Introduction

The importance of an olfactory assessment of individuals with neurological diseases has attracted attention. Cerebrovascular disease is one of the most common diseases in Japan, but there are few reports on olfaction in patients with stroke. Herein we examined olfaction in patients with stroke.

Methods

We assessed 50 patients hospitalized for neurorehabilitation after stroke. For the assessment of olfaction, the dual tests known as the T&T olfactometry (T&T) test and the odor identification Open Essence (OE) test were administered. Since the OE test was introduced only recently in Japan, 100 healthy volunteers participated to provide OE data as the control group. We analyzed the patients’ T&T and OE data and the controls’ OE data, and we investigated the relationship between the olfaction data and the patients’ stroke-induced lesion areas.

Results

None of the patients reported experiencing inconvenience due to olfactory loss, although we classified 45 (90%) patients as hyposmic or anosmic based on their identification thresholds on the T&T test as well as their significantly low OE scores compared to the control data. However, the patients’ perception thresholds on the T&T test were in the normal range. Brain computed tomography examination data revealed that odor identification was not impaired in about half of the 23 patients with a putamen-thalamus lesion. In addition, our correlation analysis of each odorant in the OE test indicated that six of the 12 odorants are sufficient for olfactory assessments.

Conclusions

The results of the dual olfactory tests revealed that patients with stroke showed impaired odor identification but intact odor perception. It is possible that the direct pathway from the piriform cortex to the orbitofrontal cortex is essential for odor identification.

Implications

Because of their normal odor perception, most patients with stroke are not aware of their impaired odor identification. A set of six of the 12 odorants used in the OE test is capable of representing the total OE score, and its use will save time for olfactory tests in clinical assessments.

中文翻译：

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双重检测可以揭示脑血管病患者嗅觉鉴定的缺陷

介绍

对神经系统疾病患者进行嗅觉评估的重要性已引起关注。脑血管疾病是日本最常见的疾病之一，但是关于中风患者嗅觉的报道很少。在这里，我们检查了中风患者的嗅觉。

方法

我们评估了50名中风后住院的神经康复患者。为了评估嗅觉，进行了双重测试，称为T＆T嗅觉测试（T＆T）测试和气味识别开放式精华（OE）测试。由于OE测试仅在日本才刚刚引入，因此有100名健康志愿者作为对照组提供了OE数据。我们分析了患者的T＆T和OE数据以及对照组的OE数据，并调查了嗅觉数据与患者中风诱发的病变区域之间的关系。

结果

尽管我们根据其在T＆T测试中的识别阈值以及与对照数据相比显着较低的OE评分，将45名（90％）患者分类为低渗或厌氧患者，但没有患者因嗅觉丧失而感到不便。但是，患者在T＆T测试中的感知阈值在正常范围内。脑部计算机断层扫描检查数据显示，在23名患有普塔门-丘脑病变的患者中，大约一半没有异味识别。此外，我们在OE测试中对每种香精的相关分析表明，在12种香精中，有6种足以进行嗅觉评估。

结论

双重嗅觉测试的结果显示，中风患者的气味识别受损，但嗅觉却完整。从梨状皮层到眶额皮层的直接通路可能对气味识别至关重要。

含义

由于他们的嗅觉正常，大多数中风患者并未意识到他们的气味识别能力受损。OE测试中使用的12种增香剂中的6种能够代表OE总得分，使用它可以节省临床评估中嗅觉测试的时间。