Assessment of Olfactory Nerve by SPECT-MRI Image with Nasal Thallium-201 Administration in Patients with Olfactory Impairments in Comparison to Healthy Volunteers

Purpose

The aim of this study was to assess whether migration of thallium-201 (²⁰¹Tl) to the olfactory bulb were reduced in patients with olfactory impairments in comparison to healthy volunteers after nasal administration of ²⁰¹Tl.

Procedures

10 healthy volunteers and 21 patients enrolled in the study (19 males and 12 females; 26–71 years old). The causes of olfactory dysfunction in the patients were head trauma (n = 7), upper respiratory tract infection (n = 7), and chronic rhinosinusitis (n = 7). ²⁰¹TlCl was administered unilaterally to the olfactory cleft, and SPECT-CT was conducted 24 h later. Separate MRI images were merged with the SPECT images. ²⁰¹Tl olfactory migration was also correlated with the volume of the olfactory bulb determined from MRI images, as well as with odor recognition thresholds measured by using T&T olfactometry.

Results

Nasal ²⁰¹Tl migration to the olfactory bulb was significantly lower in the olfactory-impaired patients than in healthy volunteers. The migration of ²⁰¹Tl to the olfactory bulb was significantly correlated with odor recognition thresholds obtained with T&T olfactometry and correlated with the volume of the olfactory bulb determined from MRI images when all subjects were included.

Conclusions

Assessment of the ²⁰¹Tl migration to the olfactory bulb was the new method for the evaluation of the olfactory nerve connectivity in patients with impaired olfaction.     

Cross-cultural comparison of data using the odor stick identification test for Japanese (OSIT-J)

A new olfactory test, the odor stick identification test for Japanese (OSIT-J), has been developed in Japan. To determine if the OSIT-J would be effective cross-culturally, we administered the test to 52 US and 50 Japanese subjects reporting normal olfactory function. The average composite OSIT-J test score for US subjects was significantly lower (77%) than that for Japanese subjects (94%, P < 0.0001). Both US and Japanese subjects correctly identified eight of the 13 odorants included in the OSIT-J with scores of 80% or higher. However, for five odorants, the US subjects' scores fell below 80% and were consistently lower than Japanese subjects, presumably reflecting cultural differences in odor experience. Most of the US subjects found the OSIT-J to be easy, interesting, pleasant, and short in duration. Although the 13-odorant OSIT-J was found to be suitable for testing US populations, elimination of five test odorants that were unfamiliar to US subjects significantly enhanced the test's effectiveness. Findings from this study emphasize the importance of identifying test odorants that may have a cultural bias, a crucial issue when comparing data obtained from different smell tests used at smell and taste centers around the world.     

Evaluation of the validity of a maximum likelihood adaptive staircase procedure for measurement of olfactory detection threshold in mice

Threshold is defined as the stimulus intensity necessary for a subject to reach a specified percent correct on a detection test. MLPEST (maximum likelihood parameter estimation by sequential testing) is a method that is able to determine threshold accurately and more rapidly than many other methods. Originally developed for human auditory and visual tasks, it has been adapted for human olfactory and gustatory tests. In order to utilize this technique for olfactory testing in mice, we have adapted MLPEST methodology for use with computerized olfactometry as a tool to estimate odor detection thresholds. Here we present Monte Carlo simulations and operant conditioning data that demonstrate the potential utility of this technique in mice, we explore the ramifications of altering MLPEST test parameters on performance, and we discuss the advantages and disadvantages of using MLPEST compared to other methods for the estimation of thresholds in rodents. Using MLPEST, we find that olfactory detection thresholds in mice deficient for the cyclic nucleotide-gated channel subunit A2 are similar to those of wild-type animals for odorants the knockout animals are able to detect.     

Development of a smell identification test using a novel stick-type odor presentation kit

The odor identification is strongly influenced by the social and cultural factors; therefore, the odorants used in a smell identification test should be familiar to the test population. In addition, the device used in the test is desired to be simply handled and retain odor quality over time. We developed a novel stick-type odor presentation kit that consists of microcapsules of odorant incorporated into stable cream and the smell identification test using it. Thirteen odorants were selected to be familiar to the test population. In the test, we used two identification methods: one was a modified forced-choice paradigm with "detectable but not recognizable" and "no smell detected" added as choices and the other was a two-step identification paradigm where the participant first selected one of eight odor categories and then chose the specific odor name from the selected category. We verified the performance of the odor stick and the test by stability, using a test-retest paradigm, comparing this test with another smell test, and testing Japanese people from a range of age groups. We conclude that this kit is a useful odor presentation device, and the test using it works effectively as a smell identification test.     

Olfactory deficits in patients affected by minimal hepatic encephalopathy: a pilot study

Minimal hepatic encephalopathy (MHE) is the earliest stage of hepatic encephalopathy and is associated with changes in cognitive functions, in electrophysiological parameters, and in cerebral neurochemical/neurotransmitter homeostasis. MHE can be observed in patients with cirrhosis who have no clinical evidence of hepatic encephalopathy (HE). At present, no data are available on a possible olfactory dysfunction in such a syndrome, although the pathophysiology of HE may alter olfactory functions since some of the neurotransmitters impaired in the syndrome are involved in the transmission of olfactory information. In the present paper, we performed a preliminary study aimed at detecting whether identification and recognition odor memory is altered in patients with MHE. Twelve patients diagnosed as MHE on the basis of their scores at the portosystemic encephalopathy (PSE)-syndrome test battery, and 12 age-matched controls were studied. Consistent with the hypothesis, patients performed significantly worse than controls for both odor identification and recognition tasks. In addition, a significant correlation between the two olfactory tests and the PSE-syndrome test score was found. This pattern supports the notion that olfactory alterations related to cognitive dysfunction in patients with MHE may be linked to the pathophysiology of HE.     

Olfactory functioning and callosotomy: a report of two cases

Two callosotomy patients with presumably intact anterior commissures were evaluated on a battery of olfactory tasks including sensitivity, discrimination, memory, identification, cross-modality matching, bilateral summation (dirhinic vs. monorhinic thresholds), and localization of odorants. One case was evaluated both pre- and post-surgery. He showed marked decrements after surgery in odor memory and in matching across modalities. After surgery, both patients were better able to name odorants presented to the left nostril than the right nostril. The patient who was asked to remember odorants that could be readily labeled was better able to remember those odorants presented to the left nostril. The findings that both cases performed equally well whether olfactory and tactile information was projected to the same hemisphere or a different one, that some bilateral summation was evident, and that the cases were unable to localize odorants suggests that the remaining neuronal pathways allow for some communication between hemispheres.     

Demystifying wine expertise: olfactory threshold,perceptual skill and semantic memory in expert and novice wine judges

We investigated recognition and identification of wine-relevant odours as a function of domain-specific expertise. Eleven wine experts and 11 wine novices participated in tasks measuring olfactory threshold, odour recognition, odour identification, and consistency of odour naming. Twenty-four wine-relevant odorants were sampled orthonasally by each participant in the semantic (identification; consistency of naming) and episodic (recognition) memory tasks. Results showed superior olfactory recognition by expert wine judges, despite their olfactory sensitivity and bias measures being similar to those of novices. Contrary to predictions based on reports of an association between odour memory and semantic processing, wine experts did not perform better than novices on the verbal memory tasks. Further, ability to recognize odours and ability to name odours were not positively correlated, although the novices' data showed a trend in this direction. The results imply that the source of superior odour recognition in wine experts was not enhanced semantic memory and linguistic capabilities for wine-relevant odours. One interpretation of the data is that wine experts were less susceptible than wine novices to verbal overshadowing. When forced to identify the odorants, experts' superior perceptual skills protected them from verbal interference, whereas novices' generated verbal representations of the odours were emphasized at the expense of the odorant itself. This has implications for training in wine-evaluation skills.     

Different odor tests contribute differently to the evaluation of olfactory loss

In a clinical context, the importance of the sense of smell has increasingly been recognized, for example, in terms of the evaluation of neurodegenerative disorders. In this study, 2 strategies of olfactory testing, a simple one and a more complex one, were compared with respect to their suitability to assess olfactory dysfunction. Odor threshold (T), discrimination (D), and identification (I) were assessed in a control sample of 916 males and 1160 females, aged 6-90 years, and in 81 men and 21 women, aged 38-80 years, suffering from idiopathic Parkinson's disease (IPD). Sums of the 3 subtest results T, D, and I yielded threshold discrimination identification (TDI) scores reflecting olfactory function. Sensitivity of any of the 3 subtests to confirm the diagnosis established by the composite TDI score was assessed separately for each test. Principal component analyses were applied to determine any common source of variance among the 3 specific subtests. Sensitivities of the subtests to provide the diagnosis established by the composite TDI score were 64% (T), 56% (D), and 47% (I), respectively. In IPD patients, each of the subtests provided the correct diagnosis (sensitivity >90%), as olfaction was impaired in 99% of the patient group. Two principal components emerged in both controls and IPD patients, with eigenvalues >0.5. The first component received high loadings from all factors. The second component received high loadings from odor threshold, whereas loadings from odor discrimination and identification were much smaller. In conclusion, combined testing of several components of olfaction, especially including assessment of thresholds, provides the most significant approach to the diagnosis of smell loss.     

Olfactory acuity after total laryngectomy

The olfactory acuity of 29 patients receiving laryngectomy was prospectively studied. The olfactory acuity was evaluated by Jet Stream Olfactometer (JSO) and Alinamin test preoperatively and at 3, 6 and 12 months postoperatively. The findings of nasal/olfactory mucosae were also observed by rigid endoscope. Based on the results of JSO, the averages of detection/recognition thresholds tended to increase 3 months postoperatively, then the averaged thresholds tended to decrease thereafter. There were significant differences between preoperative values and those 3 months after surgery, but there were no significant differences between preoperative values and these 6/12 months after surgery. Nasal respiratory mucosae observed 12 months after laryngectomy showed atrophic nasal mucosa in 11/14 patients. However, olfactory mucosae appeared normal in all of the patients observed. These results suggested that the function of the olfactory epithelium remained intact after laryngectomy.     

Retronasal but not oral-cavity-only identification of "purely olfactory" odorants

Identifications of 5 odorants selected to be nontrigeminal stimuli were compared using retronasal and oral-cavity-only (OCO) air-phase presentations, with OCO produced by both exhalation through the mouth and a nose clip that closed the nostrils. Nine identifiers were available on each trial; 1 or 2 were correct for each odorant. Correct retronasal identifications were more common than OCO identifications and exceeded chance across subjects and for each subject; OCO correct identifications did not exceed chance. Retronasal reaction times were briefer than OCO reaction times. Correct retronasal identifications for vanillin, octanoic acid, phenylethyl alcohol, coumarin, and octane were 88%, 73%, 87%, 70%, and 85%, respectively; correct OCO identifications were, respectively, 10%, 12%, 18%, 35%, and 33%. Identifiers selected for retronasally presented odorants differed from those for other retronasally presented odorants, but identifiers for OCO-presented odorants did not differ between odorants. Overall, the retronasal identifications of nontrigeminal odorants both depended upon the odorant that was presented and corresponded to previous reported orthonasal identifications. In contrast, the OCO identifications, characterized by low percentages of correct identifications and an absence of differences between odorants in selected identifiers, suggested that OCO responses to nontrigeminal, purely olfactory odorants lack sufficient sensory information for either correct or differential identification.     

Intranasal volume and olfactory function

The aim of this exploratory study was to identify the volume intranasal segments as they relate to parameters of olfactory function. Fifty healthy male volunteers (age range 22-59 years, mean age 28.5 years) were included. Olfactory function was measured by lateralized phenyl ethyl alcohol odor thresholds and odor discrimination, and by bilateral odor identification. Magnetic resonance imaging of the nasal cavity was performed immediately following olfactometry. To correlate the results of olfactometry with intranasal volume, each nasal cavity was divided into 11 segments. Significant correlations were found between the odor thresholds and volumes of the anterior part of the lower and upper meatus of the right nasal cavity. These results reveal that two nasal segments are important for inter-individual differences of odor thresholds in healthy subjects: (i) the segment in the upper meatus below the cribriform plate and (ii) the anterior segment of the inferior meatus. The latter finding is of special interest for nasal surgery, which allows modification of this volume through resection of the inferior turbinate and/or septoplasty.     

Partition coefficient and comparative olfactometry

The air/water partition coefficients of many odorants can becalculated from available data on their vapor pressures andsolubilities at 25°. A gas-flow method is described forobtaining equilibrium concentration data to calculate the coefficientsof certain odorants for which theoretical or gas chromatographictechniques are not applicable. It is shown that the odor thresholdsobtained in airdilution olfactometry agree with those measuredby sniff tests on aqueous dilutions, when the air/water partitioncoefficient is taken into consideration. Similar calculationsinvolving the oil/water partition coefficient show close correspondencebetween thresholds measured in water or safflower oil dilution.A conversion factor was obtained for comparing squeeze-bottlepair tests with stoppered flask 2/5 tests in the measurementof olfactory threshold.     

Olfactory sensitivity to conspecific bile fluid and skin mucus in the European eel Anguilla anguilla (L.)

The present study assessed the olfactory potency of conspecific bile fluid and skin mucus in the European eel Anguilla anguilla by the electro-olfactogram. Immature males showed high olfactory sensitivity to conspecific bile, giving large amplitude responses in a concentration-dependent manner with estimated thresholds of detection of <1:10⁷ ( n = 6). Mucus also proved to contain highly potent odorants with thresholds of detection of c . 1:10⁶ ( n = 6). Crude solid-phase extraction of bile fluid (C-18 and C-2/ENV+ cartridges) showed that the majority of olfactory activity in bile fluid was contained in the eluate of C-18 cartridges ( n = 6). There were quantitative differences, however, between the sexes; female bile fluid had a higher proportion of activity in this fraction. Similar solid-phase extraction of mucus showed that it contains a higher proportion of odorants in the C-18 filtrate than bile fluid. Mucus from mature eels, however, had a higher proportion of olfactory activity in the eluate than immature fish ( n = 6). Cross-adaptation experiments suggest that there are qualitative differences in the odorants contained in bile and mucus depending on both the sex and state of sexual maturation of the donor ( n = 6). These results are consistent with a role for chemical communication in the reproduction of the European eel and suggest that both bile and mucus are potential sources of the odorants involved.     

Cross-adaptation between olfactory responses induced by two subgroups of odorant molecules

It has long been believed that vertebrate olfactory signal transduction is mediated by independent multiple pathways (using cAMP and InsP3 as second messengers). However, the dual presence of parallel pathways in the olfactory receptor cell is still controversial, mainly because of the lack of information regarding the single-cell response induced by odorants that have been shown to produce InsP3 exclusively (but not cAMP) in the olfactory cilia. In this study, we recorded activities of transduction channels of single olfactory receptor cells to InsP3-producing odorants. When the membrane potential was held at -54 mV, application of InsP3-producing odorants to the ciliary region caused an inward current. The reversal potential was 0 +/- 7 mV (mean +/- SD, n = 10). Actually, InsP3-producing odorants generated responses in a smaller fraction of cells (lilial, 3.4%; lyral, 1.7%) than the cAMP-producing odorant (cineole, 26%). But, fundamental properties of responses were surprisingly homologous; namely, spatial distribution of the sensitivity, waveforms, I-V relation, and reversal potential, dose dependence, time integration of stimulus period, adaptation, and recovery. By applying both types of odorants alternatively to the same cell, furthermore, we observed cells to exhibit symmetrical cross-adaptation. It seems likely that even with odorants with different modalities adaptation occurs completely depending on the amount of current flow. The data will also provide evidence showing that olfactory response generation and adaptation are regulated by a uniform mechanism for a wide variety of odorants.     

Variability of olfactory thresholds

It is well known from earlier studies that olfactory thresholdsare extremely variable across subjects. The present study demonstratesthat the major source of this variability is the fluctuationof any individual's threshold over time. Each of the three subjectsgave 60 thresholds, two on each of 30 testing days and 20 eachfor three odorants: butanol, pyridine and ß-phenylethylmethylethylcarbinol.The variability of each subject was of comparable magnitudeto that encountered among large groups of subjects tested onlyonce. In contrast, the mean thresholds of the three subjectswere much alike. The outcome suggests that the extreme fluctuationsof threshold from one test to another may tend to obscure realand stable average differences among subjects' olfactory keennessor dullness.     

Evidence for deficiencies in perceptual and semantic olfactory processes in Parkinson's disease

Olfactory deficits have been reported in Parkinson's disease (PD) and are thought to represent a sensitive marker of the disease. The aim of the present study was to examine the differential contribution in olfactory dysfunction of perceptual and semantic processes of odours in PD patients. Twenty-four PD patients (12 males and 12 females) and 24 control subjects (12 males and 12 females) were tested. The experiment included two sessions. Initially, 12 odorants were delivered, one per minute. For each odour, subjects were asked to rate intensity, pleasantness, familiarity and edibility using linear rating scales. The odorants were again presented and the subjects were asked to identify them. The four olfactory judgements and odour identification were severely disturbed in PD patients when compared to control subjects. These findings demonstrate major deficits for all cognitive tasks of olfactory judgement in PD, and suggest that PD is associated with disruption of olfactory areas situated in the temporal lobes and also in the prefrontal cortex.     

'Sniffin' Sticks': Olfactory Performance Assessed by the Combined Testing of Odour Identification, Odor Discrimination and Olfactory Threshold

‘Sniffin’ Sticks' is a new test of nasal chemosensoryperformance based on pen-like odor dispensing devices. It comprisesthree tests of olfactory function, namely tests for odor threshold(n-butanol, testing by means of a single staircase), odor discrimination(15 pairs of odorants, triple forced choice) and odor identification(16 common odorants, multiple forced choice from four verbalitems per test odorant). After extensive preliminary investigationsthe tests were applied to a group of 104 healthy volunteers(52 female, 52 male, mean age 49.5 years, range 18–84years) in order to establish test-retest reliability and tocompare them with an established measure of olfactory performance(the Connecticut Chemosensory Clinical Research Center Test,CCCRC). Performance decreased with increasing age of the subjects(     

Olfactory function in patients with hypogonadotropic hypogonadism: an all-or-none phenomenon?

Hypogonadotropic hypogonadism (HH) refers to an endocrine defectof hypothalamic origin resulting in gonadal hypoplasia and frequentlyassociated with anosmia or severely impaired olfactory function(Kallmann's syndrome). This apparently results from a disruptionin the migration of neurons from the olfactory placode to thebulb and hypothalamus early in development, and so providesa unique opportunity to investigate olfactory function in humansubjects with congenitally incomplete peripheral systems. Olfactoryperformance in 37 HH patients and 37 age-matched controls wascompared using a modified version of the Munich Olfaction Test.This test is based on the sniff-bottle method and includes testsof (i) odor quality discrimination, (ii) intensity discrimination,(iii) detection thresholds, and (iv) recognition, hedonic evaluationand identification ability. The patients could be divided intotwo distinct groups differing significantly on all four subtestsand showing no overlap in performance: 20 anosmics, conformingto Kallmann's syndrome, and 17 apparent normosmics whose performancewas slightly poorer, but not significantly different to thatof the controls. The unexpected failure to find a continuumof olfactory dysfunction now raises the question whether HHwith or without anosmia represents two syndromes with distinctetiologies, or rather reflects the ability of the olfactorysystem to function well despite morphological impairment.     

Ratings of different olfactory judgements in schizophrenia

We assessed the influence of schizophrenia on different olfactory tasks. Forty patients with schizophrenia (20 males and 20 females) and 40 control subjects (20 males and 20 females) were tested. The experiment included two sessions. Initially, 12 odorants were presented at a rate of one per minute. The subjects were asked to rate intensity, pleasantness, familiarity and edibility for each odour using linear rating scales. The odorants were then presented a second time and the subjects were asked to identify them. The results showed that the scores for pleasantness, familiarity, edibility and identification but not intensity were disturbed in patients when compared with control subjects. Furthermore, the familiarity judgement of male patients was more often deficient than that of female patients and they rated odorants as being inedible when the women judged them as neutral. Considered together, these data show that our olfactory test may be used in patients with schizophrenia for evidencing various dysfunctions specific to different types of olfactory processing that represent steps in the odour name identification process.     

High-throughput Analysis of Mammalian Olfactory Receptors: Measurement of Receptor Activation via Luciferase Activity

Odorants create unique and overlapping patterns of olfactory receptor activation, allowing a family of approximately 1,000 murine and 400 human receptors to recognize thousands of odorants. Odorant ligands have been published for fewer than 6% of human receptors^1-11. This lack of data is due in part to difficulties functionally expressing these receptors in heterologous systems. Here, we describe a method for expressing the majority of the olfactory receptor family in Hana3A cells, followed by high-throughput assessment of olfactory receptor activation using a luciferase reporter assay. This assay can be used to (1) screen panels of odorants against panels of olfactory receptors; (2) confirm odorant/receptor interaction via dose response curves; and (3) compare receptor activation levels among receptor variants. In our sample data, 328 olfactory receptors were screened against 26 odorants. Odorant/receptor pairs with varying response scores were selected and tested in dose response. These data indicate that a screen is an effective method to enrich for odorant/receptor pairs that will pass a dose response experiment, i.e. receptors that have a bona fide response to an odorant. Therefore, this high-throughput luciferase assay is an effective method to characterize olfactory receptors—an essential step toward a model of odor coding in the mammalian olfactory system.