLUSIONS: Taste disorders after stroke are frequent. A significant association was found for male gender, high NIHSS score, swallowing disorder, and PACS, particularly in the frontal lobe. Generally, taste disorders after stroke seem to have a good prognosis.

Adult↗
PubMed2005

Reduced olfactory bulb volume in post-traumatic and post-infectious olfactory dysfunction.

The olfactory bulb is a highly plastic structure the volume of which partly reflects the degree of afferent neural activity. In this study, 22 patients with post-infectious olfactory deficit, nine participants with post-traumatic olfactory deficit, and 17 healthy controls underwent magnetic resonance volumetry of the olfactory bulb. Patients presented with significantly smaller olfactory bulb volumes than controls; significant correlations between olfactory function and bulb volume were observed. Patients with parosmia exhibited smaller olfactory bulb volumes than those without parosmia. Findings indicate that smell deficits leading to a reduced sensory input to the olfactory bulb result in structural changes at the level of the bulb. Reduced olfactory bulb volumes may also be considered to be characteristic of parosmia.

Adult↗
PubMed2005

Sex differentiated responses to intranasal trigeminal stimuli.

The aim of the study was to address sex-related hemispheric differences in trigeminal event-related potentials while controlling for the subjects' olfactory sensitivity. Event-related potentials to lateralized stimulation using the trigeminal stimulant CO(2) were recorded in 28 healthy young subjects (16 women). There was no sex-related difference in olfactory sensitivity. Results indicated a sex-differentiated response to trigeminally induced pain. Women were found to have generally higher amplitudes and shorter latencies of the late positive component than men. Moreover, men and women exhibited different hemispheric activations in that women expressed shorter latencies over the left hemisphere than men. The pronounced sex-related difference of the late positive component suggests a cognitive/emotional impact on the processing of intranasal pain as indicated by others.

Adult↗
PubMed2005

Gustatory stimulation influences the processing of intranasal stimuli.

OBJECTIVES: Taste and smell interact. The aim of this study was to examine this interaction using gustatory and olfactory stimuli applied at the same time, which exhibited perceptual compatibility and incompatibility. METHODS: Thirty-two, young, healthy normosmic subjects (16 men, 16 women) took part in two randomized sessions. Event-related potentials (ERP) were recorded in response to vanillin, or gaseous CO2. These two conditions were combined with three "taste conditions" including sweet taste, sour taste, and the intraoral presentation of an empty taste dispenser. RESULTS: Vanillin responses were largest for the "sweet" condition, while they were smaller for the "sour condition". In contrast, responses to CO2 were largest under the "sour" condition, and smallest under the "sweet" condition. Moreover, during the "sweet" condition the latencies of P1 and N1 were shorter than in the "sour" condition, which was the other way around for CO2. CONCLUSIONS: Results of the present investigation suggested that (1) the early processing of intranasal chemosensory stimuli is modulated through concomitant gustatory stimulation, and that (2) this modulation may depend, at least in part, on the contextual compatibility between intranasal and intraoral stimuli.

Adult↗
PubMed2005

Androstadienone odor thresholds in adolescents.

A sex-related difference in olfactory sensitivity to androstenone has been reported to occur during adolescence. More males than females exhibited anosmia to androstenone, or an increase in androstenone threshold with age. The current study addressed the question whether similar, sexually dimorphic effects of aging over puberty can also be found for androstadienone. A total of 102 subjects participated (36 females, 66 males). Similar to previous investigations, subjects were divided into a group of 47 individuals with a mean age of 13.3 years, defined as pre/peri-pubertal, and a group of 55 subjects with a mean age of 17.1 years, defined as post-pubertal. All subjects underwent tests for verbal abilities, general olfactory function, and measurements of androstadienone thresholds. The study provided the following major results: (1) Male subjects exhibited higher androstadienone sensitivity in the pre/peri-pubertal group as compared to the post-pubertal group. This difference was not observed in female subjects. Correspondingly, a negative correlation between age and androstadienone sensitivity was found for male subjects, but not for female subjects. (2) In contrast to this sex-specific change of the androstadienone odor threshold, verbal skills and odor identification abilities increased with age in all subjects regardless of their sex. In conclusion, the present observations confirm previous research on sex-differentiated effects of aging during puberty on sensitivity towards odorous steroids. While the underlying causes are unknown, it may be hypothesized that the decreased sensitivity could result from the increased endogenous levels of androstadienone in male subjects. Future studies should include both steroid and non-steroid odorants to further explore these age-related changes.

Adolescent↗
PubMed2005

Differences between orthonasal and retronasal olfactory functions in patients with loss of the sense of smell.

OBJECTIVE: To investigate differences between orthonasal and retronasal olfaction in patients with loss of the sense of smell without taste complaints. DESIGN: Electrophysiological and psychophysical testing of orthonasal and retronasal olfactory functions. SETTING: Outpatient clinics. PATIENTS: A series of 18 patients who had olfactory loss due to various reasons but no "taste" complaints. MAIN OUTCOME MEASURES: Orthonasal and retronasal olfactory functions assessed by olfactory event-related potentials and psychophysical smell tests. RESULTS: Psychophysical testing revealed retronasal olfaction to be normal or slightly altered, whereas orthonasal olfaction was either absent or severely compromised. Findings from nasal endoscopic examinations and computed tomographic scans were within the reference range in all subjects. In response to orthonasal stimulation there were neither detectable olfactory event-related potentials nor any with small amplitudes, whereas olfactory event-related potentials in response to retronasal stimulation were clearly present in some patients. CONCLUSION: These clinical observations, together with the psychophysical and electrophysiological findings, suggest that orthonasal and retronasal olfaction might be processed differently.

Adult↗
PubMed2005

Dysfunction of the liver affects the sense of smell.

BACKGROUND: Cirrhosis of the liver (CL) has been reported to be accompanied by olfactory loss. The aim of the present study was to re-investigate previous work with a special focus on differential olfactory function, the relation between CL etiology and olfactory function, and the correlations between laboratory/psychological parameters and olfactory function. MATERIALS AND METHODS: A total of 45 CL patients participated. Olfactory function was tested using the "Sniffin' Sticks" technique, which provides measures for butanol odor thresholds, odor discrimination and odor identification. Serum levels of zinc and bilirubin were obtained. Psychometric measurements included the trailmaking test. RESULTS: The study provided the following major results: (1) Olfactory function was compromised in 76% of CL patients; in addition, the patient's ability to identify odors, but not odor thresholds or odor discrimination, was related to the degree of CL. This pattern may be an expression of a stronger effect of CL on the central- nervous processing of odors than on the periphery of the system. (2) Neither etiology of the CL (e.g., alcoholism) nor serum levels of bilirubin and zinc were correlated with olfactory function. However, (3) there was a relation between the results from psychometric function tests and the ability to identify odors. CONCLUSION: Although the reason for olfactory dysfunction in CL is far from clear, future investigations should focus on the hypothesis that endogenous intoxication may lead to a stronger deficit in the central-nervous processing of olfactory information than to peripheral lesions in the olfactory system. In addition, while more specific research is needed, olfactory dysfunction may serve as a subclinical indicator of hepatic encephalopathy.

Adult↗
PubMed2005

The 5-hydroxytryptamine 4 receptor agonist mosapride does not antagonize morphine-induced respiratory depression.

BACKGROUND: On the basis of experiments in rats, serotonin 4 receptor (5-hydroxytryptamine 4 [5-HT4]) agonists have been proposed as a novel therapeutic strategy for the selective treatment of respiratory depression caused by opioids while leaving analgesic effects unaffected. The effects in rats have been seen with the 5-hydroxytryptamine 4a (5-HT4a) agonist BIMU8, which is currently not available for use in humans. METHODS: In a proof-of-applicability study, the clinically recommended dose of 5 mg mosapride, currently the only 5-HT4 agonist available for clinical use, was given in a placebo-controlled manner 3 times daily for 5 days to 12 healthy men and women. During the actual experiments, a further 15 mg mosapride was administered. After baseline measurements of respiratory depression, by use of a carbon dioxide rebreathing method, and of pain, by use of electrical and chemical pain stimuli, 30 mg morphine per 70 kg body weight was administered intravenously within 2 hours. After assessment of respiratory depression and pain, 2 mg naloxone was intravenously administered within 20 minutes, followed by a third assessment of respiratory depression and pain. In ancillary experiments 10 rats received 100 mg/kg mosapride orally or placebo 50 minutes before intraperitoneal injection of 10 mg/kg morphine, followed 20 minutes later by injection of naloxone, and the respiratory frequency was monitored. RESULTS: With placebo coadministration, the slope of the relationship between expiratory volume and CO2 concentration in the inspired air was significantly reduced, from 1.11 +/- 0.46 L/mm Hg CO2 at baseline to 0.39 +/- 0.25 L/mm Hg CO2 at the end of the morphine infusion (P < .001). Coadministration of mosapride had no effect on respiratory depression induced by morphine (slope of 0.39 +/- 0.19 L/mm Hg CO2, P > .7). In contrast, naloxone significantly reversed the slope to 0.78 +/- 0.36 L/mm Hg CO2 (P = .001). Morphine produced significant effects on electrical and chemical pain stimuli, which were partially reversed by naloxone, but mosapride did not affect the analgesic effects of morphine. In rats mosapride similarly failed to prevent a slowing of the breathing frequency after morphine administration but naloxone reversed the respiratory depression. CONCLUSION: Our results show that, with mosapride, opioid-induced respiratory depression cannot be prevented, and because other 5-HT4 agonists are not currently available for clinical use, a cure for opioid-induced respiratory depression as promised by the previous successful experiments in laboratory animals is not yet available in clinical practice.

Adult↗
PubMed2005

Chemosensory perception and event-related potentials in self-reported chemical hypersensitivity.

Anormal chemosensory perception has been identified as a possible mechanism underlying odor intolerance, but research in this domain has yet been rather limited. The main objective of the present study was to investigate total perceived intensity, unpleasantness, sensory irritation, and cortical activity assessed with chemosensory event-related potentials (ERPs) for three concentrations of pyridine ranging from predominantly olfactory to trigeminal in activation. Results from 19 individuals with self-reported chemical hypersensitivity and 19 controls with self-reported normal chemical sensitivity show that the hypersensitive group, compared to controls, rated the pyridine stimuli to be more intense and unpleasant, and that these group differences increased with pyridine concentration. Sensory irritation was also the perceptual dimension found to correlate strongest with score on the chemical sensitivity scale. However, no group differences were found in ERP amplitudes or latencies. These findings suggest that self-reported chemical hypersensitivity (1) can be associated with anormal chemosensory perception, (2) may be more closely related to trigeminal function than to olfaction, and (3) has a neural basis at a higher cortical level than that captured by chemosensory ERPs.

Adult↗
PubMed2005

Olfactory disorders and their consequences for quality of life.

Olfactory disorders are common in the general population, but research into the consequences of these disorders has been lacking. Not until recently, when specific tools for assessing changes in quality of life due to olfactory disorders have become available, have systematic investigations been conducted. In this article we present the most important roles that olfaction plays in humans and review the scientific literature on the consequences of olfactory disorders. This review suggests that quality of life, regarding safety issues and interpersonal relations, as well as eating habits and nutritional intake are severely altered in a large proportion of patients with olfactory disorders.

Environment↗