背景:由于其病理生理学和神经影像学方面的争议,继续研究COVID后持续的嗅觉功能障碍。
方法:患者已确认轻度COVID-19感染伴嗅觉功能障碍演变超过一个月,并与嗅觉正常的对照组进行比较,使用Sniffin\'Sticks嗅觉测试进行评估,并接受了大脑,嗅球的磁共振成像(MRI)和嗅觉功能。
结果:共有8名患者和2名对照参加。患者的平均年龄为34.5岁(SD8.5),对照组为28.5(SD2.1)。患者嗅觉测试的平均得分为7.9分(SD2.2)。在大脑和嗅球核磁共振检查中,没有发现形态学差异。当通过功能磁共振成像评估时,与对照组相比,没有患者激活内嗅区域,在这个级别上确实显示了激活。在病例和对照组中,二级嗅觉区的激活如下:眶额(25%vs100%),基底神经节(25%vs50%)和脑岛(38%vs0%)。
结论:脑MRI没有观察到形态学改变。与控件不同,在嗅觉功能MRI中,没有患者激活内嗅皮层。
BACKGROUND: Persistent post-COVID olfactory dysfunction continues to be studied due to the controversy in its pathophysiology and neuroimaging.
METHODS: The patients had confirmed mild COVID-19 infection with olfactory dysfunction of more than one month of evolution and they were compared to controls with normal olfaction, assessed using the Sniffin\' Sticks Olfactory Test and underwent brain, magnetic resonance imaging (MRI) of the olfactory bulb and olfactory function.
RESULTS: A total of 8 patients and 2 controls participated. The average age of the patients was 34.5 years (SD 8.5), and that of the controls was 28.5 (SD 2.1). The average score in the patients\' olfactory test was 7.9 points (SD 2.2). In brain and olfactory bulb MRI tests, no morphological differences were found. When evaluated by functional MRI, none of the patients activated the entorhinal area in comparison to the controls, who did show activation at this level. Activation of secondary olfactory areas in cases and controls were as follows: orbitofrontal (25% vs 100%), basal ganglia (25% vs 50%) and insula (38% vs 0%) respectively.
CONCLUSIONS: There were no observed morphological changes in the brain MRI. Unlike the controls, none of the patients activated the entorhinal cortex in the olfactory functional MRI.