Geran Rohat, Uecker Florian C, Prüss Harald, Haeusler Karl Georg, Paul Friedemann, Ruprecht Klemens, Harms Lutz, Schmidt Felix A
Department of Neurology, Clinical and Experimental Multiple Sclerosis Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Center for Stroke Research, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Front Neurol. 2019 May 14;10:480. doi: 10.3389/fneur.2019.00480. eCollection 2019.
To test the hypothesis that olfactory (OF) and gustatory function (GF) is disturbed in patients with autoimmune encephalitides (AE). The orthonasal OF was tested in 32 patients with AE and 32 age- and sex-matched healthy controls (HC) with the standardized Threshold Discrimination Identification (TDI) score. This validated olfactory testing method yields individual scores for olfactory threshold (T), odor discrimination (D), and identification (I), along with a composite TDI score. The GF was determined by the Taste Strip Test (TST). Overall, 24/32 (75%) of patients with AE, but none of 32 HC ( < 0.001) had olfactory dysfunction in TDI testing. The results of the threshold, discrimination and identification subtests were significantly reduced in patients with AE compared to HC (all < 0.001). Assessed by TST, 5/19 (26.3%) of patients with AE, but none of 19 HC presented a significant limitation in GF ( < 0.001). The TDI score was correlated with the subjective estimation of the olfactory capacity on a visual analog scale (VAS; r = 0.475, = 0.008). Neither age, sex, modified Rankin Scale nor disease duration were associated with the composite TDI score. This is the first study investigating OF and GF in AE patients. According to unblinded assessment, patients with AE have a reduced olfactory and gustatory capacity compared to HC, suggesting that olfactory and gustatory dysfunction are hitherto unrecognized symptoms in AE. Further studies with larger number of AE patients would be of interest to verify our results.
为了验证自身免疫性脑炎（AE）患者存在嗅觉（OF）和味觉功能（GF）障碍这一假设。对32例AE患者和32例年龄及性别匹配的健康对照者（HC）进行了经鼻嗅觉测试，采用标准化的阈值辨别识别（TDI）评分。这种经过验证的嗅觉测试方法可得出嗅觉阈值（T）、气味辨别（D）和识别（I）的个体评分，以及综合TDI评分。味觉功能通过味觉试纸测试（TST）来确定。总体而言，在TDI测试中，24/32（75%）的AE患者存在嗅觉功能障碍，而32例HC中无一例出现（P<0.001）。与HC相比，AE患者的阈值、辨别和识别子测试结果显著降低（均P<0.001）。通过TST评估，5/19（26.3%）的AE患者存在味觉功能显著受限，而19例HC中无一例出现（P<0.001）。TDI评分与视觉模拟量表（VAS）上嗅觉能力的主观估计相关（r = 0.475，P = 0.008）。年龄、性别、改良Rankin量表评分及病程均与综合TDI评分无关。这是第一项研究AE患者嗅觉和味觉功能的研究。根据非盲法评估，与HC相比，AE患者的嗅觉和味觉能力降低，提示嗅觉和味觉功能障碍是AE中迄今未被认识到的症状。进一步纳入更多AE患者的研究将有助于验证我们的结果。
