Fortschr Neurol Psychiatr 2020; 88(03): 184-193
DOI: 10.1055/a-1003-6798
Übersicht

Störungen des Geruchssinns: Psychiatrisch-neurologische Bezüge und Diagnostik

Olfactory Dysfunctions: References to Neuropsychiatric Disorders and Diagnostics
Sylvia Waldmann
1   Zentrum für Krisenintervention, Psychiatrie Baselland
,
Katrin T. Lübke
2   Institut für Experimentelle Psychologie, Heinrich-Heine-Universität Düsseldorf
,
Michael Pentzek
3   Institut für Allgemeinmedizin (ifam), Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf
,
Bettina M Pause
2   Institut für Experimentelle Psychologie, Heinrich-Heine-Universität Düsseldorf
› Author Affiliations

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.



Publication History

Received: 16 February 2019

Accepted: 22 August 2019

Article published online:
31 March 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 
  • Literatur

  • 1 McGann JP. Poor human olfaction is a 19th-century myth. Science 2017; 356: 6338
  • 2 Doty RL. Psychophysical testing of human olfactory function. In: Buettner A. , ed. Handbook of Odor. New York: Springer; 2017: 225-260
  • 3 Leopold DA, Hummel T, Schwob JE. et al. Anterior distribution of human olfactory epithelium. Laryngoscope 2000; 110: 417-421
  • 4 Bushdid C, Magnasco MO, Vosshall LB. et al. Humans can discriminate more than 1 trillion olfactory stimuli. Science 2014; 343: 1370-1372
  • 5 Gerkin RC, Castro JB. The number of olfactory stimuli that humans can discriminate is still unknown. eLife 2015; DOI: 10.7554/eLife.08127.
  • 6 Patin A, Pause BM. Human amygdala activations during nasal chemoreception. Neuropsychologia 2015; 78: 171-194
  • 7 Manzini I, Frasnelli J, Croy I. Wie wir riechen und was es für uns bedeutet. Grundlagen des Geruchssinns HNO 2014; 62: 846-852
  • 8 Haehner A, Boesveldt S, Berendse HW. et al. Prevalence of smell loss in Parkinson’s disease – a multicenter study. Parkinsonism Relat Disord 2009; 15: 490-494
  • 9 Ross GW, Petrovitch H, Abbott RD. et al. Association of olfactory dysfunction with risk for future Parkinson’s disease. Ann Neurol 2008; 63: 167-173
  • 10 Rahayel S, Frasnelli J, Joubert S. The effect of Alzheimer’s disease and Parkinson’s disease on olfaction: A meta-analysis. Behav Brain Res 2012; 231: 60-74
  • 11 Barz S, Hummel T, Pauli E. et al. Chemosensory event-related potentials in response to trigeminal and olfactory stimulation in idiopathic Parkinson’s disease. Neurology 1997; 49: 1424-1431
  • 12 Berendse HW, Roos DS, Raijmakers P. et al. Motor and non-motor correlates of olfactory dysfunction in Parkinson’s disease. J Neurol Sci 2011; 310: 21-24
  • 13 Herting B, Schulze S, Reichmann H. et al. A longitudinal study of olfactory function in patients with idiopathic Parkinson’s disease. J Neurol 2008; 255: 367-370
  • 14 Cavaco S, Gonçalves A, Mendes A. et al. Abnormal Olfaction in Parkinson’s disease is related to faster disease progression. Behav Neurol 2015; DOI: 10.1155/2015/976589. .
  • 15 Ponsen MM, Stoffers D, Twisk JWR. et al. Hyposmia and executive dysfunction as predictors of future Parkinson’s disease: A prospective Study. Mov Disord 2009; 24: 1060-1065
  • 16 Krismer F, Pinter B, Mueller C. et al. Sniffing the diagnosis: Olfactory testing in neurodegenerative parkinsonism. Parkinsonism Relat Disord 2017; 35: 36-41
  • 17 Doty RL. Olfaction in Parkinson’s disease and related disorders. Neurobiol Dis 2012; 46: 527-552
  • 18 Fullard ME, Tran B, Xie SX. et al. Olfactory impairment predicts cognitive decline in early Parkinson’s disease. Parkinsonism Relat Disord 2016; 25: 45-51
  • 19 Djordjevic J, Jones-Gotman M, De Sousa K. et al. Olfaction in patients with mild cognitive impairment and Alzheimer’s disease. Neurobiol Aging 2008; 29: 693-706
  • 20 Devanand DP, Lee S, Manly J. et al. Olfactory deficits predict cognitive decline and Alzheimer dementia in an urban community. Neurology 2015; 84: 182-189
  • 21 Roalf DR, Moberg MJ, Turetsky BI. et al. A quantitative meta-analysis of olfactory dysfunction in mild cognitive impairment. J Neurol Neurosurg Psychiatry 2017; 88: 226-232
  • 22 Roberts RO, Christianson TJ, Kremers WK. et al. Association between olfactory dysfunction and amnestic mild cognitive impairment and Alzheimer’s disease dementia. JAMA Neurol 2016; 73: 93-101
  • 23 Murphy C, Bacon AW, Bondi MW. et al. Apolipoprotein E status is associated with odor identification deficits in nondemented older persons. Ann N Y Acad Sci 1998; 855: 744-750
  • 24 Kowalewski J, Murphy C. Olfactory ERPs in an odor / visual congruency task differentiate ApoE ε4 carriers from non-carriers. Brain Res 2012; 1442: 55-65
  • 25 Bacon AW, Bondi MW, Salmon DP. et al. Very early changes in olfactory functioning due to Alzheimer’s disease and the role of apolipoprotein E in olfaction. Ann N Y Acad Sci 1998; 855: 723-731
  • 26 Serby M, Mohan C, Aryan M. et al. Olfactory identification deficits in relatives of Alzheimer’s disease patients. Biol Psychiatry 1996; 39: 375-377
  • 27 Schiffmann SS, Graham BG, Sattely-Miller EA. et al. Taste, smell and neuropsychological performance of individuals at familial risk for Alzheimer’s disease. Neurobiol Aging 2002; 23: 397-404
  • 28 Negoias S, Croy I, Gerber J. et al. Reduced olfactory bulb volume and olfactory sensitivity in patients with acute major depression. Neuroscience 2010; 169: 415-421
  • 29 Pause BM, Miranda A, Goder R. et al. Reduced olfactory performance in patients with major depression. J Psychiatr Res 2001; 35: 271-277
  • 30 Pause BM, Lembcke J, Reese I. et al. Reduced olfactory sensitivity in antidepressant drug-free patients with major depression. Z Klin Psychol Psychother 2005; 34: 79-85
  • 31 Pause BM, Raack N, Sojka B. et al. Convergent and divergent effects of odors and emotions in depression. Psychophysiology 2003; 40: 209-225
  • 32 Kopala LC, Good KP, Honer WG. Olfactory hallucinations and olfactory identification ability in patients with schizophrenia and other psychiatric disorders. Schizophr Res 1994; 12: 205-211
  • 33 Schablitzky S, Pause BM. Sadness might isolate you in a non-smelling world: olfactory perception and depression. Front Psychol 2014; 5: 45
  • 34 Pabel LD, Hummel T, Weidner K. et al. The impact of severity, course and duration of depression on olfactory function. J Affect Disord 2018; 238: 194-203
  • 35 Rottstaedt F, Weidner K, Strauß T. et al. Size matters - The olfactory bulb as a marker for depression. J Affect Disord 2018; 229: 193-198
  • 36 Negoias S, Hummel T, Symmank A. et al. Olfactory bulb volume predicts therapeutic outcome in major depression disorder. Brain Imaging Behav 2016; 10: 367-372
  • 37 Croy I, Hummel T. Olfaction as a marker for depression. J Neurol 2017; 264 (04) : 631-638
  • 38 Pentzek M, Grass-Kapanke B, Ihl R. Odor identification in Alzheimer’s disease and depression. Aging Clin Exp Res 2007; 19: 255-258
  • 39 Solomon GS, Petrie WM, Hart JR. et al. Olfactory dysfunction discriminates Alzheimer’s dementia from major depression. J Neuropsychiatry Clin Neurosci 1998; 10: 64-67
  • 40 Naudin M, Atanasova B. Olfactory markers of depression and Alzheimer’s disease. Neurosci Biobehav Rev 2014; 45: 262-270
  • 41 Moberg PJ, Kamath V, Marchetto DM. et al. Meta-analysis of olfactory function in schizophrenia, first-degree family members, and youths at-risk for psychosis. Schizophr Bull 2014; 40: 50-59
  • 42 Moberg PJ, Arnold SE, Doty RL. et al. Olfactory functioning in schizophrenia: relationship to clinical, neuropsychological, and volumetric MRI measures. J Clin Exp Neuropsychol 2006; 28: 1444-1461
  • 43 Kopala LC, Clark C, Hurwitz T. Olfactory deficits in neuroleptic naive patients with schizophrenia. Schizophr Res 1993; 8: 245-250
  • 44 Ugur T, Weisbrod M, Franzek E. et al. Olfactory impairment in monozygotic twins discordant for schizophrenia. Eur Arch Psychiatry Clin Neurosci 2005; 255: 94-98
  • 45 Turetsky BI, Kohler CG, Gur RE. et al. Olfactory physiological impairment in first-degree relatives of schizophrenia patients. Schizophr Res 2008; 102: 220-229
  • 46 Rupp CI. Olfactory function and schizophrenia: an update. Curr Opin Psychiatry 2010; 23: 97-102
  • 47 Kamath V, Turetsky BI, Moberg PJ. Identification of pleasant, neutral, and unpleasant odors in schizophrenia. Psychiatry Res 2011; 187: 30-35
  • 48 Pause BM, Hellmann G, Göder R. et al. Increased processing speed for emotionally negative odors in schizophrenia. Int J Psychophysiol 2008; 70: 16-22
  • 49 Crespo-Facorro B, Paradiso S, Andreasen NC. et al. Neural Mechanisms of Anhedonia in Schizophrenia A PET Study of Response to Unpleasant and Pleasant Odors. JAMA 2001; 286: 427-435
  • 50 Doty RL, Shaman P, Dann M. Development of the University of Pennsylvania Smell Identification Test: a standardized microencapsulated test of olfactory function. Physiol Behav 1984; 32: 489-502
  • 51 Doty RL, Marcus A, Lee WW. Development of the 12-item Cross-Cultural Smell Identification Test (CC-SIT). Laryngoscope 1996; 106: 353-356
  • 52 Hummel T, Sekinger B, Wolf SR. et al. „Sniffin’ Sticks“: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses 1997; 22: 39-52
  • 53 Hummel T, Konnerth CG, Rosenheim K. et al. Screening of olfactory function with a four-minute odor identification test: reliability, normative data and investigations in patients with olfactory loss. Ann Otol Rhinol Laryngol 2001; 110: 976-981
  • 54 Simmen D, Briner HR, Hess K. Screeningtest des Geruchssinns mit Riechdisketten. Laryngorhinotologie 1999; 78: 125-130
  • 55 Lehrner J, Deecke L. Die Wiener Olfaktorische Testbatterie (WOTB). Akt Neurol 2000; 27: 170-177
  • 56 Weierstall R, Pause BM. Development of a 15-item odour discrimination test (Düsseldorf Odour Discrimination Test). Perception 2012; 41: 193-203
  • 57 Laska M, Hudson R. A comparison of the detection thresholds of odour mixtures and their components. Chem Senses 1991; 16: 651-662
  • 58 Hsieh JW, Keller A, Wong M. et al. SMELL-S and SMELL-R: Olfactory tests not influenced by odor-specific insensitivity or prior olfactory experience. Proc Natl Acad Sci USA 2017; 114: 11275-11284
  • 59 Doty RL, Brugger WE, Jurs PC. et al. Intranasal trigeminal stimulation from odorous volatiles: psychometric responses from anosmic and normal humans Physiol. Behav 1978; 20: 175-185
  • 60 Mozell MM, Hornung DE, Sheehe PR. et al. What should be controlled in studies of smell?. In: Meiselmann HL, Rivlin RS. , eds. Clinical Measurement of Taste and Smell. New York: Macmillian Publishing Company; 1986: 154-169.
  • 61 Berglund B, Berglund U, Lindvall T. Theory and methods for odor evaluation. Experientia 1986; 42: 280-287
  • 62 Laing DG. Natural sniffing gives optimum odour perception for humans. Perception 1983; 12: 99-117
  • 63 Schubert CR, Cruickshanks KJ, Fischer ME. Odor identification and cognitive function in the Beaver Dam Offspring Study. J Clin Exp Neuropsychol 2013; 35: 669-676
  • 64 Zucco GM, Hummel T, Tomaiuolo F. et al. The influence of short-term memory on standard discrimination and cued identification olfactory tasks. J Neurosci Methods 2014; 222: 138-141
  • 65 Folstein MF, Folstein SE, McHugh PR. Mini Mental State. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189-198
  • 66 Stemmler M, Lehfeld H, Horn R. , Hrsg. SKT nach Erzigkeit. SKT Manual Edition. Spardorf: Geromed; 2015
  • 67 Nasreddine ZS, Phillips NA, Bèdririan V. et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53: 695-699
  • 68 Doty RL, Kamath V. The influences of age on olfaction: a review. Front Psychol 2014; DOI: 10.3389/fpsyg.2014.00020.
  • 69 Nordin S, Brämerson A, Liden E. et al. The Scandinavian Odor-Identification Test: Development, reliability, validity and normative data. Acta Otolaryngol 1998; 118: 226-234
  • 70 Wolfensberger M, Schnieper I. Sniffin’ Sticks: Ein neues Instrument zur Geruchsprüfung im klinischen Alltag. HNO 1999; 47: 629-636
  • 71 Hummel T, Kobal G, Gudziol H. et al. Normative data for the „Sniffin’ Sticks” including tests of odor identification, odor discrimination, and olfactory thresholds: an upgrade based on a group of more than 3000 subjects. Eur Arch Otorhinolaryngol 2007; 264: 237-243
  • 72 Haehner A, Mayer AM, Landis BN. et al. High test-retest reliability of the extended version of the “Sniffin’ Sticks” test. Chem Sens 2009; 34: 705-711
  • 73 Freiherr J, Gordon AR, Alden EC. et al. The 40-item monell extended sniffin’sticks identification test (MONEX-40). J Neurosci Methods 2012; 205 (01) : 10-16
  • 74 Frasnelli J, Hummel T. Interactions between the chemical senses: Trigeminal function in patients with olfactory loss. Int J Psychophysiol 2007; 65: 177-181
  • 75 Briner HR, Simmen D, Jones N. Impaired sense of smell in patients with nasal surgery. Clin Otolaryngol Allied Sci 2003; 28: 417-419
  • 76 Manestar D, Tićac R, Maričić S. et al. Amount of airflow required for olfactory perception in laryngectomees: a prospective interventional study. Clin Otolaryngol 2012; 37: 28-34
  • 77 Lehrner J, Maly J, Walla P. et al. Verminderte olfaktorische Identifikationsleistung bei Patienten mit mild cognitive impairment. Verhaltenstherapie Verhaltensmedizin 2003; 24: 87-98
  • 78 AWMF-Leitlinie: S2k-Leitlinie 017 / 050. Riech- und Schmeckstörungen aktueller Stand. Oktober 2016 https://www.awmf.org/uploads/tx_szleitlinien/017-050l_S2k_Riech-und-Schmeckstörungen_2017-03.pdf