Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel; Department of Pediatrics A, Schneider Children's Medical Center of Israel, Petach Tikva, 4920235, Israel.
Eur J Paediatr Neurol. 2021 Jan;30:162-169. doi: 10.1016/j.ejpn.2020.09.006. Epub 2020 Oct 3.
To assess the association between pediatric Idiopathic intracranial hypertension (IIH) and olfactory performance.
A cross-sectional comparative study was conducted including 17 patients under 18 years diagnosed with IIH at a tertiary hospital and 17 healthy age- and sex-matched subjects. All participants underwent the semi-objective chemosensory Sniffin' Sticks test for evaluation of odor threshold (OT), indicative of peripheral olfactory function, and odor identification (OI), reflecting higher cognitive olfactory processing. Scores were compared and referred to the updated normative values. Demographic, clinical, and neuroimaging data were collected from the medical files. The patients with IIH were reassessed for olfactory function and clinical state at the subsequent follow-up, under treatment.
Compared to controls, the IIH group had a significantly lower mean OT score (6.41 ± 3.43 vs 10.21 ± 2.79, p = 0.001) and higher rate of OT score below the 10th percentile for age and sex according to the normative values (47.1% vs 0%, p = 0.001). There was no significant between-group difference in mean OI scores (9.82 ± 1.63, vs 10.59 ± 1.84, p = 0.290). OT scores were not associated with sex, age, body mass index, neuroimaging abnormalities, or lumbar puncture opening pressure. At the follow-up assessment, the OT scores were improved (9.36 ± 4.17 vs 6.7 ± 3.32, p = 0.027) whereas the OI scores were unchanged (9.88 ± 2.5 vs 9.69 ± 1.58, p = 0.432).
As reported in adults, children and adolescents with IIH appear to have a selective reversible deficit in olfactory detection threshold, which may imply a reduction in peripheral olfactory perceptual ability. Future studies should examine the predictive value of olfactory function for IIH.
评估小儿特发性颅内高压(IIH)与嗅觉表现之间的关联。
这是一项横断面对比研究,纳入了在一家三级医院确诊为 IIH 的 17 名 18 岁以下的患者和 17 名年龄和性别匹配的健康对照者。所有参与者均接受了半客观的嗅觉 Sniffin' Sticks 测试,以评估嗅觉阈值(OT),这反映了外周嗅觉功能,以及嗅觉识别(OI),这反映了更高阶的认知嗅觉处理能力。比较评分并参考最新的正常值。从病历中收集了人口统计学、临床和神经影像学数据。在后续治疗随访中,对 IIH 患者进行了嗅觉功能和临床状态的重新评估。
与对照组相比,IIH 组的平均 OT 评分显著降低(6.41 ± 3.43 比 10.21 ± 2.79,p = 0.001),且根据正常值,OT 评分低于第 10 个百分位数的比例更高(47.1%比 0%,p = 0.001)。两组间平均 OI 评分无显著差异(9.82 ± 1.63,比 10.59 ± 1.84,p = 0.290)。OT 评分与性别、年龄、体重指数、神经影像学异常或腰椎穿刺开放压力无关。在随访评估时,OT 评分改善(9.36 ± 4.17 比 6.7 ± 3.32,p = 0.027),而 OI 评分无变化(9.88 ± 2.5 比 9.69 ± 1.58,p = 0.432)。
与成人报道的结果相似,IIH 的儿童和青少年似乎存在嗅觉检测阈值的选择性、可逆转缺陷,这可能意味着外周嗅觉感知能力下降。未来的研究应探讨嗅觉功能对 IIH 的预测价值。