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PubMedDate not supplied

Clinical problems in chemosensory disturbances.

The clinical evaluation of patients with disorders of smell and taste has been hampered by difficulties in stimulus control and response measurement. These senses play a crucial role in food selection and enjoyment and in avoidance of danger, and they deserve the attention of the otolaryngologist as much as audition and vestibular function do. The definition of the degree of disability should be based on psychophysical measures rather than the patient's complaint. An anatomic diagnosis may facilitate the etiologic diagnosis, and it is important to attempt to differentiate transport abnormalities from sensorineural deficits, and receptor deficits from neural deficits. The common causes of smell and taste abnormalities are listed. Selected current work in the field with immediate clinical relevance is reviewed, and opportunities for basic studies that may provide needed data to improve the diagnostic evaluation of patients and to suggest therapeutic strategies for clinical trials are briefly discussed. These areas of study can be pursued with currently available technology.

Chemoreceptor Cells↗
PubMed1990

Taste perceptions and hedonics in eating disorders.

Hedonic and intensity ratings of 20 dairy solutions, with varying levels of fat and sucrose, were obtained before and after treatment for anorectic-restrictors, anorectic-bulimics, normal-weight bulimics, and control subjects. There were no differences between diagnostic groups in ability to rate sweetness intensity; all subjects were able to correctly assess increasing sucrose concentration. During the pretreatment test, both bulimic groups showed elevated intensity ratings of lower fat solutions and solutions which contained no sugar as compared with the other two groups. These differences were not present after treatment. There were differences in hedonic ratings between the anorectic groups and the controls, which persisted even after treatment. Both groups of patients showed an aversion to high fat solutions; anorectic-restrictors also demonstrated an aversion to all solutions which contained no sugar. The stability of these hedonic profiles suggests that these responses may be trait characteristics of anorexia nervosa.

Adolescent↗
PubMed1988

Neuropsychologic symptoms in the migraine syndrome.

Twenty patients with complex neuropsychologic symptoms associated with classic migraine were selected from a group of 200 patients with vascular headache. Twenty types of symptoms were found and grouped into six categories (language, visual symptoms, cognitive-dysmnesic symptoms, olfactory-gustatory hallucinations, automatisms, and somatosensory symptoms). Some of the symptoms found have apparently not been reported previously. The importance of the analysis of this complex neuropsychologic set of symptoms and of the possible consequences of complicated, frequent vascular headache is emphasized.

Adult↗
PubMed2002

Gustation: intersensory experience par excellence.

On the face of it, basic tactile sensation might seem the only essential sensory requirement for the delivery of foods and beverages to the digestive system. In practice, however, the appropriate delivery of raw materials for the maintenance and repair of the body requires complex sensory and cognitive processes, such that flavour sensation arguably constitutes the pre-eminent example of an integrated multicomponent perceptual experience. To raise the profile of the chemical senses amongst researchers in other perceptual domains, I review here the contribution of various sense modalities to the flavour of foods and beverages. Further, in the light of these multisensory inputs, the physiological and psychophysical research summarised in this paper invites optimism that novel ways will be found to intervene when nutritional status is compromised either by specific dietary restraints, or by taste and smell disorders.

Beverages↗
PubMed1996

Geriatric oral health and its impact on eating.

OBJECTIVE: Adequate food and fluid intake and nutritional health are requisites for sustaining life. The oral-pharyngeal region has evolved multiple, highly regulated processes to ensure that the intake, chewing, and swallowing of foods and beverages is maintained. The objective of this paper is to identify the independent and collective roles of oral health on eating in older people. DESIGN: Research reports from peer-reviewed scientific journals. Hypothesis-driven research that objectively examined taste, smell, dental and oral mucosal health, dental prostheses, chewing, and swallowing in the context of aging. DATA EXTRACTION AND SYNTHESIS: Data results were extracted independently by multiple observers. A qualitative synthesis of data results from independent studies was made in order to form conclusions regarding the role of oral health on eating in older people. CONCLUSIONS: Many oral functions remain intact in healthy older adults. However, significant alterations arise from oral and systemic diseases and their treatments, and these may have a profound effect on eating, drinking, and the nutritional status of older individuals. The care of older persons with smell, taste, dental/alveolar, oral mucosal, chewing, and swallowing problems requires a multidisciplinary team of health care providers. Recognition of the interrelationship between oral, pharyngeal, and systemic physiological processes will help practitioners identify the etiology of these disorders and implement appropriate therapy.

Aged↗
PubMed2005

[Assessment of the correlation between taste and smell functioning].

UNLABELLED: There are few studies examining relationship between taste and smell. However their clinical unity is more often indicated. Smell perception abnormalities cause modification in taste of food intensity, disabling perception of taste as a consequence of taste's sniffing failure. Thus disturbances of these senses, which often commonly coexist could cause great discomfort in patients, however taste sense is estimated as less important comparing to smell sense. The aim of that study was to compare the taste perception in patients with normal smell function and patients with hyposmia and anosmia. There was analyzed correlation between the patients' subjective estimation of smell and taste senses and results of gustometry and olfactometry examinations. MATERIAL AND METHOD: there were indicated three groups of patients based on smell examination with usage of Elsberga--Levy'ego olfactometr in Pruszewicz modification. The first group included patients with normosmia, the second--patients with hyposmia or anosmia related to every smell, the third--patients with hyposmia on few smells and normal smell feeling of others. The Bornstein's method gustometry modified by us was performed for all groups. Moreover patients presented their subjective estimation of smell and taste senses. All results were statistically analyzed, taking into consideration results with alpha < or = 0.05. RESULTS: All (100%) patients with normosmia correctly identified sour, bitter and salty tastes, while only 53% of patients with hyposmia and anosmia got similar results. However 76.5% of patients from the second group subjectively estimated their sense of taste as a normal perception. CONCLUSIONS: Patients with smell disturbances significantly more often have abnormalities in taste perception than patients with normosmia and their subjective estimation of taste and smell senses is much more different than gustometry and olfactometry results.

Adult↗
PubMed2004

Metallic taste and retronasal smell.

A series of experiments investigated the nature of metallic taste reports and whether they can be attributed to the development of a retronasal smell. Two studies showed that the metallic sensation reports following oral stimulation with solutions of FeSO4 were reduced to baseline when the nose was occluded. No such reduction was seen for CuSO4 or ZnSO4, which were more bitter and astringent, respectively, and less metallic. A discrimination test based on weak but equi-intense levels of FeSO4 and CuSO4 showed that FeSO4 could be discriminated from water with the nose open but not when occluded, but that discrimination of CuSO4 from water was not impaired by nasal occlusion. A discrimination test demonstrated that the headspace over solutions of FeSO4 was not different from water, although some subjects could discriminate FeSO4 solutions from water in the mouth when the nose was occluded, perhaps by tactile or astringent cues. These results confirm that metallic taste reports following oral stimulation with FeSO4 are likely due to development of a retronasal smell, possibly following a lipid oxidation reaction in the mouth. However, metallic taste reports may arise from different mechanisms with copper and zinc salts.

Ferrous Compounds↗
PubMed1996

Seasonal alteration in taste detection and recognition threshold in seasonal affective disorder: the proximate source of carbohydrate craving.

Increased appetite with associated carbohydrate craving are core symptoms of seasonal affective disorder (SAD) and have been attributed to decreased central serotonergic function. The proximate mechanisms for centrally mediated selective macronutrient consumption are unknown. We questioned whether seasonal alterations in taste sensation could serve as a mediator of dietary intake, as implied by the term 'craving'. Specifically, individuals who were seasonally depressed and reported carbohydrate craving would be more sensitive to gustatory cues associated with the presence of carbohydrate than nondepressed subjects. Taste detection and recognition thresholds for the four primary gustatory sensations--sweet, sour, salty, and bitter--were obtained in a group of 25 SAD patients and 23 non-psychiatric subjects during the winter, after 2 weeks of 10 000 lux morning and evening light treatment, and during the summer. Relative to the comparison group, the SAD group was less sensitive to sweet taste during the winter. Sweet taste threshold in the SAD group normalized during the summer; however, 2 weeks of light treatment failed to alter sweet detection thresholds in the SAD group. Moreover, within the SAD group, season exerted significant effects on sweet, sour, and bitter detection, but it did not influence salt-detection thresholds. The findings represent the first demonstration of specific changes in taste perception associated with the self-report of carbohydrate craving in SAD and are discussed in terms of the development of sweet craving and the serotonin hypothesis of SAD.

Adult↗
PubMed1998

Age-related changes in the prevalence of smell/taste problems among the United States adult population. Results of the 1994 disability supplement to the National Health Interview Survey (NHIS).

Information about the prevalence of disorders of the chemical senses has been limited. In the late 1970s, the consensus among experts convened by the National Institutes of Health (NIH) was that more than 2 million adults in the United States had a disorder of smell or taste. A large, nonrandom survey conducted by the National Geographic Society in 1987 found that 1% of their 1.2 million respondents could not smell 3 or more of 6 odorants using a 'scratch and sniff' test. Age was an important factor, with a decline beginning in the second decade of life. No comparable data have been available for taste, although it has been suggested that the sense of taste remains more robust with age. The National Institute on Deafness and Other Communication Disorders (NIDCD), NIH, began collaborating with the National Center for Health Statistics (NCHS) in 1993 to acquire information on the prevalence of smell/taste problems using the Disability Supplement to the National Health Interview Survey (NHIS). This survey was administered to approximately 42,000 randomly-selected households (representing about 80,000 adults over 18 years of age) in 1994. Adjusted national estimates derived from this survey showed a prevalence of 2.7 million (1.4%) U.S. adults with an olfactory problem. Also, 1.1 million (0.6%) adults reported a gustatory problem. When smell or taste problems were combined, 3.2 million (1.65%) adults indicated a chronic chemosensory problem. The prevalence rates increased exponentially with age. Almost 40% with a chemosensory problem (1.5 million) were 65 years of age or greater. In a multivariate analysis, the individual's overall health status, other sensory impairments, functional limitations (including difficulty standing or bending), depression, phobia, and several other health-related characteristics were associated with an increase in the rate of chemosensory disorders.

Adolescent↗
PubMedDate not supplied

A clinical study of patients with hypersensitive teeth.

Hypersensitive teeth have been a nemesis to patients in every dental practice. This clinical study was done to find a causal relationship of hypersensitive teeth and other organs of special senses, namely, sight, hearing, taste, smell, and touch. The analysis of the findings offers a basis for conclusion that dentition hypersensitivity and hypersensitivity of the special senses have a causal relationship. The dental clinician can provide the patient with an understanding and explanation of the cause(s) of hypersensitivity that will assist in a cooperative analysis of the symptoms and aid in the treatment to alleviate the pain.

Adolescent↗
PubMed1999

Long-term effects on the olfactory system of exposure to hydrogen sulphide.

OBJECTIVE: To study chronic effects of hydrogen sulphide (H2S) on cranial nerve I (nervi olfactorii), which have been only minimally described. METHODS: Chemosensations (smell and taste) were evaluated in eight men who complained of continuing dysfunction 2-3 years after the start of occupational exposure to H2S. Various bilateral (both nostrils) and unilateral (one nostril at a time) odour threshold tests with standard odorants as well as the Chicago smell test, a three odour detection and identification test and the University of Pennsylvania smell identification test, a series of 40 scratch and sniff odour identification tests were administered. RESULTS: Six of the eight patients showed deficits of various degrees. Two had normal scores on objective tests, but thought that they continued to have problems. H2S apparently can cause continuing, sometimes unrecognised olfactory deficits. CONCLUSION: Further exploration into the extent of such problems among workers exposed to H2S is warranted.

Adult↗
PubMedDate not supplied

[Smell and taste thresholds in older people].

The smell and taste ability of 105 persons at an age of 65 to 93 years was examined by adequate qualitative and semiquantitative chemical and electrogustometric methods. The basic levels of seniors were found above the levels of younger people. For the sense of smelling a significant connection of age and smell sensitivity could be measured. There was no difference between men and women using chemical test methods. With electrogustometry, however, women had a better taste sensitivity than men. At the age of 65 the taste levels are at a fix point. No higher levels could be realized in older persons. A significant reduction of smell ability was recognized in persons with reduction of cerebral blood flow and in smokers. The taste ability was disturbed in cases of diabetes, in persons using dental prostheses and selectively for "salty" in cases of hypertonia and "bitter" in smokers. Loss of taste was recognized in two women who used NaF-drugs, but also some other drugs were able to induce smell and taste alteration.

Aged↗
PubMed1986

The effects of sensory changes in older persons.

An increasing proportion of persons encountered in professional nursing practice are older. This paper discusses the effects of sensory changes in older persons, specifically, the visual, auditory, olfactory, and gustatory effects. Nursing interventions aimed at assisting older persons to cope with or more effectively adapt to these potentially disabling alterations are explained, and some guidelines for nursing care are discussed.

Aged↗