ABSTRACT
Resumen Alrededor de una cuarta parte de la población de adultos de más de 40 años presenta algún trastorno del olfato. Las alteraciones primarias del gusto son menos frecuentes y suelen atribuirse a un problema del olfato concomitante. Ambos tienen un fuerte impacto en la calidad de vida de las personas que lo padecen, generando depresión, aislamiento y sensación de vulnerabilidad. El grado de disfunción del olfato y el gusto han sido utilizados como predictor de mortalidad y pronóstico en ciertas enfermedades. Las etiologías son diversas e incluyen desde problemas nasosinusales hasta enfermedades neurodegenerativas. Existen diversas pruebas, fáciles de aplicar y almacenar, que permiten al clínico medir de manera objetiva el grado de disfunción de estos sistemas. El propósito de este artículo de revisión es mostrar al médico de cualquier área, la importancia de explorar estos sistemas y cómo realizarlo. También se discuten las distintas opciones de tratamiento y rehabilitación.
Abstract It is estimated that around 25% of adults over 40 years have some form of smell disorder. The primary taste disfunctions are less frequent and they are usually caused by some olfactory alteration. They both have an important impact on the quality of life of people who suffer from them, predisposing to depression, isolation and vulnerability. The degree of smell and taste dysfunction have been used as mortality predictor and prognosis in certain diseases. The etiologies go from sinonasal causes to neurodegenerative diseases. There are multiple identification tests that let us objectively know the magnitude of these disorders. The objective of these article is to show the healthcare personnel the importance of these senses, how to explore their alterations, how to approach them and their possible management and rehabilitation.
ABSTRACT
OBJECTIVE: Depression, anxiety, and obsessive-compulsive disorder have been widely reported in patients with dystonia. On the other hand, cognitive impairment, frontal lobe function, impulsiveness and pseudobulbar affect are less studied. The objective of the study is to assess these neuropsychiatric symptoms along with the quality of life of subjects with craniocervical dystonia. PATIENTS AND METHODS: A cross-sectional study was carried out in patients with craniocervical dystonia. Sex- and age-matched healthy controls were included. Neuropsychiatric assessment included the Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Barrat Impulsiveness Scale (BIS-11), Center for Neurologic Study-Lability Scale (CNS-LS), Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), and the 12-item Short Form Health Survey (SF-12). RESULTS: A total of 44 patients with craniocervical dystonia and 44 controls were included. The mean age was 57 ± 13.7 years. Depression (56.1 % vs 9.1 %, p < 0.001), anxiety (56.8 % vs 6.8 %, p < 0.001), and pseudobulbar affect (31.8 % vs 9.1 %, p = 0.02) were more common in the dystonia group in comparison to controls. No difference between groups was found in impulsiveness (p = 0.65), MoCA score (p = 0.14) or executive dysfunction (p = 0.42). Quality of life was worst in the dystonia group with 90.9 % (p = 0.03) and 61.4 % (p < 0.001) of the subjects scoring under average in the Physical Composite Score (PCS) and Mental Composite Score (MCS) of the SF-12. CONCLUSION: MoCA scores ≤18, pseudobulbar affect, depression and anxiety are more prevalent in subjects with craniocervical dystonia in comparison to sex- and age-matched healthy controls. Regarding quality of life, MCS is more affected that the PCS in subjects with dystonia.