Foundation School Offices, St Mary's Hospital, London, UK.
Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.
J Neurol Neurosurg Psychiatry. 2016 Oct;87(10):1146-54. doi: 10.1136/jnnp-2015-312600. Epub 2016 Mar 21.
Olfactory dysfunction is recognised across an ever broadening spectrum of neuropsychiatric conditions including central nervous system (CNS) demyelinating diseases such as multiple sclerosis (MS) and neuromyelitis optica (NMO). In this review, we unravel the striking evidence highlighting how olfactory loss is a common clinical feature in MS and NMO. We provide an overview of the supportive psychophysical, electrophysiological, radiological and pathological data that point to the anatomical substrate of olfactory deficits in these diseases. The pattern of underlying pathology affecting the olfactory system is shown to be complex, involving multiple structures that are affected in different ways throughout the course of the disease. This review is the first to synthesise the expanding body of literature on the topic, provides novel insight into the way in which the olfactory system is affected in CNS demyelinating diseases, and raises intriguing questions about the role of this system in the pathogenesis of these diseases.
嗅觉功能障碍在越来越广泛的神经精神疾病谱中得到认可，包括中枢神经系统（CNS）脱髓鞘疾病，如多发性硬化症（MS）和视神经脊髓炎（NMO）。在这篇综述中，我们揭示了令人瞩目的证据，强调了嗅觉丧失是 MS 和 NMO 的常见临床特征。我们概述了支持性的心理物理学、电生理学、影像学和病理学数据，这些数据指向了这些疾病中嗅觉缺陷的解剖学基础。受影响的潜在病理学模式表明是复杂的，涉及多个结构，在疾病过程中以不同的方式受到影响。这是第一篇综合该主题不断扩大的文献的综述，为中枢神经系统脱髓鞘疾病中嗅觉系统受影响的方式提供了新的见解，并提出了关于该系统在这些疾病发病机制中的作用的有趣问题。
