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Olfactory impairment in autoimmune encephalitis: another piece of the puzzle.
Morano, Alessandra; Cerulli Irelli, Emanuele; Fanella, Martina; Orlando, Biagio; Salamone, Enrico Michele; Tinelli, Emanuele; Ruffolo, Gabriele; Zuliani, Luigi; Fattouch, Jinane; Manfredi, Mario; Giallonardo, Anna Teresa; Di Bonaventura, Carlo.
  • Morano A; Epilepsy Centre, Department of Human Neurosciences, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
  • Cerulli Irelli E; Epilepsy Centre, Department of Human Neurosciences, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
  • Fanella M; Neurology Unit, Ospedale "San Camillo de' Lellis", Rieti, Italy.
  • Orlando B; Epilepsy Centre, Department of Human Neurosciences, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
  • Salamone EM; Epilepsy Centre, Department of Human Neurosciences, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
  • Tinelli E; Neuroradiology Unit, "Sapienza" University of Rome, Rome, Italy.
  • Ruffolo G; Department of Physiology and Pharmacology, Istituto Pasteur-Fondazione Cenci Bolognetti, "Sapienza" University of Rome, Rome, Italy.
  • Zuliani L; IRCCS San Raffaele Pisana, Rome, Italy.
  • Fattouch J; Neurology Unit, AULSS8 Berica, Vicenza, Italy.
  • Manfredi M; Epilepsy Centre, Department of Human Neurosciences, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
  • Giallonardo AT; Epilepsy Centre, Department of Human Neurosciences, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
  • Di Bonaventura C; Epilepsy Centre, Department of Human Neurosciences, "Sapienza" University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
J Neurol ; 269(5): 2762-2768, 2022 May.
Article in English | MEDLINE | ID: covidwho-1615458
ABSTRACT

BACKGROUND:

Despite being long neglected, olfaction has recently become a focus of intense research in neuroscience, as smell impairment has been consistently documented in both neurodegenerative and neuroinflammatory diseases. Considering the close anatomo-functional correlations between the limbic system and the central olfactory structures, we investigated olfaction in a population of patients with autoimmune encephalitis (AE).

METHODS:

Nineteen adult subjects (14 males, median age 64 years) diagnosed with definite (14/19) or possible (5/19) AE and followed for ≥ 6 months were enrolled. The Brief Smell Identification Test (B-SIT), a 12-item, forced-choice, scratch-and-sniff measure, was used to assess the patients' olfactory function in comparison with a group of sex- and age-matched healthy controls (HC). According to the B-SIT score, subjects were classified as anosmic (< 6), hyposmic (6-8) and normal (≥ 9). Electro-clinical, laboratory and neuroimaging findings were reviewed.

RESULTS:

Smell impairment was revealed in 15/19 patients (9 hyposmic, 6 anosmic), compared with 5/19 HC (p = 0.0029). Age, gender and smoking habits did not affect the participants' performance at B-SIT. Olfactory dysfunction appeared more common among patients with definite AE (p = 0.0374), regardless of autoantibody status. Subjects with higher modified Rankin Scale (mRS) scores at AE onset more likely presented hyposmia/anosmia (p = 0.033), and so did those with bilateral ictal/interictal EEG abnormalities (p = 0.006).

CONCLUSIONS:

We found olfaction to be impaired in a significantly large proportion of AE cases. Smell deficits appeared more common in subjects with severe AE (as indicated by both definite diagnosis and higher mRS score), and might represent an additional feature of immune-mediated encephalitis.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Encephalitis / Hashimoto Disease / Olfaction Disorders Type of study: Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: J Neurol Year: 2022 Document Type: Article Affiliation country: S00415-022-10959-6

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Encephalitis / Hashimoto Disease / Olfaction Disorders Type of study: Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: J Neurol Year: 2022 Document Type: Article Affiliation country: S00415-022-10959-6