Smelling multiple sclerosis: Different qualities of olfactory function reflect either inflammatory activity or neurodegeneration

2018 ◽  
Vol 26 (1) ◽  
pp. 57-68 ◽  
Author(s):  
Gabriel Bsteh ◽  
Klaus Berek ◽  
Harald Hegen ◽  
Barbara Teuchner ◽  
Michael Auer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Function ◽  
Disease Duration ◽  
Olfactory Function ◽  
Odor Identification ◽  
Linear Regression Models ◽  
Olfactory Threshold ◽  
Short Term ◽  
Fiber Layer ◽  
Cross Sectional

Background: Peripapillary retinal nerve fiber layer (pRNFL) thickness and olfactory function are both emerging biomarkers in multiple sclerosis (MS). Impairment of odor identification and discrimination is an irreversible feature of more advanced MS suggested to be associated with neurodegeneration, while olfactory threshold is a transient feature of early, active MS possibly associated with short-term inflammatory disease activity. Objective: The aim of this study was to validate the association of olfactory (dys)function and parameters of MS disease course in a large cohort of MS patients and to correlate olfactory function with pRNFL thickness as a surrogate biomarker of neurodegeneration. Methods: In a cross-sectional design, olfactory function was assessed using the Sniffin’ Sticks test, which quantifies three different qualities of olfactory function (threshold, discrimination, and identification). pRNFL thickness was measured by spectral-domain optical coherence tomography (OCT). Results were correlated with age, sex, disease duration, relapses, Expanded Disability Status Scale (EDSS), cognitive function, depression, smoking, and pRNFL thickness by multivariable linear regression models. Results: We included 260 MS patients (mean age of 35.9 years, 68.7% female). Olfactory threshold correlated significantly with number of relapses in the year prior to assessment and shorter disease duration. Odor discrimination, identification, and their sum score were significantly correlated with longer disease duration, higher EDSS, and reduced cognitive function. pRNFL thickness was associated with identification and discrimination, but not with threshold. Conclusion: Olfactory threshold is a marker of short-term inflammatory relapse activity unrelated to parameters of neurodegeneration, while odor identification and discrimination are markers of neurodegeneration mostly independent of relapse activity. Assessment of olfactory function provides an opportunity to stratify MS patients with regard to inflammation and neurodegeneration.

Olfactory threshold is impaired in early, active multiple sclerosis

2011 ◽  
Vol 17 (8) ◽  
pp. 964-969 ◽  
Author(s):  
A Lutterotti ◽  
M Vedovello ◽  
M Reindl ◽  
R Ehling ◽  
F DiPauli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Disease Duration ◽  
Demographic Data ◽  
Olfactory Function ◽  
Olfactory Threshold ◽  
Perception Threshold ◽  
Cross Sectional ◽  
Odour Perception

Background: Olfactory dysfunction has been reported in multiple sclerosis (MS). However, to date no data are available on different qualities of olfactory function, namely odour identification, odour discrimination and odour perception threshold. Objective: To assess different qualities of olfactory function in patients with MS and correlate these with demographic data, clinical data, depression, quality of life and cognitive functions. Methods: In this cross-sectional study, 50 patients with MS or clinically isolated syndrome and 30 healthy controls were included. Olfactory function was measured using the Sniffin’ Sticks test. Results: The scores for odour identification ( p = 0.001), odour perception threshold ( p = 0.037) and the combined score of odour identification, discrimination and perception threshold (TDI, p = 0.002) were significantly lower in MS. Hyposmia for identification ( p = 0.0017), threshold ( p = 0.017) and TDI score ( p = 0.0014) was more frequent in MS. Olfactory threshold was impaired in patients who were clinically active in the previous year ( p = 0.026) and in patients with a disease duration less than 2 years ( p = 0.0093). Identification score was negatively correlated with disease duration ( p = 0.0017). Olfactory function was not associated with disability, depression or quality of life. Conclusions: We report evidence for qualitatively distinct hyposmia in MS, with increased smell threshold in the early inflammatory phases of the disease and impaired identification with a more widespread chronic disease.

scholarly journals Inner nuclear layer and olfactory threshold are interlinked and reflect inflammatory activity in multiple sclerosis

2020 ◽  
Vol 6 (3) ◽  
pp. 205521732094573
Author(s):  
Gabriel Bsteh ◽  
Harald Hegen ◽  
Patrick Altmann ◽  
Klaus Berek ◽  
Michael Auer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Inner Nuclear Layer ◽  
Inflammatory Activity ◽  
Strongly Correlated ◽  
Olfactory Threshold ◽  
Short Term ◽  
Cross Sectional ◽  
Time Pattern ◽  
The Central Nervous System ◽  
Disease Modifying Treatment

Background Retinal inner nuclear layer (INL) and olfactory threshold (OT) are associated with inflammatory activity in multiple sclerosis (MS). Objective The study aims to investigate (a) whether there is an association of INL and OT in MS and (b) if changes in INL and OT follow a time pattern in relation to MS relapse. Methods We assessed INL by optical coherence tomography and OT by Sniffin’ Sticks in three different cohorts: a cross-sectional MS cohort ( n = 260), a longitudinal, 3-year cohort of MS ( n = 141) and healthy controls ( n = 30), and a longitudinal, 24-weeks cohort with acute MS relapse ( n = 28) and stable MS controls ( n = 27). Results Cross-sectionally, INL and OT were strongly correlated with number but not localization of relapse in the previous 12 months and INL correlated with OT. Longitudinally, INL was thicker and OT score was lower short term in times of relapse activity, but not long term and independent of relapse localization. In acute MS relapse, INL and OT were altered compared with stable MS, again, independent of relapse localization resolving over 12–24 weeks with faster approximation to stable MS after escalation of disease-modifying treatment. Conclusions INL and OT are interlinked markers of short-term inflammatory activity, following a nearly congruent time pattern and independent of relapse localization, possibly reflecting a proinflammatory state within the central nervous system.

scholarly journals The Factors Associated With Olfactory Dysfunction in Patients with Multiple Sclerosis

2021 ◽  
Vol 12 (1) ◽  
pp. 89-94
Author(s):  
Mostafa Almasi ◽  
◽  
Mohammad Ali Sahraian ◽  
Fahimeh Haji Akhoundi ◽  
Hamid Reza Ezzati ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Duration ◽  
Admission Rate ◽  
Cross Sectional Study ◽  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Older Age ◽  
Cross Sectional ◽  
Hospital Admission Rate ◽  
Secondary Progressive

Introduction: An impaired sense of smell has a remarkable impact on the quality of life. It is seen in a variety of neurodegenerative diseases such as Parkinson disease. In this study, we assessed the olfactory function in patients with Multiple Sclerosis (MS) by Sniff Magnitude Test (SMT). Methods: A cross-sectional study was conducted on 48 patients with MS. A questionnaire, including demographic and clinical variables, was completed for each patient. The SMT was used for the evaluation of olfactory function. Results: Olfactory dysfunction was found in 14.6% of patients (8.3% hyposmia and 6.3% anosmia). Older age, longer disease duration, higher hospital admission rate, lower mini-mental status examination score, and secondary progressive course of MS were significantly related to olfactory dysfunction. Conclusion: Secondary progressive MS and markers of advanced disease toward neurodegenerative phase (including older age, longer disease duration, and lower cognitive function) can be associated with olfactory dysfunction in MS patients.

Change of olfactory function as a marker of inflammatory activity and disability progression in MS

2017 ◽  
Vol 25 (2) ◽  
pp. 267-274 ◽  
Author(s):  
Gabriel Bsteh ◽  
Harald Hegen ◽  
Felix Ladstätter ◽  
Klaus Berek ◽  
Matthias Amprosi ◽  
...  
Keyword(s):  
Multivariate Model ◽  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Odor Identification ◽  
Olfactory Threshold ◽  
Disability Progression ◽  
Increased Risk ◽  
Changes Over Time ◽  
Over Time ◽  
Risk Of Relapse

Background: Impaired olfactory threshold has been reported in early inflammatory phases of MS, while impaired odor identification was associated with more widespread disability. Objective: To prospectively assess the development of olfactory function and its correlation with relapse and disability progression. Methods: In this prospective, 3-year longitudinal study on 151 MS patients and 30 healthy controls, three different qualities of olfactory function (threshold, discrimination, and identification) were quantified using the Sniffin’ Sticks test. The influence of relapses and disability on olfactory function was analyzed at different time points and in a multivariate model. Results: Discrimination and identification capability significantly worsened over 3 years, while threshold did not. Threshold was markedly impaired in patients with relapse activity within 12 months, recovered in the absence of relapse, and was associated with a 2.5-fold increased risk of relapse. Deterioration of discrimination and identification was irreversible and both strongly associated with and predictive of EDSS progression. Conclusion: Olfactory function changes over time in MS. Threshold impairment is transient and predicts inflammatory disease activity, while odor identification and discrimination are associated with disability progression. Olfactory dysfunction might be a useful and easily obtainable parameter to monitor patients with regard to inflammation and neurodegeneration in MS.

Internet-based cognitive testing in multiple sclerosis

2007 ◽  
Vol 13 (8) ◽  
pp. 1011-1019 ◽  
Author(s):  
M. Younes ◽  
J. Hill ◽  
J. Quinless ◽  
M. Kilduff ◽  
B. Peng ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Function ◽  
Verbal Memory ◽  
Stability Index ◽  
Cross Sectional Study ◽  
Cognitive Testing ◽  
The Internet ◽  
Cross Sectional ◽  
Multiple Sclerosis Patients

Cognitive impairment in multiple sclerosis is difficult to study because of the heterogeneity and variability of this disease. The gold standard for measurement of cognitive function in multiple sclerosis is a full battery of neurocognitive tests, which is time consuming and expensive. Some cognitive tests like the PASAT, a measure of working verbal memory and processing speed, have been proposed for screening and follow-up of cognitive function in clinical trials. We studied whether we could measure cognitive function in multiple sclerosis over the Internet. For this we used the Cognitive Stability Index (CSI)™, developed for persons with known or suspected primary central nervous system illness. The CSI was compared with formal neurocognitive testing (NPsych) and the PASAT in a cross-sectional study of 40 consecutive multiple sclerosis patients with subjective cognitive complaints. NPsych revealed that only 18 of the 40 patients (46%) were cognitively impaired. Although both the CSI and the PASAT were equalivalent in their specificity (86%), the CSI was significantly more sensitive than the PASAT (83% versus 28%). We conclude that the CSI, because of its availability over the Internet, has great potential as a tool for screening and follow up of cognitive function in multiple sclerosis. Multiple Sclerosis 2007; 13: 1011—1019. http://msj.sagepub.com

scholarly journals Fatty acid binding protein-4 is associated with disability in multiple sclerosis patients

2018 ◽  
Vol 25 (3) ◽  
pp. 344-351 ◽  
Author(s):  
Riley Bove ◽  
Brain C Healy ◽  
Alexander Musallam ◽  
Pejvak Soltany ◽  
Camilo Diaz-Cruz ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Fatty Acid ◽  
Fatty Acid Binding Protein ◽  
Disease Duration ◽  
Binding Protein ◽  
Longitudinal Models ◽  
Cross Sectional ◽  
Fatty Acid Binding ◽  
Acid Binding Protein ◽  
Multiple Sclerosis Patients

Background: Increased adiposity is a risk factor for multiple sclerosis (MS) and is associated with increased disability scores. Adipokines may mediate the effects of adiposity on MS disease course. Objective: The objective of this study is to examine the association between the adipokines (leptin and fatty acid binding protein-4, FABP4) and clinical course in individuals with MS. Methods: Subjects (18–65 years) with relapsing-remitting MS or clinically isolated syndrome and <10 year disease duration were selected from a longitudinal clinical study. Cross-sectional and longitudinal models assessed the relationship between two adipokines (leptin and FABP4) and disease severity in women and men, adjusting for age, disease duration and disease type, Vitamin D level, testosterone level, and as well by body mass index (BMI). Results: Mean age of subjects ( N = 163, 56% women) was 39.3 years. Higher FABP4 levels were associated with higher Expanded Disability Status Scale (EDSS) scores in women in both univariate and multivariate analyses (odds ratio: 1.30; p = 0.005). In men, higher FABP4 level was significantly associated with change in EDSS over time (estimate: 0.0062; p = 0.035). We found no association of FABP4 levels with time to next relapse or a measure of processing speed. Conclusion: FABP4 levels may be associated with increased disability in both men and women with MS independent of effects of BMI and other hormones. Future studies should expand these analyses and further explore downstream mechanisms of adiposity-related effects in MS.

Associations between functional capacity, isokinetic leg strength, sleep quality and cognitive function in multiple sclerosis patients: a cross-sectional study

2019 ◽  
Vol 131 (7) ◽  
pp. 453-460 ◽  
Author(s):  
Panayiotis Aristotelous ◽  
Manos Stefanakis ◽  
Marios Pantzaris ◽  
Constantinos Pattichis ◽  
Georgios M Hadjigeorgiou ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Function ◽  
Sleep Quality ◽  
Functional Capacity ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Leg Strength ◽  
Multiple Sclerosis Patients

Dietary intake adequacy and cognitive function in free-living active elderly: A cross-sectional and short-term prospective study

2008 ◽  
Vol 27 (1) ◽  
pp. 77-86 ◽  
Author(s):  
Sónia Velho ◽  
Pedro Marques-Vidal ◽  
Fátima Baptista ◽  
Maria Ermelinda Camilo
Keyword(s):  
Cognitive Function ◽  
Dietary Intake ◽  
Prospective Study ◽  
Short Term ◽  
Free Living ◽  
Cross Sectional

scholarly journals Age Related Multiple Sclerosis Severity Score: Disability ranked by age

2017 ◽  
Vol 23 (14) ◽  
pp. 1938-1946 ◽  
Author(s):  
Ali Manouchehrinia ◽  
Helga Westerlind ◽  
Elaine Kingwell ◽  
Feng Zhu ◽  
Robert Carruthers ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Severity Score ◽  
Statistical Power ◽  
Disease Duration ◽  
Population Based ◽  
Cross Sectional ◽  
The United Kingdom ◽  
Age Related ◽  
Versatile Tool ◽  
Study Population

Background: The Multiple Sclerosis Severity Score (MSSS) is obtained by normalising the Expanded Disability Status Scale (EDSS) score for disease duration and has been a valuable tool in cross-sectional studies. Objective: To assess whether use of age rather than the inherently ambiguous disease duration was a feasible approach. Method: We pooled disability data from three population-based cohorts and developed an Age Related Multiple Sclerosis Severity (ARMSS) score by ranking EDSS scores based on the patient’s age at the time of assessment. We established the power to detect a difference between groups afforded by the ARMSS score and assessed its relative consistency over time. Results: The study population included 26058 patients from Sweden ( n = 11846), Canada ( n = 6179) and the United Kingdom ( n = 8033). There was a moderate correlation between EDSS and disease duration ( r = 0.46, 95% confidence interval (CI): 0.45–0.47) and between EDSS and age ( r = 0.44, 95% CI: 0.43–0.45). The ARMSS scores showed comparable power to detect disability differences between groups to the updated and original MSSS. Conclusion: Since age is typically unbiased and readily obtained, and the ARMSS and MSSS were comparable, the ARMSS may provide a more versatile tool and could minimise study biases and loss of statistical power caused by inaccurate or missing onset dates.

Color vision is strongly associated with retinal thinning in multiple sclerosis

2012 ◽  
Vol 18 (7) ◽  
pp. 991-999 ◽  
Author(s):  
Pablo Villoslada ◽  
Ami Cuneo ◽  
Jeffrey Gelfand ◽  
Stephen L Hauser ◽  
Ari Green
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
Color Vision ◽  
Color Discrimination ◽  
Visual Pathway ◽  
Visual Disability ◽  
Fiber Layer ◽  
Cross Sectional ◽  
Low Contrast ◽  
Sd Oct

Objectives: Multiple Sclerosis (MS) frequently causes injury to the anterior visual pathway (AVP), impairing quality of life due to visual dysfunction. Development of biomarkers in MS is a high priority and both low-contrast visual acuity (LCVA) and time-domain optical coherence tomography (TD-OCT) have been proposed as candidates for this purpose. We sought to assess whether psychophysical assessments of color vision are similarly correlated with structural measures of AVP injury, and therefore augment measures of visual disability in MS. Methods: We studied the association between high-contrast visual acuity (HCVA), LCVA, color vision (Hardy–Rand–Rittler plates (HRR) and Lanthony D15 tests) and OCT, using both high-resolution spectral-domain OCT (SD-OCT; Spectralis, Heidelberg Engineering, Germany) and TD-OCT (Stratus, Carl Zeiss, US) in a cohort of 213 MS patients (52 with previous optic neuritis) and 47 matched controls in a cross-sectional study. Results: We found that MS patients have impairments in HCVA and LCVA ( p < 0.001) but that they suffer from even more profound abnormalities in color discrimination ( p < 0.0001). We found strong correlation between color vision and SD-OCT measures of retinal nerve fiber layer (RNFL) thickness (average RNFL, r = 0.594, p < 0.001) and papillomacular bundle thickness ( r = −0.565, p < 0.001). The correlation between OCT scores and functional visual impairments of all types was much stronger for SD-OCT than for TD-OCT. Conclusion: Our results indicate that color vision is highly correlated with these OCT scores when compared with traditional measures of visual acuity. Also we found that SD-OCT is superior to TD-OCT for detecting anterior visual pathway damage in MS. This makes both color-visual measures and SD-OCT strong candidate biomarkers of disease progression.

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