Zorzon M, Ukmar M, Bragadin L M, Zanier F, Antonello R M, Cazzato G, Zivadinov R
Neurological Clinic, University of Trieste, Italy.
Mult Scler. 2000 Dec;6(6):386-90. doi: 10.1177/135245850000600605.
The relative contribution to the olfactory dysfunction of the lesions in the specific brain regions involved in olfaction compared with the lesions scattered all over the rest of the brain has not been fully clarified yet in patients with multiple sclerosis (MS). The concurrent use of Magnetic Resonance Imaging (MRI) and a standardized test of odor identification ability now permits to study the relation between smell loss and the extent of white matter abnormalities.
We tested the olfactory function of 40 patients with definite MS and of 40 age-sex- and smoking-habit-matched healthy controls by using the Cross Cultural Smell Identification Test. We measured also the lesion load on T2-weighted images in the inferior-frontal and temporal lobes and in the rest of the brain in MS patients. Therefore, we tried to correlate measures of lesion load and smell test scores.
A robust correlation was demonstrated between MR measures of lesion load in the white matter of the olfactory brain region and smell loss (r=-0. 739, P<0.0001). A significant relationship has been found even after taking potential confounding factors, such as sex, age, disease duration, disability, anxiety and depression, into account (r=-0.90, P<0.0001).
Our findings show, in MS patients with stable neurological impairment and no recent disease exacerbation, a correlation between smell loss and the lesion load in the regions of the brain involved in olfaction and support the theory that the extent and severity of MRI abnormalities in specific brain regions are related to the presence of selective neurologic and neuropsychologic impairment.
在多发性硬化症（MS）患者中，与散在于大脑其他部位的病变相比，嗅觉相关特定脑区的病变对嗅觉功能障碍的相对影响尚未完全阐明。磁共振成像（MRI）与标准化气味识别能力测试的同时应用，现在使得研究嗅觉丧失与白质异常程度之间的关系成为可能。
我们使用跨文化嗅觉识别测试，对40例确诊为MS的患者以及40名年龄、性别和吸烟习惯相匹配的健康对照者的嗅觉功能进行了测试。我们还测量了MS患者额叶下部、颞叶以及大脑其他部位T2加权图像上的病变负荷。因此，我们试图将病变负荷测量值与嗅觉测试分数进行关联。
嗅脑区白质病变负荷的磁共振测量值与嗅觉丧失之间显示出强烈的相关性（r = -0.739，P < 0.0001）。即使考虑了潜在的混杂因素，如性别、年龄、病程、残疾、焦虑和抑郁，也发现了显著的关系（r = -0.90，P < 0.0001）。
我们的研究结果表明，在神经功能稳定且近期无疾病加重的MS患者中，嗅觉丧失与嗅脑区的病变负荷之间存在相关性，并支持以下理论：特定脑区MRI异常的程度和严重程度与选择性神经和神经心理损害的存在有关。
