Störungen des Geruchssinns: Psychiatrisch-neurologische Bezüge und Diagnostik

Zusammenfassung

Untersuchungen zur olfaktorischen Wahrnehmung bei psychiatrischen und neurodegenerativen Erkrankungen zeigen vielfältige Veränderungen auf psychophysikalischer, neurophysiologischer und anatomischer Ebene. Diese Veränderungen stellen sich zum Teil erkrankungsspezifisch dar. So wird z. B. die dysfunktionale Geruchswahrnehmung bei affektiven Erkrankungen mit anatomisch-funktionellen Überlappungen von geruchs- und emotionsverarbeitenden Arealen in Verbindung gebracht. Auf Basis der aktuellen Datenlange zur veränderten Riechfähigkeit bei Major Depression, Schizophrenie, Alzheimer-Demenz und der Parkinson-Erkrankung wird hier die Erfassung der olfaktorischen Wahrnehmung als zusätzlicher diagnostischer Marker bei neuropsychiatrischen Erkrankungen diskutiert. Dabei besteht die Notwendigkeit einer objektiven Erfassung der Riechfunktion über validierte Testverfahren, verknüpft mit Kenntnissen in der Interpretation der erhaltenen Befunde. Ziel dieser Übersichtsarbeit ist es, die Veränderungen der olfaktorischen Wahrnehmung bei den genannten Erkrankungen darzustellen und ausgewählte, im deutschen Sprachraum verfügbare Verfahren vorzustellen und anwendungsbezogen einzuordnen. Eigene aktuelle Daten zur Validierung eines Geruchsdiskriminationstests (Düsseldorf Odour Discrimination Test) an einer klinischen Stichprobe werden vorgestellt.

Abstract

Past research has revealed a variety of olfactory deficits associated with psychiatric and neurodegenerative disorders. These deficits are evident in psychophysical olfactory testing as well as neurophysiological and neuroanatomical examinations. The specific type of olfactory dysfunction appears disorder specific. For example, with regard to affective disorders, the functional and anatomical overlap between olfactory and emotion-specific brain areas has been suggested as a major underlying factor for olfactory dysfunction. Based on converging evidence of changes in olfactory perception related to Major Depression, Schizophrenia, Alzheimer’s and Parkinson’s Disease, olfactory testing has been discussed as an important additional diagnostic marker. Hence, valid methods for objective and reliable olfactory testing as well as guidelines for the interpretation of the respective diagnostic findings are required. The aim of this review is to provide an overview of reported olfactory deficits in psychiatric and neurodegenerative disorders. In addition, a selection of olfactory tests, available in German-speaking countries, with regard to the respective disorder-related olfactory deficit in question are presented and classified. Original data regarding an empirical validation of the Düsseldorf Odour Discrimination Test in a clinical population are presented.

Schlüsselwörter

Riechstörung - Depression - Schizophrenie - Neurodegenerative Erkrankungen - Olfaktorischer Test

Key words

Olfactory Dysfunction - Major Depression - Schizophrenia - Neurodegenerative Diseases - Olfactory Testing

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