A data set of symptoms and needs of individuals affected by COVID-19.

Here we provide data from an online survey of 639 people diagnosed with COVID-19 and resident in France, who were diagnosed with COVID-19 between 30th Jan 2020 and 29th August 2022. In addition to demographic information the survey includes questions about participants' symptoms (by category), symptom onset and persistence, and the effects these symptoms had on their daily lives. Participants were able to include information related to their perceived medical, social and professional needs. These data are needed in order to create effective care policies addressing post-COVID sequelae. Information related to symptom association & dynamics is expected to be useful to clinicians and may also inform more fundamental studies.

Loss of smell in lung cancer patients undergoing chemotherapy: Prevalence and relationship with food habit changes.

BACKGROUND AND OBJECTIVES: Cancer patients undergoing cytotoxic chemotherapies exhibit a series of adverse side effects including smell and taste alterations, which can have a significant impact on their food behavior and quality of life. Particularly, olfactory alterations are often underestimated, although declared as frequent by cancer patients. In the present study, we set out to examine loss of smell in lung cancer patients undergoing chemotherapy and its relationship to food habits. MATERIAL AND METHODS: Forty-four bronchial cancer patients receiving cisplatin and 44 controls age and gender matched participants were tested for olfactory and gustatory functions using the European Test of Olfactory Capabilities and the Taste Strips test. Participants reported their food and dietary habits by filling a self-administered questionnaire. Patients were tested under two different sessions: i) before the beginning of the treatment, and ii) 6 weeks later, after 2 cycles of chemotherapy. Controls were tested under the same protocol with two sessions separated by 6 weeks. RESULTS AND CONCLUSIONS: The results highlighted decreased smell and taste abilities in almost half of the lung patients' group even before the exposition to Cisplatin. On a perceptual level, patients rated typical food odors as less edible compared to controls. Moreover, within the patients' group, hyposmics reported using more condiments, possibly as a compensatory mechanism to their decreased sensory abilities. Taken together, these findings showed that loss of smell is prevalent in lung cancer patients and is related to changes in dietary practices including seasoning. Future studies will provide a better understanding of these sensory compensation mechanisms associated with olfactory loss and their effects on food pleasure in this patient population.

Cognitive and hormonal regulation of appetite for food presented in the olfactory and visual modalities.

The ability to regulate appetite is essential to avoid food over-consumption. The desire for a particular food can be triggered by its odor before it is even seen. Using fMRI, we identify the neural systems modulated by cognitive regulation when experiencing appetizing food stimuli presented in both olfactory and visual modalities, while being hungry. Regulatory instruction modulated bids for food items and inhalation patterns. Distinct brain regions were observed for up and down appetite-regulation, respectively the dorsomedial prefrontal cortex (dmPFC) and dorsolateral PFC. Food valuation engaged the ventromedial PFC and bilateral striatum. Furthermore, we identified a neurobiological marker for successful appetite upregulation. Individuals with higher blood levels of ghrelin were better at exercising up-regulation, and engaged the dmPFC more. These findings characterize the neural circuitry regulating food consumption within the healthy population and highlight how cognitive regulation modulates olfactomotor measures of olfaction.

Configural memory of a blending aromatic mixture reflected in activation of the left orbital part of the inferior frontal gyrus.

Blending aromatic mixtures components naturally fuse to form a unique odor - a configuration- qualitatively different from each component's odor. Repeated exposure to the components either in the mixture or separately, favors respectively, configural and elemental processings. The neural bases of such processes are still unknown. We examined the brain correlates of the experienced-induced configural processing of a well-known model of binary blending odor mixture, the aromatic pineapple blending (AB, ethyl maltol + ethyl isobutyrate). Before fMRI recording, half of the participants were repeatedly exposed to the mixture (AB, group Gmix), with the other half exposed to its separate components (A and B; Gcomp). During the fMRI recording, all participants were stimulated with the mixture (AB) and the components (A and B). Finally, participants rated the number of odors perceived for each stimulus. Gmix perceived the AB mixture as less complex than did Gcomp. While Gcomp perceived the mixture as more complex than its components, Gmix did not. These results show the presence of experience-induced configural or elemental processing of the AB mixture in each group. Contrasting the brain activity of Gcomp and Gmix, when stimulated with AB, revealed higher activation in the left orbital part of the inferior frontal gyrus. This result sheds light on this area's function, commonly found activated in olfactory studies, and closely connected with the lateral orbitofrontal cortex. We discuss the role of this area as a mediator of configural percepts between temporal and orbitofrontal areas involved in configural memory processes.

Chemotherapy-induced taste and smell changes influence food perception in cancer patients.

PURPOSE: Chemotherapy-induced taste and smell alterations may have a negative impact on the quality of life and nutritional status. A prominent issue when dealing with taste and smell alterations and their consequences on food behavior and well-being lies in the variation arising from individual differences in chemosensory perceptions. The main aim of this study was to examine the effect of individuals' variation in the severity of taste and smell alterations relative to the stage of chemotherapy on self-reported food behavior and food perception. METHODS: Eighty-nine cancer patients completed a questionnaire subdivided into two parts: a chemosensory part that allowed classification of patients in three groups ("no alterations," "moderate alterations," and "severe alterations") and a food behavior part. RESULTS: The results highlighted a negative impact of chemosensory alterations on food perception. Compared with patients without taste and smell alterations, patients with severe chemosensory alterations reported significantly more frequent food perception problems, including modification of the perceived taste of food, finding bad taste in all food, and being unable to perceive food taste. Whereas 72% of patients with severe alterations were in late stage, only 37% of patients were in late stage in the no alterations group, indicating an effect of the treatment stage on taste and smell alterations. CONCLUSION: Our results underlie the importance of providing specific attention to the severity of chemotherapy-induced taste and smell alterations and considering the individual differences among patients for a better nutritional management.

A methodological investigation of a flexible surface MRI coil to obtain functional signals from the human olfactory bulb.

BACKGROUND: Mammalian olfaction begins with transduction in olfactory receptors, continues with extensive processing in the olfactory bulb, and culminates in cortical representation. Most rodent studies on the functional neuroanatomy of olfaction have concentrated on the olfactory bulb, yet whether this structure is tuned only to basic chemical features of odorants or also to higher-order perceptual features is unclear. NEW METHOD: Whereas studies of the human brain can typically uncover involvement of higher-order feature extraction, this has not been possible in the case of the olfactory bulb, inaccessible to fMRI. The present study examined whether a novel method of acquisition using a facial coil could overcome this limitation. RESULTS: A series of experiments provided preliminary evidence of odor-driven responses in the human olfactory bulb, and found that these responses differed between individuals. COMPARISON WITH EXISTING METHODS AND CONCLUSIONS: The present preliminary technical achievement renders possible to design novel human odor fMRI studies by considering the olfactory system from the olfactory bulb to associative areas.

Structural Plasticity of the Primary and Secondary Olfactory cortices: Increased Gray Matter Volume Following Surgical Treatment for Chronic Rhinosinusitis.

Functional plasticity of the adult brain is well established. Recently, the structural counterpart to such plasticity has been suggested by neuroimaging studies showing experience-dependent differences in gray matter (GM) volumes. Within the primary and secondary olfactory cortices, reduced GM volumes have been demonstrated in patients with olfactory loss. However, these cross-sectional studies do not provide causal evidence for GM volume change, and thereby structural plasticity. Disorders of the peripheral olfactory system, such as chronic rhinosinusitis (CRS), provide an ideal model to study GM structural plasticity, given that patients may experience long periods of olfactory impairment, followed by near complete recovery with treatment. We therefore performed a prospective longitudinal study in patients undergoing surgical treatment for CRS. We used voxel-based morphometry (VBM) to investigate GM volume change in 12 patients (M:F = 7:5; 47.2 ±â€¯14.9 years), 3 months post-op. There was a significant improvement in olfactory function according to birhinal psychophysical testing. We performed a voxel-wise region of interest analysis, with significance corrected for number of regions (p < 0.0036corr). We found significantly increased post-operative GM volumes within the primary (left piriform cortex, right amygdala) and secondary (right orbitofrontal cortex, caudate nucleus, hippocampal-parahippocampal complex and bilateral temporal poles) olfactory networks, and decreased GM volumes within the secondary network only (left caudate nucleus and temporal pole, bilateral hippocampal-parahippocampal complex). As a control measure, we assessed GM change within V1, S1 and A1, where there were no suprathreshold voxels. To our knowledge, this is the first study to demonstrate GM structural plasticity within the primary and secondary olfactory cortices, following restoration of olfaction.

Impaired Odor Perception in Autism Spectrum Disorder Is Associated with Decreased Activity in Olfactory Cortex.

Autism Spectrum Disorders (ASDs) are characterized by atypical sensory functioning in the visual, tactile, and auditory systems. Although less explored, olfactory changes have been reported in ASD patients. To explore these changes on a neural level, 18 adults with ASD and 18 healthy neurotypical controls were examined in a 2-phase study. Participants were first tested for odor threshold and odor identification. Then, (i) structural magnetic resonance (MR) images of the olfactory bulb were acquired, and (ii) a functional MR imaging olfaction study was conducted. ASD patients exhibited decreased function for odor thresholds and odor identification; this was accompanied by a relatively decreased activation in the piriform cortex. In conclusion, these findings suggest, that the known alterations in olfaction in ASD are rooted in the primary olfactory cortex.

Pleasantness and trigeminal sensations as salient dimensions in organizing the semantic and physiological spaces of odors.

A major issue in human olfaction research is to characterize the main dimensions that organize the space of odors. The present study examines this question and shows that, beside pleasantness, trigeminal sensations, and particularly irritation, play an important role. These results were consistent along two different spaces constructed using semantic description and physiological responses to 105 odorants, smelled and described by human participants. Taken together, these findings suggest that salient trigeminal features, in conjunction with pleasantness, are involved in detecting relevant emotional stimuli, and modify the way organisms categorize smells. These results shed light on the importance of trigeminal sensitivity in the well-established defensive function of olfaction.

Multidimensional representation of odors in the human olfactory cortex.

What is known as an odor object is an integrated representation constructed from physical features, and perceptual attributes mainly mediated by the olfactory and trigeminal systems. The aim of the present study was to comprehend how this multidimensional representation is organized, by deciphering how similarities in the physical, olfactory and trigeminal perceptual spaces of odors are represented in the human brain. To achieve this aim, we combined psychophysics, functional MRI and multivariate representational similarity analysis. Participants were asked to smell odors diffused by an fMRI-compatible olfactometer and to rate each smell along olfactory dimensions (pleasantness, intensity, familiarity and edibility) and trigeminal dimensions (irritation, coolness, warmth and pain). An event-related design was implemented, presenting different odorants. Results revealed that (i) pairwise odorant similarities in anterior piriform cortex (PC) activity correlated with pairwise odorant similarities in chemical properties (P < 0.005), (ii) similarities in posterior PC activity correlated with similarities in olfactory perceptual properties (P <0.01), and (iii) similarities in amygdala activity correlated with similarities in trigeminal perceptual properties (P < 0.01). These findings provide new evidence that extraction of physical, olfactory and trigeminal features is based on specific fine processing of similarities between odorous stimuli in a distributed manner in the olfactory system. Hum Brain Mapp 37:2161-2172, 2016. © 2016 Wiley Periodicals, Inc.

Application of the European Test of Olfactory Capabilities in patients with olfactory impairment.

A central issue in olfaction concerns the characterization of loss of olfactory function: partial (hyposmia) or total (anosmia). This paper reports the application in a clinical setting of the European Test of Olfactory Capabilities (ETOC), combining odor detection and identification. The study included three phases. In phase 1, anosmics, hyposmics and controls were tested with the 16-items version of the ETOC. In phase 2, a short version of the ETOC was developed: patients with and controls without olfactory impairment were tested on a 6-items ETOC. In phase 3, to predict olfactory impairments in new individuals, the 16-items ETOC was administered on samples of young and older adults, and the 6-items version was applied in samples of young, elderly participants and Alzheimer patients. In phase 1, linear discriminant analysis (LDA) of ETOC scores classified patients and controls with 87.5 % accuracy. In phase 2, LDA provided 84 % correct classification. Results of phase 3 revealed: (1) 16-items ETOC: whereas in young adults, 10 % were classified as hyposmic and 90 % as normosmic, in elderly, 1 % were classified as anosmic, 39 % hyposmic and 60 % normosmic; (2) 6-items ETOC: 15 % of the young adults were classified as having olfactory impairment, compared to 28 % in the older group and 83 % in Alzheimer patients. In conclusion, the ETOC enables characterizing the prevalence of olfactory impairment in young subjects and in normal and pathological aging. Whereas the 16-items ETOC is more discriminant, the short ETOC may provide a fast (5-10 min) tool to assess olfaction in clinical settings.

Dissociated neural representations induced by complex and simple odorant molecules.

An important challenge in olfaction research is to understand how percepts relate to the molecular structure of stimuli. Previous psychophysical studies showed that, whereas structurally simple odorant molecules evoked a more uniform qualitative perception as revealed by the use of a small number of labels to describe their olfactory quality, more complex odorants evoked a larger variety of olfactory qualities, reflecting a more heterogeneous qualitative perception. The present study examined how this influence of odorant molecular complexity on perception is reflected in the human brain. To this end, participants were stimulated with structurally simple and complex odorant molecules and their brain responses were assessed by functional magnetic resonance imaging (fMRI). Low- and high-complexity odorants were judged to have the same intensity, pleasantness and familiarity (p>0.05 in all cases), whereas complex odorants induced more quality labels than simple odorants (p<0.02) as expected. Imaging analysis of complex vs. simple odorants revealed significant activation in dorsal anterior cingulate gyrus, but not in primary olfactory areas. Taken together, these findings suggest dissociated neural representations of uniform and heterogeneous olfactory perception, highlighting for the first time the impact of odorant complexity on activity of the cingulate gyrus.

Cisplatin chemotherapy induces odor perception changes in bronchial cancer patients.

A study of olfactory function was performed in 15 bronchial cancer patients receiving cisplatin and 15 control subjects. Whereas odor detection and odor identification abilities were not influenced by the administration of cisplatin, a decrease in pleasantness was observed only for food odors, and not for non-food odors. Taken as a whole, these findings suggest that cisplatin therapy in bronchial cancer patients impairs the pleasure of perceived food odors, which may account for disturbances in food intake and quality of life in this population.

A portable experimental apparatus for human olfactory fMRI experiments.

Human olfactory perception can be measured using psychophysical tools or more complex odor generating devices systems, namely olfactometers. The present paper is aimed at presenting a new inexpensive, non-voluminous portable olfactometer adapted for human fMRI experiments. The system adjusts odorant stimulus presentation to human nasal respiration and records behavioral responses in the same experimental device. Validation by psychophysical measures and photo-ionization detection showed a linear increase in both odor intensity perception and vapor concentration as a function of odorant concentration. Further validation by brain imaging revealed neural activation in typical olfactory areas. In summary, the system represents a new low-cost, easy-use, easy-maintenance portable olfactometry tool for brain imaging, opening up new possibilities for investigating neural response to odors using event-related fMRI designs.

Does olfactory specific satiety take place in a natural setting?

Olfactory-specific satiety (OSS) is characterized by a specific decrease in the odor pleasantness of a food eaten to satiety or smelled without ingestion. The usual protocol for studying OSS takes place in laboratory, a setting rather removed from the real world. Here, we set out to examine OSS in a natural setting: during a meal in a restaurant. We hypothesized that an aroma contained in a food that is eaten at the beginning of a meal decreases the pleasantness of the flavor of a food with the same aroma eaten at the end of the meal. In the first experiment (Experiment 1), a test group received an appetizer flavored with a test aroma (anise) at the beginning of the meal. After the main dish, they received a dessert flavored with the same aroma. A control group received the same aromatized dessert, but after a non-aromatized appetizer. This experiment was replicated (Experiment 2) using verbena as the test aroma. For both experiments, results revealed that aroma pleasantness, but not intensity or familiarity, significantly decreased in the test groups vs. the control groups. These findings extend the concept of OSS to a realistic eating context.

Molecular complexity determines the number of olfactory notes and the pleasantness of smells.

One major unresolved problem in olfaction research is to relate the percept to the molecular structure of stimuli. The present study examined this issue and showed for the first time a quantitative structure-odor relationship in which the more structurally complex a monomolecular odorant, the more numerous the olfactory notes it evokes. Low-complexity odorants were also rated as more aversive, reflecting the fact that low molecular complexity may serve as a warning cue for the olfactory system. Taken together, these findings suggest that molecular complexity provides a framework to explain the subjective experience of smells.

Neural coding of stimulus concentration in the human olfactory and intranasal trigeminal systems.

Nasal chemical sensations are mediated principally by the olfactory and the trigeminal systems. Over the last few years brain structures involved in processing of trigeminal stimuli have been more and more documented. However, the exact role of individual regions in stimulus intensity processing is unclear. The present study set out to examine the neural network involved in encoding stimulus intensity in the trigeminal system and the olfactory system of humans. Participants were presented with two concentrations of relatively specific trigeminal stimuli (CO2) and olfactory (H2S), respectively. Responses were assessed by functional magnetic resonance imaging (fMRI). Whereas brain responses to stimulus intensity in the olfactory modality involved a wide neural network including cerebellum, entorhinal cortex, visual areas, and frontal regions, contrasting high and low CO2 concentrations revealed activation in a less complex network including various sub-regions of the cingulate cortex. Taken together, these results suggest separate but overlapping neural networks involved in encoding stimulus intensity in the two chemosensory systems.

Synergy and masking in odor mixtures: an electrophysiological study of orthonasal vs. retronasal perception.

Perceptual interactions in a model of wine woody-fruity binary mixtures were previously reported in a psychophysical study performed through orthonasal stimulation only. However, recent studies suggested that the perception of food-like and nonfood-like odors may depend on the route of stimulation. The aim of the present study was two-fold: first to examine the neural correlates of perceptual interactions using electroencephalogram (EEG)-derived event-related potentials (ERPs) and second to test the influence of the stimulation route on quality perception. Therefore, we designed an experiment with 30 subjects to study perceptual interactions in woody-fruity mixtures and compared ortho- vs. retronasal stimulation sites on perceived odor quality and ERPs. The results revealed synergy or masking of the fruity component, depending on the woody component level. Synergy was supported by larger N1 amplitude of the ERP. Furthermore, mixtures including a medium level of the woody odor elicited a strong increase of P2 amplitude only retronasally. This study evidenced for the first time electrophysiological correlates of both perceptual synergy and masking on the early component of the ERPs and confirmed that retro- vs. orthonasal stimulation route induces different neural processes that are reflected in the late component of the ERP.

Improved smell pleasantness after odor-taste associative learning in humans.

Whereas some aspects of olfactory hedonism in humans are present from birth, others form during development and throughout adulthood. Although it is generally agreed that such hedonic representations emerge by associative learning, it is not yet clear which learning parameters are prominent. The present study investigated the influence of number of trials on odor preference acquisition in human adults. Forty-eight subjects randomly assigned to three groups were tested in three sessions. In the first session, subjects ranked eight food odors from most pleasant to most unpleasant. The second session consisted in an associative learning, the two most neutral odors were randomly associated with a drink: one odor with water (CS-) and the other odor with a pleasant sweet solution (CS+). In the third session subjects ranked the eight food odors again. In group A, CS+ was paired three times with the US, and in group B only once; in group C, CS+ was paired only once with the US but with a total duration identical to that in group A. Results showed that CS+ was ranked as significantly more pleasant after learning in group A (p<.05), but not in groups B and C (p>.05). In conclusion, the study showed that a neutral smell can acquire positive emotional features after being paired with a pleasant taste, and that this learning depends on the number of associations between smell and taste.