Smell As a Disease Marker in Multiple Sclerosis

Overview

Journal J Clin Med

Specialty General Medicine

Date 2022 Sep 9

PMID 36079145

Authors

Athanasia Printza

Marina Boziki

Constantinos Valsamidis

Christos Bakirtzis

Jannis Constantinidis

Nikolaos Grigoriadis

Stefanos Triaridis

Affiliations

Soon will be listed here.

Abstract

Existing data suggest that people with multiple sclerosis (pwMS) are at an elevated risk for experiencing olfactory impairment. We investigated if smell dysfunction can be used as an MS disease marker. This is a cross-sectional, case−control study. All data were collected prospectively from 171 participants, 115 pwMS and 56 controls (age and sex stratified and matched to the patients), who reported smell, taste, and nasal breathing, and completed the Greek-validated questionnaires for nasal obstruction (NOSE), nasal-symptoms QoL (SNOT-22), and olfaction-associated QoL (QOD). The smell was assessed with the “Sniffin’ sticks” (odor threshold (OT), discrimination (OD), identification (OI) test, and total TDI). We recorded the pwMS disease characteristics (Expanded Disability Status Scale-EDSS, the disease type and duration), cognitive function, emotional status, fatigue, and impact of MS in everyday activities. A TDI < 30.75 (hyposmia) was detected in 30.8% of the patients. The patients’ OD and TDI scores were significantly lower than the controls’ (p = 0.005, and 0.015, respectively). The hyposmia correlated with disease severity and duration. The EDSS score correlated negatively with OD (r = −0.299, p = 0.001) and TDI (r = −0.242, p = 0.01). The disease duration correlated negatively with OD (r = −0.305, p = 0.001, OI (r = −0.253, p = 0.008) and TDI (r = −0.3, p = 0.001). The information processing speed (SDMT) correlated with OD, OT, and TDI (r = 0.302, p = 0.002; r = 0.242, p = 0.016; r = 0.326, p = 0.001). The olfactory function is changing in MS in accordance with disease progression.

References

Bakalidou D, Voumvourakis K, Tsourti Z, Papageorgiou E, Poulios A, Giannopoulos S . Validity and reliability of the Greek version of the Modified Fatigue Impact Scale in multiple sclerosis patients. Int J Rehabil Res. 2014; 37(3):271-6. DOI: 10.1097/MRR.0000000000000057. View

Valsamidis K, Printza A, Titelis K, Constantinidis J, Triaridis S . Olfaction and quality of life in patients with nasal septal deviation treated with septoplasty. Am J Otolaryngol. 2019; 40(5):747-754. DOI: 10.1016/j.amjoto.2019.07.008. View

Hobart J, Lamping D, Fitzpatrick R, Riazi A, Thompson A . The Multiple Sclerosis Impact Scale (MSIS-29): a new patient-based outcome measure. Brain. 2001; 124(Pt 5):962-73. DOI: 10.1093/brain/124.5.962. View

Bsteh G, Hegen H, Ladstatter F, Berek K, Amprosi M, Wurth S . Change of olfactory function as a marker of inflammatory activity and disability progression in MS. Mult Scler. 2017; 25(2):267-274. DOI: 10.1177/1352458517745724. View

Benedict R, Fishman I, McClellan M, Bakshi R, Weinstock-Guttman B . Validity of the Beck Depression Inventory-Fast Screen in multiple sclerosis. Mult Scler. 2003; 9(4):393-6. DOI: 10.1191/1352458503ms902oa. View

Frasnelli J, Hummel T . Olfactory dysfunction and daily life. Eur Arch Otorhinolaryngol. 2004; 262(3):231-5. DOI: 10.1007/s00405-004-0796-y. View

Valsamidis K, Printza A, Constantinidis J, Triaridis S . The Impact of Olfactory Dysfunction on the Psychological Status and Quality of Life of Patients with Nasal Obstruction and Septal Deviation. Int Arch Otorhinolaryngol. 2020; 24(2):e237-e246. PMC: 7153923. DOI: 10.1055/s-0040-1701269. View

Hawkes C, Shephard B, Kobal G . Assessment of olfaction in multiple sclerosis: evidence of dysfunction by olfactory evoked response and identification tests. J Neurol Neurosurg Psychiatry. 1997; 63(2):145-51. PMC: 2169670. DOI: 10.1136/jnnp.63.2.145. View

Vlahou C, Kosmidis M, Dardagani A, Tsotsi S, Giannakou M, Giazkoulidou A . Development of the Greek Verbal Learning Test: reliability, construct validity, and normative standards. Arch Clin Neuropsychol. 2012; 28(1):52-64. DOI: 10.1093/arclin/acs099. View

10.

Lachanas V, Tsea M, Tsiouvaka S, Hajiioannou J, Skoulakis C, Bizakis J . The sino-nasal outcome test (SNOT)-22: validation for Greek patients. Eur Arch Otorhinolaryngol. 2014; 271(10):2723-8. DOI: 10.1007/s00405-014-2969-7. View

11.

Doty R, Li C, Mannon L, Yousem D . Olfactory dysfunction in multiple sclerosis. N Engl J Med. 1997; 336(26):1918-9. DOI: 10.1056/NEJM199706263362617. View

12.

Majde J . Neuroinflammation resulting from covert brain invasion by common viruses - a potential role in local and global neurodegeneration. Med Hypotheses. 2010; 75(2):204-13. PMC: 2897933. DOI: 10.1016/j.mehy.2010.02.023. View

13.

Bsteh G, Steiger R, Tuovinen N, Hegen H, Berek K, Wurth S . Impairment of odor discrimination and identification is associated with disability progression and gray matter atrophy of the olfactory system in MS. Mult Scler. 2019; 26(6):706-715. PMC: 7232781. DOI: 10.1177/1352458519838205. View

14.

Oleszkiewicz A, Schriever V, Croy I, Hahner A, Hummel T . Updated Sniffin' Sticks normative data based on an extended sample of 9139 subjects. Eur Arch Otorhinolaryngol. 2018; 276(3):719-728. PMC: 6411676. DOI: 10.1007/s00405-018-5248-1. View

15.

Hummel T, Sekinger B, Wolf S, Pauli E, Kobal G . 'Sniffin' sticks': olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses. 1997; 22(1):39-52. DOI: 10.1093/chemse/22.1.39. View

16.

Silva A, Santos E, Moreira I, Bettencourt A, Coutinho E, Goncalves A . Olfactory dysfunction in multiple sclerosis: association with secondary progression. Mult Scler. 2011; 18(5):616-21. DOI: 10.1177/1352458511427156. View

17.

Artemiadis A, Bakirtzis C, Chatzittofis A, Christodoulides C, Nikolaou G, Boziki M . Brief international cognitive assessment for multiple sclerosis (BICAMS) cut-off scores for detecting cognitive impairment in multiple sclerosis. Mult Scler Relat Disord. 2021; 49:102751. DOI: 10.1016/j.msard.2021.102751. View

18.

Stadio A, Brenner M, De Luca P, Albanese M, DAscanio L, Ralli M . Olfactory Dysfunction, Headache, and Mental Clouding in Adults with Long-COVID-19: What Is the Link between Cognition and Olfaction? A Cross-Sectional Study. Brain Sci. 2022; 12(2). PMC: 8870047. DOI: 10.3390/brainsci12020154. View

19.

Lucassen E, Turel A, Knehans A, Huang X, Eslinger P . Olfactory dysfunction in Multiple Sclerosis: A scoping review of the literature. Mult Scler Relat Disord. 2016; 6:1-9. DOI: 10.1016/j.msard.2015.12.002. View

20.

Langdon D, Amato M, Boringa J, Brochet B, Foley F, Fredrikson S . Recommendations for a Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Mult Scler. 2011; 18(6):891-8. PMC: 3546642. DOI: 10.1177/1352458511431076. View