A recently published prospective study marks a breakthrough for congenital olfactory disorders in children.The study provides the first long-term,three-year follow-up data,robustly demonstrating the durable efficacy a...A recently published prospective study marks a breakthrough for congenital olfactory disorders in children.The study provides the first long-term,three-year follow-up data,robustly demonstrating the durable efficacy and safety of autologous nasal epithelial stem cell transplantation.This work reveals immense therapeutic potential for a condition traditionally considered untreatable.However,this milestone achievement also presents new challenges.To translate this pioneering therapy from a single-center success to a global standard,multicenter,controlled clinical trials must be initiated immediately.Only through rigorous validation can we ensure its widespread adoption and ultimately bring hope to millions of children worldwide.展开更多
Objectives:2019 novel coronavirus disease(COVID-19)infection is commonly associated with olfactory dysfunctions,but the basic pathogenesis of these complications remains controversial.This study seeks to evaluate the ...Objectives:2019 novel coronavirus disease(COVID-19)infection is commonly associated with olfactory dysfunctions,but the basic pathogenesis of these complications remains controversial.This study seeks to evaluate the value of magnetic resonance spectroscopy(MRS)in determining the molecular neurometabolite alterations within the main brain olfactory areas in patients with COVID-19-related anosmia.Methods:In a cross-sectional study,seven patients with persistent COVID-19-related anosmia(mean age:29.57 years)and seven healthy volunteers(mean age:27.28 years)underwent MRS in which N-acetyl-aspartate(NAA),choline(Cho),creatine(Cr),and their ratios were measured in the anterior cingulate cortex,dorsolateral prefrontal cortex,orbitofrontal cortex(OFC),insular cortex,and ventromedial prefrontal cortex.Data were analyzed using TARQUIN software(version 4.3.10),and the results were compared with an independent sample t-test and nonparametric Mann-Whitney test based on the normality of the MRS data distribution.Results:The mean duration of anosmia before imaging was 8.5 months in COVID-19-related anosmia group.MRS analysis elucidated a significant association between MRS findings within OFC and COVID-19-related anosmia(P_(disease)<0.01),and NAA was among the most important neurometabolites(P_(interaction)=0.006).Reduced levels of NAA(P<0.001),Cr(P<0.001)and^(NAA)/Cho ratio(P=0.007)within OFC characterize COVID-19-related anosmia.Conclusions:This study emphasizes that MRS can be illuminating in COVID-19-related anosmia and indicates a possible association between central nervous system impairment and persistent COVID-19-related anosmia.展开更多
BACKGROUND Congenital olfactory disorders(CODs)are rare but impactful conditions that impair the sense of smell from birth.These disorders can significantly affect a child’s appetite,nutrition,safety awareness,and ov...BACKGROUND Congenital olfactory disorders(CODs)are rare but impactful conditions that impair the sense of smell from birth.These disorders can significantly affect a child’s appetite,nutrition,safety awareness,and overall quality of life.Despite their clinical importance,treatment options for CODs remain limited and largely ineffective,with no established therapies capable of restoring olfactory function in pediatric patients.Recent advances in regenerative medicine and stem cell therapy offer promising avenues for addressing sensory deficits.Nasal epithelial stem cells have emerged as a viable candidate for therapeutic intervention due to their accessibility and intrinsic ability to differentiate into olfactory sensory neurons.Preliminary studies suggest their potential in promoting the re-generation of the olfactory epithelium and functional recovery.However,long-term data on the efficacy and safety of such approaches in children are lacking.AIM To evaluate the long-term efficacy and safety of autologous nasal epithelial stem cell transplantation for the treatment of CODs in children.METHODS This prospective,single-center study enrolled 50 children aged 3-15 years with CODs.All patients underwent autologous nasal epithelial stem cell transplantation and were followed up for 3 years.The primary outcome measure was change in olfactory function,assessed using the Sniffin’Sticks test and the University of Pennsylvania Smell Identification Test-Children’s Version.Secondary outcomes included quality of life(measured by the Pediatric Quality of Life Inventory™and a custom olfaction-specific questionnaire),safety,endoscopic evaluation,and electro-olfactogram measurements.Data were analyzed using repeated measures analysis of variance,Friedman’s test,and multiple regression analysis.RESULTS The mean composite olfactory score increased from 8.3±4.7 at baseline to 52.6±18.9 at the 3-year follow-up(P<0.001).Significant improvement(≥50%increase in score)was observed in 60%of patients,with 24%showing moderate improvement.Quality of life scores improved significantly across all domains(P<0.001).No serious adverse events were reported.Minor complications occurred in 16%of patients,which resolved within 2 weeks.Endoscopic evaluation revealed normal-appearing olfactory epithelium in 84%of patients at 3 years,compared to 24%at baseline(P<0.001).Electro-olfactogram amplitudes increased from 0.11±0.08 mV to 0.67±0.31 mV(P<0.001).Age at intervention(β=0.31,P=0.02)and baseline residual olfactory function(β=0.45,P<0.001)were positively associated with treatment outcomes.CONCLUSION Autologous nasal epithelial stem cell transplantation demonstrates significant and sustained improvements in olfactory function and quality of life in children with CODs,with a favorable safety profile over a 3-year follow-up period.This approach represents a promising advancement in the treatment of pediatric sensory disorders.展开更多
The olfactory system is one of a few areas in the nervous system which is capable of regeneration throughout the life.Olfactory sensory neurons reside in the nasal cavity are continuously replenished with new neurons ...The olfactory system is one of a few areas in the nervous system which is capable of regeneration throughout the life.Olfactory sensory neurons reside in the nasal cavity are continuously replenished with new neurons arising from stem cells.Some factors such as aging,neurodegenerative diseases,head trauma,brain tumor extraction and infection cause olfactory dysfunction which significantly influences physical wellbeing,quality of life,mental health,nutritional status,memory processes,identifying danger and is associated with increased mortality.Therefore,finding a treatment to improve olfactory dysfunction is needed.Recent research efforts in the field have shown some very promising new approaches to treat olfactory dysfunction.This review explores the current studies that have addressed therapeutic approaches to improve olfactory neuron regeneration based on cell transplantation therapy,modulation of physiological olfactory dysfunction and drug treatments.展开更多
Objective The scientific community knows little about the long-term influence of coronavirus disease2019(COVID-19) on olfactory dysfunction(OD). With the COVID-19 pandemic ongoing worldwide, the risk of imported cases...Objective The scientific community knows little about the long-term influence of coronavirus disease2019(COVID-19) on olfactory dysfunction(OD). With the COVID-19 pandemic ongoing worldwide, the risk of imported cases remains high. In China, it is necessary to understand OD in imported cases.Methods A prospective follow-up design was adopted. A total of 11 self-reported patients with COVID-19 and OD from Xi’an No. 8 Hospital were followed between August 19, 2021, and December 12, 2021.Demographics, clinical characteristics, laboratory and radiological findings, and treatment outcomes were analyzed at admission. We surveyed the patients via telephone for recurrence and sequelae at the1-, 6-, and 12-month follow-up.Results Eleven patients with OD were enrolled;of these, 54.5%(6/11) had hyposmia and 45.5%(5/11)had anosmia. 63.6%(7/11) reported OD before or on the day of admission as their initial symptom;of these, 42.9%(3/7) described OD as the only symptom. All patients in the study received combined treatment with traditional Chinese medicine and Western medicine, and 72.7%(8/11) had partially or fully recovered at discharge. In terms of OD recovery at the 12-month follow-up, 45.5%(5/11) reported at least one sequela, 81.8%(9/11) had recovered completely, 18.2%(2/11) had recovered partially, and there were no recurrent cases.Conclusions Our data revealed that OD frequently presented as the initial or even the only symptom among imported cases. Most OD improvements occurred in the first 2 weeks after onset, and patients with COVID-19 and OD had favorable treatment outcomes during long-term follow-up. A better understanding of the pathogenesis and appropriate treatment of OD is needed to guide clinicians in the care of these patients.展开更多
Background Anosmia is one of the symptoms in individuals with SARS-CoV-2 infection.In anosmic patients,SARS-CoV-2 temporarily alters the signaling process in olfactory nerve cells and olfactory bulb(OB),which eventual...Background Anosmia is one of the symptoms in individuals with SARS-CoV-2 infection.In anosmic patients,SARS-CoV-2 temporarily alters the signaling process in olfactory nerve cells and olfactory bulb(OB),which eventually damages the structure of the olfactory epithelium,leading to a permanent disorder in the olfactory pathway that this damaged structure is showed in MRI imaging Method Two investigators independently searched four databases consisting of PubMed,ProQuest,Scopus,and Web of Science for relevant records as of November 11,2020 with no time,space,and language restrictions.Google Scholar was also searched for the related resources within the time limit of 2020.All the found articles were reviewed based on the PRISMA flow diagram.Qualitative studies,case reports,editorials,letters,and other non-original studies were excluded from this systematic analysis.Results Initial search yielded 434 records.After reviewing the titles and abstracts,we selected 74 articles;finally,8 articles were depicted to be investigated and read in full text.The obtained results showed an increase in the width and volume of the olfactory cleft(OC),complete or partial destruction of OC,and complete occlusion of OC in COVID-19 patients.Deformation and degeneration as well as a subtle asymmetry were evident in the OBs.Computed tomography(CT),meganetic resonance imaging(MRI),and positron emission tomography(PET)were used to detect the outcomes of anosmia in these studies.Conclusions The changes in OC are greater than those in OB in patients with COVID-19,mainly due to the inflammatory and immune responses in OC.However,fewer changes in OB are due to neurological or vascular disorders.Topical steroid therapy and topical saline can be helpful.展开更多
Traumatic brain injury(TBI)is among the leading causes of death and disability all over the globe.TBI is also commonly associated with clinical sequelae of posttraumatic depression,and reports of other subsequent affe...Traumatic brain injury(TBI)is among the leading causes of death and disability all over the globe.TBI is also commonly associated with clinical sequelae of posttraumatic depression,and reports of other subsequent affective distress are common.Similarly,posttraumatic changes in chemoreceptive sensory functions,primarily due to coup-contrecoup injury induced shearing of the olfactory nerve fibers,leading to anosmia and ageusia are also well documented in the literature.However,the current literature is limited in addressing the intersections between said variables.The aim of this study was to provide a focused narrative review of the literature,to address these intersections found in clinical sequelae of TBI.As chemoreceptive sensory deficits are also linked to significant affective distress of their own,this review addresses the bidirectionality between sensory deficit and affective distress.Prevalence,demographics,mechanisms,and clinical implications are presented.Previous research is presented and discussed,in an effort to highlight the importance of consideration for all factors in TBI patient care and future research.展开更多
Methods: Asystematic literature search was performed using PUBMED for all English articles up to April 2014. Although this review mainly focuses on published human studies, it also draws attention to where future rese...Methods: Asystematic literature search was performed using PUBMED for all English articles up to April 2014. Although this review mainly focuses on published human studies, it also draws attention to where future research should be directed based on animal studies. Results: Besides the 9 known mutations widely quoted for KS namely KAL1, Fibroblast growth factor 8 (FGF8), fibroblast growth factor receptor 1 (FGFR1), prokineticin 2 (PROK2), PROK receptor 2 (PROKR2), WDR11, heparin sulfate-6-O-Transferase (HS6T1), chromodomain helicase DNA binding protein 7 (CHD7) and semaphorin 3A (SEMA 3A), additional mutations in “FGF8 synexpression” group e.g., FGF 17, ILRD, DUSP 6, SPRY4 and FLRT3 have been shown to be involved in CHH, mostly KS besides SEMA 7A. Although traditionally division has been based on anosmic/normosnic criteria, further genes found to cause so called nIHH like Gonadotropin releasing hormone receptor (GNRHR). KISS1, TAC3, TACR3 have also been found to be associated with hyposmia on detailed testing on UPSIT and MRI for olfactory structures revealed absent OB. Further detailed examination of transcription factor genes have revealed involvement of HESX1, TSHZ1, AXL, SOX10 with a strong overlap of in transcription factors in development of septooptic dysplasia (SOD), combined pituitary hormone deficiency (CHPD) and KS. Treatment with rFSH/-hCG gives almost similar results to pulsatile GnRH therapy and should be based on cost factor, availability and in occasional cases specific treatment like kisspeptin therapy. Conclusions: Contrary to the traditional thinking, one shoud reconsider classifying cases of IHH simply on basis of anosmia/normosmia. Deafness calls for looking for mutations in Sox 10/CHD7/ILRD7 considering 38% association of former. Therapy should be individualized based on availability of pulsatile GnRH, cost factor and in recalcitrant cases kp therapy may be of use with kp mutations and NKB mutations.展开更多
BACKGROUND Anosmia was one of the main symptoms of coronavirus disease 2019(COVID-19).A psychiatric history(i.e.,depression)may be an independent contributor to the risk of COVID-19 diagnosis,and COVID-19 survivors ap...BACKGROUND Anosmia was one of the main symptoms of coronavirus disease 2019(COVID-19).A psychiatric history(i.e.,depression)may be an independent contributor to the risk of COVID-19 diagnosis,and COVID-19 survivors appear to have an increased risk of neuropsychiatric sequelae(bidirectional association).AIM To compare the rate of psychiatric disorder among post-COVID patients without anosmia vs patients with persistent olfactory complaints.METHODS We conducted a prospective case control study from March 2020 to May 2021.Patients recruited at the ENT department of Nice University Hospital had a subjective olfactory complaint(visual analogue scale)for over 6 wk and a molecular or CT-proven severe acute respiratory syndrome coronavirus 2 diagnosis confirmed by serology.Post-COVID patients without persistent olfactory disorders were recruited at the university hospital infectiology department.Psychiatric medical histories were collected by a psychiatrist during the assessments.RESULTS Thirty-four patients with post-COVID-19 olfactory complaints were included in the first group of the study.Fifty percent of the patients were female(n=17).The group’s mean age was 40.5±12.9 years.The control group included 32 participants,of which 34.4%were female(n=11),and had a mean age of 61.2±12.2 years.The rate of psychiatric disorder among post-COVID patients with olfactory complaints was significatively higher(41.7%)than among patients without(18.8%)(χ2=5.9,P=0.015).CONCLUSION The presence of a psychiatric history may constitute a potential risk factor for the development of long COVID due to persistent anosmia.It therefore seems important to establish reinforced health monitoring after a COVID 19 infection in at-risk patients.Further prospective,translational,and collaborative studies are needed to extrapolate these results to the general population.展开更多
The nose and the oral cavities are the main sites for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)entry into the body.Smell and taste deficits are the most common acute viral manifestations.Persistent s...The nose and the oral cavities are the main sites for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)entry into the body.Smell and taste deficits are the most common acute viral manifestations.Persistent smell disorders are the most common and bothersome complications after SARS-CoV-2 infection,lasting for months to years.The mechanisms and treatment of persistent post-coronavirus disease 2019(COVID-19)smell and taste disorders are still challenges.Information sources for the review are PubMed,Centers for Disease Control and Prevention,Ovid Medline,Embase,Scopus,Web of Science,International Prospective Register of Systematic Reviews,Cumulative Index to Nursing and Allied Health Literature,Elton Bryson Stephens Company,Cochrane Effective Practice and Organization of Care,Cooperation in Science and Technology,International Clinical Trials Registry Platform,World Health Organization,Randomized Controlled Trial Number Registry,and MediFind.This review summarizes the up-to-date information about the prevalence,patterns at onset,and prognoses of post-COVID-19 smell and taste disorders,evidence for the neurotropism of SARS-CoV-2 and the overlap between SARSCoV-1,Middle East respiratory syndrome coronavirus,and SARS-CoV-2 in structure,molecular biology,mode of replication,and host pathogenicity,the suggested cellular and molecular mechanisms for these post-COVID19 chemosensory disorders,and the applied pharmacotherapies and interventions as trials to treat these disorders,and the recommendations for future research to improve understanding of predictors and mechanisms of these disorders.These are crucial for hopeful proper treatment strategies.展开更多
文摘A recently published prospective study marks a breakthrough for congenital olfactory disorders in children.The study provides the first long-term,three-year follow-up data,robustly demonstrating the durable efficacy and safety of autologous nasal epithelial stem cell transplantation.This work reveals immense therapeutic potential for a condition traditionally considered untreatable.However,this milestone achievement also presents new challenges.To translate this pioneering therapy from a single-center success to a global standard,multicenter,controlled clinical trials must be initiated immediately.Only through rigorous validation can we ensure its widespread adoption and ultimately bring hope to millions of children worldwide.
文摘Objectives:2019 novel coronavirus disease(COVID-19)infection is commonly associated with olfactory dysfunctions,but the basic pathogenesis of these complications remains controversial.This study seeks to evaluate the value of magnetic resonance spectroscopy(MRS)in determining the molecular neurometabolite alterations within the main brain olfactory areas in patients with COVID-19-related anosmia.Methods:In a cross-sectional study,seven patients with persistent COVID-19-related anosmia(mean age:29.57 years)and seven healthy volunteers(mean age:27.28 years)underwent MRS in which N-acetyl-aspartate(NAA),choline(Cho),creatine(Cr),and their ratios were measured in the anterior cingulate cortex,dorsolateral prefrontal cortex,orbitofrontal cortex(OFC),insular cortex,and ventromedial prefrontal cortex.Data were analyzed using TARQUIN software(version 4.3.10),and the results were compared with an independent sample t-test and nonparametric Mann-Whitney test based on the normality of the MRS data distribution.Results:The mean duration of anosmia before imaging was 8.5 months in COVID-19-related anosmia group.MRS analysis elucidated a significant association between MRS findings within OFC and COVID-19-related anosmia(P_(disease)<0.01),and NAA was among the most important neurometabolites(P_(interaction)=0.006).Reduced levels of NAA(P<0.001),Cr(P<0.001)and^(NAA)/Cho ratio(P=0.007)within OFC characterize COVID-19-related anosmia.Conclusions:This study emphasizes that MRS can be illuminating in COVID-19-related anosmia and indicates a possible association between central nervous system impairment and persistent COVID-19-related anosmia.
基金Supported by Hangzhou Medical and Health Technology Project,No.B20210443.
文摘BACKGROUND Congenital olfactory disorders(CODs)are rare but impactful conditions that impair the sense of smell from birth.These disorders can significantly affect a child’s appetite,nutrition,safety awareness,and overall quality of life.Despite their clinical importance,treatment options for CODs remain limited and largely ineffective,with no established therapies capable of restoring olfactory function in pediatric patients.Recent advances in regenerative medicine and stem cell therapy offer promising avenues for addressing sensory deficits.Nasal epithelial stem cells have emerged as a viable candidate for therapeutic intervention due to their accessibility and intrinsic ability to differentiate into olfactory sensory neurons.Preliminary studies suggest their potential in promoting the re-generation of the olfactory epithelium and functional recovery.However,long-term data on the efficacy and safety of such approaches in children are lacking.AIM To evaluate the long-term efficacy and safety of autologous nasal epithelial stem cell transplantation for the treatment of CODs in children.METHODS This prospective,single-center study enrolled 50 children aged 3-15 years with CODs.All patients underwent autologous nasal epithelial stem cell transplantation and were followed up for 3 years.The primary outcome measure was change in olfactory function,assessed using the Sniffin’Sticks test and the University of Pennsylvania Smell Identification Test-Children’s Version.Secondary outcomes included quality of life(measured by the Pediatric Quality of Life Inventory™and a custom olfaction-specific questionnaire),safety,endoscopic evaluation,and electro-olfactogram measurements.Data were analyzed using repeated measures analysis of variance,Friedman’s test,and multiple regression analysis.RESULTS The mean composite olfactory score increased from 8.3±4.7 at baseline to 52.6±18.9 at the 3-year follow-up(P<0.001).Significant improvement(≥50%increase in score)was observed in 60%of patients,with 24%showing moderate improvement.Quality of life scores improved significantly across all domains(P<0.001).No serious adverse events were reported.Minor complications occurred in 16%of patients,which resolved within 2 weeks.Endoscopic evaluation revealed normal-appearing olfactory epithelium in 84%of patients at 3 years,compared to 24%at baseline(P<0.001).Electro-olfactogram amplitudes increased from 0.11±0.08 mV to 0.67±0.31 mV(P<0.001).Age at intervention(β=0.31,P=0.02)and baseline residual olfactory function(β=0.45,P<0.001)were positively associated with treatment outcomes.CONCLUSION Autologous nasal epithelial stem cell transplantation demonstrates significant and sustained improvements in olfactory function and quality of life in children with CODs,with a favorable safety profile over a 3-year follow-up period.This approach represents a promising advancement in the treatment of pediatric sensory disorders.
基金supported by a grant from the Perry Cross Spinal Research Foundation to FC,JASTby Queensland University of Technology to FC
文摘The olfactory system is one of a few areas in the nervous system which is capable of regeneration throughout the life.Olfactory sensory neurons reside in the nasal cavity are continuously replenished with new neurons arising from stem cells.Some factors such as aging,neurodegenerative diseases,head trauma,brain tumor extraction and infection cause olfactory dysfunction which significantly influences physical wellbeing,quality of life,mental health,nutritional status,memory processes,identifying danger and is associated with increased mortality.Therefore,finding a treatment to improve olfactory dysfunction is needed.Recent research efforts in the field have shown some very promising new approaches to treat olfactory dysfunction.This review explores the current studies that have addressed therapeutic approaches to improve olfactory neuron regeneration based on cell transplantation therapy,modulation of physiological olfactory dysfunction and drug treatments.
基金funded by the COVID-19 Project of Shaanxi Administration of Traditional Chinese Medicine[SZY-KJCYC-2020-YJ002]the COVID-19 Project of National Administration of Traditional Chinese Medicine[2020ZYLCYJ06-4]and the CACMS Innovation Fund[CI2021A00704].
文摘Objective The scientific community knows little about the long-term influence of coronavirus disease2019(COVID-19) on olfactory dysfunction(OD). With the COVID-19 pandemic ongoing worldwide, the risk of imported cases remains high. In China, it is necessary to understand OD in imported cases.Methods A prospective follow-up design was adopted. A total of 11 self-reported patients with COVID-19 and OD from Xi’an No. 8 Hospital were followed between August 19, 2021, and December 12, 2021.Demographics, clinical characteristics, laboratory and radiological findings, and treatment outcomes were analyzed at admission. We surveyed the patients via telephone for recurrence and sequelae at the1-, 6-, and 12-month follow-up.Results Eleven patients with OD were enrolled;of these, 54.5%(6/11) had hyposmia and 45.5%(5/11)had anosmia. 63.6%(7/11) reported OD before or on the day of admission as their initial symptom;of these, 42.9%(3/7) described OD as the only symptom. All patients in the study received combined treatment with traditional Chinese medicine and Western medicine, and 72.7%(8/11) had partially or fully recovered at discharge. In terms of OD recovery at the 12-month follow-up, 45.5%(5/11) reported at least one sequela, 81.8%(9/11) had recovered completely, 18.2%(2/11) had recovered partially, and there were no recurrent cases.Conclusions Our data revealed that OD frequently presented as the initial or even the only symptom among imported cases. Most OD improvements occurred in the first 2 weeks after onset, and patients with COVID-19 and OD had favorable treatment outcomes during long-term follow-up. A better understanding of the pathogenesis and appropriate treatment of OD is needed to guide clinicians in the care of these patients.
文摘Background Anosmia is one of the symptoms in individuals with SARS-CoV-2 infection.In anosmic patients,SARS-CoV-2 temporarily alters the signaling process in olfactory nerve cells and olfactory bulb(OB),which eventually damages the structure of the olfactory epithelium,leading to a permanent disorder in the olfactory pathway that this damaged structure is showed in MRI imaging Method Two investigators independently searched four databases consisting of PubMed,ProQuest,Scopus,and Web of Science for relevant records as of November 11,2020 with no time,space,and language restrictions.Google Scholar was also searched for the related resources within the time limit of 2020.All the found articles were reviewed based on the PRISMA flow diagram.Qualitative studies,case reports,editorials,letters,and other non-original studies were excluded from this systematic analysis.Results Initial search yielded 434 records.After reviewing the titles and abstracts,we selected 74 articles;finally,8 articles were depicted to be investigated and read in full text.The obtained results showed an increase in the width and volume of the olfactory cleft(OC),complete or partial destruction of OC,and complete occlusion of OC in COVID-19 patients.Deformation and degeneration as well as a subtle asymmetry were evident in the OBs.Computed tomography(CT),meganetic resonance imaging(MRI),and positron emission tomography(PET)were used to detect the outcomes of anosmia in these studies.Conclusions The changes in OC are greater than those in OB in patients with COVID-19,mainly due to the inflammatory and immune responses in OC.However,fewer changes in OB are due to neurological or vascular disorders.Topical steroid therapy and topical saline can be helpful.
文摘Traumatic brain injury(TBI)is among the leading causes of death and disability all over the globe.TBI is also commonly associated with clinical sequelae of posttraumatic depression,and reports of other subsequent affective distress are common.Similarly,posttraumatic changes in chemoreceptive sensory functions,primarily due to coup-contrecoup injury induced shearing of the olfactory nerve fibers,leading to anosmia and ageusia are also well documented in the literature.However,the current literature is limited in addressing the intersections between said variables.The aim of this study was to provide a focused narrative review of the literature,to address these intersections found in clinical sequelae of TBI.As chemoreceptive sensory deficits are also linked to significant affective distress of their own,this review addresses the bidirectionality between sensory deficit and affective distress.Prevalence,demographics,mechanisms,and clinical implications are presented.Previous research is presented and discussed,in an effort to highlight the importance of consideration for all factors in TBI patient care and future research.
文摘Methods: Asystematic literature search was performed using PUBMED for all English articles up to April 2014. Although this review mainly focuses on published human studies, it also draws attention to where future research should be directed based on animal studies. Results: Besides the 9 known mutations widely quoted for KS namely KAL1, Fibroblast growth factor 8 (FGF8), fibroblast growth factor receptor 1 (FGFR1), prokineticin 2 (PROK2), PROK receptor 2 (PROKR2), WDR11, heparin sulfate-6-O-Transferase (HS6T1), chromodomain helicase DNA binding protein 7 (CHD7) and semaphorin 3A (SEMA 3A), additional mutations in “FGF8 synexpression” group e.g., FGF 17, ILRD, DUSP 6, SPRY4 and FLRT3 have been shown to be involved in CHH, mostly KS besides SEMA 7A. Although traditionally division has been based on anosmic/normosnic criteria, further genes found to cause so called nIHH like Gonadotropin releasing hormone receptor (GNRHR). KISS1, TAC3, TACR3 have also been found to be associated with hyposmia on detailed testing on UPSIT and MRI for olfactory structures revealed absent OB. Further detailed examination of transcription factor genes have revealed involvement of HESX1, TSHZ1, AXL, SOX10 with a strong overlap of in transcription factors in development of septooptic dysplasia (SOD), combined pituitary hormone deficiency (CHPD) and KS. Treatment with rFSH/-hCG gives almost similar results to pulsatile GnRH therapy and should be based on cost factor, availability and in occasional cases specific treatment like kisspeptin therapy. Conclusions: Contrary to the traditional thinking, one shoud reconsider classifying cases of IHH simply on basis of anosmia/normosmia. Deafness calls for looking for mutations in Sox 10/CHD7/ILRD7 considering 38% association of former. Therapy should be individualized based on availability of pulsatile GnRH, cost factor and in recalcitrant cases kp therapy may be of use with kp mutations and NKB mutations.
文摘BACKGROUND Anosmia was one of the main symptoms of coronavirus disease 2019(COVID-19).A psychiatric history(i.e.,depression)may be an independent contributor to the risk of COVID-19 diagnosis,and COVID-19 survivors appear to have an increased risk of neuropsychiatric sequelae(bidirectional association).AIM To compare the rate of psychiatric disorder among post-COVID patients without anosmia vs patients with persistent olfactory complaints.METHODS We conducted a prospective case control study from March 2020 to May 2021.Patients recruited at the ENT department of Nice University Hospital had a subjective olfactory complaint(visual analogue scale)for over 6 wk and a molecular or CT-proven severe acute respiratory syndrome coronavirus 2 diagnosis confirmed by serology.Post-COVID patients without persistent olfactory disorders were recruited at the university hospital infectiology department.Psychiatric medical histories were collected by a psychiatrist during the assessments.RESULTS Thirty-four patients with post-COVID-19 olfactory complaints were included in the first group of the study.Fifty percent of the patients were female(n=17).The group’s mean age was 40.5±12.9 years.The control group included 32 participants,of which 34.4%were female(n=11),and had a mean age of 61.2±12.2 years.The rate of psychiatric disorder among post-COVID patients with olfactory complaints was significatively higher(41.7%)than among patients without(18.8%)(χ2=5.9,P=0.015).CONCLUSION The presence of a psychiatric history may constitute a potential risk factor for the development of long COVID due to persistent anosmia.It therefore seems important to establish reinforced health monitoring after a COVID 19 infection in at-risk patients.Further prospective,translational,and collaborative studies are needed to extrapolate these results to the general population.
文摘The nose and the oral cavities are the main sites for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)entry into the body.Smell and taste deficits are the most common acute viral manifestations.Persistent smell disorders are the most common and bothersome complications after SARS-CoV-2 infection,lasting for months to years.The mechanisms and treatment of persistent post-coronavirus disease 2019(COVID-19)smell and taste disorders are still challenges.Information sources for the review are PubMed,Centers for Disease Control and Prevention,Ovid Medline,Embase,Scopus,Web of Science,International Prospective Register of Systematic Reviews,Cumulative Index to Nursing and Allied Health Literature,Elton Bryson Stephens Company,Cochrane Effective Practice and Organization of Care,Cooperation in Science and Technology,International Clinical Trials Registry Platform,World Health Organization,Randomized Controlled Trial Number Registry,and MediFind.This review summarizes the up-to-date information about the prevalence,patterns at onset,and prognoses of post-COVID-19 smell and taste disorders,evidence for the neurotropism of SARS-CoV-2 and the overlap between SARSCoV-1,Middle East respiratory syndrome coronavirus,and SARS-CoV-2 in structure,molecular biology,mode of replication,and host pathogenicity,the suggested cellular and molecular mechanisms for these post-COVID19 chemosensory disorders,and the applied pharmacotherapies and interventions as trials to treat these disorders,and the recommendations for future research to improve understanding of predictors and mechanisms of these disorders.These are crucial for hopeful proper treatment strategies.
