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2.
Sci Rep ; 12(1): 2111, 2022 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-35136124

RESUMO

Alterations in the three chemosensory modalities-smell, taste, and chemesthesis-have been implicated in Coronavirus Disease 2019 (COVID-19), yet emerging data suggest a wide geographic and ethnic variation in the prevalence of these symptoms. Studies on chemosensory disorders in COVID-19 have predominantly focused on Caucasian populations whereas Asians remain understudied. We conducted a nationwide, multicentre cross-sectional study using an online questionnaire on a cohort of RT-PCR-confirmed adult COVID-19 patients in Malaysia between 6 June and 30 November 2020. The aim of our study was to investigate their presenting symptoms and assess their chemosensory function using self-ratings of perceived smell, taste, chemesthesis, and nasal blockage. In this cohort of 498 patients, 41.4% reported smell and/or taste loss when diagnosed with COVID-19, which was the commonest symptom. Blocked nose, loss of appetite, and gastrointestinal disturbances were independent predictors of smell and/or taste loss on multivariate analysis. Self-ratings of chemosensory function revealed a reduction in smell, taste, and chemesthesis across the entire cohort of patients that was more profound among those reporting smell and/or taste loss as their presenting symptom. Perceived nasal obstruction accounted for only a small proportion of changes in smell and taste, but not for chemesthesis, supporting viral disruption of sensorineural mechanisms as the dominant aetiology of chemosensory dysfunction. Our study suggests that chemosensory dysfunction in COVID-19 is more widespread than previously reported among Asians and may be related to the infectivity of viral strains.Study Registration: NMRR-20-934-54803 and NCT04390165.


Assuntos
Teste de Ácido Nucleico para COVID-19 , Transtornos do Olfato , SARS-CoV-2 , Autorrelato , Inquéritos e Questionários , Distúrbios do Paladar , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/complicações , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/fisiopatologia , Feminino , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/etiologia , Transtornos do Olfato/fisiopatologia , Distúrbios do Paladar/diagnóstico , Distúrbios do Paladar/epidemiologia , Distúrbios do Paladar/etiologia , Distúrbios do Paladar/fisiopatologia
4.
J Alzheimers Dis ; 85(2): 745-754, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34864678

RESUMO

BACKGROUND: The olfactory system is affected very early in Alzheimer's disease and olfactory loss can already be observed in patients with mild cognitive impairment (MCI), an early stage of AD. OBJECTIVE: The aim of this randomized, prospective, controlled, blinded study was to evaluate whether olfactory training (OT) may have an effect on olfactory function, cognitive impairment, and brain activation in MCI patients after a 4-month period of frequent short-term exposure to various odors. METHODS: A total of 38 MCI outpatients were randomly assigned to OT or a control training condition, which were performed twice a day for 4 months. Olfactory testing, comprehensive neuropsychological assessment, and a passive odor perception task based on magnetic resonance imaging were performed before and after training. RESULTS: The results suggested that OT exhibited no significant effect on olfaction and cognitive function. Additionally, OT exhibited a positive effect on frontal lobe activation (left middle frontal gyrus and orbital-frontal cortex) but exhibited no effect on grey matter volume. Moreover, the change of olfactory scores was positively associated with the change of frontal activation. CONCLUSION: OT was found to have a limited effect on olfaction and cognition in patients with MCI compared to a non-OT condition but increased their functional response to odors in frontal area.


Assuntos
Encéfalo/fisiopatologia , Cognição , Disfunção Cognitiva/fisiopatologia , Transtornos do Olfato/fisiopatologia , Idoso , Encéfalo/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Odorantes , Transtornos do Olfato/diagnóstico por imagem , Estudos Prospectivos , Olfato/fisiologia
5.
Behav Brain Res ; 417: 113597, 2022 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-34563601

RESUMO

Volatile solvents exposure can result in various behavioral impairments that have been partly associated to altered adult hippocampal neurogenesis. Despite recent evidence supporting this association, few studies have been devoted to examine the impact on olfactory functioning and olfactory bulb (OB) neurogenesis, although olfactory system is directly in contact with volatile molecules. Thus, this study was designed to evaluate in adult mice the potential modifications of the olfactory functioning after acute (1 day), subchronic (6 weeks) and chronic (12 weeks) exposure to thinner vapor at both behavioral and cellular levels. Firstly, behavioral evaluations showed that chronic thinner exposure impacts on odor detection ability of treated mice but does not affect mice ability to efficiently discriminate between two different odors. Moreover, chronic thinner exposure produces impairment in the olfactory-mediated associative memory. Secondly, analysis of the effects of thinner exposure in the subventricular zone (SVZ) of the lateral ventricle and in the OB revealed that thinner treatments do not induce apoptosis nor glial activation. Thirdly, immunohistochemical quantification of different markers of adult olfactory neurogenesis showed that inhalant treatments do not change the number of proliferating progenitors in the SVZ and the rostral migratory stream (RMS), as well as the number of newborn cells reaching and integrating in the OB circuitry. Altogether, our data highlight that the impaired olfactory performances in chronically-exposed mice are not associated to an alteration of adult neurogenesis in the SVZ-OB system.


Assuntos
Abuso de Inalantes/fisiopatologia , Neurogênese/efeitos dos fármacos , Transtornos do Olfato/fisiopatologia , Bulbo Olfatório/efeitos dos fármacos , Compostos Orgânicos Voláteis/toxicidade , Animais , Ventrículos Laterais/efeitos dos fármacos , Camundongos , Olfato/efeitos dos fármacos
6.
Am J Otolaryngol ; 43(1): 103239, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34547716

RESUMO

OBJECTIVE: To determine which factors (demographic, symptoms, comorbidities, and treatments) are associated with recovery of smell in patients with COVID-19 associated olfactory loss. STUDY DESIGN: Prospective, longitudinal questionnaires. SETTING: National survey. METHODS: A longitudinal web-based nationwide survey of adults with COVID-19 associated smell and taste loss was launched April 10, 2020. After completing an initial entry survey, participants received detailed follow-up questionnaires 14 days, and 1, 3 and 6 months later. RESULTS: As of June 25, 2021, 798 participants met study inclusion criteria and completed 6-month questionnaires. Of demographic characteristics only age <40 years was positively associated with smell recovery (p < .003). Of symptoms, difficulty breathing was negatively associated with smell recovery (p < .004), and nasal congestion positively associated with smell recovery (p < .03). Of pre-existing comorbidities only previous head injury (p < .017) was negatively associated with smell recovery. None of the queried medications used to treat COVID were associated with better rates of smell recovery. CONCLUSIONS: Age <40 and presence of nasal congestion at time of COVID-19 infection were predictive of improved rates of smell recovery, while difficulty breathing at time of COVID-19 infection, and prior head trauma predicted worsened rates of recovery. Further study will be required to identify potential mechanisms for the other observed associations. Such information can be used by clinicians to counsel patients suffering COVID-19 associated smell loss as to prognosis for recovery.


Assuntos
COVID-19/complicações , Transtornos do Olfato/fisiopatologia , Transtornos do Olfato/virologia , Recuperação de Função Fisiológica , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , SARS-CoV-2 , Inquéritos e Questionários
7.
Parkinsonism Relat Disord ; 92: 76-82, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34715608

RESUMO

INTRODUCTION: Altered brain activity and functional reorganization patterns during self-initiated movements have been reported in early pre-motor and motor stages of Parkinson's disease. The aim of this study was to investigate whether similar alterations can be observed in patients with idiopathic REM-sleep behavior disorder (RBD). METHODS: 13 polysomnography-confirmed male and right-handed RBD patients and 13 healthy controls underwent a bilateral hand-movement fMRI task including internally selected (INT) and externally-guided (EXT) movement conditions for each hand. We examined functional activity and connectivity differences between groups and task-conditions, structural differences using voxel-based morphometry, as well as associations between functional activity and clinical variables. RESULTS: No group differences were observed in fMRI-task performance or in voxel-based morphometry. Both groups showed faster reaction times and exhibited greater neural activation when movements were internally selected compared to externally-guided tasks. Compared to controls, RBD patients displayed stronger activation in the dorsolateral prefrontal cortex and primary somatosensory cortex during INT-tasks, and in the right fronto-insular cortex during EXT-tasks performed with the non-dominant hand. Stronger activation in RBD patients was associated with cognitive and olfactory impairment. Connectivity analysis demonstrated overall less interregional coupling in patients compared to controls. In particular, patients showed reduced temporo-cerebellar, occipito-cerebellar and intra-cerebellar connectivity, but stronger connectivity in fronto-cerebellar and fronto-occipital pathways. CONCLUSION: The observed stronger activation during hand-movement tasks and connectivity changes in RBD may reflect early compensatory and reorganization patterns in order to preserve motor functioning. Our findings may contribute to a better understanding and prognosis of prodromal stages of α-synucleinopathies.


Assuntos
Imageamento por Ressonância Magnética , Neurônios Motores/fisiologia , Transtorno do Comportamento do Sono REM/fisiopatologia , Idoso , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Estudos de Casos e Controles , Cerebelo/diagnóstico por imagem , Cerebelo/fisiopatologia , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , /fisiopatologia , Mãos/diagnóstico por imagem , Mãos/fisiopatologia , Humanos , /fisiopatologia , Masculino , Pessoa de Meia-Idade , Movimento , Transtornos do Olfato/diagnóstico por imagem , Transtornos do Olfato/etiologia , Transtornos do Olfato/fisiopatologia , Polissonografia , Sintomas Prodrômicos , Transtorno do Comportamento do Sono REM/complicações , Transtorno do Comportamento do Sono REM/diagnóstico por imagem , Córtex Somatossensorial/diagnóstico por imagem , Córtex Somatossensorial/fisiopatologia , Sinucleinopatias/complicações , Sinucleinopatias/diagnóstico por imagem , Sinucleinopatias/fisiopatologia , Análise e Desempenho de Tarefas
8.
Neurobiol Aging ; 108: 47-57, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34507271

RESUMO

Olfactory damage develops at the early stages of Alzheimer's disease (AD). While amyloid-ß (Aß) oligomers are shown to impair inhibitory circuits in the olfactory bulb (OB), its underlying mechanisms remain unclear. Here, we investigated the olfactory dysfunction due to impaired inhibitory transmission to mitral cells (MCs) of the OB in APP/PS1 mice. Using electrophysiological studies, we found that MCs exhibited increased spontaneous firing rates as early as 3 months, much before development of Aß deposits in the brain. Furthermore, the frequencies but not amplitudes of MC inhibitory postsynaptic currents decreased markedly, suggesting that presynaptic GABA release is impaired while postsynaptic GABAA receptor responses remain intact. Notably, muscimol, a GABAA receptor agonist, improved odor identification and discrimination behaviors in APP/PS1 mice, reduced MC basal firing activity, and rescued inhibitory circuits along with reducing the Aß burden in the OB. Our study links the presynaptic deficits of GABAergic transmission to olfactory dysfunction and subsequent AD development and implicates the therapeutic potential of maintaining local inhibitory microcircuits against early AD progression.


Assuntos
Agonistas de Receptores de GABA-A/farmacologia , Agonistas de Receptores de GABA-A/uso terapêutico , Transtornos do Olfato/tratamento farmacológico , Transtornos do Olfato/fisiopatologia , Bulbo Olfatório/patologia , Bulbo Olfatório/fisiopatologia , Receptores de GABA-A/fisiologia , Olfato/efeitos dos fármacos , Transmissão Sináptica/efeitos dos fármacos , Doença de Alzheimer/complicações , Doença de Alzheimer/tratamento farmacológico , Peptídeos beta-Amiloides/efeitos adversos , Peptídeos beta-Amiloides/metabolismo , Precursor de Proteína beta-Amiloide/genética , Animais , Encéfalo/metabolismo , Camundongos Transgênicos , Transtornos do Olfato/etiologia , Bulbo Olfatório/citologia , Presenilina-1/genética , Fatores de Tempo
9.
J Laryngol Otol ; 135(10): 932-936, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34420533

RESUMO

OBJECTIVE: To assess the prevalence of abnormal rhinological findings in a Sjögren's syndrome population. METHODS: A cohort-matched, prospective, cross-sectional, observational study was conducted. Sixty-seven subjects (30 patients and 37 controls) were enrolled. Rhinological assessment including smell threshold was evaluated using a standardised, validated clinical test as part of a larger study. RESULTS: Smell thresholds were -4.4 and -5.4 in the Sjögren's syndrome and control groups, respectively (p = 0.001). Hyposmia (threshold values of less than -4.5) was demonstrated in the Sjögren's syndrome group (47 per cent). Smell was negatively correlated with age (p = 0.040). Nasal septal perforation was noted in 3 Sjögren's syndrome patients (10 per cent) and nasal mucosal dryness in 10 patients (33 per cent), but none of the control group were affected. CONCLUSION: Hyposmia in Sjögren's syndrome was demonstrated using the Smell Threshold Test. Nasal septal perforation and nasal mucosa dryness were also noted in patients with Sjögren's syndrome. A diagnosis of Sjögren's syndrome should be considered and investigated in smell deprivation and/or nasal septal perforation patients.


Assuntos
Transtornos do Olfato/etiologia , Síndrome de Sjogren/complicações , Síndrome de Sjogren/diagnóstico , Olfato/fisiologia , Idoso , Anosmia/epidemiologia , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/fisiopatologia , Perfuração do Septo Nasal/epidemiologia , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/fisiopatologia , Prevalência , Estudos Prospectivos , Limiar Sensorial , Síndrome de Sjogren/fisiopatologia
10.
JAMA Otolaryngol Head Neck Surg ; 147(10): 855-863, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34436517

RESUMO

Importance: Olfactory dysfunction is a prodromal manifestation of many neurodegenerative disorders, including Alzheimer and Parkinson disease. However, its neuroanatomical basis is largely unknown. Objective: To assess the association between olfactory brain structures and olfactory function in adults 30 years or older and to examine the extent to which olfactory bulb volume (OBV) mediates the association between central olfactory structures and olfactory function. Design, Setting, and Participants: This cross-sectional study analyzed baseline data from the first 639 participants with brain magnetic resonance imaging (MRI) in the Rhineland Study, an ongoing population-based cohort study in Bonn, Germany. Participants were enrolled between March 7, 2016, and October 31, 2017, and underwent brain MRI and olfactory assessment. Data were analyzed from March 1, 2018, to June 30, 2021. Exposure: Volumetric measures were derived from 3-T MRI T1-weighted brain scans, and OBV was manually segmented on T2-weighted images. The mean volumetric brain measures from the right and left sides were calculated, adjusted by head size, and normalized to all participants. Main Outcomes and Measures: Performance on the 12-item smell identification test (SIT-12) was used as a proxy for olfactory function. Results: A total of 541 participants with complete data on MRI-derived measures and SIT-12 scores were included. This population had a mean (SD) age of 53.6 (13.1) years and comprised 306 women (56.6%). Increasing age (difference in SIT-12 score, -0.04; 95% CI, -0.05 to -0.03), male sex (-0.26; 95% CI, -0.54 to 0.02), and nasal congestion (-0.28; 95% CI, -0.66 to 0.09) were associated with worse olfactory function (SIT-12 scores). Conversely, larger OBV was associated with better olfactory function (difference in SIT-12 score, 0.46; 95% CI, 0.29-0.64). Larger volumes of amygdala (difference in OBV, 0.12; 95% CI, 0.01-0.24), hippocampus (0.16; 95% CI, 0.04-0.28), insular cortex (0.12; 95% CI, 0.01-0.24), and medial orbitofrontal cortex (0.10; 95% CI, 0.00-0.20) were associated with larger OBV. Larger volumes of amygdala (volume × age interaction effect, 0.17; 95% CI, 0.03-0.30), parahippocampal cortex (0.17; 95% CI, 0.03-0.31), and hippocampus (0.21; 95% CI, 0.08-0.35) were associated with better olfactory function only in older age groups. The age-modified association between volumes of central olfactory structures and olfactory function was largely mediated through OBV. Conclusions and Relevance: This cross-sectional study found that olfactory bulb volume was independently associated with odor identification function and was a robust mediator of the age-dependent association between volumes of central olfactory structures and olfactory function. Thus, neurodegeneration-associated olfactory dysfunction may primarily originate from the pathology of peripheral olfactory structures, suggesting that OBV may serve as a preclinical marker for the identification of individuals who are at an increased risk of neurodegenerative diseases.


Assuntos
Imageamento por Ressonância Magnética , Transtornos do Olfato/diagnóstico por imagem , Transtornos do Olfato/fisiopatologia , Bulbo Olfatório/diagnóstico por imagem , Adulto , Idoso , Tonsila do Cerebelo/diagnóstico por imagem , Córtex Cerebral/diagnóstico por imagem , Estudos Transversais , Feminino , Alemanha , Hipocampo/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Córtex Pré-Frontal/diagnóstico por imagem
11.
Lancet Neurol ; 20(9): 753-761, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34339626

RESUMO

BACKGROUND: The mechanisms by which any upper respiratory virus, including SARS-CoV-2, impairs chemosensory function are not known. COVID-19 is frequently associated with olfactory dysfunction after viral infection, which provides a research opportunity to evaluate the natural course of this neurological finding. Clinical trials and prospective and histological studies of new-onset post-viral olfactory dysfunction have been limited by small sample sizes and a paucity of advanced neuroimaging data and neuropathological samples. Although data from neuropathological specimens are now available, neuroimaging of the olfactory system during the acute phase of infection is still rare due to infection control concerns and critical illness and represents a substantial gap in knowledge. RECENT DEVELOPMENTS: The active replication of SARS-CoV-2 within the brain parenchyma (ie, in neurons and glia) has not been proven. Nevertheless, post-viral olfactory dysfunction can be viewed as a focal neurological deficit in patients with COVID-19. Evidence is also sparse for a direct causal relation between SARS-CoV-2 infection and abnormal brain findings at autopsy, and for trans-synaptic spread of the virus from the olfactory epithelium to the olfactory bulb. Taken together, clinical, radiological, histological, ultrastructural, and molecular data implicate inflammation, with or without infection, in either the olfactory epithelium, the olfactory bulb, or both. This inflammation leads to persistent olfactory deficits in a subset of people who have recovered from COVID-19. Neuroimaging has revealed localised inflammation in intracranial olfactory structures. To date, histopathological, ultrastructural, and molecular evidence does not suggest that SARS-CoV-2 is an obligate neuropathogen. WHERE NEXT?: The prevalence of CNS and olfactory bulb pathosis in patients with COVID-19 is not known. We postulate that, in people who have recovered from COVID-19, a chronic, recrudescent, or permanent olfactory deficit could be prognostic for an increased likelihood of neurological sequelae or neurodegenerative disorders in the long term. An inflammatory stimulus from the nasal olfactory epithelium to the olfactory bulbs and connected brain regions might accelerate pathological processes and symptomatic progression of neurodegenerative disease. Persistent olfactory impairment with or without perceptual distortions (ie, parosmias or phantosmias) after SARS-CoV-2 infection could, therefore, serve as a marker to identify people with an increased long-term risk of neurological disease.


Assuntos
COVID-19/complicações , COVID-19/diagnóstico por imagem , Transtornos do Olfato/diagnóstico por imagem , Transtornos do Olfato/etiologia , Mucosa Olfatória/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Encéfalo/virologia , COVID-19/fisiopatologia , Humanos , Doenças Neurodegenerativas/diagnóstico por imagem , Doenças Neurodegenerativas/etiologia , Doenças Neurodegenerativas/fisiopatologia , Transtornos do Olfato/fisiopatologia , Transtornos do Olfato/virologia , Mucosa Olfatória/fisiopatologia , Mucosa Olfatória/virologia , Estudos Prospectivos , Olfato/fisiologia
12.
Sci Rep ; 11(1): 14085, 2021 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-34238956

RESUMO

The aim of this study was to determine whether handgrip strength attenuates the negative relationship between age and olfactory function in a representative US population sample 40 years old and over. A cross-sectional study was performed with 2861 adults from the US National Health and Nutrition Examination Survey NHANES (2013-2014). An 8-item odor identification test was applied to determine olfactory function. Muscle strength was determined through a handgrip dynamometer (defined as the sum of the largest handgrip strength reading from right and left hands). Moderation analysis was performed to test whether the association between age and olfactory impairment was moderated by handgrip strength. Moderation analysis highlighted two regions of significance: the first region was found at < 56.6 kg, indicating that the adverse influence of age on olfactory function may be greater for the participants in this area; the second region was found at ≥ 56.6 kg, indicating that the negative impact of age on olfactory function disappeared for adults who were above this estimate point. In conclusion, handgrip strength, a general indicator of muscle strength, moderates the relationship between age and olfactory ability in a US adult population aged 40 years and older. Our findings are clinically relevant, since they emphasize the importance of muscular fitness in adulthood and old age by diminishing the deleterious effect of aging on olfactory performance.


Assuntos
Força da Mão/fisiologia , Transtornos do Olfato/fisiopatologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Odorantes
13.
Neurology ; 97(8): e825-e835, 2021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34088871

RESUMO

OBJECTIVE: The associations of Lewy bodies (LBs) with olfactory dysfunction, parkinsonism, and higher odds of dementia were assessed in Black and White community-dwelling elders and racial differences in these associations were tested. METHODS: Black decedents (n = 81) were matched 2-to-1 by age, sex, years of education, and follow-up time in the study with White decedents (n = 154) from 4 longitudinal studies of dementia and aging. Participants underwent uniform clinical examination and cognitive, motor, and olfactory testing. LBs were detected in 7 brain regions by α-synuclein immunohistochemistry and racial differences in their association with olfaction, parkinsonism, and odds of dementia were determined using regression analyses. RESULTS: The mean scores of the odor test, global parkinsonism signs, and global cognition were lower in Black than White decedents; the frequency of dementia was similar in both groups. The frequency of LBs was similar in Black and White decedents (∼25%), as was the frequency of LBs in individual brain regions, while the mean LB counts/mm2 were similar in all regions except the cingulate cortex, which showed higher mean LB counts in Black decedents. In regression analyses, LBs were associated with impaired olfaction (-2.23, 95% confidence interval [CI] -3.45 to -1.01) and higher odds of dementia (odds ratio 3.0, 95% CI 1.10-8.17) in both racial groups; an association with parkinsonism was stronger in Black than White decedents. CONCLUSIONS: The frequency, distribution, and clinical manifestations of LBs are similar in Black and White elders.


Assuntos
Afro-Americanos/etnologia , Tonsila do Cerebelo/patologia , Córtex Cerebral/patologia , Corpos de Lewy/patologia , Doença por Corpos de Lewy/etnologia , Transtornos do Olfato/etnologia , Substância Negra/patologia , /etnologia , Idoso , Idoso de 80 Anos ou mais , Autopsia , Feminino , Humanos , Doença por Corpos de Lewy/complicações , Doença por Corpos de Lewy/patologia , Doença por Corpos de Lewy/fisiopatologia , Estudos Longitudinais , Masculino , Transtornos do Olfato/etiologia , Transtornos do Olfato/fisiopatologia , Índice de Gravidade de Doença , Estados Unidos/etnologia
14.
BMC Infect Dis ; 21(1): 612, 2021 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-34174816

RESUMO

BACKGROUND: The unexpected outbreak of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused more than 49 million cases and an estimated 2,000,000 associated deaths worldwide. In Germany, there are currently more than 2,000,000 laboratory-confirmed coronavirus disease 2019 (COVID-19) cases including 51,800 deaths. However, regional differences also became apparent and with the second wave of infections, the detailed characterization of COVID-19 patients is crucial to early diagnosis and disruption of chains of infections. METHODS: Handing out detailed questionnaires to all individuals tested for COVID-19, we evaluated the clinical characteristics of negative and positive tested individuals. Expression of symptoms, symptom duration and association between predictor variables (i.e. age, gender) and a binary outcome (olfactory and gustatory dysfunction) were assessed. RESULTS: Overall, the most common symptoms among individuals who tested positive for SARS-CoV-2 were fatigue, headache, and cough. Olfactory and gustatory dysfunction were also reported by many SARS-CoV-2 negative individuals, more than 20% of SARS-CoV-2 negative tested individuals in our study reported olfactory and gustatory dysfunction. Independent of SARS-CoV-2 status, more females displayed symptoms of gustatory (29.8%, p = 0.0041) and olfactory dysfunction (22.9%, p = 0.0174) compared to men. CONCLUSIONS: Bringing early SARS-CoV-2 tests to the populations at risk must be a main focus for the upcoming months. The reliability of olfactory and gustatory dysfunction in COVID-19 negative tested individuals requires deeper investigation in the future.


Assuntos
COVID-19/epidemiologia , COVID-19/virologia , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/virologia , Distúrbios do Paladar/epidemiologia , Distúrbios do Paladar/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/fisiopatologia , Tosse/epidemiologia , Diagnóstico Precoce , Fadiga/epidemiologia , Feminino , Alemanha/epidemiologia , Cefaleia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/fisiopatologia , Pandemias , Reprodutibilidade dos Testes , SARS-CoV-2/patogenicidade , Caracteres Sexuais , Olfato , Inquéritos e Questionários , Distúrbios do Paladar/fisiopatologia , Adulto Jovem
15.
Am J Otolaryngol ; 42(6): 103068, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33940252

RESUMO

The effects of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) exist on a spectrum. Clinical symptoms of smell and taste dysfunction are prominent features of COVID-19. The objective of this study was to elucidate the factors associated with smell and taste dysfunction amongst hospitalized COVID-19 patients. A retrospective review of a multi-hospital health network's COVID-19 database between March and June 2020 was performed. Patients with self-reported smell or taste loss were included. Demographic information, patient comorbidities, and mortality data was obtained. There were 2892 patients included in this analysis and 117 reported smell or taste loss (4.0%, 95% confidence interval [CI]: 3.4%-4.8%). The proportion of females with smell or taste loss was significantly higher than males (6.3% vs. 2.5%, P < 0.001), whereas no differences existed between ethnicity or smoking status. When compared with age of 30-40 years, the age group of 10-20 years were most likely to present with smell or taste dysfunction (odds ratio [OR] 6.59, 95% CI 1.32-26.12; P = 0.01). The majority of specific comorbidities were not associated with increased incidence of smell or taste dysfunction. Outpatient healthcare workers were more likely to present with smell or taste loss (OR 3.2, CI 1.8-5.47; P < 0.001). The mortality rate among COVID-19 patients with smell or taste dysfunction was significantly lower than those without (0% vs. 20.3%; P < 0.001). Smell or taste loss is more prevalent in women, younger age groups, and healthier individuals. It may be associated with lower mortality and a milder disease trajectory compared to the overall cohort.


Assuntos
COVID-19/complicações , COVID-19/fisiopatologia , Hospitalização , Transtornos do Olfato/etiologia , Transtornos do Olfato/fisiopatologia , Olfato/fisiologia , Distúrbios do Paladar/etiologia , Distúrbios do Paladar/fisiopatologia , Paladar/fisiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , COVID-19/mortalidade , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/mortalidade , Estudos Retrospectivos , Fatores Sexuais , Distúrbios do Paladar/epidemiologia , Distúrbios do Paladar/mortalidade , Adulto Jovem
16.
Neuroepidemiology ; 55(2): 154-161, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33794531

RESUMO

INTRODUCTION: Smell and taste loss are characteristic symptoms of SARS-CoV-2 infection. The aim of this study is to investigate the prevalence and risk factors associated with olfactory and gustatory dysfunctions in coronavirus disease (COVID-19) patients. METHODS: We conducted an observational, retrospective study on 376 patients with documented SARS-CoV-2 infection admitted to the San Gerardo Hospital in Monza, Italy, from March to July 2020. All patients answered a phone questionnaire providing information on age, sex, smoking status, and clinical characteristics. Adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated through logistic regression models including relevant covariates. RESULTS: The prevalence of olfactory and gustatory dysfunctions in COVID-19 patients was 33.5 and 35.6%, respectively. Olfactory dysfunctions were significantly directly associated with current smoking and history of allergy, the multivariable ORs being 6.53 (95% CI 1.16-36.86) for current smokers versus never smokers, and 1.89 (95% CI 1.05-3.39) for those with an allergy compared to those without any allergy. Respiratory allergy in particular was significantly associated with olfactory dysfunctions (multivariable OR 2.30, 95% CI 1.02-5.17). Significant inverse associations were observed for patients aged 60 years or more (multivariable OR 0.33, 95% CI 0.19-0.57) and hospitalization (multivariable OR 0.22, 95% CI 0.06-0.89). Considering gustatory dysfunctions, after allowance of other variables a significant direct association was found for respiratory allergies (OR 2.24, 95% CI 1.03-4.86), and an inverse association was found only for hospitalization (OR 0.21, 95% CI 0.06-0.76). CONCLUSION: Our study indicates that current smoking and history of allergy (particularly respiratory) significantly increase the risk for smell loss in COVID-19 patients; the latter is also significantly associated to taste loss. Hospitalization has an inverse association with the risk of olfactory and gustatory dysfunctions, suggesting that these may be symptoms characteristics of less severe SARS-CoV-2 infection.


Assuntos
Anosmia/epidemiologia , COVID-19/fisiopatologia , Disgeusia/epidemiologia , Hipersensibilidade Respiratória/epidemiologia , Fumar/epidemiologia , Fatores Etários , Idoso , Anosmia/fisiopatologia , Disgeusia/fisiopatologia , Serviço Hospitalar de Emergência , Feminino , Hospitalização , Humanos , Hipersensibilidade/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/fisiopatologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Distúrbios do Paladar/epidemiologia , Distúrbios do Paladar/fisiopatologia
18.
J Alzheimers Dis ; 81(2): 641-650, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33843686

RESUMO

BACKGROUND: Olfactory dysfunction (OD) is an early symptom of Alzheimer's disease (AD). However, olfactory testing is not commonly performed to test OD in the setting of AD. OBJECTIVE: This work investigates objective OD as a non-invasive biomarker for accurately classifying subjects as cognitively unimpaired (CU), mild cognitive impairment (MCI), and AD. METHODS: Patients with MCI (n = 24) and AD (n = 24), and CU (n = 33) controls completed two objective tests of olfaction (Affordable, Rapid, Olfactory Measurement Array -AROMA; Sniffin' Sticks Screening 12 Test -SST12). Demographic and subjective sinonasal and olfaction symptom information was also obtained. Analyses utilized traditional statistics and machine learning to determine olfactory variables, and combinations of variables, of importance for differentiating normal and disease states. RESULTS: Inability to correctly identify a scent after detection was a hallmark of MCI/AD. AROMA was superior to SST12 for differentiating MCI from AD. Performance on the clove scent was significantly different between all three groups. AROMA regression modeling yielded six scents with AUC of the ROC of 0.890 (p < 0.001). Random forest model machine learning algorithms considering AROMA olfactory data successfully predicted MCI versus AD disease state. Considering only AROMA data, machine learning algorithms were 87.5%accurate (95%CI 0.4735, 0.9968). Sensitivity and specificity were 100%and 75%, respectively with ROC of 0.875. When considering AROMA and subject demographic and subjective data, the AUC of the ROC increased to 0.9375. CONCLUSION: OD differentiates CUs from those with MCI and AD and can accurately predict MCI versus AD. Leveraging OD data may meaningfully guide management and research decisions.


Assuntos
Doença de Alzheimer/psicologia , Disfunção Cognitiva/psicologia , Aprendizado de Máquina , Transtornos do Olfato/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/análise , Progressão da Doença , Humanos , Pessoa de Meia-Idade , Testes Neuropsicológicos , Transtornos do Olfato/diagnóstico , Sensibilidade e Especificidade
19.
Lupus ; 30(7): 1078-1085, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33858264

RESUMO

OBJECTIVE: To investigate the changes of olfactory function and odor-induced brain activation in patients with systemic lupus erythematosus (SLE) at early stages compared with healthy controls. MATERIALS AND METHODS: Olfactory function and odor-induced brain activation in 12 SLE patients at early stages and 12 age, gender and education matched healthy controls were evaluated using olfactory behavior test and odor-induced task-functional magnetic resonance imaging (task-fMRI). RESULTS: No significant differences in olfactory behavior scores (including olfactory threshold, olfactory identification, and olfactory memory) were found in the patients with SLE at early stages compared with the healthy controls, while significantly decreased odor-induced activations in olfactory-related brain regions were observed in the patients. In the SLE group, the patients with better performance in the olfactory threshold test had significantly lower levels of anti-dsDNA antibody. CONCLUSION: The current study demonstrated that significant alterations in odor-induced brain activations occurred prior to measurable olfactory decline in SLE at early stages, which provided a new method for early diagnosis of olfactory dysfunction in SLE.


Assuntos
Encéfalo/fisiopatologia , Lúpus Eritematoso Sistêmico/fisiopatologia , Transtornos do Olfato/fisiopatologia , Nervo Olfatório/fisiopatologia , Adulto , Anticorpos Antinucleares/sangue , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico/métodos , Estudos de Casos e Controles , Disfunção Cognitiva/complicações , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/fisiopatologia , Diagnóstico Precoce , Feminino , Humanos , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/complicações , Imageamento por Ressonância Magnética/métodos , Condução Nervosa/fisiologia , Testes Neuropsicológicos/normas , Transtornos do Olfato/etiologia , Estudos Prospectivos , Limiar Sensorial/fisiologia , Índice de Gravidade de Doença
20.
Behav Brain Res ; 408: 113283, 2021 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-33819530

RESUMO

Deficits in olfaction are associated with neurodegenerative disorders such as Alzheimer's disease. A recent study reported that intranasal zinc sulfate (ZnSO4)-treated mice show olfaction and memory deficits. However, it remains unknown whether olfaction deficit-induced learning and memory impairment is associated with the cholinergic system in the brain. In this study, we evaluated olfactory function by the buried food find test, and learning and memory function by the Y-maze and passive avoidance tests in ZnSO4-treated mice. The expression of choline acetyltransferase (ChAT) protein in the olfactory bulb (OB), prefrontal cortex, hippocampus, and amygdala was assessed by western blotting. Moreover, we observed the effect of the acetylcholinesterase inhibitor physostigmine on ZnSO4-induced learning and memory deficits. We found that intranasal ZnSO4-treated mice exhibited olfactory dysfunction, while this change was recovered on day 14 after treatment. Both short-term and long-term learning and memory were impaired on days 4 and 7 after treatment with ZnSO4, whereas the former, but not the latter, was recovered on day 14 after treatment. A significant correlation was observed between olfactory function and short-term memory, but not long-term memory. Treatment with ZnSO4 decreased the ChAT level in the OB on day 4, and increased and decreased the ChAT levels in the OB and hippocampus on day 7, respectively. Physostigmine improved the ZnSO4-induced deficit in short-term, but not long-term, memory. Taken together, the present results suggest that short-term memory may be closely associated with olfactory function via the cholinergic system.


Assuntos
Colina O-Acetiltransferase/metabolismo , Inibidores da Colinesterase/farmacologia , Hipocampo , Transtornos da Memória , Memória de Longo Prazo , Memória de Curto Prazo , Transtornos do Olfato , Bulbo Olfatório , Animais , Adstringentes/farmacologia , Modelos Animais de Doenças , Hipocampo/efeitos dos fármacos , Hipocampo/metabolismo , Masculino , Transtornos da Memória/induzido quimicamente , Transtornos da Memória/tratamento farmacológico , Transtornos da Memória/fisiopatologia , Memória de Longo Prazo/efeitos dos fármacos , Memória de Longo Prazo/fisiologia , Memória de Curto Prazo/efeitos dos fármacos , Memória de Curto Prazo/fisiologia , Camundongos , Transtornos do Olfato/induzido quimicamente , Transtornos do Olfato/tratamento farmacológico , Transtornos do Olfato/fisiopatologia , Bulbo Olfatório/efeitos dos fármacos , Bulbo Olfatório/metabolismo , Fisostigmina/farmacologia , Sulfato de Zinco/farmacologia
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