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多发性硬化症的纵向嗅觉模式:一项范围综述及其在疾病管理中的应用意义

Longitudinal Olfactory Patterns in Multiple Sclerosis: A Scoping Review and Implication for Use in Management of Disease.

作者信息

Todd Lauren L, Sivakumar Ram, Lynch Sharon G, Diebolt Jennifer H, White Jacob, Villwock Jennifer A

机构信息

From the School of Medicine (LLT, RS), University of Kansas Medical Center, Kansas City, KS, USA.

From the Department of Neurology (SGL), University of Kansas Medical Center, Kansas City, KS, USA.

出版信息

Int J MS Care. 2023 May-Jun;25(3):131-136. doi: 10.7224/1537-2073.2022-019. Epub 2023 May 9.

Abstract

BACKGROUND

Although studies regarding multiple sclerosis (MS) and olfactory dysfunction (OD) have been previously described and summarized, there is not a sole review of longitudinal studies regarding the matter. This review examines the existing literature investigating MS and its effect on olfaction. In addition, the role of OD in the diagnosis and prognosis of MS is explored.

METHODS

A scoping review of the literature was performed covering longitudinal studies investigating MS and OD. Systematic searches of PubMed, Google Scholar, Web of Science, Embase, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, AgeLine, and MEDLINE were performed using terms that encompassed MS and olfaction. The aim of this review was to build on the existing literature by summarizing only findings that were demonstrated longitudinally.

RESULTS

Of 6938 articles identified from the search, 9 met the inclusion criteria: longitudinal observation of relapsing-remitting or progressive MS. Olfaction was measured and scored using various testing arrays, and these scores were then correlated with a multitude of clinical markers. Across all studies, patients with MS demonstrated increased OD. Longitudinally, 2 contrasting patterns were identified: (1) clinical markers of acute inflammation correlated with an increased odor threshold and (2) clinical markers of neurodegeneration, or progression of disease, correlated with a decreased ability to discriminate and identify odors.

CONCLUSIONS

These studies suggest that olfaction is a dynamic, dependent variable of neurodegeneration, correlating with inflammation and clinical markers. This opens the door for future exploration of olfaction's relationship with MS diagnosis, characterization, and therapeutic response.

摘要

背景

尽管先前已有关于多发性硬化症(MS)和嗅觉功能障碍(OD)的研究被描述和总结,但尚无对该问题纵向研究的单独综述。本综述考察了有关MS及其对嗅觉影响的现有文献。此外,还探讨了OD在MS诊断和预后中的作用。

方法

对有关MS和OD的纵向研究进行文献范围综述。使用涵盖MS和嗅觉的术语,对PubMed、谷歌学术、科学网、Embase、PsycInfo、护理及联合健康文献累积索引、AgeLine和MEDLINE进行系统检索。本综述的目的是通过仅总结纵向研究结果来完善现有文献。

结果

在检索到的6938篇文章中,9篇符合纳入标准:复发缓解型或进展型MS的纵向观察。使用各种测试组合对嗅觉进行测量和评分,然后将这些分数与多种临床指标相关联。在所有研究中,MS患者的OD均有所增加。纵向来看,发现了两种截然不同的模式:(1)急性炎症的临床指标与气味阈值升高相关;(2)神经退行性变或疾病进展的临床指标与辨别和识别气味的能力下降相关。

结论

这些研究表明,嗅觉是神经退行性变的一个动态相关变量,与炎症和临床指标相关。这为未来探索嗅觉与MS诊断、特征及治疗反应之间的关系打开了大门。

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Mult Scler J Exp Transl Clin. 2019 Nov 5;5(4):2055217319885987. doi: 10.1177/2055217319885987. eCollection 2019 Oct-Dec.
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Transient impairment of olfactory threshold in acute multiple sclerosis relapse.急性多发性硬化症复发时嗅觉阈的短暂损害。
Mult Scler Relat Disord. 2018 Jul;23:74-77. doi: 10.1016/j.msard.2018.05.006. Epub 2018 May 26.

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