Добірка наукової літератури з теми "Odor dysfunction"

To assess all clinically relevant components of olfactory perception, examinations for olfactory sensitivity, discrimination, and identification are performed. Besides the standard perceptual test battery, episodic olfactory memory might offer additional information about olfactory abilities relative to these standard clinical tests. As both olfactory deficits and memory deficits are early symptoms in neurodegenerative disorders, olfactory memory may be of particular interest. However, to date little is known about episodic olfactory memory performance in patients with decreased olfactory function. This study includes the investigation of olfactory memory performance in 14 hyposmic patients (8 female, mean age 52.6 years) completing two episodic odor memory tests (Sniffin’ Test of Odor Memory and Odor Memory Test). To control for a general impairment in memory function, a verbal and a figural memory test were carried out. A regression model with multiple predictors was calculated for both odor memory tests separately. Odor identification was identified as the only significant predictor for both odor memory tasks. From our results, we conclude that currently available olfactory memory tests are highly influenced by odor identification abilities, implying the need for the development and validation of additional tests in this field which could serve as additional olfactory perception variables for clinical assessment.

Objective:We tested the hypothesis that olfactory function is more impaired in patients with primary progressive MS (PPMS) than that in relapsing-remitting MS (RRMS).Methods:Standardized olfactory testing was performed in 32 patients with PPMS, 32 patients with RRMS, and 32 healthy controls (HCs). Patients with olfactory dysfunction due to an alternative primary etiology were excluded. The validated olfactory testing method yielded individual scores for olfactory threshold, odor discrimination, and odor identification, along with a composite Threshold Discrimination Identification (TDI) score.Results:Olfactory dysfunction was identified in 27 (84%) patients with PPMS, 10 (31%) patients with RRMS, and 1 (3%) HC. While age and sex were similar between PPMS and HCs, the TDI score and all olfactory subscores were significantly worse in patients with PPMS compared with HCs (all p < 0.001). After adjustment for differences in age, sex, Expanded Disability Status Scale (EDSS), and disease duration, odor discrimination, odor identification, and the composite TDI score were worse in patients with PPMS vs RRMS (p = 0.03, 0.04, and 0.02, respectively). Neither age, sex, EDSS, nor disease duration was significantly associated with the composite TDI score.Conclusions:Olfactory dysfunction was more frequent and severe in PPMS compared with RRMS, independent of disease duration and overall disability status. Further research on cellular level differences in olfactory neural pathways may lead to new insights about disease pathogenesis in MS.

Abstract Purpose Cushing’s syndrome (CS) can lead to structural changes in the brain and cognitive impairment, but chemosensory function has not been investigated yet. The aim was to analyze sense of smell and taste in patients with CS and explore the effect of therapy. Methods The study cohort comprised 20 patients with florid CS treated between 2018 and 2020 in the outpatient clinic of the LMU Munich. We compared these 20 patients with CS to 40 healthy subjects matched for age, sex, and smoking status. Patients’ sense of smell and taste was examined at diagnosis and 3 months after successful therapeutic surgery leading to clinical and biochemical remission. Odor threshold, discrimination, and identification were measured with “Sniffin’ Sticks”, taste was measured with “Taste Strips”. Perceived sense of smell and taste was retrieved via a questionnaire. Results Patients with florid CS had significantly reduced smell (total smell score 30.3 vs. 34.4, p < 0.0005) and taste scores (9.5 vs. 12.0, p < 0.0005) compared to controls and significantly more frequently hyposmia (55 vs. 2.5%, p < 0.0005), hypogeusia (40 vs. 0%, p < 0.0005), and self-reported chemosensory impairment (60 vs. 0%, p < 0.0005). Three months after successful surgery, CS patients showed significant improvement of odor threshold (8.1 vs. 7.0, p < 0.0005), odor discrimination (12.0 vs. 11.0, p = 0.003), total smell score (33.4 vs. 30.3, p < 0.0005), and taste (11.5 vs. 9.5, p = 0.003). Conclusions Chemosensory dysfunction is a novel and clinically relevant feature of CS.

AbstractNeuropathology in Huntington's disease (HD) known to project to areas that process olfactory information raises the questions of which olfactory function, if any, is most affected in HD, and how to explain such dysfunction in terms of olfactory sensitivity and cognition. These questions were studied by comparing HD patients and controls (matched for age, gender, and education) on absolute detection, intensity discrimination, quality discrimination, short-term recognition memory, and lexical- and picture-based identification for odor. Taste or vision were used as comparison modalities. The results suggest that whereas odor-recognition memory is not affected in patients with HD, these patients have impaired olfactory functioning with respect to absolute detection, intensity discrimination, quality discrimination, and identification. The three latter impairments were significantly explained by poor detection sensitivity. Odor identification was the function most affected. (JINS, 1995, I, 281–290.)

SUMMARY OBJECTIVE To compare two combinations of olfactory agents for olfactory training therapy of olfactory dysfunction after upper respiratory tract infection (URTI) and investigate the influencing factors on clinical effects. METHODS 125 patients with olfactory dysfunction were randomly divided into two groups: test and control. During the olfactory training, four odors were used in both groups. The olfactory training lasted for 24 weeks. Then, participants were tested using Sniffin’ Sticks and threshold-discrimination-identification (TDI) composite scoring before treatment and at 1, 3, and 6 months after treatment. The TDI scores were compared at different time points between the groups and within them, and influence factors were analyzed. RESULTS There was no significant difference in TDI scores between both groups. Furthermore, TDI scores did not significantly change after one month of treatment in either of the groups. After 3 and 6 months of treatment, TDI scores both significantly increased, and the odor discrimination and identification abilities significantly strengthened in both groups; however, the odor thresholds did not improve. The course of the disease was a significant influencing factor on the therapeutic effect of olfactory training for both groups. CONCLUSION The combination of essential balm, vinegar, alcohol, and rose perfume for olfactory training, which are scents commonly found in daily life, can effectively cure URTI-induced olfactory dysfunction, and significantly improve the odor discrimination and identification abilities. Furthermore, prolonging the treatment time can help with the recovery of olfactory functions, and earlier olfactory training can improve the therapeutic effect.

Smell dysfunction is a common and underdiagnosed medical condition that can have serious consequences. It is also an early biomarker of neurodegenerative diseases, including Alzheimer’s disease, where olfactory deficits precede detectable memory loss. Clinical tests that evaluate the sense of smell face two major challenges. First, human sensitivity to individual odorants varies significantly, so test results may be unreliable in people with low sensitivity to a test odorant but an otherwise normal sense of smell. Second, prior familiarity with odor stimuli can bias smell test performance. We have developed nonsemantic tests for olfactory sensitivity (SMELL-S) and olfactory resolution (SMELL-R) that use mixtures of odorants that have unfamiliar smells. The tests can be self-administered by healthy individuals with minimal training and show high test–retest reliability. Because SMELL-S uses odor mixtures rather than a single molecule, odor-specific insensitivity is averaged out, and the test accurately distinguished people with normal and dysfunctional smell. SMELL-R is a discrimination test in which the difference between two stimulus mixtures can be altered stepwise. This is an advance over current discrimination tests, which ask subjects to discriminate monomolecular odorants whose difference in odor cannot be quantified. SMELL-R showed significantly less bias in scores between North American and Taiwanese subjects than conventional semantically based smell tests that need to be adapted to different languages and cultures. Based on these proof-of-principle results in healthy individuals, we predict that SMELL-S and SMELL-R will be broadly effective in diagnosing smell dysfunction.

The authors studied a 53-year-old man with progressive prosopagnosia and inability to recognize his favorite foods by smell. He could not identify pictures of familiar faces, but he could match unfamiliar faces and distinguish them from familiar ones. He could not identify familiar odors, but he could detect them and could perceive them as pleasant or familiar. Neuroimaging revealed temporal lobe changes, especially on the right. Right temporal lesions may produce face and odor agnosia by preventing perceptual familiarity units from accessing semantic associations.

(1) Background: Odor identification (OI) dysfunction is a potential predictor of developing dementia in late life depression (LLD). However, it is not clear whether patients with early onset depression (EOD) and late onset depression (LOD) may exhibit different OI dysfunctions. The aim of this study was to compare OI between EOD patients and LOD patients and its relationship with cognitive function. (2) Methods: A total of 179 patients with LLD and 189 normal controls were recruited. Participants underwent clinical assessment, olfactory testing, and comprehensive neuropsychological assessment. The OI scores of EOD patients and LOD patients were compared, and correlation analyses and mediation analyses were used to explore the relationship between OI and cognition. (3) Result: LOD patients exhibited lower OI scores than EOD patients and normal controls (NCs). Additionally, the LOD patients exhibited a higher percentage of OI dysfunction than the EOD patients. Moreover, OI scores were associated with global cognition, memory, language, and visuospatial ability in the EOD group (p < 0.05) but were not associated with any cognitive score in the LOD patients (p > 0.05). Finally, the scores of the Auditory Verbal Learning Test Immediate recall and Boston Naming Test exhibited a partially mediating effect on the difference in OI scores between the EOD and LOD patients. (4) Conclusions: LOD patients exhibited worse OI than EOD patients, and their difference in OI was mediated by their memory and language function.

Abnormalities in olfactory function have been identified in a number of neurological and psychiatric disorders, including Parkinson’s disease and schizophrenia. However, little is known about olfactory function in autism spectrum disorder (ASD). The present study aims to assess the olfactory profiles of children with ASD, compared to an age- and sex-matched comparison group of typically developing children and a second clinical control group consisting of non-ASD children with sensory processing dysfunction (SPD). Participants completed a battery of sensory and behavioral assessments including olfactory tasks (Sniffin’ Sticks Threshold Test and self-reported valence ratings for two target odorants (phenylethyl alcohol and vanillin) and the University of Pennsylvania Smell Identification Test), and an autism evaluation (Autism Diagnostic Observation Schedule-2). Children with ASD showed intact odor detection with reduced odor identification ability. Poor odor identification was significantly correlated with autism symptom severity. Children with SPD demonstrated reduced odor detection and identification ability. These findings provide evidence for differential patterns of smell processing among ASD and non-ASD neurodevelopmental disorders. Future studies are needed to determine whether the association of impaired olfaction and increased autism symptoms is due to shared etiology.

Большинство методов оценки обонятельных расстройств имеют широкий спектр применения для диагностики различных заболеваний, в том числе психических расстройств, повреждения головного мозга и нервной системы. Однако , необходимо рассмотреть обонятельную дисфункцию в связи с проблемой блокирования воздушного канала в обонятельной системе человека. Поэтому необходимо разработать узкоспециализированный метод оценки обонятельно-респираторных заболеваний, которые имели бы высокую степень объективности для использования в клинической практике оториноларингологов.

Orientador: Maria Aparecida Azevedo Pereira da Silva
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia de Alimentos
Made available in DSpace on 2018-08-19T19:30:51Z (GMT). No. of bitstreams: 1 Natalicio_MariaAngelica_D.pdf: 1137447 bytes, checksum: bf1a6d401d0100649213c09ece37f7f9 (MD5) Previous issue date: 2012
Resumo: Testes sensoriais para a avaliação da função olfatória de indivíduos têm sido validados e utilizados em diagnósticos da população em geral, e em portadores de desordens cerebrais e pesquisas em neurociência em particular. No Brasil, testes para serem utilizados com segurança e eficiência para a avaliação da capacidade de identificação e discriminação de odores de indivíduos ainda não foram adequadamente desenvolvidos e validados. Assim, os objetivos da presente pesquisa foram: i) desenvolver, testar e validar testes de identificação e discriminação de odores para avaliar a função olfatória de indivíduos brasileiros, ii) avaliar a potencialidade das metodologias desenvolvidas para uso em pré-diagnóstico clínico de indivíduos da terceira idade e pacientes portadores de epilepsia, iii) verificar o desempenho, em portadores de epilepsia, de uma metodologia já validada e utilizada mundialmente para avaliar a capacidade de identificação de odores de indivíduos e, iv) avaliar em portadores de epilepsia, funções que são processadas por substratos neurais comuns à função olfatória, neste caso, a capacidade de reconhecimento de emoção facial e vocal. Para o teste de identificação de odores, foi desenvolvido um instrumento intitulado "Pastilhas de Odor¿ contendo em pastilhas individuais, 36 odores familiares aos brasileiros. Os odores foram caracterizados quanto à intensidade, aceitação, pungência, refrescância e familiaridade, sendo considerados adequados para comporem um teste de avaliação da função olfatória. A identificação dos odores de "Pastilhas de Odor¿ foi realizada através de um teste de múltipla escolha contendo quatro alternativas, das quais apenas uma é a correta. Para o desenvolvimento do teste de discriminação de odores, 24 voláteis odoríferos puros (P.A.), associados a 6 diferentes categorias de odor - doce, verde, frutal, cítrico, floral e desagradável - foram selecionados e diluídos em propilenoglicol. Com essas amostras, 36 testes de comparação pareada foram construídos, onde em cada categoria de odor, uma amostra alvo foi selecionada para ser comparada com as demais da mesma categoria. O desempenho de cada indivíduo neste teste é analisado utilizando-se a teoria "signaldetection¿, através dos seguintes parâmetros: taxa de acertos (HR), taxa de falsos alarmes (FR), poder discriminativo (d¿L) e vício de resposta (CL). Os dois testes desenvolvidos - "Pastilhas de Odor¿ e teste de discriminação - foram validados com a participação de três grupos de indivíduos: grupo controle, grupo da terceira idade e grupo de indivíduos portadores de epilepsia do lobo temporal (ELT). A capacidade de identificação de odores, de pacientes norte-americanos portadores de ELT foi também avaliada, utilizando-se com esse fim, o teste já validado, denominado "University of Pennsylvania Smell Identification Test¿ (UPSIT), o qual consiste em um teste de múltipla escolha, composto por 40 estímulos odoríferos microencapsulados. Adicionalmente, avaliou-se nesses pacientes, a capacidade de reconhecimento de emoção facial e vocal, utilizando-se uma nova ferramenta intitulada "Comprehensive Affect Testing System¿ (CATS). Com relação à capacidade de identificação de odores dos indivíduos brasileiros, os resultados obtidos através do teste "Pastilhas de Odor¿ revelaram significância estatística tanto para o efeito "sexo¿ (p=0,0003), como para o efeito "idade¿ (p<0,001). O teste também permitiu identificar que os portadores de ELT, sem cirurgia e após ressecção do lobo temporal, apresentavam menor capacidade de identificação de odores comparativamente ao grupo controle (p= 0,05); este mesmo resultado foi observado ao aplicar o UPSIT em portadores de ELT norte-americanos, antes e após os mesmos terem sido submetidos à mencionada cirurgia. O teste "Pastilhas de Odor¿ mostrou ser de fácil manuseio e aplicação em indivíduos adultos, apresentou alto coeficiente de confiabilidade no teste-reteste (r=0,87, p<0,001) e suas pastilhas apresentaram boa estabilidade ao armazenamento durante 3 meses. Por sua vez, os dados obtidos através do teste de discriminação de odores identificaram que tanto o grupo da terceira idade como o dos portadores de ELT apresentaram poder discriminativo e taxa de acertos inferiores (p=0.05) aos indivíduos do grupo controle. Os resultados obtidos pela aplicação do teste CATS em indivíduos norte-americanos, revelaram que pacientes ELT tanto pré- como póscirúrgicos apresentaram menor reconhecimento de emoção facial e vocal quando comparados com o grupo controle, principalmente para as emoções negativas. O fato dos testes "Pastilhas de Odor¿ e de discriminação de odores desenvolvidos na presente pesquisa terem detectado deficiência olfatória nos indivíduos brasileiros da terceira idade e portadores de epilepsia, constrói validade para a utilização dos mesmos em diagnósticos clínicos associados a essas populações
Abstract: Sensory tests to evaluate olfactory function have been validated and used in the diagnosis of subjects, mainly in brain disorders patients, and in the neuroscience research. In Brazil, reliable tests of odor discrimination and identification have not been appropriately developed and validated. The aims of the present study were: i) to develop, test and validate odor discrimination and identification tests to assess olfactory function of Brazilian population; ii) to evaluate the methodologies performance in the diagnosis of elderly subjects and epilepsy patients. For odor identification test, the developed instrument was entitled "Odor Tablets¿, with 36 different odors familiar to Brazilians; to verify the performance in patients with epilepsy, a methodology previously validated and used worldwide to evaluate the ability to identify odors of individuals, and iv) to evaluate in patients with epilepsy, functions that are processed by common neural substrates for olfactory function, in this case, the ability of recognition of voice and facial emotion. Odors were rated as to their intensity, pleasantness, pungency, coolness and familiarity and they were considered suitable for composing a test to assess olfactory function. "Odor Tablets¿ proceeded through multiple-choice test with four alternatives which only one was correct. For the development of odor discrimination test, 24 pure odorants, associated with six different odor categories ¿ sweet, green, fruity, citric, floral and unpleasant - were selected and diluted in propylene glycol. With these samples, 36 paired comparison tests were constructed, where in each odor category, a target sample was selected to be compared with the others in the same category. The participant¿s performance in the odor discrimination test was analyzed using the "signal-detection" theory through the following parameters: hit rate (HR), false-alarm rate (FR), discrimination measurement (d 'L) and bias response (CL). Both tests, "Odor Tablets¿ and odor discrimination test, were validated with three groups of subjects: control group, elderly group and temporal lobe epilepsy patients group (TLE). The ability to identify odors from North American TLE patients was also measured, using for this purpose, the validated test "University of Pennsylvania Smell Identification Test" (UPSIT), a multiple choice test consisting of 40 microencapsulated odor stimuli. In addition, the ability of recognition of voice and facial emotion of TLE patients were evaluated using a new tool entitled "Comprehensive Affect Testing System" (CATS). For the subject¿s ability to identify odors, there were significant differences for gender (p=0.0003) and age (p<0.001). Also, for this test, the results showed that pre- and postsurgery epilepsy patients presented lower performance than the control group (p= 0.05); This same result was observed when applying the UPSIT in American TLE patients before and after surgery. "Odor Tablets¿ proved to be easy to administer in adult subjects, showed a high coefficient of the test-retest reliability (r = 0.87, p<0.001), and the tablets presented a storage stability for 3 months. The discrimination test results showed that elderly and epilepsy patient groups presented lower performance in the discrimination measurement and hit rate parameters than the control group. The results obtained using the CATS test in American TLE patients revealed that both pre-and post-surgery showed deficits in the facial and vocal emotions when compared with the control group, especially for negative emotions. The fact that the "Odor Tablets¿ and the discrimination odor test developed in the present study had detected olfactory dysfunction in elderly subjects and epilepsy patients, provides their validity for use in the diagnoses of these population
Doutorado
Consumo e Qualidade de Alimentos
Doutor em Alimentos e Nutrição

Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina
O síndrome de Usher (USH) é uma doença autossómica recessiva rara que cursa com alterações da visão e audição apresentando heterogeneidade clínica e genética. Vários estudos psicofísicos e de imagiologia estrutural evidenciaram também a existência de défices olfativos em doentes com USH. No entanto, o efeito desta condição no circuito central de processamento olfativo ainda não foi avaliado através de imagiologia funcional. Deste modo, procurámos comparar a atividade cerebral relacionada com uma tarefa olfativa nos córtices orbito-frontal (COF) e piriforme (CP) entre doentes com USH e indivíduos saudáveis. Além disso, foi realizada uma análise de classificação entre grupos de modo a avaliar o potencial da imagiologia funcional para discriminar doentes com USH de indivíduos saudáveis.Vinte e seis indivíduos saudáveis sem história de disfunção olfativa e 27 doentes com USH (4 USH1, 21 USH2, 2 USH3) foram incluídos neste estudo. Todos os sujeitos realizaram a mesma tarefa de deteção olfativa durante as sessões de ressonância magnética funcional para avaliar as respostas evocadas no COF e CP. Quatro níveis de concentração de butanol foram apresentados a cada participante. As regiões cerebrais foram definidas funcionalmente através do Neurosynth, uma ferramenta de meta-análise automatizada. Na análise univariada foi ajustado um modelo linear geral multi-sujeito com efeitos aleatórios e os parâmetros beta estimados de cada região foram usados para a comparação entre grupos. Na análise de classificação foi ajustado um modelo linear geral com sujeitos separados e foram criados mapas de estatística t para cada sujeito. Estes mapas foram classificados através de um modelo de regressão logística.Verificou-se a existência de um efeito de interação entre o grupo e o nível de butanol no COF direito (F(2,365;118,247)=3,032, p=0,043) e no CP direito (F(3,150)=4,537, p=0,004). Não se verificou nenhum efeito significativo na ativação cerebral evocada pelo estímulo olfativo no COF e CP esquerdos. O contraste planeado da ativação cerebral da maior concentração de odor menos a da menor concentração de odor entre grupos revelou uma diferença significativa no COF direito (t(51)=2,339, p=0,023). O mesmo contraste mostrou uma diferença significativa entre doentes e controlos no CP direito (t(51)=-3.380, p=0.001).Quanto à análise de classificação de doentes versus controlos, apresentamos um modelo preditivo com precisão de 71,7% (p=0,0072), sensibilidade de 67,7% (p=0,0328), especificidade de 77,3% (p=0,0041) e AUC de 0,785 (p=0,0087).Estes resultados evidenciam uma diminuição da ativação no CP direito e um aumento compensatório da ativação no COF direito em doentes com USH reforçando a noção de olfação disfuncional neste síndrome. Além disso, sugerem que os padrões de ativação cerebral em regiões olfativas medidos por ressonância magnética funcional permitem discriminar doentes com USH de indivíduos saudáveis sendo uma técnica promissora em termos de diagnóstico deste síndrome.
Usher syndrome (USH) is a rare autosomal recessive disease, affecting vision and audition, and showing clinical and genetic heterogeneity. Evidence of olfactory impairment in USH patients has emerged through psychophysical and structural imaging studies. However, the effect of this condition in the central olfactory processing network has not yet been evaluated through functional imaging studies. We sought to compare olfactory task-related activity in the orbitofrontal (OFC) and piriform (PC) cortices between USH patients and healthy subjects. Also, a classification analysis between these groups was carried out to assess functional imaging potential of discriminating USH patients.Twenty-six age- and gender-matched controls with no history of olfactory dysfunction and 27 USH patients (4 USH1, 21 USH2, 2 USH3) were studied. Functional magnetic resonance imaging (fMRI) was used with an olfactory detection task to evaluate responses in the OFC and PC. Four butanol concentration levels were presented to each participant. These regions were functionally defined using an automated meta-analysis toolbox, Neurosynth. In the univariate analyses a multi-subject general linear model (GLM) with random effects was performed and the beta estimates from each region were used to compare between groups. In the classification analysis a separate-subject GLM was performed and t-statistic maps were created for each subject which then were used as input to a logistic regression classifier.An interaction effect between group and butanol level was found in the right OFC (F(2.365;118.247)=3.032, p=0.043). Also, an interaction effect between group and butanol level emerged in the right PC (F(3,150)=4.537, p=0.004). Stimulus-evoked activation in both the left OFC and left PC did not show any significant effect. Planned contrast of the highest odor concentration minus the lowest odor concentration activation between groups revealed a significant difference in the right OFC (t(51)=2.339, p=0.023). The same contrast showed a significant difference between USH patients and controls in the right PC (t(51)=-3.380, p=0.001).As for the USH patients vs controls classification analysis we report a predictor model with accuracy of 71.7% (p=0.0072), sensitivity of 67.7% (p=0.0328), specificity of 77.3% (p=0.0041) and an AUC of 0.785 (p=0.0087).These data provide evidence of decreased activation in the right PC and increased compensatory activation in the right OFC in USH patients reinforcing the notion of dysfunctional olfactory sensory function. Also, it shows that olfactory fMRI patterns can discriminate USH patients from controls which holds promise in USH diagnosis improvement.

Hyposmia, psychiatric disorders, and cognitive problems are common non-motor manifestations of Parkinson’s disease (PD), but how they are related to the progression of PD remains unclear. Olfactory dysfunction, which is a common non-motor symptom of Parkinson’s disease, is considered to be an early manifestation of this disease. The aim of this study is to investigate the usefulness of near-infrared spectroscopy (NIRS) in measuring olfaction in PD patients and to establish the cortical basis of olfactory function in PD patients. This study was conducted on 9 healthy normosmic volunteers and 24 patients with PD. The authors employed a 22-channel NIRS device with eight light-incident fibers and seven light-detection fibers and placed fibers every 2.5 cm on the forehead of volunteers. Isovaleric acid was used as the odor stimulant. The authors measured the changes in total hemoglobin (tHb) concentration from baseline values and compared the results obtained from healthy normosmic volunteers with those from PD patients. PD patients had higher scores in the subjective olfactory test and smaller changes in tHb concentrations compared with normal volunteers. In particular, no changes in tHb concentration were detected in patients with the awareness of the sense of smell disorder.