Olfaction Disorders

嗅觉障碍
  • 文章类型: Journal Article
    原理:脑室下区(SVZ)的成人神经发生对于维持神经稳态至关重要,它的失调会导致神经系统疾病的失语症和组织愈合延迟,如帕金森病(PD)。尽管在SVZ神经发生中发现了复杂的调节网络,动态维持神经干/祖细胞(NSPCs)响应生理和病理刺激的分子机制仍未完全阐明。方法:我们建立了一个RNA结合基序蛋白24(Rbm24)敲除模型,以研究其对SVZ中成人神经发生的影响。采用免疫荧光,免疫印迹,电生理学,RNA测序,和体外实验。进一步的研究利用PD小鼠模型,连同遗传和药理操作,阐明Rbm24参与PD病理。结果:Rbm24,细胞稳态的多方面转录后调节因子,从发育到衰老在SVZ中表现出广泛的表达。Rbm24的缺失显着损害成年SVZ的NSPC增殖,最终导致嗅球神经发生塌陷。值得注意的是,Rbm24在维持成年NSPCs中Notch1mRNA的稳定性中起着特定的作用。Rbm24/Notch1信号轴在PD小鼠的SVZ中显著下调。值得注意的是,Rbm24的过表达拯救了PD小鼠成年神经发生和嗅觉功能障碍的破坏,这些影响受到DAPT的阻碍,Notch1的有效抑制剂。结论:我们的发现强调了Rbm24/Notch1信号轴在生理和病理情况下调节成人SVZ神经发生的关键作用。这为NSPC稳态的动态调节提供了有价值的见解,并为PD和相关神经系统疾病提供了潜在的针对性干预措施。
    Rationale: Adult neurogenesis in the subventricular zone (SVZ) is essential for maintaining neural homeostasis, and its dysregulation contributes to anosmia and delayed tissue healing in neurological disorders, such as Parkinson\'s disease (PD). Despite intricate regulatory networks identified in SVZ neurogenesis, the molecular mechanisms dynamically maintaining neural stem/progenitor cells (NSPCs) in response to physiological and pathological stimuli remain incompletely elucidated. Methods: We generated an RNA binding motif protein 24 (Rbm24) knockout model to investigate its impact on adult neurogenesis in the SVZ, employing immunofluorescence, immunoblot, electrophysiology, RNA-sequencing, and in vitro experiments. Further investigations utilized a PD mouse model, along with genetic and pharmacological manipulations, to elucidate Rbm24 involvement in PD pathology. Results: Rbm24, a multifaceted post-transcriptional regulator of cellular homeostasis, exhibited broad expression in the SVZ from development to aging. Deletion of Rbm24 significantly impaired NSPC proliferation in the adult SVZ, ultimately resulting in collapsed neurogenesis in the olfactory bulb. Notably, Rbm24 played a specific role in maintaining Notch1 mRNA stability in adult NSPCs. The Rbm24/Notch1 signaling axis was significantly downregulated in the SVZ of PD mice. Remarkably, overexpression of Rbm24 rescued disruption of adult neurogenesis and olfactory dysfunction in PD mice, and these effects were hindered by DAPT, a potent inhibitor of Notch1. Conclusions: Our findings highlight the critical role of the Rbm24/Notch1 signaling axis in regulating adult SVZ neurogenesis under physiological and pathological circumstances. This provides valuable insights into the dynamic regulation of NSPC homeostasis and offers a potential targeted intervention for PD and related neurological disorders.
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  • 文章类型: Journal Article
    背景技术精神麻痹(GPI)以认知障碍为特征,神经精神症状,大脑结构异常,模仿许多神经精神疾病。在许多神经精神疾病中,嗅觉功能障碍与认知能力下降和神经精神症状有关。然而,目前尚不清楚GPI患者是否出现嗅觉功能障碍,以及嗅觉功能障碍是否与其临床表现相关.材料和方法40名GPI患者和37名健康对照(HCs)接受了“SniffinSticks”测试电池,迷你精神状态检查,和神经精神量表来测量嗅觉功能,认知功能,和神经精神症状,分别。使用视觉评估量表评估脑结构异常,包括内侧颞叶萎缩(MTA)视觉评定量表和Fazekas量表。结果与HC相比,GPI患者表现出显著的嗅觉功能障碍,如气味阈值(OT)的缺陷(P=0.001)所示,气味辨别(OD)(P<0.001),气味识别(OI)(P<0.001)。在GPI患者中,OI与认知功能呈正相关(r=0.57,P<0.001),但是嗅觉功能和神经精神症状之间没有发现显著的相关性,血,或脑脊液生物标志物(快速血浆反应蛋白环卡试验和梅毒螺旋体颗粒凝集试验),或脑结构异常(MTA和Fazekas量表评分)。中介分析表明,GPI患者的OI受损分别由认知障碍和OT受损介导。结论GPI患者表现出整体嗅觉功能障碍。OI与认知功能相关,OI受损是由GPI患者的认知障碍介导的。因此,OI可以作为反映GPI患者认知功能的标志物。
    BACKGROUND General paresis of the insane (GPI) is characterized by cognitive impairment, neuropsychiatric symptoms, and brain structural abnormalities, mimicking many neuropsychiatric diseases. Olfactory dysfunction has been linked to cognitive decline and neuropsychiatric symptoms in numerous neuropsychiatric diseases. Nevertheless, it remains unclear whether patients with GPI experience olfactory dysfunction and whether olfactory dysfunction is associated with their clinical manifestations. MATERIAL AND METHODS Forty patients with GPI and 37 healthy controls (HCs) underwent the \"Sniffin Sticks\" test battery, Mini-Mental State Examination, and Neuropsychiatric Inventory to measure olfactory function, cognitive function, and neuropsychiatric symptoms, respectively. Brain structural abnormalities were evaluated using visual assessment scales including the medial temporal lobe atrophy (MTA) visual rating scale and Fazekas scale. RESULTS Compared with HCs, patients with GPI exhibited significant olfactory dysfunction, as indicated by deficits in the odor threshold (OT) (P=0.001), odor discrimination (OD) (P<0.001), and odor identification (OI) (P<0.001). In patients with GPI, the OI was positively correlated with cognitive function (r=0.57, P<0.001), but no significant correlation was found between olfactory function and neuropsychiatric symptoms, blood, or cerebrospinal fluid biomarkers (rapid plasma reagin circle card test and Treponema pallidum particle agglutination test), or brain structural abnormalities (MTA and Fazekas scale scores). Mediation analysis indicated that the impaired OI in patients with GPI was mediated by cognitive impairment and impaired OT respectively. CONCLUSIONS Patients with GPI exhibited overall olfactory dysfunction. OI is correlated with cognitive function and the impaired OI is mediated by cognitive impairment in patients with GPI. Thus, OI may serve as a marker for reflecting cognitive function in patients with GPI.
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  • 文章类型: Journal Article
    背景:嗅觉丧失显著影响患者的生活质量。然而,关于肌萎缩侧索硬化症(ALS)患者嗅觉丧失的研究有限,嗅觉丧失与认知障碍之间的相关性尚不清楚。本研究旨在探讨ALS患者嗅觉丧失与认知障碍的相关性。
    方法:该研究包括216名ALS患者。爱丁堡认知和行为ALS筛查(ECAS)和专门针对中国人群的嗅觉识别测试(CSIT)进行了评估参与者的认知和嗅觉功能,分别。
    结果:在考虑年龄因素后,性别,BMI,教育水平,饥饿程度,饮食偏见,渴望食物,压力,吸烟状况,酒精消费,和上呼吸道感染(URTI)或鼻炎,CSIT得分与ECAS得分显著相关(r=0.162,p=0.028),尤其是ALS特异性评分(r=0.158,p=0.031)。即使排除URTI或鼻炎患者,结果相似。CSIT得分与ECAS得分显著相关(r=0.224,p=0.011),尤其是ALS特异性评分(r=0.205,p=0.019)。
    结论:在ALS患者中,嗅觉丧失与认知障碍显著相关,尤其是额颞叶功能障碍。认知功能障碍可能导致ALS患者嗅觉表现变差。
    BACKGROUND: Smell loss significantly impacts the quality of life in patients. However, there is limited research on smell loss in individuals with amyotrophic lateral sclerosis (ALS), and the correlation between smell loss and cognitive impairment is unclear. This study aimed to investigate the correlation between smell loss and cognition impairment in ALS patients.
    METHODS: The study included 216 ALS patients. The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) and smell identification test specifically for the Chinese population (CSIT) were administered to evaluate participants\' cognitive and olfactory function, respectively.
    RESULTS: After covarying for age, sex, BMI, education level, degree of hunger, dietary bias, eagerness for food, stress, smoking status, alcohol consumption, and upper respiratory tract infection (URTI) or rhinitis, CSIT scores were significantly correlated with ECAS scores (r = 0.162, p = 0.028), especially the ALS-specific scores (r = 0.158, p = 0.031). Even after excluding patients with URTI or rhinitis, the results were similar. CSIT scores were significantly correlated with ECAS scores (r = 0.224, p = 0.011), especially the ALS-specific scores (r = 0.205, p = 0.019).
    CONCLUSIONS: In patients with ALS, smell loss is significantly correlated with cognitive impairment, particularly frontotemporal dysfunction. Cognitive dysfunction may lead to worse olfactory performance in ALS patients.
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  • 文章类型: Journal Article
    尽管最近在理解嗅觉机制方面取得了进展,目前没有工具可用于非侵入性地识别气味损失。由于2019年与冠状病毒相关的嗅觉丧失的患者大幅增加,大流行突出了迫切需要开发定量方法。方法:我们研究了一种名为Tsp1a-IR800P的新型荧光探针作为诊断嗅觉丧失的工具的使用。Tsp1a-IR800P靶向钠通道1.7,通过帮助信号传播到嗅球,在嗅觉中起关键作用。结果:直观,我们已经确定了导致嗅觉丧失的条件,包括慢性炎症和冠状病毒病2019,与嗅觉上皮中钠通道1.7表达下调相关,在转录本和蛋白质水平。我们证明了较低的Tsp1a-IR800P荧光发射与活体动物的嗅觉丧失显着相关,因此代表了其半定量评估的潜在工具。目前可用的方法依赖于延迟的主观行为研究。结论:该方法可以通过提供一种客观诊断嗅觉丧失的方法来帮助显着改善临床前和临床研究,从而帮助开发治疗干预措施。
    Despite the recent advances in understanding the mechanisms of olfaction, no tools are currently available to noninvasively identify loss of smell. Because of the substantial increase in patients presenting with coronavirus disease 2019-related loss of smell, the pandemic has highlighted the urgent need to develop quantitative methods. Methods: Our group investigated the use of a novel fluorescent probe named Tsp1a-IR800P as a tool to diagnose loss of smell. Tsp1a-IR800P targets sodium channel 1.7, which plays a critical role in olfaction by aiding the signal propagation to the olfactory bulb. Results: Intuitively, we have identified that conditions leading to loss of smell, including chronic inflammation and coronavirus disease 2019, correlate with the downregulation of sodium channel 1.7 expression in the olfactory epithelium, both at the transcript and at the protein levels. We demonstrated that lower Tsp1a-IR800P fluorescence emissions significantly correlate with loss of smell in live animals-thus representing a potential tool for its semiquantitative assessment. Currently available methods rely on delayed subjective behavioral studies. Conclusion: This method could aid in significantly improving preclinical and clinical studies by providing a way to objectively diagnose loss of smell and therefore aid the development of therapeutic interventions.
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  • 文章类型: Journal Article
    背景:从COVID-19康复一年多后,很大一部分人,他们中的许多人在医疗保健部门工作,仍然报告嗅觉障碍。然而,在COVID-19大流行之前,嗅觉功能障碍已经很常见,这使得有必要考虑现有的嗅觉功能障碍基线患病率。建立COVID-19相关嗅觉功能障碍的调整患病率,我们使用心理物理测试评估了在第一波大流行期间感染COVID-19的医护人员的嗅觉功能.
    方法:自大流行开始以来,不断对参与者进行SARS-CoV-2IgG抗体测试。为了评估人群中嗅觉功能障碍的基线率,并控制先前有嗅觉功能障碍的个体的倾斜招募的可能性,将一致的SARS-CoV-2IgG初治个体作为对照组进行检测.
    结果:在与COVID-19签约15个月后,37%的医护人员表现出嗅觉数量上的减少,与对照组中只有20%的个体相比。51%的COVID-19康复个体报告了定性症状,而对照组只有5%。在COVID-19诊断后2.6年的一项随访研究中,24%的所有测试恢复个体仍然经历了假发。
    结论:总之,65%的医护人员在感染COVID-19后15个月经历了阵发性/低症。与对照组相比,嗅觉功能障碍在人群中的患病率增加了41个百分点.两年半后,24%的SARS-CoV-2感染者的阵痛症状仍然挥之不去。考虑到感染和检测之间的时间,嗅觉问题可能在多个个体中不完全可逆。
    BACKGROUND: More than a year after recovering from COVID-19, a large proportion of individuals, many of whom work in the healthcare sector, still report olfactory dysfunctions. However, olfactory dysfunction was common already before the COVID-19 pandemic, making it necessary to also consider the existing baseline prevalence of olfactory dysfunction. To establish the adjusted prevalence of COVID-19 related olfactory dysfunction, we assessed smell function in healthcare workers who had contracted COVID-19 during the first wave of the pandemic using psychophysical testing.
    METHODS: Participants were continuously tested for SARS-CoV-2 IgG antibodies since the beginning of the pandemic. To assess the baseline rate of olfactory dysfunction in the population and to control for the possibility of skewed recruitment of individuals with prior olfactory dysfunction, consistent SARS-CoV-2 IgG naïve individuals were tested as a control group.
    RESULTS: Fifteen months after contracting COVID-19, 37% of healthcare workers demonstrated a quantitative reduction in their sense of smell, compared to only 20% of the individuals in the control group. Fifty-one percent of COVID-19-recovered individuals reported qualitative symptoms, compared to only 5% in the control group. In a follow-up study 2.6 years after COVID-19 diagnosis, 24% of all tested recovered individuals still experienced parosmia.
    CONCLUSIONS: In summary, 65% of healthcare workers experienced parosmia/hyposmia 15 months after contracting COVID-19. When compared to a control group, the prevalence of olfactory dysfunction in the population increased by 41 percentage points. Parosmia symptoms were still lingering two-and-a half years later in 24% of SARS-CoV-2 infected individuals. Given the amount of time between infection and testing, it is possible that the olfactory problems may not be fully reversible in a plurality of individuals.
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  • 文章类型: Journal Article
    嗅觉上皮(OE)直接暴露于进入鼻腔的环境因素,使OSN容易受伤和变性。嗅觉功能障碍的原因多种多样,包括头部外伤,神经退行性疾病,和衰老,但主要原因是慢性鼻-鼻窦炎(CRS)和病毒感染。在CRS和病毒感染中,局部炎症导致气流减少,炎性细胞因子的产生,从嗜酸性粒细胞释放脱颗粒蛋白,细胞损伤导致嗅觉功能下降。众所周知,成年OE中损伤诱导的成熟OSN的丧失会在几个月内通过随后掺入嗅觉神经回路的祖细胞的增殖和分化导致新OSN的大量再生。尽管在大多数情况下受伤后恢复了正常的嗅觉功能,在某些情况下,长期的嗅觉障碍和嗅觉功能缺乏改善是主要的临床问题。OE的持续炎症或严重损伤会导致OE和呼吸道上皮的形态变化,并减少成熟OSN的数量。导致嗅觉功能不可逆的丧失。在这次审查中,我们讨论了人类OE的组织学结构和分布,以及与CRS和病毒感染相关的嗅觉功能障碍的发病机制。
    The olfactory epithelium (OE) is directly exposed to environmental agents entering the nasal cavity, leaving OSNs prone to injury and degeneration. The causes of olfactory dysfunction are diverse and include head trauma, neurodegenerative diseases, and aging, but the main causes are chronic rhinosinusitis (CRS) and viral infections. In CRS and viral infections, reduced airflow due to local inflammation, inflammatory cytokine production, release of degranulated proteins from eosinophils, and cell injury lead to decreased olfactory function. It is well known that injury-induced loss of mature OSNs in the adult OE causes massive regeneration of new OSNs within a few months through the proliferation and differentiation of progenitor basal cells that are subsequently incorporated into olfactory neural circuits. Although normal olfactory function returns after injury in most cases, prolonged olfactory impairment and lack of improvement in olfactory function in some cases poses a major clinical problem. Persistent inflammation or severe injury in the OE results in morphological changes in the OE and respiratory epithelium and decreases the number of mature OSNs, resulting in irreversible loss of olfactory function. In this review, we discuss the histological structure and distribution of the human OE, and the pathogenesis of olfactory dysfunction associated with CRS and viral infection.
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  • 文章类型: Journal Article
    背景:近年来,嗅觉障碍的发病率有所增加,主要与COVID-19感染有关。在巴西,已经报告了超过3700万例COVID-19病例,这些病例中约有10%的嗅觉障碍持续超过一个月。尽管对福祉有重大负面影响,目前尚无经过验证的仪器来评估嗅觉障碍如何影响巴西的生活质量.
    目的:本研究旨在验证巴西葡萄牙语的嗅觉障碍问卷(QOD)。
    方法:作者首先进行翻译,回译,专家评审,预先测试,英文版问卷的心理测量评价和文化适应。为了确保翻译问卷的语言和概念对等,来自巴西两个州和不同程度嗅觉丧失的126名参与者回答了QOD和世界卫生组织生活质量bref(WHOQOL-bref)问卷。宾夕法尼亚大学气味鉴定测试(UPSIT®)用于量化嗅觉损失。此外,为了评估葡萄牙语版本的可靠性,我们对一组患者进行了复检.作者观察到生活质量(QOD-QOL)陈述的内部一致性较高的Cronbachα(α=0.86)。
    结果:如预期,QOD-QOL和UPSIT®之间存在负相关(斯皮尔曼ρ=-0.275,p=0.002),随着嗅觉功能的恶化,QOL评分增加,UPSIT®评分降低。QOD-QOL和WHOQOL-bref平均值之间的相关性为中度(Spearman'sρ=-0.374,p<0.001),而QOD-QOL和QOD视觉模拟量表之间的相关性为轻度至中度,休闲,和私人生活(Spearman的ρ=-0.316,p=0.000;Spearman的ρ=-0.293,p=0.001;Spearman的ρ=-0.261,p=0.004;分别)。
    结论:结论:作者已证明巴西葡萄牙语版QOD在评估嗅觉障碍患者生活质量方面具有较高的内部一致性和有效性.
    The incidence of olfactory disorders has increased in recent years, mainly related to COVID-19 infection. In Brazil, over 37 million cases of COVID-19 have been reported, and approximately 10 % of those cases continue to experience olfactory disorders for more than one month. Despite the significant negative impact on well-being, there is currently no validated instrument to assess how olfactory disorders impact the quality of life in Brazil.
    This study aimed to validate the Questionnaire of Olfactory Disorders (QOD) for Brazilian Portuguese.
    The authors first performed translation, back-translation, expert review, pre-testing, psychometric evaluation and cultural adaptation of the English version of the questionnaire. To assure linguistic and conceptual equivalence of the translated questionnaire, 126 participants from two Brazilian states and varying degrees of olfactory loss answered the QOD and the World Health Organization Quality of Life bref (WHOQOL-bref) questionnaires. The University of Pennsylvania Smell Identification Test (UPSIT®) was used to quantify the olfactory loss. Furthermore, to evaluate the reliability of the Portuguese version a test-retest was performed on a subgroup of patients. The authors observed a high Cronbach\'s alpha (α = 0.86) for internal consistency of the quality of Life (QOD-QOL) statements.
    As expected, there was a negative correlation between QOD-QOL and UPSIT® (Spearman\'s ρ = -0.275, p = 0.002), since QOL score increases and UPSIT® score decreases with worsening of olfactory function. Correlations were moderate between QOD-QOL and WHOQOL-bref mean (Spearman\'s ρ = -0.374, p < 0.001) and weak to moderate between the QOD-QOL and Visual Analog Scale of the QOD regarding professional life, leisure, and private life (Spearman\'s ρ = -0.316, p = 0.000; Spearman\'s ρ = -0.293, p = 0.001; Spearman\'s ρ = -0.261, p = 0.004; respectively).
    In conclusion, the authors have demonstrated a high internal consistency and validity of the Brazilian Portuguese version of the QOD for evaluating the quality of life in individuals with olfactory disorders.
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  • 文章类型: Journal Article
    嗅觉障碍降低了日常生活质量(QOL),部分原因是降低了进食的乐趣。嗅觉在风味感觉和适口性中起着至关重要的作用。推测嗅觉功能障碍导致的QOL下降是由于大脑嗅觉和边缘区域的神经活动异常所致,以及周围气味受体功能障碍。然而,具体的潜在神经生物学机制尚不清楚.由于嗅结节(OT)是内源性阿片类药物高表达的脑区之一,我们假设嗅觉功能障碍导致QOL下降的潜在机制涉及OT中神经活动的减少以及随后在特定亚区的内源性阿片样物质释放.在这次审查中,我们提供了关于OT的概述和最近的更新,内源性阿片系统,和大脑中的快乐系统,然后讨论我们的假设。为了促进有效治疗嗅觉障碍和生活质量下降,阐明通过风味感觉进食的乐趣的神经生物学机制至关重要。
    Olfactory dysfunctions decrease daily quality of life (QOL) in part by reducing the pleasure of eating. Olfaction plays an essential role in flavor sensation and palatability. The decreased QOL due to olfactory dysfunction is speculated to result from abnormal neural activities in the olfactory and limbic areas of the brain, as well as peripheral odorant receptor dysfunctions. However, the specific underlying neurobiological mechanisms remain unclear. As the olfactory tubercle (OT) is one of the brain\'s regions with high expression of endogenous opioids, we hypothesize that the mechanism underlying the decrease in QOL due to olfactory dysfunction involves the reduction of neural activity in the OT and subsequent endogenous opioid release in specialized subregions. In this review, we provide an overview and recent updates on the OT, the endogenous opioid system, and the pleasure systems in the brain and then discuss our hypothesis. To facilitate the effective treatment of olfactory dysfunctions and decreased QOL, elucidation of the neurobiological mechanisms underlying the pleasure of eating through flavor sensation is crucial.
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  • 文章类型: Journal Article
    尽管流行率很高,COVID-19气味受损的决定因素仍未完全了解。在这项工作中,我们旨在通过大规模磁共振成像(MRI)分析,研究嗅球体积与COVID-19相关气味损害的临床轨迹之间的关联.分析了2020年3月至12月在前瞻性汉堡市健康研究COVID计划框架内招募的未接种COVID-19疗养者的数据。在基线,233名参与者接受了MRI和神经心理学测试以及嗅觉功能结构化问卷。2022年3月至4月,随访时评估嗅觉功能,包括使用Sniffin\'Sticks进行定量嗅觉测试。这项研究包括233名主要从轻度至中度SARS-CoV-2感染中恢复的个体。纵向评估显示,急性感染时自我报告的嗅觉功能障碍患病率从67.1%下降。基线检查为21.0%,随访为17.5%。急性后自我报告嗅觉功能障碍的参与者在基线时的嗅球体积明显低于正常嗅觉个体。基线时的嗅球体积预测随访时的嗅觉测量评分。神经心理学测试的性能与嗅球体积没有显着相关。我们的工作表明,在主要从轻度至中度COVID-19中恢复的个体样本中,长期自我报告的气味功能障碍与嗅球完整性之间存在关联。总的来说,我们的研究结果突出了嗅球体积作为COVID-19的替代指标,可以为COVID-19的诊断和康复策略提供指导.
    Despite its high prevalence, the determinants of smelling impairment in COVID-19 remain not fully understood. In this work, we aimed to examine the association between olfactory bulb volume and the clinical trajectory of COVID-19-related smelling impairment in a large-scale magnetic resonance imaging (MRI) analysis. Data of non-vaccinated COVID-19 convalescents recruited within the framework of the prospective Hamburg City Health Study COVID Program between March and December 2020 were analyzed. At baseline, 233 participants underwent MRI and neuropsychological testing as well as a structured questionnaire for olfactory function. Between March and April 2022, olfactory function was assessed at follow-up including quantitative olfactometric testing with Sniffin\' Sticks. This study included 233 individuals recovered from mainly mild to moderate SARS-CoV-2 infections. Longitudinal assessment demonstrated a declining prevalence of self-reported olfactory dysfunction from 67.1% at acute infection, 21.0% at baseline examination and 17.5% at follow-up. Participants with post-acute self-reported olfactory dysfunction had a significantly lower olfactory bulb volume at baseline than normally smelling individuals. Olfactory bulb volume at baseline predicted olfactometric scores at follow-up. Performance in neuropsychological testing was not significantly associated with the olfactory bulb volume. Our work demonstrates an association of long-term self-reported smelling dysfunction and olfactory bulb integrity in a sample of individuals recovered from mainly mild to moderate COVID-19. Collectively, our results highlight olfactory bulb volume as a surrogate marker that may inform diagnosis and guide rehabilitation strategies in COVID-19.
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  • 文章类型: Journal Article
    背景:嗅觉障碍在老年人中很常见,可能与不良心血管健康有关;然而,经验证据是稀疏的。我们检查了嗅觉与冠心病(CHD)风险的关系,中风,充血性心力衰竭(CHF)。
    结果:这项研究包括来自健康ABC(健康,衰老,和身体成分)通过1999年至2000年的12项简短气味识别测试评估的嗅觉研究,定义为不良(得分≤8),中等(9-10),或者好(11-12)。结果是冠心病,中风,和CHF。在长达12年的随访中,353例冠心病,258行程,并确定了477例CHF事件。嗅觉在统计学上与CHF事件显著相关,但不是冠心病或中风。调整人口统计后,危险因素,和CHF的生物标志物,中度CHF的病因特异性风险比(HR)为1.32(95%CI,1.05-1.66),不良嗅觉CHF的病因特异性风险比为1.28(95%CI,1.01-1.64).在按年龄进行的预先计划的亚组分析中,这些关联是稳健的,性别,种族,和普遍的冠心病/中风。虽然亚组结果没有统计学差异,嗅觉与CHF的关联在报告非常健康至极好的参与者中似乎很明显(HR,中度为1.47[95%CI,1.01-2.14];不良嗅觉为1.76[95%CI,1.20-2.58]),但不是那些自我报告健康状况良好或较差的人(HR,中度为1.04[95%CI,0.64-1.70];不良嗅觉为0.92[95%CI,0.58-1.47])。
    结论:在社区居住的老年人中,单一嗅觉测试与CHF事件的长期风险相关,特别是那些报告非常健康的人。
    BACKGROUND: Olfactory impairment is common in older adults and may be associated with adverse cardiovascular health; however, empirical evidence is sparse. We examined olfaction in relation to the risk of coronary heart disease (CHD), stroke, and congestive heart failure (CHF).
    RESULTS: This study included 2537 older adults (aged 75.6±2.8 years) from the Health ABC (Health, Aging, and Body Composition) study with olfaction assessed by the 12-item Brief Smell Identification Test in 1999 to 2000, defined as poor (score ≤8), moderate (9-10), or good (11-12). The outcomes were incident CHD, stroke, and CHF. During up to a 12-year follow-up, 353 incident CHD, 258 stroke, and 477 CHF events were identified. Olfaction was statistically significantly associated with incident CHF, but not with CHD or stroke. After adjusting for demographics, risk factors, and biomarkers of CHF, the cause-specific hazard ratio (HR) of CHF was 1.32 (95% CI, 1.05-1.66) for moderate and 1.28 (95% CI, 1.01-1.64) for poor olfaction. These associations were robust in preplanned subgroup analyses by age, sex, race, and prevalent CHD/stroke. While the subgroup results were not statistically significantly different, the association of olfaction with CHF appeared to be evident among participants who reported very good to excellent health (HR, 1.47 [95% CI, 1.01-2.14] for moderate; and 1.76 [95% CI, 1.20-2.58] for poor olfaction), but not among those with fair to poor self-reported health (HR, 1.04 [95% CI, 0.64-1.70] for moderate; and 0.92 [95% CI, 0.58-1.47] for poor olfaction).
    CONCLUSIONS: In community-dwelling older adults, a single olfaction test was associated with a long-term risk for incident CHF, particularly among those reporting very good to excellent health.
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