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PubMed1983

Taste and smell in disease (second of two parts).

Disorders of taste and smell are common occurrences that can lead to modifications of dietary habits that may in turn exacerbate disease states or nutritional deficiencies. In addition, they are often nagging problems that diminish the quality of life. Such disorders can result from a range of disease states, pharmacologic and surgical intervention, aging, radiation, and environmental exposure. A search for the pathogenetic mechanism should include the determination of possible (1) local injury from physical or chemical causes, (2) damage to neural projections, (3) disturbance of the cycle of regeneration of chemoreceptors resulting from general malnutrition, disease agents, metabolic disturbances, drugs, or radiation, and (4) alteration in the saliva or fluids bathing the olfactory mucosa by drugs or metabolic agents. Viral infections, normal aging, head injuries, and nasal obstructions are the most common causes of smell disorders. Drugs are common offenders in taste dysfunction. Chemosensory disorders frequently remit when concomitant medical conditions are treated or offending drugs removed, although full recovery may take several months. Considerable research is now under way in this area, and it is to be hoped that we will soon have a better understanding of how to diagnose and treat these common disorders.

Age Factors↗
PubMed2005

Osmophobia in primary headaches.

This study evaluates osmophobia (defined as an unpleasant perception, during a headache attack, of odours that are non-aversive or even pleasurable outside the attacks) in connection with the diagnosis of primary headaches. We recruited 775 patients from our Headache Centre (566 females, 209 males; age 38+/-12 years), of whom 477 were migraineurs without aura (MO), 92 with aura (MA), 135 had episodic tension-type headache (ETTH), 44 episodic cluster headache (ECH), 2 chronic paroxysmal hemicrania (CPH) and 25 other primary headaches (OPHs: 12 primary stabbing headaches, 2 primary cough headaches, 3 primary exertional headaches, 2 primary headaches associated with sexual activity, 3 hypnic headaches, 2 primary thunderclap headaches and 1 hemicrania continua). Among them, 43% with MO (205/477), 39% with MA (36/92), and 7% with CH (3/44) reported osmophobia during the attacks; none of the 135 ETTH and 25 OPH patients suffered this symptom. We conclude that osmophobia is a very specific marker to discriminate adequately between migraine (MO and MA) and ETTH; moreover, from this limited series it seems to be a good discriminant also for OPHs, and for CH patients not sharing neurovegetative symptoms with migraine. Therefore, osmophobia should be considered a good candidate as a new criterion for the diagnosis of migraine.

Adult↗
PubMed2006

Olfactory identification deficits in first-episode psychosis may predict patients at risk for persistent negative and disorganized or cognitive symptoms.

OBJECTIVE: One-third of patients with a schizophrenia spectrum disorder have a measurable olfactory identification deficit at first examination. The authors studied the relationship of this deficit to symptom remission after 1 year of treatment. METHOD: Fifty-eight patients naive to antipsychotic medication who entered the Nova Scotia Early Psychosis Program were symptomatically rated with the Positive and Negative Syndrome Scale (PANSS) (at baseline and 1 year). At baseline, the University of Pennsylvania Smell Identification Test (UPSIT) was also completed. Remission was determined for four symptom factors derived from the PANSS (positive, negative, cognitive/disorganized, and anxiety/depression). Patients with and without remission were compared on UPSIT scores. RESULTS: Patients with nonremission of negative and cognitive/disorganized symptoms had significantly lower baseline UPSIT scores compared with patients with remission. UPSIT scores were unrelated to remission of positive or anxiety/depression symptoms. CONCLUSIONS: UPSIT scores can be used to identify patients at risk for persistent negative and disorganized/cognitive symptoms.

Adult↗
PubMed2004

Smell and taste disorders.

Disorders of taste and smell can present a challenge to the facial plastic surgeon. Obtaining a detailed history and examination is the key to the diagnosis and work-up of olfactory and gustatory dysfunction. Easy-to-administer tests are available for olfactory evaluation(University of Pennsylvania Smell Identification Test) and gustatory (taste sticks, tasting tablets) evaluation. The prognosis and management of olfactory and gustatory disease depend on its etiology. Despite ongoing research, the treatment of the disorders of smell and taste is limited.

Chemoreceptor Cells↗
PubMed2005

[Olfactory and gustatory disorders--causes, diagnosis and treatment].

Olfactory and gustatory disorders are by no means uncommon, and may be associated with an appreciable impairment of the patient's quality of life. In many cases, diagnosis and treatment is not easy, and necessitates interdisciplinary cooperation between the general practitioner, internist, ENT specialist, neurologist and psychiatrist. Many of the non-evidence-based treatments still applied in hospitals and the physician's office should, for reasons of quality control and to avoid polypragmasy possibly associated with undesirable side effects, be employed with reservations. With reference to the guidelines issued by the working group Olfactologie/Gustologie der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie (Olfactology/Gustology of the German Society of ENT Medicine, Head and Neck Surgery), a review of the causes, diagnosis and treatment of olfactory and gustatory disorders [3,4] is presented.

Ageusia↗
PubMed1989

[Occupations and the sense of smell].

Olfactometric fitness examinations in relation to the place of work are required since the olfactory organ has support and protective functions. Smelling disorders result at work from trauma, hypersensitivity, acute and chronic intoxications, but most frequently from chemical and physical substances taken up by inhalation. They are different due to their expression (slight hyposmia till to anosmia, parosmia), latency, localization (respiratory, epithelial, nerval, central), and a combination with other disorders. In order to examine rhinologically the patient, the nasal mucosa has to be assessed. Its lesion does not necessarily correlate to the smell disorder. 475 patients were exposed to a total of 10 different substances or classes of substances. It was demonstrated that disorders of the whole nasal physiology can be caused by toxic and nontoxic substances, e.g. calcium carbide when taking effect for a longer period, even below their legally required "maximum absorption concentration". The treatment is started after ending the exposition. The expert's opinion is based on the clinical findings, a standardized investigation of smelling, the patient's history incl. the history of occupation, and an analysis of the place-of-work conditions. The degree of bodily defect is related to the single types of disorder. In case of a complete anosmia it is 20%. It is assumed that a growing number of occupation-related smell disorders become known and, hence, have to be assessed.

Environmental Exposure↗
PubMed2003

The neonatal rat as a developmental animal model of attention deficit hyperactivity disorder: Effects of frontal lesions on activity and learning.

We examined a developmental animal model of Attention Deficit Hyperactivity Disorder (ADHD) by evaluating the effects of suppressed frontal cortical functioning on habituation in neonatal rats. Frontal cortical activity was suppressed with brain transections in neonatal rats 3, 6, 9, or 12 days of age. Pups were tested in a habituation-to-odor paradigm and behaviors (general activity, headwaving, probing, and rolling) were recorded. Frontal cortical suppression via brain transection resulted in significantly higher activity levels in 3-day-old rats, particularly with regard to rolling, suggesting that the frontal cortex is involved in the regulation of this age-dependent behavior. Frontal transections also increased probing during the odor habituation test in 12-day-old pups. Results are consistent with the neuropsychological research regarding frontal cortical functioning and inhibition in children with ADHD, and suggest that neonatal rats with frontal lesions may provide a useful developmental animal model for studying ADHD.

Animals↗
PubMed2004

Olfactory deficits in anorexia nervosa.

OBJECTIVE: Young patients admitted to the hospital due to anorexia nervosa report reduced pleasure and impaired perception of smell while eating. So far, two studies on odour identification ability in eating disorders did not suggest any significant deficits. Therefore a new and more detailed method of olfactory testing may be needed, in order to determine the subjective impairment of olfaction. METHOD: By using all three subtests of the recently developed smell test called "Sniffin'Sticks", the olfactory deficits were assessed in more detail and the results of female anorectic patients (n = 17) were compared with those of healthy females (n = 15). RESULTS: By examining the anorectic patients no deficits in the subtest odour identification were found. On the contrary, in the subtests odour discrimination and odour threshold deficits of the anorectic patients were detected. CONCLUSION: Reduced olfactory perception might be considered as a common deficit in anorexia nervosa with possible influences and consequences for therapy.

Adolescent↗
PubMed2004

Odour identification as a marker for postoperative cognitive dysfunction: a pilot study.

The onset of postoperative cognitive dysfunction is delayed in some elderly surgical patients and the condition may persist. Increasing age is a risk factor for both postoperative cognitive dysfunction and dementia. Major surgery may unmask an underlying dementia; we report findings of a pilot study designed to inform this hypothesis. Impaired odour identification ability is a characteristic of the preclinical phase of some neuro-degenerative diseases. This pilot study was designed to establish whether odour identification deficit is a marker for postoperative cognitive dysfunction, particularly in elderly patients genetically predisposed to develop late-onset Alzheimer's disease. We found no association between odour identification ability and postoperative cognitive dysfunction in 53 patients aged 62-86, undergoing major non-cardiac surgery under general anaesthesia. Our pilot study showed that a high number of patients genetically predisposed to develop Alzheimer's disease is required to test the utility of odour identification as a marker for postoperative cognitive dysfunction.

Aged↗