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Objective: To explore the establishment and validation of a risk model for postoperative olfactory impairment in patients with chronic sinusitis with nasal polyps (CRSwNP) based on immunoinflammatory indexes. Methods: Retrospective analysis of 100 patients who attended CRSwNP in the Second Affiliated Hospital of Hainan Medical College from October 2020 to October 2022 all underwent nasal endoscopic surgery and were divided into no olfactory impairment group (44 cases) and olfactory impairment group (56 cases) according to the results of postoperative olfactory test, baseline data and routine examination indexes of the two groups were compared and analyzed, independent risk variables affecting olfactory impairment in CRSwNP patients were analyzed by Logistic multifactorial regression, and columnar graph prediction model was constructed and validated. Results: There were statistically significant differences in staging, lesion site, Lund-Mackay score, anterior olfactory fissure score, posterior olfactory fissure score, percentage of serum eosinophils, olfactory marker protein-positive cell count in the upper turbinate mucosa, and urea nitrogen between the two groups of CRSwNP patients (P<0.05) . IL-5, human eosinophil cationic protein (ECP) /peroxidase (MPO), tissue inhibitor of metalloproteinases 1 (TIMP1), chemokine 2 (CCL2), chemokine 3 (CCL3), chemokine 4 (CCL4), total immunoglobulin E (IgE) of tissue specimens, and total IgE of serum specimens in the olfactory impairment group were higher than those in the group without olfactory impairment, the differences were statistically significant (P<0.05) . The multifactorial logistic results were that staging, lesion site, Lund-Mackay score, anterior olfactory fissure score, posterior olfactory fissure score, IL-5, ECP/MPO, CCL4, and total IgE of tissue specimens were all independent risk factors affecting olfactory impairment in patients with CRSwNP；while olfactory marker protein-positive cell count in the upper turbinate mucosa was an independent protective factor for olfactory impairment in patients with CRSwNP. The results were validated by establishing a line graph model. The validation results of building the column line graph model suggested that the C-index of the training and validation sets were 0.858 and 0.825, respectively, and the area under the characteristic curve (AUC) of the subject patients were 0.853 and 0.815, respectively. Conclusion: A model to explore the risk of postoperative olfactory impairment in CRSwNP patients based on immunoinflammatory indexes has been established, the model with high predictive performance to help guide clinical decision making. [ABSTRACT FROM AUTHOR]

Introduction: Baseline olfactory impairment, poor performance on cognitive test, and medial temporal lobe atrophy are considered biomarkers for predicting future cognitive decline in dementia-free older adults. However, the combined effect of these predictors has not been fully investigated. Methods: A group of 110 participants without dementia were continuously recruited into this study, and underwent olfactory, cognitive tests and MRI scanning at baseline and 5-year follow-up. Olfactory function was assessed using the University of Pennsylvania Smell Identification Test (UPSIT). Participants were divided into the cognitive decliners and non-decliners. Results: Among 87 participants who completed the 5-year follow-up, cognitive decline was present in 32 cases and 55 remained stable. Compared with non-decliners, cognitive decliners presented lower scores on both the UPSIT and the Montreal Cognitive Assessment (MoCA), and smaller hippocampal volume at baseline (all P <.001). The logistic regression analysis revealed that lower scores on UPSIT and MoCA, and smaller hippocampal volume were strongly associated with subsequent cognitive decline, respectively (all P <.001). For the prediction of cognitive decline, lower score on UPSIT performed the sensitivity of 63.6% and specificity of 81.2%, lower score on MoCA with the sensitivity of 74.5% and specificity of 65.6%, smaller hippocampal volume with the sensitivity of 70.9% and specificity of 78.1%, respectively. Combining three predictors resulted in the sensitivity of 83.6% and specificity of 93.7%. Conclusions: The combination of olfactory test, cognitive test with structural MRI may enhance the predictive ability for future cognitive decline for dementia-free older adults. [ABSTRACT FROM AUTHOR]

The present study shows that animals with experimental autoimmune encephalomyelitis (EAE) exhibit olfactory dysfunction and impaired general cognitive abilities, as well as anxiety-like behavior. Olfactory dysfunction occurs on average at 2 dpi, well before the onset of the first motor signs of EAE (8-10 dpi). After the initial olfactory dysfunction, the EAE animals show a fluctuation in olfactory performance that resembles the relapsing-remitting course of human MS. The study also shows severe neuroinflammation in the olfactory bulb (OB), with numerous infiltrated CD4+ T cells and peripheral macrophages in the superficial OB layers, marked microgliosis, and massive induction of TNF-α, IL-1β, and IL-6. Reduced tyrosine hydroxylase activity in the glomerular layer, pronounced granule cell atrophy, and reduced numbers of type B neuroblasts in the rostral migratory stream also indicate altered plasticity of the neuronal network in the OB. Considering the exceptionally high purinome expression in the OB, the possible involvement of purinergic signaling was also investigated. The study shows that macrophages infiltrating the OB overexpress A3R, while highly reactive microglia overexpress the adenosine-producing enzyme eN/CD73 as well as A2BR, A3R, and P2X4R. Given the simultaneous induction of complement component C3, the results suggest that the microglial cells develop a functional phenotype of phagocytizing microglia. The study also demonstrates transcriptional and translational upregulation of A1R in mitral and tufted cells, which likely influence resting network activity in OB and likely contribute to olfactory dysfunction in EAE. Overall, our study shows that olfactory dysfunction and altered social and cognitive behavior in EAE are associated with increased adenosine signaling via A1R, A2BR, and A3R. [ABSTRACT FROM AUTHOR]

Objectives: The new corona virus infection, has a wide range of clinical manifestations. Fever and cough are the most common symptoms. The olfactory function may be also affected with COVID-19. In this randomized clinical trial, we wanted to evaluate the therapeutic effect of olfactory training with and without oral vitamin A for COVID-19-related olfactory dysfunction. Methods: Patients answered to the standard Persian version of anosmia reporting tool and performed the quick smell test before and after 12 weeks and at the end of the 12 months follow up. The patients were randomly allocated to three groups; Group A treatment with olfactory training, Group B treatment with oral vitamin A and olfactory training, and Group C as control group which only underwent nasal irrigation twice a day. Patients were treated for 3 months and followed up for 12 months. Results: Totally 90 patients were included in three groups. After interventions, 76.9% of patients in Group A, 86.7% of patients in Group B, and 26.7% of patients in Group C completely improved. The average intervention time was statistically significant in relationship with the final olfactory status of the patients in the 12 months follow-up. The olfactory training has significantly improved the smell alteration at the end of 3- and 12- months follow-up in A and B groups. Conclusion: A three-months olfactory training is effective for improvement of COVID-19-related olfactory dysfunction. Adding daily oral vitamin A to olfactory training did not lead to better results in improving olfactory dysfunction. Level of evidence: Step 2 (Level 2*): Randomized trial.

Abstract To construct a prediction model of olfactory dysfunction after transnasal sellar pituitary tumor resection based on machine learning algorithms. A cross-sectional study was conducted. From January to December 2022, 158 patients underwent transnasal sellar pituitary tumor resection in three tertiary hospitals in Sichuan Province were selected as the research objects. The olfactory status was evaluated one week after surgery. They were randomly divided into a training set and a test set according to the ratio of 8:2. The training set was used to construct the prediction model, and the test set was used to evaluate the effect of the model. Based on different machine learning algorithms, BP neural network, logistic regression, decision tree, support vector machine, random forest, LightGBM, XGBoost, and AdaBoost were established to construct olfactory dysfunction risk prediction models. The accuracy, precision, recall, F1 score, and area under the ROC curve (AUC) were used to evaluate the model's prediction performance, the optimal prediction model algorithm was selected, and the model was verified in the test set of patients. Of the 158 patients, 116 (73.42%) had postoperative olfactory dysfunction. After missing value processing and feature screening, an essential order of influencing factors of olfactory dysfunction was obtained. Among them, the duration of operation, gender, type of pituitary tumor, pituitary tumor apoplexy, nasal adhesion, age, cerebrospinal fluid leakage, blood scar formation, and smoking history became the risk factors of olfactory dysfunction, which were the key indicators of the construction of the model. Among them, the random forest model had the highest AUC of 0.846, and the accuracy, precision, recall, and F1 score were 0.750, 0.870, 0.947, and 0.833, respectively. Compared with the BP neural network, logistic regression, decision tree, support vector machine, LightGBM, XGBoost, and AdaBoost, the random forest model has more advantages in predicting olfactory dysfunction in patients after transnasal sellar pituitary tumor resection, which is helpful for early identification and intervention of high-risk clinical population, and has good clinical application prospects.

Abstract Sensory impairment and brain atrophy is common among older adults, increasing the risk of dementia. Yet, the degree to which multiple co-occurring sensory impairments (MSI across vision, proprioception, vestibular function, olfactory, and hearing) are associated with brain morphometry remain unexplored. Data were from 208 cognitively unimpaired participants (mean age 72 ± 10 years; 59% women) enrolled in the Baltimore Longitudinal Study of Aging. Multiple linear regression models were used to estimate cross-sectional associations between MSI and regional brain imaging volumes. For each additional sensory impairment, there were associated lower orbitofrontal gyrus and entorhinal cortex volumes but higher caudate and putamen volumes. Participants with MSI had lower mean volumes in the superior frontal gyrus, orbitofrontal gyrus, superior parietal lobe, and precuneus compared to participants with

To construct a prediction model of olfactory dysfunction after transnasal sellar pituitary tumor resection based on machine learning algorithms. A cross-sectional study was conducted. From January to December 2022, 158 patients underwent transnasal sellar pituitary tumor resection in three tertiary hospitals in Sichuan Province were selected as the research objects. The olfactory status was evaluated one week after surgery. They were randomly divided into a training set and a test set according to the ratio of 8:2. The training set was used to construct the prediction model, and the test set was used to evaluate the effect of the model. Based on different machine learning algorithms, BP neural network, logistic regression, decision tree, support vector machine, random forest, LightGBM, XGBoost, and AdaBoost were established to construct olfactory dysfunction risk prediction models. The accuracy, precision, recall, F1 score, and area under the ROC curve (AUC) were used to evaluate the model's prediction performance, the optimal prediction model algorithm was selected, and the model was verified in the test set of patients. Of the 158 patients, 116 (73.42%) had postoperative olfactory dysfunction. After missing value processing and feature screening, an essential order of influencing factors of olfactory dysfunction was obtained. Among them, the duration of operation, gender, type of pituitary tumor, pituitary tumor apoplexy, nasal adhesion, age, cerebrospinal fluid leakage, blood scar formation, and smoking history became the risk factors of olfactory dysfunction, which were the key indicators of the construction of the model. Among them, the random forest model had the highest AUC of 0.846, and the accuracy, precision, recall, and F1 score were 0.750, 0.870, 0.947, and 0.833, respectively. Compared with the BP neural network, logistic regression, decision tree, support vector machine, LightGBM, XGBoost, and AdaBoost, the random forest model has more advantages in predicting olfactory dysfunction in patients after transnasal sellar pituitary tumor resection, which is helpful for early identification and intervention of high-risk clinical population, and has good clinical application prospects. [ABSTRACT FROM AUTHOR]

Sensory impairment and brain atrophy is common among older adults, increasing the risk of dementia. Yet, the degree to which multiple co-occurring sensory impairments (MSI across vision, proprioception, vestibular function, olfactory, and hearing) are associated with brain morphometry remain unexplored. Data were from 208 cognitively unimpaired participants (mean age 72 ± 10 years; 59% women) enrolled in the Baltimore Longitudinal Study of Aging. Multiple linear regression models were used to estimate cross-sectional associations between MSI and regional brain imaging volumes. For each additional sensory impairment, there were associated lower orbitofrontal gyrus and entorhinal cortex volumes but higher caudate and putamen volumes. Participants with MSI had lower mean volumes in the superior frontal gyrus, orbitofrontal gyrus, superior parietal lobe, and precuneus compared to participants with < 2 impairments. While MSI was largely associated with lower brain volumes, our results suggest the possibility that MSI was associated with higher basal ganglia volumes. Longitudinal analyses are needed to evaluate the temporality and directionality of these associations. [ABSTRACT FROM AUTHOR]

Simple Summary: This study investigates the relationship between genomic alterations and preoperative olfactory function in patients with olfactory groove meningioma (OGM), often associated with olfactory impairment. Utilizing next-generation sequencing on 22 individuals with OGM, the research identified mutations with SMO/SUFU, with AKT1, and as wild type. The presence of planum sphenoidale hyperostosis (PSH) correlated with significant variations in tumour morphology and negatively impacted olfactory function, affecting odour threshold, discrimination, identification, and overall olfactory performance. Additionally, perifocal oedema was linked to decreased olfactory performance. The study also found that age over 65 and female gender were associated with reduced olfactory capabilities. Despite these findings, no direct link between olfactory impairment and tumour mutations was established, possibly due to the limited sample size. The research suggests further investigation with a larger participant group in order to better understand the impact of OGM driver mutations on olfactory function. Purpose: The study aims to examine the possible correlation between genomic alterations and preoperative olfactory function in patients with olfactory groove meningioma (OGM), due to the frequent presence of olfactory impairment. Methods: We utilised next-generation sequencing to analyse samples from 22 individuals with OGM in order to detect driver mutations. Tumour morphology was assessed using preoperative imaging, whereas olfactory function was examined using Sniffin' Sticks. Results: In a study of 22 OGM patients, mutations were as follows: 10 with SMO/SUFU, 7 with AKT1, and 5 as wild type. Planum sphenoidale hyperostosis (PSH) was present in 75% of patients, showing significant variation by mutation (p = 0.048). Tumour volumes, averaging 25 cm3, significantly differed among groups. PSH negatively impacted olfaction, notably affecting odour threshold, discrimination, identification, and global olfactory performance score (TDI) (p values ranging from <0.001 to 0.003). Perifocal oedema was associated with lower TDI (p = 0.009) and altered threshold scores (p = 0.038). Age over 65 and female gender were linked to lower thresholds and discrimination scores (p = 0.037 and p = 0.019). Conclusion: The study highlights PSH and perifocal oedema's significant effect on olfactory function in OGM patients but finds no link between olfactory impairment and tumour mutations, possibly due to the small sample size. This suggests that age and gender affect olfactory impairment. Additional research with a larger group of participants is needed to explore the impact of OGM driver mutations on olfactory performance. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is characterized not only by motor symptoms but also by non-motor dysfunctions, such as olfactory impairment; the cause is not fully understood. Our study suggests that neuronal loss and inflammation in brain regions along the olfactory pathway, such as the olfactory bulb (OB) and the piriform cortex (PC), may contribute to olfactory dysfunction in PD mice, which might be related to the downregulation of the trace amine-associated receptor 1 (TAAR1) in these areas. In the striatum, although only a decrease in mRNA level, but not in protein level, of TAAR1 was detected, bioinformatic analyses substantiated its correlation with PD. Moreover, we discovered that neuronal death and inflammation in the OB and the PC in PD mice might be regulated by TAAR through the Bcl-2/caspase3 pathway. This manifested as a decrease of anti-apoptotic protein Bcl-2 and an increase of the pro-apoptotic protein cleaved caspase3, or through regulating astrocytes activity, manifested as the increase of TAAR1 in astrocytes, which might lead to the decreased clearance of glutamate and consequent neurotoxicity. In summary, we have identified a possible mechanism to elucidate the olfactory dysfunction in PD, positing neuronal damage and inflammation due to apoptosis and astrocyte activity along the olfactory pathway in conjunction with the downregulation of TAAR1. [ABSTRACT FROM AUTHOR]

Summary: Objective: An association between odor and cognitive impairment has been shown in many studies. The objective of the present hospital-based, single-center retrospective study was to assess the impact of odor impairment on the mortality of patients with Alzheimer's disease (AD), subjective cognitive decline (SCD), and mild cognitive impairment (MCI). Methods: Odor function was measured by Sniffin Sticks (Burghart Messtechnik, Holm, Germany) and the assessment of self-reported olfactory functioning and olfaction-related quality of life (ASOF) test. Cognitive performance was assessed by an extensive neuropsychological test battery, symptoms of depression were diagnosed with the Geriatric Depressive Scale (GDS). The influence of demographic factors such as gender, age, and education were examined. Results: Although the univariate analyses and pairwise post hoc comparison showed significant differences for some of the olfactory performance tests/subtests, the multivariate models showed no association between olfactory test performance and mortality among patients with cognitive impairment. "Attention," a domain of the Neuropsychological Test Battery Vienna (NTBV), as well as depressive symptoms, gender, and age, showed a significant influence on the mortality of the patient group. Conclusion: Lower olfactory performance showed no impact on mortality. However, decreased cognitive function of "Attention" can be considered as an influential predictor for mortality. [ABSTRACT FROM AUTHOR]

Introduction: The early detection and diagnosis of dementia are of key importance in treatment, slowing disease progression, or suppressing symptoms. The possible role of changes in the sense of smell is considered with regard to potential markers for early detection of Alzheimer's disease (AD). Materials and methods: A literature search was conducted using the electronic databases PubMed, Scopus, and Web of Science between May 30, 2022 and August 2, 2022. The term "dementia" was searched with keyword combinations related to olfaction. Results: A total of 1,288 records were identified through the database search. Of these articles, 49 were ultimately included in the analysis. The results showed the potential role of changes in the sense of smell as potential biomarkers for early detection of AD. Multiple studies have shown that olfactory impairment may be observed in patients with AD, PD, MCI, or other types of dementia. Even though smell tests are able to detect olfactory loss caused by neurodegenerative diseases, they cannot reliably distinguish between certain diseases. Conclusions: In individuals with cognitive impairment or neurodegenerative diseases, olfactory assessment has repeatedly been reported to be used for early diagnosis, but not for differential diagnosis. [ABSTRACT FROM AUTHOR]

The present study shows that animals with experimental autoimmune encephalomyelitis (EAE) exhibit olfactory dysfunction and impaired general cognitive abilities, as well as anxiety-like behavior. Olfactory dysfunction occurs on average at 2 dpi, well before the onset of the first motor signs of EAE (8–10 dpi). After the initial olfactory dysfunction, the EAE animals show a fluctuation in olfactory performance that resembles the relapsing–remitting course of human MS. The study also shows severe neuroinflammation in the olfactory bulb (OB), with numerous infiltrated CD4+ T cells and peripheral macrophages in the superficial OB layers, marked microgliosis, and massive induction of TNF-α, IL-1β, and IL-6. Reduced tyrosine hydroxylase activity in the glomerular layer, pronounced granule cell atrophy, and reduced numbers of type B neuroblasts in the rostral migratory stream also indicate altered plasticity of the neuronal network in the OB. Considering the exceptionally high purinome expression in the OB, the possible involvement of purinergic signaling was also investigated. The study shows that macrophages infiltrating the OB overexpress A3R, while highly reactive microglia overexpress the adenosine-producing enzyme eN/CD73 as well as A2BR, A3R, and P2X4R. Given the simultaneous induction of complement component C3, the results suggest that the microglial cells develop a functional phenotype of phagocytizing microglia. The study also demonstrates transcriptional and translational upregulation of A1R in mitral and tufted cells, which likely influence resting network activity in OB and likely contribute to olfactory dysfunction in EAE. Overall, our study shows that olfactory dysfunction and altered social and cognitive behavior in EAE are associated with increased adenosine signaling via A1R, A2BR, and A3R.

Olfaction is one of the five basic human senses, and it is known to be one of the most primitive senses. The sense of olfaction may have been critical for human survival in prehistoric society, and although many believe its importance has diminished over time, it continues to have an impact on human interaction, bonding, and propagation of the species. Even if we are unaware of it, the sense of smell greatly affects our lives and is closely related to overall quality of life and health. Nonetheless, olfaction has been neglected from a scientific perspective compared to other senses. However, olfaction has recently received substantial attention since the loss of smell and taste has been noted as a key symptom of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Studies investigating olfaction loss in association with coronavirus disease 2019 (COVID-19) have revealed that olfactory dysfunction can be both conductive and sensorineural, possibly causing structural changes in the brain. Olfactory training is an effective treatment for olfactory dysfunction, suggesting the reorganization of neural associations. A reduced ability to smell may also alert suspicion for neurodegenerative or psychiatric disorders. Here, we summarize the basic knowledge that we, as otorhinolaryngologists, should have about the sense of smell and the peripheral and central olfactory pathways for managing and helping patients with olfactory dysfunction.

Introduction:Considering the inconsistent results regarding the association between the severity and duration of olfactory dysfunction (OD), and the viral load in coronavirus disease 2019 (COVID-19) patients, we aimed to conduct this study. Materials and Methods:This is a prospective cohort study in which COVID-19 patients were evaluated for the initial cycle threshold value (Ct values) measured by the nasopharyngeal samples along with olfactory function measured by the University of Pennsylvania Smell Identification Test (UPSIT) within 2 months of COVID-19 onset.Results:Among 309 COVID-19 patients who were included in this study, 108 (34.9%), 112 (36.2%) and 89 (28.8%) were normosmic, hyposmic, and anosmic, respectively based on the UPSIT. The severity of COVID-19 and the rate of hospitalization were higher in anosmic patients (p

Aim: Although studies have analyzed the relationship between frailty and human senses, few have comprehensively evaluated and examined their correlations. This study aimed to clarify the relationship between frailty and the senses of sight, hearing, smell, and taste. Methods: The subjects were outpatients at the Locomo Frail Outpatient Clinic. Sensory organ items were evaluated subjectively, and frailty was classified as nonfrail or frail using the Kihon Checklist. Univariate analysis was performed using the presence or absence of frailty as the dependent variable. Logistic regression analysis (forced entry method) was performed for the variables that showed significant differences. Results: A total of 269 and 226 participants were assigned to the nonfrail and frail groups, respectively. The frequency of sensory organ impairment was 10.1% for taste, 12.7% for smell, 44.6% for vision, and 58.3% for hearing. Univariate analysis using the presence or absence of frailty as the dependent variable was determined to be significant for years of education, number of medications, Geriatric Depression Scale, Mini‐Mental State Examination, Mini Nutritional Assessment–Short Form, grip strength, gait speed, sense of taste, sense of smell, sense of vision, and sense of hearing. Logistic regression analysis using the presence or absence of frailty as the dependent variable, adjusted for age, showed significant correlations with the Geriatric Depression Scale, gait speed, Mini Nutritional Assessment–Short Form, and olfactory impairment. Conclusions: Olfactory impairment had the strongest correlation with frailty. Although the sense of smell decreases with disease and aging, olfactory impairment may be correlated with frailty as a symptom of neurodegenerative diseases. Geriatr Gerontol Int 2023; 23: 871–876. [ABSTRACT FROM AUTHOR]

Key points: Nearly half of all olfactory dysfunction (OD) clinical trials since 2010 are COVID‐19–related.COVID‐19‐related OD trials are published significantly faster than COVID‐19–unrelated trials.High‐quality clinical trials and publications are crucial to discovering effective treatments. [ABSTRACT FROM AUTHOR]

Background: There are discrepancies of olfactory impairment between Alzheimer's disease (AD) and other neurodegenerative disorders. Olfactory deficits may be a potential marker for early and differential diagnosis of AD. We aimed to assess olfactory functions in patients with AD and other neurodegenerative disorders, to further evaluate the smell tests using subgroup analysis, and to explore moderating factors affecting olfactory performance. Methods: Cross-sectional studies relating to olfactory assessment for both AD and other neurodegenerative disorders published before 27 July 2022 in English, were searched on PubMed, Embase and Cochrane. After literature screening and quality assessment, meta-analyses were conducted using stata14.0 software. Results: Forty-two articles involving 12 smell tests that evaluated 2,569 AD patients were included. It was revealed that smell tests could distinguish AD from mild cognitive impairment (MCI), Lewy body disease (LBD), depression, and vascular dementia (VaD), but not from diseases such as frontotemporal dementia (FTD). Our finding indicated that in discriminating AD from MCI, the University of Pennsylvania Smell Identification Test (UPSIT) was most frequently used (95%CI: -1.12 to -0.89), while the Brief Smell Identification Test (B-SIT), was the most widely used method in AD vs. LBD group. Further subgroup analyses indicated that the methods of smell test used contributed to the heterogeneity in olfactory threshold and discrimination scores in group AD vs. MCI. While the moderating variables including age, MMSE scores, education years in AD vs. LBD, were account for heterogeneity across studies. Conclusion: Our finding suggests smell tests have potential value in early differential diagnosis of AD. UPSIT and its simplified variant, B-SIT, are widely used methods in the analyses. [ABSTRACT FROM AUTHOR]

Introduction: Considering the inconsistent results regarding the association between the severity and duration of olfactory dysfunction (OD), and the viral load in coronavirus disease 2019 (COVID-19) patients, we aimed to conduct this study. Materials and Methods: This is a prospective cohort study in which COVID-19 patients were evaluated for the initial cycle threshold value (Ct values) measured by the nasopharyngeal samples along with olfactory function measured by the University of Pennsylvania Smell Identification Test (UPSIT) within 2 months of COVID-19 onset. Results: Among 309 COVID-19 patients who were included in this study, 108 (34.9%), 112 (36.2%) and 89 (28.8%) were normosmic, hyposmic, and anosmic, respectively based on the UPSIT. The severity of COVID-19 and the rate of hospitalization were higher in anosmic patients (p<0.0001, and p<0.0001, respectively). Moreover, significant associations between the initial Ct value and the severity of OD at admission and follow-ups were detected (p<0.0001 and p<0.0001, respectively). Anosmic patients had higher Ct values in comparison with hyposmic (approx. 3-fold) and normosmic (approx. 12-fold) patients. The recovery rate after one- and two-month follow-ups was 47% and 84%, respectively. At the follow-ups, OD-recovered patients significantly had lower Ct values (mean Ct value: 27.79 ± 2 and 28.21 ± 2.08) in comparison with those who have not recovered yet (mean Ct value: 30.19 ± 3.36, and 33.6 ± 3.37) (p<0.0001, and p<0.0001, respectively). Conclusions: Ct value seems to be a significant factor not only in predicting OD severity in COVID-19 patients but also in the OD recovery duration. This finding may be helpful to investigate the underlying mechanisms of OD in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Parkinson’s disease (PD) is characterized not only by motor symptoms but also by non-motor dysfunctions, such as olfactory impairment; the cause is not fully understood. Our study suggests that neuronal loss and inflammation in brain regions along the olfactory pathway, such as the olfactory bulb (OB) and the piriform cortex (PC), may contribute to olfactory dysfunction in PD mice, which might be related to the downregulation of the trace amine-associated receptor 1 (TAAR1) in these areas. In the striatum, although only a decrease in mRNA level, but not in protein level, of TAAR1 was detected, bioinformatic analyses substantiated its correlation with PD. Moreover, we discovered that neuronal death and inflammation in the OB and the PC in PD mice might be regulated by TAAR through the Bcl-2/caspase3 pathway. This manifested as a decrease of anti-apoptotic protein Bcl-2 and an increase of the pro-apoptotic protein cleaved caspase3, or through regulating astrocytes activity, manifested as the increase of TAAR1 in astrocytes, which might lead to the decreased clearance of glutamate and consequent neurotoxicity. In summary, we have identified a possible mechanism to elucidate the olfactory dysfunction in PD, positing neuronal damage and inflammation due to apoptosis and astrocyte activity along the olfactory pathway in conjunction with the downregulation of TAAR1.

Background: Olfactory dysfunction is an early symptom of Alzheimer's disease (AD). However, olfactory tests are rarely performed in clinical practice because their diagnostic efficacy in detecting early AD is unclear. Objective: To investigate odor discrimination in patients with early AD and the efficacy of olfactory discrimination tests in differentiating these patients from subjects with normal cognition (CN). Methods: Thirty patients each with mild dementia due to AD (MD-AD) and mild cognitive impairment due to AD (MCI-AD) and 30 older subjects with CN were enrolled. All participants underwent cognitive examinations (CDR, MMSE, ADAS-Cog 13, and verbal fluency) and odor discrimination tests (Sniffin' Sticks test, Burghart®, Germany). Results: The MD-AD group achieved significantly worse scores on the olfactory discrimination test than the MCI-AD group, and the MCI-AD group achieved significantly worse results than the CN group (p < 0.05). A cut-off score of≤10 had a diagnostic accuracy of 94.44% (95% CI, 87.51–98.17%) in differentiating patients with MCI-AD/MD-AD from subjects with CN and of 91.67% (95% CI, 81.61–97.24%) in differentiating those with MCI-AD from subjects with CN. Our multinomial logistic regression model with demographic data and ADAS-Cog 13 scores as predictor variables correctly classified 82.2% of the cases (CN, 93.3%; MC-AD, 70%; MD-AD, 83.3%); on adding the olfactory discrimination score to the model, the percentage increased to 92.2% (CN, 96.7%; MCI-AD, 86.7%; MD-AD, 93.3%). Conclusion: Odor discrimination is impaired in cases of early AD and continues to deteriorate as the disease progresses. The olfactory discrimination test showed good diagnostic efficacy in detecting early AD. [ABSTRACT FROM AUTHOR]

Olfactory impairment is a serious symptom requiring careful differential diagnosis. This article presents the current state of the field and presents evidence showing that dysosmia is not only a symptom of pathology of the nasal cavity and paranasal sinuses, but also a manifestation of various neurodegenerative diseases. In some patients with confirmed detection of SARS-CoV-2 display neurological symptoms. Data on the development of novel disease symptoms in the form of anosmia and dysgeusia in this category of patients are presented. The importance of the diagnosis of olfaction in the relatives of patients with hereditary neurodegenerative diseases for early detection of pathology is noted. The potentials of new methods for diagnosing olfactory disorders are considered, this being a promising task in both neurology and otorhinolaryngology and having the aim of preventing the development of neurodegenerative diseases at an early stage and improving patients' quality of life and social adaptation. [ABSTRACT FROM AUTHOR]

Introduction: Olfaction is impaired in Alzheimer's disease (AD). However, olfactory memory has rarely been examined. As the pathogenesis of AD remains largely unknown, collecting more data regarding the occurrence and progression of its symptoms would help gain more insight into the disease. Objective: To investigate olfactory memory and its relationship with verbal memory and other clinical features in patients with early-stage AD. Methods: Three groups of participants were enrolled in this study: patients with mild dementia due to AD (MD-AD, N = 30), patients with mild cognitive impairment due to AD (MCI-AD, N = 30), and cognitively normal older participants (CN, N = 30). All participants underwent cognitive evaluation (Clinical Dementia Rating scale, Mini Mental State Examination, Alzheimer's Disease Assessment Scale--Cognitive Subscale, delayed verbal recall, and verbal fluency tests) and assessment of olfactory immediate and delayed recognition memory. Results: Olfactory immediate and delayed recognition memory scores were significantly lower in the MD-AD group than in the MCI-AD and CN groups. The MCI-AD and CN groups did not differ significantly [in both cases, Kruskal--Wallis test, p < 0.05; post hoc analysis revealed significant differences between the MDAD and MCI-AD groups and between the MD-AD and CN groups (p < 0.05), and no significant difference between the MCI-AD and CN groups (p > 0.05)]. Verbal immediate recall, delayed recall after 5 min, and delayed recall after 30 min scores were significantly worse in the MD-AD and MCI-AD groups than in the CN group. MD-AD and MCI-AD groups did not differ significantly [in all cases Kruskal--Wallis test, p < 0.05; post hoc analysis revealed significant differences between MD-AD and CN groups, and MCI-AD and CN groups (p < 0.05) and no significant difference between MD-AD and MCI-AD groups (p > 0.05)]. Duration of AD symptoms was a strong predictor of both immediate and delayed olfactory recognition memory scores. Conclusion: Olfactory memory impairment was observed in patients with AD. The changes progress during the course of the disease. However, unlike verbal memory, olfactory memory is not significantly impaired in the prodromal stage of AD. [ABSTRACT FROM AUTHOR]

Background: Anosmia is defined as the complete absence of olfactory function, which can be caused by a variety of causes, with upper respiratory tract infections being among the most frequent causes. Anosmia due to SARS-CoV-2 infection has attracted attention given its main role in symptomatology and the social impact of the pandemic. Methods: We conducted systematic research in a clinicaltrials.gov database to evaluate all active clinical trials worldwide regarding drug therapies in adult patients for anosmia following SARS-CoV-2 infection with the intention of identifying the nearby prospects to treat Anosmia. We use the following search terms: "Anosmia" AND "COVID-19" OR "SARS-CoV-2" OR "2019 novel coronavirus". Results: We found 18 active clinical trials that met our criteria: one phase 1, one phase 1–2, five phases 2, two phases 2–3, three phases 3, and six phases 4 studies were identified. The drug therapies that appear more effective and promising are PEA-LUT and Cerebrolysin. The other interesting drugs are 13-cis-retinoic acid plus aerosolized Vitamin D, dexamethasone, and corticosteroid nasal irrigation. Conclusions: COVID-19 has allowed us to highlight how much anosmia is an important and debilitating symptom for patients and, above all, to direct research to find a therapy aimed at curing the symptom, whether it derives from SARS-CoV-2 infection or other infections of the upper airways. Some of these therapies are very promising and are almost at the end of experimentation. They also provide hope in this field, which not addressed until recently. [ABSTRACT FROM AUTHOR]

Olfactory disorders one of the most frequent distinctive symptoms of COVID-19 infection. COVID-19-induced olfactory disorder can be classified as post-infectious olfactory dysfunction (PIOD). The effect of drugs on olfactory disorder following upper respiratory infection, including PIOD, has not been clearly established, which adds to the difficulty with treating the disorder. However, the effect of olfactory training on PIOD has been confirmed by numerous studies. As such, olfactory training is gaining attention, and has taken on greater importance, as the sole treatment for COVID-19–induced olfactory disorder in this pandemic age. This review describes the effect of olfactory training for COVID-19–induced olfactory disorder by analyzing the relevant literature.

Objective:To evaluate the smell and taste impairment in Coronavirus disease-2019 (COVID-19) pediatric patients according to the disease severity.Method:Ninety polymerase chain reaction test-confirmed COVID-19 patients were enrolled from January 2021 to July 2021. Patients were categorized into three main groups according to the stage of disease (stage 1: Outpatients, stage 2: Inpatients, stage 3: Intensive care unit patients). There were 30 pediatric patients in each group. Subjects were evaluated with a questionnaire. Visual analog scale was used to evaluate smell and taste impairment patients.Results:The impairment of smell and taste were evaluated separately, and the rates were found to be 31.1% and 35.6%, respectively. The impairment of smell showed a statistically significant difference between the groups (p=0.002). The rate of smell impairment in the outpatients was found to be significantly higher than in the patients treated in the intensive care unit. The taste impairment did not show a statistically significant difference between the groups (p=0.109; p>0.01). Persistence of smell and taste impairment was found in 5.5% of the patients.Conclusion:The rate of smell impairment in the outpatients was found to be significantly higher than in the cases treated in the intensive care unit.

In this study, we aimed to determine whether nasally administered murine adipose-derived stem cells (ADSCs) could support olfactory regeneration in vivo. Olfactory epithelium damage was induced in 8-week-old C57BL/6J male mice by intraperitoneal injection of methimazole. Seven days later, OriCell adipose-derived mesenchymal stem cells obtained from green fluorescent protein (GFP) transgenic C57BL/6 mice were nasally administered to the left nostril of these mice, and their innate odor aversion behavior to butyric acid was assessed. Mice showed significant recovery of odor aversion behavior, along with improved olfactory marker protein (OMP) expression on both sides of the upper-middle part of the nasal septal epithelium assessed by immunohistochemical staining 14 d after the treatment with ADSCs compared with vehicle control animals. Nerve growth factor (NGF) was detected in the ADSC culture supernatant, NGF was increased in the nasal epithelium of mice, and GFP-positive cells were observed on the surface of the left side nasal epithelium 24 h after left side nasal administration of ADSCs. The results of this study suggest that the regeneration of olfactory epithelium can be stimulated by nasally administered ADSCs secreting neurotrophic factors, thereby promoting the recovery of odor aversion behavior in vivo. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study evaluated olfactory function in patients undergoing hemodialysis. The evaluation utilized the Sniffin' Sticks test. PATIENTS AND METHODS: The study enrolled 56 individuals undergoing hemodialysis for chronic renal failure alongside 54 healthy controls. The Sniffin' Sticks battery was used to assess olfactory function in all subjects. The battery included 12 separately identifiable odors. A score below 6 was considered anosmia, whilst scores ranging from 7 to 10 were classed as hyposmia. A score of at least 11 indicated normal olfaction. RESULTS: There was a statistically significant difference in scores between the two groups. The hemodialysis patients scored 9.12±2.77 compared to 10.72±1.94 in the controls. In the hemodialysis patients, scores for males and females did not differ significantly. Furthermore, there was no correlation between score and age, sex or length of renal failure. Some 12.5% of hemodialysis patients were anosmic, whilst 50% were hyposmic. The corresponding rates in the control group were 7.4% and 20.4%. CONCLUSIONS: Undergoing hemodialysis is associated with a decreased total score on the Sniffin' Sticks battery, with anosmia in 12.5% of patients and hyposmia in 50.0%. Thus, olfactory impairment is present in 62.5% of hemodialysis patients. According to previous research, renal transplantation results in an improved ability to smell, depending on how plastic the neurons involved in olfaction are. [ABSTRACT FROM AUTHOR]

IntroductionOlfaction is impaired in Alzheimer’s disease (AD). However, olfactory memory has rarely been examined. As the pathogenesis of AD remains largely unknown, collecting more data regarding the occurrence and progression of its symptoms would help gain more insight into the disease.ObjectiveTo investigate olfactory memory and its relationship with verbal memory and other clinical features in patients with early-stage AD.MethodsThree groups of participants were enrolled in this study: patients with mild dementia due to AD (MD-AD, N = 30), patients with mild cognitive impairment due to AD (MCI-AD, N = 30), and cognitively normal older participants (CN, N = 30). All participants underwent cognitive evaluation (Clinical Dementia Rating scale, Mini Mental State Examination, Alzheimer’s Disease Assessment Scale–Cognitive Subscale, delayed verbal recall, and verbal fluency tests) and assessment of olfactory immediate and delayed recognition memory.ResultsOlfactory immediate and delayed recognition memory scores were significantly lower in the MD-AD group than in the MCI-AD and CN groups. The MCI-AD and CN groups did not differ significantly [in both cases, Kruskal–Wallis test, p 0.05)]. Verbal immediate recall, delayed recall after 5 min, and delayed recall after 30 min scores were significantly worse in the MD-AD and MCI-AD groups than in the CN group. MD-AD and MCI-AD groups did not differ significantly [in all cases Kruskal–Wallis test, p 0.05)]. Duration of AD symptoms was a strong predictor of both immediate and delayed olfactory recognition memory scores.ConclusionOlfactory memory impairment was observed in patients with AD. The changes progress during the course of the disease. However, unlike verbal memory, olfactory memory is not significantly impaired in the prodromal stage of AD.

Background: Olfactory impairment is a major symptom of COVID-19. Is it necessary for COVID-19 patients to perform the detection of olfactory function, even how to select the olfactory psychophysical assessment tool. Methods: Patients infected with SARS-CoV-2 Delta variant were firstly taken into three categories (mild, moderate, and severe) according to the clinical classification. The Odor Stick Identification Test for the Japanese (OSIT-J) and the Simple Olfactory Test were used to assess olfactory function. Moreover, these patients were divided into three groups based on the results of the olfactory degree (euosmia, hyposmia, and dysosmia), too. The statistical analysis of the correlations between olfaction and clinical characteristics of patients were performed. Results: Our study demonstrated that the elderly men of Han were more susceptible to infected SARS-CoV-2, the clinical symptoms of the COVID-19 patients showed a clear correspondence with the disease type and the degree of olfactory disturbance. Whether or not to vaccinate and whether to complete the whole course of vaccination was closely related to the patient's condition. OSIT-J Test and Simple Test were consistent in our work, indicating that olfactory grading would worsen with the aggravation of symptoms. Furthermore, the OSIT-J method maybe better than Simple Olfactory Test. Conclusion: The vaccination has an important protective effect on the general population, and vaccination should be vigorously promoted. Moreover, it is necessary for COVID-19 patients to perform the detection of olfactory function, and the easier, faster and less expensive method for determination of olfactory function should be utilized to COVID-19 patients as the vital physical examination.

The human brain sustains a slow but progressive decline in function as it ages and these changes are particularly profound in cognitive processing. A potential contributor to this deterioration is the gradual decline in the functioning of multiple sensory systems and the effects they have on areas of the brain that mediate cognitive function. In older adults, diminished capacity is typically observed in the visual, auditory, masticatory, olfactory, and motor systems, and these age-related declines are associated with both a decline in cognitive proficiency, and a loss of neurons in regions of the brain. We will review how the loss of hearing, vision, mastication skills, olfactory impairment, and motoric decline accompany cognitive loss, and how improved functioning of these systems may aid in the restoration of the cognitive abilities in older adults. The human brain appears to require a great deal of stimulation to maintain its cognitive efficacy as people age and environmental enrichment may aid in its maintenance and recovery.

Aim: Olfactory impairment is associated with cognitive impairment. However, differences between subjective and objective olfactory impairment measurements in older adults and their relationship with cognitive impairment are unclear. Methods: We assessed the relationship between cognitive and olfactory impairments via a single‐center observational study in 2020. Forty‐seven individuals who visited our memory clinic were enrolled and asked to complete objective and subjective olfactory tests. Participants had dementia, mild cognitive impairment, or normal cognition. We administered the Open Essence (a simple card‐type odor identification test) and self‐administered odor questionnaire to assess objective and subjective olfaction, respectively, and the Mini‐Mental State Examination to assess cognitive function. Results: Older age was related to decreased Open Essence scores (P < 0.001). Compared with the mild cognitive impairment and normal cognition groups, the dementia group had significantly lower Open Essence scores (P < 0.001). Cognitive impairment was also associated with decreased Open Essence scores after adjusting for age, sex, and education (P < 0.001). Participants with dementia did not obtain lower self‐administered odor questionnaire scores than those with normal cognition, and they tended to be unaware of their olfactory impairment. Conclusion: Open Essence scores significantly decreased according to the degree of cognitive impairment. Participants with dementia were unaware of their olfactory impairment, as indicated by odor questionnaire scores. Objective and subjective scores of olfaction differed in participants with dementia. Concomitant assessment of objective and subjective olfaction is useful to screen older adults with both olfactory and cognitive impairments. Geriatr Gerontol Int 2022; 22: 924–929. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study used the Sniffin' Sticks test battery to evaluate olfactory function in employees of a bakery exposed to flour dust. SUBJECTS AND METHODS: The study enrolled 43 individuals with exposure (i.e., to flour) plus 41 healthy volunteers as controls. Olfactory function was assessed in these subjects through the use of the Sniffin' Sticks test battery. The overall score was calculated by adding up the scores for each of the 12 separate odors. A score of 6 or less was deemed anosmia, from 7 to 10 hyposmia, and a score of 11 or 12 was taken to indicate no impairment of olfaction. RESULTS: There was a statistically significant difference between the scores obtained in the exposure group (10.09±2.29) and the control group (10.73±2.07), the exposure group having a lower score (p<0.05). Within the exposure group, men and women did not score differently (p>0.05). Furthermore, in this group, the overall score did not correlate significantly with age, sex, length of employment, or use of tobacco or alcohol use (p>0.05). Using the scheme employed in this study, 9.3% of the exposed workers were anosmic, compared to 9.8% in the controls, whereas 34.9% of baker workers were hyposmic, compared to just 14.6% of the controls. Thus, our study shows that impairment of the ability to smell was present in 44.2% of individuals exposed occupationally to flour dust. CONCLUSIONS: This study reveals that being exposed to flour dust reduces the ability to smell normally. In order to minimize the impact of being exposed, workplaces should ensure adequate ventilation and provide workers with protective facemasks. [ABSTRACT FROM AUTHOR]

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Until recently, it was thought that dementia prevention was not possible. However, a recent paper reported that 40% of the risk factors for developing dementia are modifiable. Large-scale clinical studies on dementia prevention and various initiatives to reduce the risk of developing dementia have been made worldwide. In addition to the introduction of a global initiative in dementia prevention, I also introduce the results of our research on the development of the Tottori method dementia prevention program and aromatherapy to approach olfactory impairment in Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Objectives: The new corona virus infection, has a wide range of clinical manifestations. Fever and cough are the most common symptoms. The olfactory function may be also affected with COVID-19. In this randomized clinical trial, we wanted to evaluate the therapeutic effect of olfactory training with and without oral vitamin A for COVID-19-related olfactory dysfunction., Methods: Patients answered to the standard Persian version of anosmia reporting tool and performed the quick smell test before and after 12 weeks and at the end of the 12 months follow up. The patients were randomly allocated to three groups; Group A treatment with olfactory training, Group B treatment with oral vitamin A and olfactory training, and Group C as control group which only underwent nasal irrigation twice a day. Patients were treated for 3 months and followed up for 12 months., Results: Totally 90 patients were included in three groups. After interventions, 76.9% of patients in Group A, 86.7% of patients in Group B, and 26.7% of patients in Group C completely improved. The average intervention time was statistically significant in relationship with the final olfactory status of the patients in the 12 months follow-up. The olfactory training has significantly improved the smell alteration at the end of 3- and 12- months follow-up in A and B groups., Conclusion: A three-months olfactory training is effective for improvement of COVID-19-related olfactory dysfunction. Adding daily oral vitamin A to olfactory training did not lead to better results in improving olfactory dysfunction., Level of Evidence: Step 2 (Level 2*): Randomized trial., (Copyright © 2024 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier España S.L.U. All rights reserved.)

Background: Poor olfaction is associated with worse functional performance in older adults, but longitudinal evidence is lacking. We investigated poor olfaction in relation to longitudinal changes in physical functioning among community-dwelling older adults.Method: The analysis included 2 319 participants from the Health, Aging and Body Composition study (aged 71-82 years, 47.9% men, and 37.3% Blacks) who completed the Brief Smell Identification Test in 1999-2000. Olfaction was defined as good (test score 11-12), moderate (9-10), or poor (0-8). Physical functioning was assessed up to 4 times over 8 years, using the Short Physical Performance Battery (SPPB) and the Health Aging and Body Composition Physical Performance Battery (HABCPPB). We conducted joint model analyses and reported the differences in annual declines across olfaction groups.Results: During the follow-up, compared to those with good olfaction, older adults with poor olfaction had greater annual declines in both the SPPB score (-0.137, 95% CI: -0.186, -0.088) and all its subscales: standing balance (-0.068, 95% CI: -0.091, -0.044), chair stand (-0.046, 95% CI: -0.070, -0.022), and gait speed (-0.022, 95% CI: -0.042, -0.001). A similar observation was made for the HABCPPB score (difference in annual decline: -0.032, 95% CI: -0.042, -0.021). These findings are robust and cannot be explained by measured confounding from demographics, lifestyle factors, and chronic diseases or by potential biases due to death and loss of follow-up. Similar associations were observed across subgroups of sex, race, and self-reported general health status.Conclusion: This study provides the first epidemiological evidence that poor olfaction predicts a faster decline in physical functioning. Future studies should investigate potential mechanisms. [ABSTRACT FROM AUTHOR]

Background: Dysfunction in the olfactory, auditory, and vestibular systems are commonly seen in aging and are associated with dementia. The impact of sensory loss(es) on cognition is not well understood. Our aim was to assess the relationships between performance on objective multisensory testing and quantify the impact of dysfunction on cognition. Methods: Patients presenting with subjective hearing loss presenting to a tertiary care otologic/audiologic clinic were identified and underwent multisensory testing using the Affordable, Rapid Olfactory Measurement Array (AROMA), pure tone audiometric evaluations, and the Timed "Up and Go" test. Cognitive impairment (CI) was assessed via the Montreal Cognitive Assessment (MoCA) was also administered. Key Results: 180 patients were enrolled. Thirty one percentage (n = 57) screened positive for cognitive impairment. When evaluating single sensory impairments, we found that olfactory dysfunction, gait impairment, and sensorineural hearing loss were all statistically significantly (p < 0.05) associated with a higher risk of cognitive impairment (ORs 3.89, 3.49, and 2.78, respectively) for CI. Multisensory impairment was significantly associated with cognitive impairment. Subjects with dysfunction in all domains were at the highest risk for cognitive impairment (OR 15.7, p < 0.001) vs. those with impairment in 2 domains (OR 5.32, p < 0.001). Conclusion: Dysfunction of the olfactory, auditory, and vestibular systems is associated with a significantly increased risk of CI. The dramatically increased risk of CI with multisensory dysfunction in all three systems indicated that MSD may synergistically contribute to CI. [ABSTRACT FROM AUTHOR]

Using an amyloid precursor protein (App) gene knock-in (KI) mouse of Alzheimer's disease (AD), we investigated the expression of olfactory-related genes in olfactory impairment caused by AD. We observed the change in olfactory behavior in the App-KI mice. There was no significant difference, however, in the mRNA expression levels of olfactory-related genes between the olfactory epithelia of wild-type (WT) and App-KI mice. Amyloid-β deposition was confirmed throughout the olfactory pathway in App-KI mice, but not in WT mice. These show that the change in olfactory behavior in the App-KI mice might cause by the impairment of the olfactory pathway. [ABSTRACT FROM AUTHOR]

Objectives. To study the prevalence and clinical manifestations of postcovid syndrome (PCS) in out-patients and to assess the efficacy of treatment with the drug Cortexin at doses of 10 and 20 mg i.m. for 10 days. Materials and methods. A total of 979 patients with PCS from regions of the Russian Federation, Azerbaijan, Kyrgyzstan, and Kazakhstan were studied; mean age was 54.6 ± 4.5 years; duration of COVID-19 was from one month upwards. Investigations involved three visits. The first was on the day of consultation (assessment of complaints, analysis of scale indicators, prescription of drug Cortexin at a dose of 10 or 20 mg i.m. for 10 days). The second visit (telephone consultation) was on day 10–14. The third visit was on day 30 of out-patient treatment. Assessment of patients' status used an asthenia assessment scale (MFI-20), a brief mental state assessment scale (MMSE), the Schulte test, and the Subjective Treatment Quality Assessment Scale. Results. The proportion of patients with PCS was up to 30% of all neurological admissions. The commonest manifestations were: fatigue, general weakness, decreased memory and concentration of attention, vertigo, sleep impairment, irritability, and aggression; less frequent were breathlessness, pain, increased sweating, anosmia, hyposmia, dysgeusia, paresthesia, hair loss, degradation of vision, tachycardia, allergic reactions, menstrual cycle impairments, erectile dysfunction, panic attacks, suicidal ideation, depression and refusal to eat meat. Conclusions: No associations were found between clinical symptomatology and the severity of COVID-19, the volume of lung tissue affected, or different periods of postcovid syndrome. Cortexin was found to be effective at doses of 10 and 20 mg for correcting the cognitive and asthenic manifestations of PCS. Cortexin was found to have anti-anxiety, antidepressant, and anxiolytic effects, which were more marked at the 20-mg dose. [ABSTRACT FROM AUTHOR]

Introduction. Chronic rhinosinusitis, a very common inflammatory condition, is a main public health issue affecting the quality of life. Furthermore, some patients do not respond to either medical or surgical intervention, which could be explained by the presence of the bacterial biofilm in the rhinosinusal zone. Objectives. The aim of this study is to evaluate the influence of endoscopic sinus surgery on olfactory impairment caused by chronic sinusitis with and without nasal polyps (CRSNP and CRS), by testing the olfactory function and potential dysfunction before and after endoscopic sinus surgery. Another objective is to find a connection between the percentage of coverage with bacterial biofilm of the nasal mucosa from patients with CRSNP and CRS and to evidence the fountain of infection role of the bacterial biofilm, while demonstrating that antibiotic therapy is not efficient once the bacterial biofilm is formed in the nasal sinuses. Materials and methods. We investigated 123 patients with CRSNP and CRS, which underwent functional endoscopic sinus surgery (FESS). The olfactory function was tested pre and post FESS. We also analyzed and compared the scores of endoscopic images of Lund-Kennedy and CT staging scale of LundMackey for the two study groups. The degree of olfactory rehabilitation in patients with CRSNP and CRS was evaluated performing smell diskettes test. The presence of bacterial biofilm on the surface of the nasal mucosa extracted during FESS from patients with CRSNP and CRS was examined with the electronic microscope and the percentage of coverage with bacterial biofilm was measured with Carnoy software. Results. Bacterial biofilm was present in a higher percentage in patients with CRS vs. CRSNP. By comparing the level of olfactory function, significant improvement was found after FESS intervention in both study groups. Postoperatively, Lund-Kennedy scores decrease significantly for the whole group (Z = -9.66 at p < 0.001, d Cohen = 4.40), indicating the major role of surgery in the treatment of CRS. The decrease in Lund-Kennedy score values is also significant for each group. In the case of subjects diagnosed with CRS, the mean values decrease from 6.57 (preoperative) to 0.90 (postoperative), respectively Z = -6.779 to p < 0.001. In the case of subjects diagnosed with CRSNP, the mean values decrease from 9.03 (preoperative) to 1.44 (postoperative), Z = -6.927 at p < 0.001. Out of the total number of patients included in the study, 59 patients tested positive with the Prick test for dust and mites and more than half of the patients with positive allergy test were from the lot diagnosed with CRSNP. Conclusions. FESS plays an important role in the improvement of olfactory function in patients with CRS. Bacterial biofilm was present in both study groups but in higher percentage in the CRS group and was found in lower percentage in the group with positive allergy tests. The CRSNP group presented a higher positive result regarding the allergy Prick test and a lower percentage of coverage with bacterial biofilm of the nasal mucosa. In conclusion, chronic rhinosinusitis with or without nasal polyps that is refractary to antibiotic therapy should be directed to the ENT department in order to receive surgical therapy in order to improve olfactory function.

BackgroundDysfunction in the olfactory, auditory, and vestibular systems are commonly seen in aging and are associated with dementia. The impact of sensory loss(es) on cognition is not well understood. Our aim was to assess the relationships between performance on objective multisensory testing and quantify the impact of dysfunction on cognition.MethodsPatients presenting with subjective hearing loss presenting to a tertiary care otologic/audiologic clinic were identified and underwent multisensory testing using the Affordable, Rapid Olfactory Measurement Array (AROMA), pure tone audiometric evaluations, and the Timed “Up and Go” test. Cognitive impairment (CI) was assessed via the Montreal Cognitive Assessment (MoCA) was also administered.Key Results180 patients were enrolled. Thirty one percentage (n = 57) screened positive for cognitive impairment. When evaluating single sensory impairments, we found that olfactory dysfunction, gait impairment, and sensorineural hearing loss were all statistically significantly (p < 0.05) associated with a higher risk of cognitive impairment (ORs 3.89, 3.49, and 2.78, respectively) for CI. Multisensory impairment was significantly associated with cognitive impairment. Subjects with dysfunction in all domains were at the highest risk for cognitive impairment (OR 15.7, p < 0.001) vs. those with impairment in 2 domains (OR 5.32, p < 0.001).ConclusionDysfunction of the olfactory, auditory, and vestibular systems is associated with a significantly increased risk of CI. The dramatically increased risk of CI with multisensory dysfunction in all three systems indicated that MSD may synergistically contribute to CI.

Background: Anosmia is defined as the complete absence of olfactory function, which can be caused by a variety of causes, with upper respiratory tract infections being among the most frequent causes. Anosmia due to SARS-CoV-2 infection has attracted attention given its main role in symptomatology and the social impact of the pandemic. Methods: We conducted systematic research in a clinicaltrials.gov database to evaluate all active clinical trials worldwide regarding drug therapies in adult patients for anosmia following SARS-CoV-2 infection with the intention of identifying the nearby prospects to treat Anosmia. We use the following search terms: “Anosmia” AND “COVID-19” OR “SARS-CoV-2” OR “2019 novel coronavirus”. Results: We found 18 active clinical trials that met our criteria: one phase 1, one phase 1–2, five phases 2, two phases 2–3, three phases 3, and six phases 4 studies were identified. The drug therapies that appear more effective and promising are PEA-LUT and Cerebrolysin. The other interesting drugs are 13-cis-retinoic acid plus aerosolized Vitamin D, dexamethasone, and corticosteroid nasal irrigation. Conclusions: COVID-19 has allowed us to highlight how much anosmia is an important and debilitating symptom for patients and, above all, to direct research to find a therapy aimed at curing the symptom, whether it derives from SARS-CoV-2 infection or other infections of the upper airways. Some of these therapies are very promising and are almost at the end of experimentation. They also provide hope in this field, which not addressed until recently.

Purpose of Review: Olfactory dysfunction is a prevalent condition affecting 5–15% of the general population, with significant impact on quality of life. This review summarizes the most recent and relevant literature in the treatment of olfactory dysfunction. Recent Findings: Current evidence supports the short-term use of topical corticosteroids and systemic therapy. These treatments may occur in conjunction with olfactory training, which is well supported by the literature. While there are several additional treatments currently under investigation, meaningful conclusions are not yet able to be made regarding their efficacy. Summary: The treatment of olfactory dysfunction is targeted at the suspected etiology when possible. After normal aging, chronic rhinosinusitis, post-infectious sequelae including as a result SARS-CoV-2 infection (COVID-19), and head trauma are the most common causes. Current evidence supports the short-term use of topical corticosteroids and systemic therapy. Several additional treatments are under investigation but recommendations for their use cannot currently be made. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2 virus) disease had first appeared in December 2019 in Wuhan, China, and since then, it has emerged as a global threat to humanity. An early diagnosis and isolation are the most significant measures required to prevent its spread. Recent anecdotal evidence has suggested impairment of olfactory and gustatory sensations associated with corona virus disease (COVID-19). Angiotensin-converting enzyme-2 is an important aspect for the manifestations seen in this deadly viral disease. The associated olfactory and gustatory dysfunction can also lead to partial and/or complete loss of the ability to smell and taste in the early stages of disease onset. Evidence has also suggested that the presence of SARS-CoV-2 nucleic acid in human saliva makes it the carrier of the infectious viral disease and aids in its diagnosis. The present review focuses on the listed clinical manifestations in the form of olfactory and gustatory impairment in SARS-CoV-2 virus disease.

Background: Early detection, treatment, and care are important for the prevention of dementia. Though olfactory impairment has been reported to be associated with mild cognitive impairment (MCI), there are few reports involving community-dwelling older adults with no difficulty in daily life in Japan. Objective: This study aimed to identify the frequency of MCI in community-dwelling elderly people attending community salons in a city with a high aging population, and to determine the usefulness of a pocket olfactory discrimination test. Methods: We recruited 268 independent older adults attending community salons. The Japanese version of the MCI Screen was used to evaluate cognitive function, defining MCI as <49.8 out of 100 scores of the memory performance index (MPI). The Japanese version of the University of Pennsylvania Smell Identification Test (UPSIT-J) was used for olfactory discrimination and the number of correct answers out of 4 questions was noted. Results: Of the salon participants, 138 (51.5%) were classified as having MCI. As the number of correct answers on the olfactory test decreased, the percentage of participants with MCI increased. The MPI score of the low UPSIT score group was significantly lower than that of the high UPSIT score group. Conclusions: This study revealed that approximately half of the elderly local residents living without daily problems were suspected of having MCI. The UPSIT-J-4 is a simple olfactory identification test, and can be used at any time and any place. It is useful for screening cognitive function via olfactory identification in a salon-like setting. [ABSTRACT FROM AUTHOR]

Abstract Introduction Alzheimer’s disease (AD) is a debilitating neurodegenerative disease that currently affects 850,000 individuals in the UK with estimates continuing to rise. Diagnosis is only available in the presence of significant neuronal pathology and apparent cognitive decline, meaning that treatment avenues are often limited and carry little to no effect on prognosis. Olfactory function has been shown to have a direct correlation with cognitive function and therefore may serve as a potential diagnostic tool for the detection of preclinical disease. The objective was to examine the current literature to establish the accuracy of olfactory function testing in determining current and future cognitive function. Methods A systematic review was performed via Medline on 17 October 2019 using the search terms and Boolean operators ‘Dementia OR Alzheimer’s AND olfaction AND cognitive impairment’ yielding 111 results. These were then screened using inclusion/exclusion criteria alongside a PICO strategy. After titles, abstracts and full text were screened, nine articles were included in the review and critically appraised using the AXIS and CASP tools. Results Significant correlations are demonstrated between olfactory impairment (OI) and cognitive decline. However, there were limitations of many of the studies in that confounders such as head trauma, upper respiratory infection (URTI) and smoking history were not considered. The majority of the studies also used an olfactory screening tool that was not designed for the population being examined. Conclusion Despite improvements in olfactory testing needing to be implemented, OI is clearly impaired in neurodegenerative disease across a multitude of ages and cultures, offering an early marker of future cognitive decline. As a result of the heterogenous nature of the included studies, there is a further need for future research to ensure the sensitivity, validity and reliability of implementing olfactory testing as an early marker of future cognitive decline.