Scent-delivery devices as a digital healthcare tool for olfactory training: A pilot focus group study in Parkinson's disease patients.

Parkinson's disease (PD) patients display a combination of motor and non-motor symptoms. The most common non-motor symptom is scent (olfactory) impairment, occurring at least four years prior to motor symptom onset. Recent and growing interest in digital healthcare technology used in PD has resulted in more technologies developed for motor rather than non-motor symptoms. Human-computer interaction (HCI), which uses computer technology to explore human activity and work, could be combined with digital healthcare technologies to better understand and support olfaction via scent training - leading to the development of a scent-delivery device (SDD). In this pilot study, three PD patients were invited to an online focus group to explore the association between PD and olfaction, understand HCI and sensory technologies and were demonstrated a new multichannel SDD with an associated mobile app. Participants had a preconceived link, a result of personal experience, between olfactory impairment and PD. Participants felt that healthcare professionals did not take olfactory dysfunction concerns seriously prior to PD diagnosis. Two were not comfortable with sharing scent loss experiences with others. Participants expected the multichannel SDD to be small, portable and easy-to-use, with customisable cartridges to deliver chosen scents and the mobile app to create a sense of community. None of the participants regularly performed scent training but would consider doing so if some scent function could be regained. Standardised digital SDDs for regular healthcare check-ups may facilitate improvement in olfactory senses in PD patients and potential earlier PD diagnosis, allowing earlier therapeutic and symptomatic PD management.

The Power of Odor Persuasion: The Incorporation of Olfactory Cues in Virtual Environments for Personalized Relaxation.

Olfaction is the most ancient sense and is directly connected with emotional areas in the brain. It gives rise to perception linked to emotion both in everyday life and in memory-recall activities. Despite its emotional primacy in perception and its role in sampling the real physical world, olfaction is rarely used in clinical psychological settings because it relies on stimuli that are difficult to deliver. However, recent developments in virtual-reality tools are creating novel possibilities for the engagement of the sense of smell in this field. In this article, we present the relevant features of olfaction for relaxation purposes and then discuss possible future applications of involving olfaction in virtual-reality interventions for relaxation. We also discuss clinical applications, the potential of new tools, and current obstacles and limitations.

Corrigendum: May I Smell Your Attention: Exploration of Smell and Sound for Visuospatial Attention in Virtual Reality.

[This corrects the article DOI: 10.3389/fpsyg.2021.671470.].

May I Smell Your Attention: Exploration of Smell and Sound for Visuospatial Attention in Virtual Reality.

When interacting with technology, attention is mainly driven by audiovisual and increasingly haptic stimulation. Olfactory stimuli are widely neglected, although the sense of smell influences many of our daily life choices, affects our behavior, and can catch and direct our attention. In this study, we investigated the effect of smell and sound on visuospatial attention in a virtual environment. We implemented the Bells Test, an established neuropsychological test to assess attentional and visuospatial disorders, in virtual reality (VR). We conducted an experiment with 24 participants comparing the performance of users under three experimental conditions (smell, sound, and smell and sound). The results show that multisensory stimuli play a key role in driving the attention of the participants and highlight asymmetries in directing spatial attention. We discuss the relevance of the results within and beyond human-computer interaction (HCI), particularly with regard to the opportunity of using VR for rehabilitation and assessment procedures for patients with spatial attention deficits.

Emotional ratings and skin conductance response to visual, auditory and haptic stimuli.

The human emotional reactions to stimuli delivered by different sensory modalities is a topic of interest for many disciplines, from Human-Computer-Interaction to cognitive sciences. Different databases of stimuli eliciting emotional reaction are available, tested on a high number of participants. Interestingly, stimuli within one database are always of the same type. In other words, to date, no data was obtained and compared from distinct types of emotion-eliciting stimuli from the same participant. This makes it difficult to use different databases within the same experiment, limiting the complexity of experiments investigating emotional reactions. Moreover, whereas the stimuli and the participants' rating to the stimuli are available, physiological reactions of participants to the emotional stimuli are often recorded but not shared. Here, we test stimuli delivered either through a visual, auditory, or haptic modality in a within participant experimental design. We provide the results of our study in the form of a MATLAB structure including basic demographics on the participants, the participant's self-assessment of his/her emotional state, and his/her physiological reactions (i.e., skin conductance).

Smelling the space around us: Odor pleasantness shifts visuospatial attention in humans.

The prompt recognition of pleasant and unpleasant odors is a crucial regulatory and adaptive need of humans. Reactive answers to unpleasant odors ensure survival in many threatening situations. Notably, although humans typically react to certain odors by modulating their distance from the olfactory source, the effect of odor pleasantness over the orienting of visuospatial attention is still unknown. To address this issue, we first trained participants to associate visual shapes with pleasant and unpleasant odors, and then we assessed the impact of this association on a visuospatial task. Results showed that the use of trained shapes as flankers modulates performance in a line bisection task. Specifically, it was found that the estimated midpoint was shifted away from the visual shape associated with the unpleasant odor, whereas it was moved toward the shape associated with the pleasant odor. This finding demonstrates that odor pleasantness selectively shifts human attention in the surrounding space. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

What drives sound symbolism? Different acoustic cues underlie sound-size and sound-shape mappings.

Sound symbolism refers to the non-arbitrary mappings that exist between phonetic properties of speech sounds and their meaning. Despite there being an extensive literature on the topic, the acoustic features and psychological mechanisms that give rise to sound symbolism are not, as yet, altogether clear. The present study was designed to investigate whether different sets of acoustic cues predict size and shape symbolism, respectively. In two experiments, participants judged whether a given consonant-vowel speech sound was large or small, round or angular, using a size or shape scale. Visual size judgments were predicted by vowel formant F1 in combination with F2, and by vowel duration. Visual shape judgments were, however, predicted by formants F2 and F3. Size and shape symbolism were thus not induced by a common mechanism, but rather were distinctly affected by acoustic properties of speech sounds. These findings portray sound symbolism as a process that is not based merely on broad categorical contrasts, such as round/unround and front/back vowels. Rather, individuals seem to base their sound-symbolic judgments on specific sets of acoustic cues, extracted from speech sounds, which vary across judgment dimensions.

Inter-rater agreement in the assessment of response to motor and cognitive rehabilitation of children and adolescents with epilepsy.

INTRODUCTION: To assess inter-rater agreement among child neurologists and psychiatrists on evaluation of response to physical and cognitive rehabilitation of children and adolescents with epilepsy. MATERIALS AND METHODS: Five child neurologists/psychiatrists ("raters") were invited to draw 2-3 short case reports among those most commonly seen. 14 case histories were presented and raters used a structured questionnaire to report changes after selected rehabilitation programs. Response was coded as "Yes", "No", or "Uncertain" in different functional domains (Motor, Social, Alimentary, Communication, Personal Autonomy). Inter-rater agreement was measured using the kappa statistic. Raters where then asked to discuss any reason for disagreement. The test was repeated with different cases (16 case histories) adding a sixth rater, who had participated to the discussion. RESULTS: Even with this small number of cases, the agreement mostly ranged from poor to good in the first test (worse for Social, Personal Autonomy and Communication). Training improved agreement in almost all domains. There were no frank outliers. The agreement was lower with a specific approach (i.e. grouping "Uncertain" to "No") than with sensitive approach (i.e. grouping "Uncertain" to "Yes"). DISCUSSION: The interpretation of patients' response to physical and cognitive rehabilitation tends to vary among Italian child neurologists/psychiatrists depending on measures and training procedures. Discussion and training improves agreement, although this is only a pilot study conducted using a non standardized questionnaire.

Response to rehabilitation of children and adolescents with epilepsy.

One hundred fifty-six children and adolescents with epilepsy from six Italian rehabilitation units were retrospectively enrolled to define the proportion of patients with epileptogenic developmental disorders who benefit from comprehensive rehabilitation programs and to identify factors predicting treatment response. The rehabilitation programs were classified as neuromotor, psychomotor, and speech and language. For each program, the response was coded as present or absent according to the caring physician's judgment. Selected demographic and clinical variables were correlated to treatment response. Neuromotor rehabilitation was performed in 86 cases (55%), psychomotor rehabilitation in 54 cases (34%), and speech and language rehabilitation in 40 cases (26%). Response rates were 58, 74, and 90%, respectively. Independent negative predictors of treatment response included severity of functional impairment (odds ratio=0.02, 95% confidence interval=0.01-0.14) and daily seizures (odds ratio=0.22, 95% confidence interval=0.08-0.58).

An autistic endophenotype results in complex immune dysfunction in healthy siblings of autistic children.

BACKGROUND: Endophenotypes are simple biological aspects of a disease that can be observed in unaffected relatives at a higher rate than in the general population; an "autism endophenotype" justifies the observation that a mild reduction in ideational fluency and nonverbal generativity might be observed in healthy, unaffected relatives of children with autism. Because it is becoming apparent that autism is associated with given alleles encoding within the human leukocyte antigens region, a region of pivotal importance in immunity, we examined whether the "autism endophenotype" would extend its effects on the immune system. METHODS: Multiple immune parameters were analyzed in autistic children (AC) (n = 20), their siblings (HSAC) (n = 15), and age- and gender-comparable healthy control subjects (HC) (n = 20) without any familiarity for autism. RESULTS: The immune profiles of HSAC were significantly more similar to those of their autistic siblings than to what was observed in HC. Thus, in AC and HSAC compared with HC: 1) proinflammatory and interleukin-10-producing immune cells were augmented (p < .01 in both comparisons); 2) CD8(+) naïve (CD45RA(+)/CCR7+) T lymphocytes were increased (p < .0001 and p = .001); and 3) CD8(+) effector memory (CD45RA(-)/CCR7-) (p < .0001 and p = .03) as well as CD4(+) terminally differentiated (CD45RA(-)/CCR7+) (p < .05 in both comparisons) lymphocytes were diminished. Serum autoantibodies (GM1) could be detected in 10% of AC children alone. CONCLUSIONS: Results of this pilot study indicate that a complex immune dysfunction is present both in autistic children and in their non-autistic siblings and show the presence of an "autism endophenotype" that expands its effects on immunologic functions.