Doty R L, Li C, Mannon L J, Yousem D M
Department of Otolaryngology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
Ann N Y Acad Sci. 1998 Nov 30;855:781-6. doi: 10.1111/j.1749-6632.1998.tb10658.x.
The question of whether and to what degree multiple sclerosis (MS) influences the ability to smell is controversial. We administered the University of Pennsylvania Smell Identification Test (UPSIT) to 26 MS patients and concurrently employed high-resolution magnetic resonance imaging (MRI) to quantify the number of demyelinating plaques within central brain structures. 38.5% of the patients demonstrated olfactory loss, with 7.7% exhibiting severe microsmia, 19.2% moderate microsmia, and 11.5% mild microsmia. None was anosmic, and no consistent left:right asymmetry in olfactory function or in hemispheric plaque numbers was observed. A strong negative correlation was found (Spearman r = -0.94) between UPSIT scores and the number of plaques within the inferior frontal and temporal lobes, but not within the rest of the brain. This study unequivocally demonstrates that a sizable proportion of MS patients suffer from olfactory loss commensurate with plaque activity within olfactory-related central brain regions, and is the first to explicate a physical basis for the olfactory dysfunction of any common neurologic disease.
多发性硬化症（MS）是否以及在何种程度上影响嗅觉能力这一问题存在争议。我们对26例MS患者进行了宾夕法尼亚大学嗅觉识别测试（UPSIT），同时采用高分辨率磁共振成像（MRI）来量化脑中枢结构内脱髓鞘斑块的数量。38.5%的患者存在嗅觉丧失，其中7.7%表现为严重嗅觉减退，19.2%为中度嗅觉减退，11.5%为轻度嗅觉减退。无人嗅觉缺失，且未观察到嗅觉功能或半球斑块数量存在一致的左右不对称情况。在UPSIT得分与额下回和颞叶内的斑块数量之间发现了强烈的负相关（Spearman相关系数r = -0.94），但在大脑其他区域未发现此相关性。这项研究明确表明，相当一部分MS患者存在与嗅觉相关脑中枢区域内斑块活动相称的嗅觉丧失，并且首次阐明了任何常见神经系统疾病嗅觉功能障碍的物理基础。
