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European Archives of Oto-Rhino-Laryngology

Open Access 06-09-2024 | Smelling Disorder | Rhinology

Four odorants for olfactory training are enough: a pilot study

Authors: Nicole Power Guerra, Emely Kruschwitz, Dietmar Krautwurst, Thomas Hummel

Published in: European Archives of Oto-Rhino-Laryngology

Abstract

Background: Olfactory training (OT) is commonly used for the treatment of olfactory disorders. Nevertheless, there is an ongoing debate about the most effective OT regimen. We aimed to compare the effects of OT with 7 items (rose, lemon, eucalyptus, cloves, stewed apple, balm, mint) to 4-item-OT (rose, lemon, eucalyptus, cloves) over 3 months. Methods: Participants were 40 patients with olfactory dysfunction receiving 4-item-OT or 7-item-OT and 60 gender- and age-matched individuals with normal sense of smell receiving no OT, 4-item-OT, or 7-item-OT. Before and after the OT we assessed n-butanol odor thresholds, discrimination, and identification (TDI score), additionalthresholds for (R)-(-)-carvone, β-damascenone, salicyclic acid benzylester, the degree of phantosmia and parosmia, cognitive function, and ratings of olfactory function. Results: In both patient groups, the TDI score increased with the use of OT, regardless of the number of odors used (p < 0.001; 3.48 ± 4.21 and lower than control groups). The clinically significant increase of 5.5 points in TDI score correlated with change of ratings of parosmia (r 0.62; p < 0.01) and with ratings of olfactory dysfunction (r = 0.51; p < 0.05). Conclusion: Concluding, OT over a 3-months period with 4 or 7 odors appears to produce similar results, although the sample size has to be considered.

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Gerkin RC, Ohla K, Veldhuizen MG, Joseph PV, Kelly CE, Bakke AJ et al (2021) Recent smell loss is the best predictor of COVID-19 among individuals with recent respiratory symptoms. Chem Senses 46(bjaa081):1–12

Coelho DH, Reiter ER, Budd SG, Shin Y, Kons ZA, Costanzo RM (2021) Quality of life and safety impact of COVID-19 associated smell and taste disturbances. Am J Otolaryngol 42(4):103001CrossRefPubMedPubMedCentral

Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G (1997) Sniffin’ sticks’: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses 22(1):39–52CrossRefPubMed

Hwang SH, Kim SW, Basurrah MA, Kim DH (2023) The efficacy of olfactory training as a treatment for olfactory disorders caused by Coronavirus Disease-2019: a systematic review and Meta-analysis. Am J Rhinol Allergy 37(4):495–501CrossRefPubMed

Hummel T, Whitcroft KL, Andrews P, Altundag A, Cinghi C, Costanzo RM et al (2017) Position paper on olfactory dysfunction. Rhin 54(26):1–30CrossRef

Hopkins C, Alanin M, Philpott C, Harries P, Whitcroft K, Qureishi A et al (2021) Management of new onset loss of sense of smell during the COVID-19 pandemic - BRS Consensus guidelines. Clin Otolaryngol 46(1):16–22CrossRefPubMed

Fleiner F, Lau L, Göktas Ö (2012) Active olfactory training for the treatment of smelling disorders. Ear Nose Throat J 91(5):198–203CrossRefPubMed

Konstantinidis I, Tsakiropoulou E, Bekiaridou P, Kazantzidou C, Constantinidis J (2013) Use of olfactory training in post-traumatic and postinfectious olfactory dysfunction. Laryngoscope 123(12):E85–90CrossRefPubMed

Besser G, Oswald MM, Liu DT, Renner B, Mueller CA (2020) Flavor education and training in olfactory dysfunction: a pilot study. Eur Arch Otorhinolaryngol. ; 277(7):1987–94. Available from: URL: https://pubmed.ncbi.nlm.nih.gov/32248300/

10.

Saatci O, Altundag A, Duz OA, Hummel T (2020) Olfactory training ball improves adherence and olfactory outcomes in post-infectious olfactory dysfunction. Eur Arch Otorhinolaryngol 277(7):2125–2132CrossRefPubMed

11.

Konstantinidis I, Tsakiropoulou E, Constantinidis J (2016) Long term effects of olfactory training in patients with post-infectious olfactory loss. Rhin 54(2):170–175CrossRef

12.

Qiao X-F, Bai Y-H, Wang G-P, Li X, Zheng W (1992) Clinical effects of two combinations of olfactory agents on olfactory dysfunction after upper respiratory tract infection during olfactory training. Rev Assoc Med Bras 2020; 66(1):18–24

13.

Oleszkiewicz A, Bottesi L, Pieniak M, Fujita S, Krasteva N, Nelles G et al (2022) Olfactory training with Aromastics: olfactory and cognitive effects. Eur Arch Otorhinolaryngol 279(1):225–232CrossRefPubMed

14.

Altundag A, Cayonu M, Kayabasoglu G, Salihoglu M, Tekeli H, Saglam O et al (2015) Modified olfactory training in patients with postinfectious olfactory loss. Laryngoscope 125(8):1763–1766CrossRefPubMed

15.

Manzini I, Schild D, Di Natale C (2022) Principles of odor coding in vertebrates and artificial chemosensory systems. Physiol Rev. ; 102(1):61–154. Available from: URL: https://pubmed.ncbi.nlm.nih.gov/34254835/

16.

Hummel T, Welge-Lüssen A (2006) Taste and smell: an update. Karger, Basel. (vol 63)CrossRef

17.

Hummel T, Power Guerra N, Gunder N, Hähner A, Menzel S, Laryngorhinootologie (2023) ; 102(S 01):S67–S92

18.

Butowt R, Bilinska K, von Bartheld CS (2023) Olfactory dysfunction in COVID-19: new insights into the underlying mechanisms. Trends Neurosci. ; 46(1):75–90. Available from: URL: https://www.cell.com/trends/neurosciences/fulltext/S0166-2236(22)00234-X

19.

Bryche B, St Albin A, Murri S, Lacôte S, Pulido C, Ar Gouilh M et al (2020) Massive transient damage of the olfactory epithelium associated with infection of sustentacular cells by SARS-CoV-2 in golden Syrian hamsters. Brain Behav Immun. ; 89:579–86. Available from: URL: https://pubmed.ncbi.nlm.nih.gov/32629042/

20.

Kim B-Y, Park JY, Kim EJ, Kim BG, Kim SW, Kim SW (2019) The neuroplastic effect of olfactory training to the recovery of olfactory system in mouse model. Int Forum Allergy Rhinol. ; 9(7):715–23. Available from: URL: https://pubmed.ncbi.nlm.nih.gov/30793525/

21.

Hummel T, Stupka G, Haehner A, Poletti SC (2018) Olfactory training changes electrophysiological responses at the level of the olfactory epithelium. Rhinology 56(4):330–335PubMed

22.

Gellrich J, Han P, Manesse C, Betz A, Junghanns A, Raue C et al (2018) Brain volume changes in hyposmic patients before and after olfactory training. Laryngoscope. ; 128(7):1531–6. Available from: URL: https://pubmed.ncbi.nlm.nih.gov/29238983/

23.

Vance DE, Del Bene VA, Kamath V, Frank JS, Billings R, Cho D-Y et al (2024) Does Olfactory Training Improve Brain Function and Cognition? A Systematic Review. Neuropsychol Rev. ; 34(1):155–91. Available from: URL: https://link.springer.com/article/https://doi.org/10.1007/s11065-022-09573-0

24.

Oleszkiewicz A, Abriat A, Doelz G, Azema E, Hummel T (2021) Beyond olfaction: beneficial effects of olfactory training extend to aging-related cognitive decline. Behav Neurosci 135(6):732–740CrossRefPubMed

25.

Gudziol V, Lötsch J, Hähner A, Zahnert T, Hummel T (2006) Clinical significance of results from olfactory testing. Laryngoscope 116(10):1858–1863CrossRefPubMed

26.

World Medical Association Declaration of Helsinki (2001) Ethical principles for medical research involving human subjects. Bull World Health Organ 79(4):373–374

27.

Robert Koch Institut SARS-CoV-2 Varianten in Deutschland: Daten aus der integrierten genomischen Surveillance von SARS-CoV-2; 2024 [cited 2024 Jan 5]. Available from: URL: https://public.data.rki.de/t/public/views/IGS_Dashboard/DashboardVOC?%3Aembed=y&%3AisGuestRedirectFromVizportal=y

28.

Canas LS, Molteni E, Deng J, Sudre CH, Murray B, Kerfoot E et al (2023) Profiling post-COVID-19 condition across different variants of SARS-CoV-2: a prospective longitudinal study in unvaccinated wild-type, unvaccinated alpha-variant, and vaccinated delta-variant populations. The Lancet Digital Health. ; 5(7):e421-e434. Available from: URL: https://www.thelancet.com/journals/landig/article/PIIS2589-7500%2823%2900056-0/fulltext

29.

Welge-Luessen A, Hummel T (eds) (2013) Management of smell and taste disorders. [Thieme], Stuttgart

30.

Hummel T, Hummel C, Welge-Luessen A (2013) Assessment of Olfaction and Gustation. In: Welge-Luessen A, Hummel T (eds) Management of smell and taste disorders. [Thieme], Stuttgart, pp 58–75

31.

Whitcroft KL, Altundag A, Balungwe P, Boscolo-Rizzo P, Douglas R, Enecilla MLB et al (2023) Position paper on olfactory dysfunction: Rhin 2023.

32.

Drews T, Hummel T, Rochlitzer B, Hauswald B, Hähner A (2022) Acupuncture is associated with a positive effect on odour discrimination in patients with postinfectious smell loss-a controlled prospective study. Eur Arch Otorhinolaryngol 279(3):1329–1334CrossRefPubMed

33.

Liu DT, Pellegrino R, Sabha M, Aytug A, Damm M, Poletti SC et al (2020) Factors associated with relevant olfactory recovery after olfactory training: a retrospective study including 601 participants. Rhin. ; 0(0):0. Available from: URL: https://pubmed.ncbi.nlm.nih.gov/32901616/

34.

Oleszkiewicz A, Schriever VA, Croy I, Hähner A, Hummel T (2019) Updated Sniffin’ Sticks normative data based on an extended sample of 9139 subjects. Eur Arch Otorhinolaryngol. ; 276(3):719–28. Available from: URL: https://link.springer.com/article/https://doi.org/10.1007/s00405-018-5248-1

35.

Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I et al (2005) The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. ; 53(4):695–9. Available from: URL: https://pubmed.ncbi.nlm.nih.gov/15817019/

36.

Thomann AE, Berres M, Goettel N, Steiner LA, Monsch AU (2020) Enhanced diagnostic accuracy for neurocognitive disorders: a revised cut-off approach for the Montreal Cognitive Assessment. Alz Res Therapy. ; 12(1):39. Available from: URL: https://alzres.biomedcentral.com/articles/https://doi.org/10.1186/s13195-020-00603-8

37.

Shao Z, Janse E, Visser K, Meyer AS (2014) What do verbal fluency tasks measure? Predictors of verbal fluency performance in older adults. Front. Psychol. ; 5:772. Available from: URL: https://www.frontiersin.org/articles/https://doi.org/10.3389/fpsyg.2014.00772/full

38.

Brickenkamp R (1962) Test d2: aufmerksamkeits-belastungs-test. C. J. Hogrefe

39.

Brickenkamp R, Lothar Schmidt-Atzert (2010) Detlev Liepmann. d2-R–Aufmerksamkeits-und Konzentrationstest. Hogrefe, Göttingen

40.

Yato Y, Hirose S, Wallon P, Mesmin C, Jobert M (2019) d2-R test for Japanese adolescents: concurrent validity with the attention deficit-hyperactivity disorder rating scale. Pediatr Int 61(1):43–48CrossRefPubMed

41.

Morisky DE, Green LW, Levine DM (1986) Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. ; 24(1):67–74. Available from: URL: https://pubmed.ncbi.nlm.nih.gov/3945130/

42.

Shrier I, Steele RJ, Verhagen E, Herbert R, Riddell CA, Kaufman JS (2014) Beyond intention to treat: what is the right question? Clin Trials 11(1):28–37CrossRefPubMed

43.

Kajiya K, Inaki K, Tanaka M, Haga T, Kataoka H, Touhara K (2001) Molecular bases of odor discrimination: Reconstitution of olfactory receptors that recognize overlapping sets of odorants. J Neurosci. ; 21(16):6018–25. Available from: URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6763140/

44.

Pires ÍdAT, Steffens ST, Mocelin AG, Shibukawa DE, Leahy L, Saito FL et al (2022) Intensive olfactory training in Post-COVID-19 patients: a Multicenter Randomized Clinical Trial. Am J Rhinol Allergy 36(6):780–787CrossRef

45.

Altundag A, Yilmaz E, Kesimli MC (2022) Modified olfactory training is an effective treatment method for COVID-19 Induced Parosmia. Laryngoscope 132(7):1433–1438CrossRefPubMedPubMedCentral

46.

Altundag A (2023) Parosmia and Phantosmia: Managing Quality Disorders. Curr Otorhinolaryngol Rep. :1–8. Available from: URL: https://link.springer.com/article/10.1007/s40136-023-00441-w

47.

Olofsson JK, Ekström I, Larsson M, Nordin S (2021) Olfaction and aging: a review of the current state of research and future directions. Iperception 12(3):20416695211020331PubMedPubMedCentral

48.

Vance DE, Del Bene VA, Kamath V, Frank JS, Billings R, Cho D-Y et al Does olfactory training improve brain function and cognition? A systematic review. Neuropsychol Rev 2023:1–37

49.

Wegener B-A, Croy I, Hähner A, Hummel T (2018) Olfactory training with older people. Int J Geriatr Psychiatry 33(1):212–220CrossRef

50.

Olofsson JK, Ekström I, Lindström J, Syrjänen E, Stigsdotter-Neely A, Nyberg L et al (2020) Smell-based memory training: evidence of olfactory learning and transfer to the visual domain. Chem Senses 45(7):593–600CrossRefPubMedPubMedCentral

51.

Olofsson JK, Gottfried JA (2015) The muted sense: neurocognitive limitations of olfactory language. Trends Cogn Sci. ; 19(6):314–21. Available from: URL: https://pubmed.ncbi.nlm.nih.gov/25979848/

52.

Fortin NJ, Agster KL, Eichenbaum HB (2002) Critical role of the hippocampus in memory for sequences of events. Nature neuroscience. ; 5(5):458–62. Available from: URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4053170/

53.

Haehner A, Chen B, Espin M, Haussmann R, Matthes C, Desser D et al (2022) Training with Odors Impacts Hippocampal Thickness in Patients with Mild Cognitive Impairment. Alzheimers Dis. ; 88(2):743–55. Available from: URL: https://pubmed.ncbi.nlm.nih.gov/35694924/

54.

Negoias S, Pietsch K, Hummel T (2017) Changes in olfactory bulb volume following lateralized olfactory training. Brain Imaging Behav. ; 11(4):998–1005. Available from: URL: https://pubmed.ncbi.nlm.nih.gov/27448159/

55.

Mahmut MK, Musch M, Han P, Abolmaali N, Hummel T (2020) The effect of olfactory training on olfactory bulb volumes in patients with idiopathic olfactory loss. Rhin. ; 58(4):410–2. Available from: URL: https://pubmed.ncbi.nlm.nih.gov/32533766/

56.

Kim B-Y, Park J, Kim E, Kim B (2020) Olfactory ensheathing cells mediate neuroplastic mechanisms after olfactory training in mouse model. Am J Rhinol Allergy 34(2):217–229CrossRefPubMed

57.

Moran DT, Jafek BW, Eller PM, Rowley JC (1992) Ultrastructural histopathology of human olfactory dysfunction. Microsc Res Tech. ; 23(2):103–10. Available from: URL: https://pubmed.ncbi.nlm.nih.gov/1421550/

58.

Schepens EJA, de Haas CJM, Postma EM, van Dijk B, Boesveldt S, Stegeman I et al (2024) The effect of smell training on COVID-19 induced smell loss. Rhin

59.

Pieniak M, Oleszkiewicz A, Avaro V, Calegari F, Hummel T (2022) Olfactory training - Thirteen years of research reviewed. Neurosci Biobehav Rev. ; 141:104853. Available from: URL: https://www.sciencedirect.com/science/article/pii/S0149763422003426

60.

Doty RL, Laing DG (2015) Psychophysical measurement of human olfactory function. In: Doty RL (ed) Handbook of Olfaction and Gustation. Wiley, pp 225–260

61.

Stevens JC, Cain WS, Burke RJ (1988) Variability of olfactory thresholds. Chem Senses 13(4):643–653CrossRef

Title: Four odorants for olfactory training are enough: a pilot study
Authors: Nicole Power Guerra
Emely Kruschwitz
Dietmar Krautwurst
Thomas Hummel
Publication date: 06-09-2024
Publisher: Springer Berlin Heidelberg
Keywords: Smelling Disorder
Smelling Disorder
COVID-19
Published in: European Archives of Oto-Rhino-Laryngology
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-024-08930-4

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Four odorants for olfactory training are enough: a pilot study

Abstract

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Abstract

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