Demystifying wine expertise through the lens of imagination: Descriptions and imagery vividness across sensory modalities.

For most untrained novices, talking about wine or imagining the smells and flavours of wine is difficult. Wine experts, on the other hand, have been found to have better imagery for wine, and are also more proficient in describing wine. Some scholars have suggested that imagery and language are based on similar underlying processes, but no conclusive evidence has been found regarding mental imagery and language production. In this study, we examined the relationship between imagery and language use in both novices and experts. In an online experiment, wine experts and novices were asked to imagine the colour, smell, taste and mouthfeel of wines in different situations, and were asked to rate the vividness of the imagined experience as well as describe it with words. The results show that experts differ from novices on a number of linguistic measures when describing wine, including the number of words used, the type of words used, the concreteness of those words, and the adjective to noun ratio. Similarly, imagery for wine was more vivid in wine experts compared to novices in the modalities of smell, taste, and mouthfeel, in alignment with previous work. Surprisingly, we found that no single linguistic variable significantly predicted the reported vividness of wine imagery, neither in experts nor in novices. However, the linguistic model predicted imagery vividness better using data from experts compared to novices. Taken together, these findings underscore that imagery and language are different facets of wine cognition.

Artificial Intelligence Sensing: Effective Flavor Blueprinting of Tea Infusions for a Quality Control Perspective.

Tea infusions are the most consumed beverages in the world after water; their pleasant yet peculiar flavor profile drives consumer choice and acceptance and becomes a fundamental benchmark for the industry. Any qualification method capable of objectifying the product's sensory features effectively supports industrial quality control laboratories in guaranteeing high sample throughputs even without human panel intervention. The current study presents an integrated analytical strategy acting as an Artificial Intelligence decision tool for black tea infusion aroma and taste blueprinting. Key markers validated by sensomics are accurately quantified in a wide dynamic range of concentrations. Thirteen key aromas are quantitatively assessed by standard addition with in-solution solid-phase microextraction sampling followed by GC-MS. On the other hand, nineteen key taste and quality markers are quantified by external standard calibration and LC-UV/DAD. The large dynamic range of concentration for sensory markers is reflected in the selection of seven high-quality teas from different geographical areas (Ceylon, Darjeeling Testa Valley and Castleton, Assam, Yunnan, Azores, and Kenya). The strategy as a sensomics-based expert system predicts teas' sensory features and acts as an AI smelling and taste machine suitable for quality controls.

Neural mechanisms of odour imagery induced by non-figurative visual cues.

Odour imagery, the ability to experience smell when an appropriate stimulus is absent, has widely been documented as being particularly difficult. However, previous studies have shown the beneficial effect of visual cues (e.g., pictures or words) to facilitate performance in numerous tasks of olfactory nature. Therefore, the use of visual cues to evoke odours seems relevant. In this study, our interest is directed towards non-figurative coloured arrangements, which result from a patented technology and aim at chromatically representing any smell from its chemical composition and sensory description. The aim of this study was to characterise the neural mechanisms of odour imagery facilitated by these non-figurative coloured arrangements. Using functional magnetic resonance imaging, we recorded and compared hemodynamic responses during odour imagery facilitated by non-figurative coloured arrangements and pictures. Our findings reveal that the use of non-figurative coloured arrangements during odour imagery solicits olfactory and non-olfactory brain regions (orbitofrontal cortex, insula, hippocampus, thalamus, dorsolateral prefrontal cortex and supplementary motor area), which are mainly involved in olfactory processing and multimodal integration. Moreover, very similar cortical activity was found between the use of non-figurative coloured arrangements and pictures during odour imagery, with increased activity in the supplementary motor area during the use of coloured arrangements only. Overall, non-figurative coloured arrangements could become a robust tool to visually evoke odours without requiring prior familiarity with the depicted odour. Future studies should use psychometric measures to determine the relationships between brain activation, odour imagery ability and vividness of the generated odour images.

Testing detectability, attractivity, hedonic specificity, extractability, and robustness of colostrum odor-Toward an olfactory bioassay for human neonates.

Human milk odor is attractive and appetitive for human newborns. Here, we studied behavioral and heart-rate (HR) responses of 2-day-old neonates to the odor of human colostrum. To evaluate detection in two conditions of stimulus delivery, we first presented the odor of total colostrum against water. Second, the hedonic specificity of total colostrum odor was tested against vanilla odor. Third, we delivered only the fresh effluvium of colostrum separated from the colostrum matrix; the stability of this colostrum effluvium was then tested after deep congelation; finally, after sorptive extraction of fresh colostrum headspace, we assessed the activity of colostrum volatiles eluting from the gas chromatograph (GC). Regardless of the stimulus-delivery method, neonates displayed attraction reactions (HR decrease) as well as appetitive oral responses to the odor of total colostrum but not to vanilla odor. The effluvium separated from the fresh colostrum matrix remained appetitive but appeared labile under deep freezing. Finally, volatiles from fresh colostrum effluvium remained behaviorally active after GC elution, although at lower magnitude. In sum, fresh colostrum effluvium and its eluate elicited a consistent increase in newborns' oral activity (relative to water or vanilla), and they induced shallow HR decrease. Newborns' appetitive oral behavior was the most reproducible response criterion to the effluvium of colostrum. In conclusion, a set of unidentified volatile compounds from human colostrum is robust enough after extraction from the original matrix and chromatographic processing to continue eliciting appetitive responses in neonates, thus opening new directions to isolate and assay specific volatile molecules of colostrum.

A review of traditional Chinese medicine diagnosis using machine learning: Inspection, auscultation-olfaction, inquiry, and palpation.

Traditional Chinese medicine (TCM) is an essential part of the Chinese medical system and is recognized by the World Health Organization as an important alternative medicine. As an important part of TCM, TCM diagnosis is a method to understand a patient's illness, analyze its state, and identify syndromes. In the long-term clinical diagnosis practice of TCM, four fundamental and effective diagnostic methods of inspection, auscultation-olfaction, inquiry, and palpation (IAOIP) have been formed. However, the diagnostic information in TCM is diverse, and the diagnostic process depends on doctors' experience, which is subject to a high-level subjectivity. At present, the research on the automated diagnosis of TCM based on machine learning is booming. Machine learning, which includes deep learning, is an essential part of artificial intelligence (AI), which provides new ideas for the objective and AI-related research of TCM. This paper aims to review and summarize the current research status of machine learning in TCM diagnosis. First, we review some key factors for the application of machine learning in TCM diagnosis, including data, data preprocessing, machine learning models, and evaluation metrics. Second, we review and summarize the research and applications of machine learning methods in TCM IAOIP and the synthesis of the four diagnostic methods. Finally, we discuss the challenges and research directions of using machine learning methods for TCM diagnosis.

Alpha-lipoic acid does not improve olfactory training results in olfactory loss due to COVID-19: a double-blind randomized trial.

OBJECTIVES: Olfactory loss is a recognized long-term dysfunction after Coronavirus Disease 2019 (COVID-19) infection. This investigation aimed to assess the effect of alpha-lipoic acid as an adjuvant treatment of olfactory training on the improvement of smell loss in post-COVID-19 patients. METHODS: This randomized controlled trial included 128 adult outpatients who had persistent smell loss for more than 3-months after COVID-19 infection. The participants were randomly allocated into two groups: the intervention treatment group, which received alpha-lipoic acid associated to olfactory training, and comparison treatment group, which received placebo pills associated to olfactory training. The participants were followed-up for 12-weeks. Olfactory dysfunction was assessed in terms of Visual Analog Scale (VAS), and the Connecticut Chemosensory Clinical Research Center (CCCRC) test for the Brazilian population. RESULTS: A total of 100 participants completed the follow-up period and were analyzed in this study. Both groups have improved CCCRC score (p = 0.000), olfactory threshold (p = 0.000), identification score (p = 0.000) and VAS score (p = 0.000) after 12-weeks follow-up. No significant differences were determined between the intervention and comparison treatment groups in CCCRC score (p = 0.63), olfactory threshold (p = 0.50), identification score (p = 0.96) and VAS score (p = 0.97). In all these criteria, comparison treatment group went slightly worse. At the endpoint of the study, the frequency of anosmia reduced to 2% in the intervention treatment group and to 7.8% in the comparison treatment group. Also, 16.8% of the intervention group' subjects, and 15.7% of comparison treatment group's patients reached normosmia. CONCLUSIONS: Overall, there was a strongly significant difference in olfactory function between baseline and endpoint for both groups. However, based on the lack of significant difference between the intervention treatment and the comparison treatment groups in terms of olfactory changes, our study appoints that the alpha-lipoic acid is not better than olfactory training alone to treat olfactory loss after COVID-19. LEVEL OF EVIDENCE: Level 2.

Identification of characteristic aroma compounds in chicken meat and their metabolic mechanisms using gas chromatography-olfactometry, odor activity values, and metabolomics.

Aroma has an important influence on the aroma quality of chicken meat. This study aimed to identify the characteristic aroma substances in chicken meat and elucidate their metabolic mechanisms. Using gas chromatography-olfactometry and odor activity values, we identified nonanal, octanal, and dimethyl tetrasulfide as the basic characteristic aroma compounds in chicken meat, present in several breeds. Hexanal, 1-octen-3-ol, (E)-2-nonenal, heptanal, and (E,E)-2,4-decadienal were breed-specific aroma compounds found in native Chinese chickens but not in the meat of white-feathered broilers. Metabolomics analysis showed that L-glutamine was an important metabolic marker of nonanal, hexanal, heptanal, octanal, and 1-octen-3-ol. Exogenous supplementation experiments found that L-glutamine increased the content of D-glucosamine-6-P and induced the degradation of L-proline, L-arginine, and L-lysine to enhance the Maillard reaction and promote the formation of nonanal, hexanal, heptanal, octanal, and 1-octen-3-ol, thus improving the aroma profile of chicken meat.

Hyperbaric oxygen therapy for treatment of COVID-19-related parosmia: a case report.

Parosmia is a qualitative olfactory dysfunction characterized by distortion of odor perception. Traditional treatments for parosmia include olfactory training and steroids. Some patients infected with COVID-19 have developed chronic parosmia as a result of their infection. Here, we present the case of a patient who developed parosmia after a COVID-19 infection that was not improved by traditional treatments but found significant improvement after hyperbaric oxygen therapy[A1].

Sensomics-Assisted Characterization of Fungal-Flowery Aroma Components in Fermented Tea Using Eurotium cristatum.

Fermented tea (FT) using a single Eurotium cristatum strain can produce a pleasant fungal-flowery aroma, which is similar to the composite aroma characteristic of minty, flowery, and woody aromas, but its molecular basis is not yet clear. In this study, solvent-assisted flavor evaporation and gas chromatography-mass spectrometry/olfactometry were applied to isolate and identify volatiles from the FT by E. cristatum. The application of an aroma extract dilution analysis screened out 43 aroma-active compounds. Quantification revealed that there were 11 odorants with high odor threshold concentrations. Recombination and omission tests revealed that nonanal, methyl salicylate, decanoic acid, 4-methoxybenzaldehyde, α-terpineol, phenylacetaldehyde, and coumarin were the major odorants in the FT. Addition tests further verified that methyl salicylate, 4-methoxybenzaldehyde, and coumarin were the key odorants for fungal-flowery aroma, each corresponding to minty, woody, and flowery aromas, respectively. 4-Methoxybenzaldehyde and coumarin were newly found odorants for fungal-flowery aroma in FT, and 4-methoxybenzaldehyde had not been reported as a tea volatile compound before. This finding may guide future industrial production optimization of FT with improved flavor.

Part Two: Perspectives on Olfactory and Gustatory Dysfunction Pathophysiology, Management, and Relevance to COVID-19: Current Approaches.

Context: The phenomena of olfactory and gustatory dysfunction disorders (OGD) are hardly unique to COVID-19. However, the widespread incidence of OGD as sequelae of COVID-19 has provoked rejuvenated interest in these long existing, but poorly studied maladies. Objective: This second of a three-part review discusses past and current approaches for treatment of OGD, not restricted to those that COVID-19 has caused, with the intention to lay a foundation for consideration of new paradigms for evaluation and management of OGD. Design: The researcher performed a narrative review by searching databases including PubMed, Sciencedirect, Google Scholar, Old Dominion University Libraries, and the websites of various medical journals. Searches included numerous combinations of keywords accompanied by the phrases, loss of sense of smell and taste, olfactory and gustatory dysfunction disorders, as well as the terms anosmia, parosmia, ageusia, and parageusia. Such keywords included viruses, bacteria, fungi, protozoa, parasites, infection, COVID-19, treatments, medications, steroids, supplements, nutrients, alternative medicine, acupuncture, olfactory training, clinical trials, cranial nerves, pathogenesis, pathophysiology, and etiology. Setting: The Liebell Clinic, Virginia Beach, VA, USA. Conclusions: The epidemiology and hypotheses of pathophysiology of post-COVID OGD has been addressed via numerous studies and reviews. However, extremely limited evidence of effective treatment for chronic OGD, in general, exists, Global demand for any treatment capable of reducing or resolving it is unprecedented. Past and present treatment approaches and recently initiated clinical trials, since the onset of the pandemic, have yet to yield any significant results.

A sex-specific thermogenic neurocircuit induced by predator smell recruiting cholecystokinin neurons in the dorsomedial hypothalamus.

Olfactory cues are vital for prey animals like rodents to perceive and evade predators. Stress-induced hyperthermia, via brown adipose tissue (BAT) thermogenesis, boosts physical performance and facilitates escape. However, many aspects of this response, including thermogenic control and sex-specific effects, remain enigmatic. Our study unveils that the predator odor trimethylthiazoline (TMT) elicits BAT thermogenesis, suppresses feeding, and drives glucocorticoid release in female mice. Chemogenetic stimulation of olfactory bulb (OB) mitral cells recapitulates the thermogenic output of this response and associated stress hormone corticosterone release in female mice. Neuronal projections from OB to medial amygdala (MeA) and dorsomedial hypothalamus (DMH) exhibit female-specific cFos activity toward odors. Cell sorting and single-cell RNA-sequencing of DMH identify cholecystokinin (CCK)-expressing neurons as recipients of predator odor cues. Chemogenetic manipulation and neuronal silencing of DMHCCK neurons further implicate these neurons in the propagation of predator odor-associated thermogenesis and food intake suppression, highlighting their role in female stress-induced hyperthermia.

Regulation of brain cognitive states through auditory, gustatory, and olfactory stimulation with wearable monitoring.

Inspired by advances in wearable technologies, we design and perform human-subject experiments. We aim to investigate the effects of applying safe actuation (i.e., auditory, gustatory, and olfactory) for the purpose of regulating cognitive arousal and enhancing the performance states. In two proposed experiments, subjects are asked to perform a working memory experiment called n-back tasks. Next, we incorporate listening to different types of music, drinking coffee, and smelling perfume as safe actuators. We employ signal processing methods to seamlessly infer participants' brain cognitive states. The results demonstrate the effectiveness of the proposed safe actuation in regulating the arousal state and enhancing performance levels. Employing only wearable devices for human monitoring and using safe actuation intervention are the key components of the proposed experiments. Our dataset fills the existing gap of the lack of publicly available datasets for the self-management of internal brain states using wearable devices and safe everyday actuators. This dataset enables further machine learning and system identification investigations to facilitate future smart work environments. This would lead us to the ultimate idea of developing practical automated personalized closed-loop architectures for managing internal brain states and enhancing the quality of life.

Normative and mechanistic model of an adaptive circuit for efficient encoding and feature extraction.

One major question in neuroscience is how to relate connectomes to neural activity, circuit function, and learning. We offer an answer in the peripheral olfactory circuit of the Drosophila larva, composed of olfactory receptor neurons (ORNs) connected through feedback loops with interconnected inhibitory local neurons (LNs). We combine structural and activity data and, using a holistic normative framework based on similarity-matching, we formulate biologically plausible mechanistic models of the circuit. In particular, we consider a linear circuit model, for which we derive an exact theoretical solution, and a nonnegative circuit model, which we examine through simulations. The latter largely predicts the ORN [Formula: see text] LN synaptic weights found in the connectome and demonstrates that they reflect correlations in ORN activity patterns. Furthermore, this model accounts for the relationship between ORN [Formula: see text] LN and LN-LN synaptic counts and the emergence of different LN types. Functionally, we propose that LNs encode soft cluster memberships of ORN activity, and partially whiten and normalize the stimulus representations in ORNs through inhibitory feedback. Such a synaptic organization could, in principle, autonomously arise through Hebbian plasticity and would allow the circuit to adapt to different environments in an unsupervised manner. We thus uncover a general and potent circuit motif that can learn and extract significant input features and render stimulus representations more efficient. Finally, our study provides a unified framework for relating structure, activity, function, and learning in neural circuits and supports the conjecture that similarity-matching shapes the transformation of neural representations.

Alexithymia modulates the attitudes towards odors but not the olfactory abilities or the affective reactions to odors.

Although emotion and olfaction are closely linked, only a few studies have investigated olfactory processing in alexithymia, a condition characterized by altered emotional processing. These results do not allow comprehensive conclusions on whether individuals with alexithymia present lower olfactory abilities or only altered affective reactions and awareness of odors. Three pre-registered experiments were conducted to clarify this relation. We assessed olfactory functions, the affective qualities of odors, the awareness of odors, the attitudes towards them, and the ability to form olfactory images in the mind. Bayesian statistics were used to assess differences between low, medium and high alexithymia groups, and Linear Mixed Models (LMMs) were applied to investigate the modulation of the affective and cognitive components of alexithymia. We observed that individuals with a high level of alexithymia presented the same olfactory abilities, and did not show differences in their rating of odors compared to individuals with low alexithymia levels, while they reported lower levels of social and common odor awareness and a more indifferent attitude towards odors. Olfactory imagery was not affected by alexithymia level, and the affective and cognitive components of alexithymia, when considered separately, modulated olfactory perception differently. Learning more about olfactory perception in individuals with alexithymia leads to a better understanding of how alexithymia impacts the perception of hedonic stimuli coming from different sensory modalities. Our results imply that treatment goals for alexithymia should be the enhancement of the conscious perception of odors, supporting the use of mindfulness-based protocols in the alexithymia treatment.

Omega-3 Fatty Acid Supplementation for the Treatment of Persistent COVID-Related Olfactory Dysfunction.

OBJECTIVE: To evaluate the efficacy of omega-3 fatty acid (O3FA) supplementation in the treatment of COVID-related olfactory dysfunction (OD). METHODS: Patients with laboratory-confirmed or clinically-suspected COVID-19 infection and new-onset OD from August 2020 to November 2021 were prospectively recruited. Patients with quantitative OD, defined as a brief smell identification test (BSIT) score of 9 or less, were eligible for study inclusion. The experimental group received 2 g of O3FA supplementation, while the control group received an identical placebo to be taken daily for 6 weeks. The primary outcome was a change in BSIT score between the initial and 6-week follow-up tests. RESULTS: One hundred and seventeen patients were included in the analysis, including 57 patients in the O3FA group and 60 in the placebo group. O3FA group patients demonstrated a mean BSIT improvement of 1.12 ± 1.99 compared to 0.68 ± 1.86 in the placebo group (p = 0.221). Seventy-seven patients, 42 within the O3FA group and 35 in the placebo group, completed a follow-up BSIT survey at an average of 717.8 days from study onset. At long-term follow-up, there was an average BSIT score improvement of 1.72 within the O3FA group compared to 1.76 within the placebo group (p = 0.948). CONCLUSION: Among patients with persistent COVID-related OD, our study showed no clear evidence of relative short-term or long-term olfactory recovery among patients receiving high doses of O3FA supplementation.

Obesity wars: may the smell be with you.

Classically, the regulation of energy balance has been based on central and peripheral mechanisms sensing energy, nutrients, metabolites, and hormonal cues. Several cellular mechanisms at central level, such as hypothalamic AMP-activated protein kinase (AMPK), integrate this information to elicit counterregulatory responses that control feeding, energy expenditure, and glucose homeostasis, among other processes. Recent data have added more complexity to the homeostatic regulation of metabolism by introducing, for example, the key role of "traditional" senses and sensorial information in this complicated network. In this regard, current evidence is showing that olfaction plays a key and bidirectional role in energy homeostasis. Although nutritional status dynamically and profoundly impacts olfactory sensitivity, the sense of smell is involved in food appreciation and selection, as well as in brown adipose tissue (BAT) thermogenesis and substrate utilization, with some newly described actors, such as olfactomedin 2 (OLFM2), likely playing a major role. Thus, olfactory inputs are contributing to the regulation of both sides of the energy balance equation, namely, feeding and energy expenditure (EE), as well as whole body metabolism. Here, we will review the current knowledge and advances about the role of olfaction in the regulation of energy homeostasis.

Diffusion-weighted imaging measurements of central smell regions in COVID-19 patients: insular gyrus, corpus amygdala, and thalamus.

OBJECTIVE: The aim of this study was to investigate central smell centers with cranial magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI) in COVID-19. PATIENTS AND METHODS: This retrospective study evaluated cranial MRI images of 54 adults. The experimental group (Group 1), consisting of 27 patients with positive COVID-19 real-time polymerase chain reaction (RT-PCR) assays, was compared to the control group (Group 2), comprising 27  healthy controls without COVID-19. The apparent diffusion coefficient (ADC) values were measured in the corpus amygdala, thalamus, and insular gyrus in both groups. RESULTS: Thalamus ADC values of the COVID-19 group were significantly lower compared to the control group bilaterally. However, no differences were found in the insular gyrus and corpus amygdala ADC values between the two groups. Positive correlations were observed between the insular gyrus and corpus amygdala ADC values and the thalamus ADC values. Insular gyrus ADC values (right) were higher in females. Left insular gyrus and corpus amygdala ADC values were higher in COVID-19 patients with smell loss. Right insular gyrus and left corpus amygdala ADC values were lower in COVID-19 patients with lymphopenia. CONCLUSIONS: Diffusion restriction in olfactory areas can be considered an obvious indicator that the COVID-19 virus affects and damages the immune system at the neuronal level. Given the urgency and lethality of the current pandemic, acute onset odor loss should be considered a high suspicion-adhesive index for patients with SARS-CoV-2 infection. Therefore, the sense of smell should be considered and evaluated simultaneously with other neurological symptoms. DWI should be widely used as an early imaging method for central nervous system (CNS) infections, especially in relation to COVID-19.

Physiological Effects of a Garden Plant Smellscape from the Perspective of Perceptual Interaction.

The purpose of this study was to investigate the physiological recovery effects of olfactory, visual and olfactory-visual stimuli associated with garden plants. In a randomized controlled study design, ninety-five Chinese university students were randomly selected to be exposed to stimulus materials, namely the odor of Osmanthus fragrans and a corresponding panoramic image of a landscape featuring the plant. Physiological indexes were measured by the VISHEEW multiparameter biofeedback instrument and a NeuroSky EEG tester in a virtual simulation laboratory. The results showed the following: (1) In the olfactory stimulation group, from before to during exposure to the stimuli, the subjects' diastolic blood pressure (DBP) (ΔDBP = 4.37 ± 1.69 mmHg, p < 0.05) and pulse pressure (PP) values increased (ΔPP = -4.56 ± 1.24 mmHg, p < 0.05), while their pulse (p) values decreased (ΔP = -2.34 ± 1.16 bmp, p < 0.05) significantly. When compared to the control group, only the amplitudes of α and ß brainwaves increased significantly (Δα = 0.37 ± 2.09 µV, Δß = 0.34 ± 1.01 µV, p < 0.05). (2) In the visual stimulation group, the amplitudes of skin conductance (SC) (ΔSC = 0.19 ± 0.01 µΩ, p < 0.05), α brainwaves (Δα = 6.2 ± 2.26 µV, p < 0.05) and ß brainwaves (Δß = 5.51 ± 1.7 µV, p < 0.05) all increased significantly relative to the control group. (3) In the olfactory-visual stimulus group, DBP (ΔDBP = 3.26 ± 0.45 mmHg, p < 0.05) values increased, and PP values decreased (ΔPP = -3.48 ± 0.33 bmp, p < 0.05) significantly from before to during exposure to the stimuli. The amplitudes of SC (ΔSC = 0.45 ± 0.34 µΩ, p < 0.05), α brainwaves (Δα = 2.28 ± 1.74 µV, p < 0.05) and ß brainwaves (Δß = 1.4 ± 0.52 µV, p < 0.05) all increased significantly relative to the control group. The results of this study show that the interaction of olfactory and visual stimuli associated with a garden plant odor landscape was able to relax and refresh the body to a certain extent, and this physiological health effect was greater with regards to the integrated response of the autonomic nervous system and central nervous system than the effect of only smelling or viewing the stimuli. In the planning and designing of plant smellscapes in garden green space, it should be ensured that plant odors and corresponding landscapes are present at the same time in order to ensure the best health effect.

The Effect of Chinese Herbal Medicine on Traumatic Anosmia: A Prospective, Randomized Clinical Trial.

OBJECTIVE: Chinese herbal medicine (CHM) has been implemented as a form of treatment for olfactory dysfunction. In this study, we aimed to use a tailored Guizhi decoction for the treatment of traumatic olfactory dysfunction. METHODS: Patients who had lost olfactory function after experiencing head trauma and whose olfactory function was anosmic were selected. The eligible patients were randomly assigned to two groups. In the CHM group, a tailored Guizhi decoction was prescribed, with patients also undergoing olfactory training (OT). In the OT group, patients performed OT only. The olfactory function of each patient was evaluated by both the phenyl ethyl alcohol (PEA) odor detection threshold test and the traditional Chinese version of the University of Pennsylvania Smell Identification Test (TC-UPSIT), at both 3 and 6 months after the completion of treatment. RESULTS: A total of 38 patients in the CHM group and 40 in the OT group completed the study. The TC-UPSIT scores of patients slightly rose after treatment in both the CHM and OT groups. Nevertheless, there were no significant differences in TC-UPSIT scores before and after treatment in both groups. However, the PEA thresholds improved significantly in both CHM and OT groups (p = 0.005 and 0.016, respectively). Of note, there were no significant differences in threshold or identification scores between the CHM and OT groups. CONCLUSION: Our results show that adding a tailored Guizhi decoction to OT conferred a limited benefit to the olfactory function of patients experiencing traumatic anosmia. LEVEL OF EVIDENCE: 2 Laryngoscope, 133:1473-1479, 2023.

Dental pain perception and emotional changes: on the relationship between dental anxiety and olfaction.

BACKGROUND: The purpose of the study was to determine to what extent olfactory aromatherapy reduces the intensity of dental pain and the level of dental anxiety. It also attempted to corelate between olfactory aromatherapy, stages of dental visits, and various dental procedures. METHODS: Female patients were enrolled in a randomized controlled study. Olfactory aromatherapy was performed using lavender oils. Patients were randomly assigned to one of two groups: the lavender group, in which patients inhaled 2% lavender vapors, and the control group, in which patients inhaled water vapors. Pain score, anxiety score, and changes in vital signs were among the predictable variables. Anxiety and pain were assessed using the Modified Dental Anxiety Scale (MDAS), Speilberger State-Trait Anxiety Inventory (STAI), and visual analog scales (VAS). The vital signs were systolic (SBP) and diastolic (DBP), heart rate (HR), respiratory rate (RR), and oxygen saturation (Spo2). Variables were evaluated before inhalations, 20 min after inhalations, at the end of settings, and on the following day. RESULTS: Each group had 175 participants. Pain and anxiety scores were significantly reduced, and all vital signs improved, except for DBP. The MDAS, STAI, and pain scores are reduced by 3.4, 4.2, and 2.4 times, respectively, compared to the control group. Olfactory aromatherapy had the greatest impact during the phase of waiting rooms. CONCLUSION: When compared to the control group, olfactory aromatherapy reduces anxiety scores three to four times more. Pain perception is reduced by twice as much as in the control group. It also significantly reduces the anxiety associated with minor to moderately stressful dental procedures.