山东大学耳鼻喉眼学报 ›› 2024, Vol. 38 ›› Issue (5): 119-125.doi: 10.6040/j.issn.1673-3770.0.2023.134

• 综述 • 上一篇    

嗅觉测试在轻度认知障碍患者早期诊断中的研究进展

周纯祎,胡慧,张艾琳,王云翠   

  1. 湖北中医药大学 护理学院, 湖北 武汉 430065
  • 发布日期:2024-09-25
  • 通讯作者: 王云翠. E-mail:yuncui_wang@hbtcm.edu.cn

Advancements in olfactory testing for early diagnosis of mild cognitive impairment in patients

ZHOU Chunyi, HU Hui, ZHANG Ailin, WANG Yuncui   

  1. College of Nursing, Hubei University of Chinese Medicine, Wuhan 430065, Hubei, China
  • Published:2024-09-25

PDF (PC)

45

摘要： 轻度认知障碍(mild cognitive impairment, MCI)是介于正常衰老与阿尔兹海默病之间的一种过渡状态。有研究发现,MCI患者中存在嗅球萎缩、神经元丢失等病理改变,且病理改变的严重程度与认知功能障碍呈正相关,嗅觉测试有望成为筛查MCI患者的补充工具。目前国内基于嗅觉测试早期诊断MCI的研究相对较少,属于起步阶段。本研究通过文献回顾,对嗅觉功能的相关概述、嗅觉测试的内容、特点及应用现状等内容进行综述,为临床工作人员选择合适的嗅觉测试工具早期识别MCI提供参考依据。

关键词: 轻度认知障碍, 嗅觉, 嗅觉测试工具, 嗅球萎缩, 神经元丢失

Abstract: Mild cognitive impairment(MCI)serves as a transitional state between the typical ageing process and the onset of Alzheimer's disease. Emerging research indicates that MCI patients exhibit pathological alterations such as olfactory bulb atrophy and neuronal loss. Moreover, the severity of these pathological changes correlates with the degree of cognitive impairment. Hence, olfactory testing holds potential as a supplementary tool for MCI screening. Despite being in its nascent stages in China, research on early MCI diagnosis through olfactory tests is gaining momentum. In this study, we conduct a comprehensive review of pertinent literature, encompassing olfactory function, test content, characteristics, and current applications. Our aim is to furnish healthcare practitioners with insights into selecting suitable olfactory test instruments to enhance the early detection rate of MCI.

Key words: Mild cognitive impairment, Olfactory, Olfactory test instruments, Bulb atrophy, Neuronal loss

中图分类号: 

  • R765
[1] Geneva: World Health Organization. Global status report on the public health response to dementia [EB/OL].(2022-10-15)[2023-04-07].https://apps.who.int/iris/handle/10665/344701
[2] Petersen RC. Early diagnosis of Alzheimer's disease: is MCI too late?[J]. Curr Alzheimer Res, 2009, 6(4): 324-330. doi:10.2174/156720509788929237
[3] 任汝静, 殷鹏, 王志会, 等. 中国阿尔茨海默病报告2021[J]. 诊断学理论与实践, 2021, 20(4): 317-337. doi: 10.16150/j.1671-2870.2021.04.001 REN Rujing, YIN Peng, WANG Zhihui, et al. China Alzheimer's disease report 2021[J]. Journal of Diagnostics Concepts & Practice, 2021, 20(4): 317-337. doi: 10.16150/j.1671-2870.2021.04.001
[4] Brai E, Tonacci A, Brugada-Ramentol V, et al. Intercepting dementia: awareness and innovation as key tools[J]. Front Aging Neurosci, 2021, 13: 730727. doi:10.3389/fnagi.2021.730727
[5] Brai E, Hummel T, Alberi L. Smell, an underrated early biomarker for brain aging[J]. Front Neurosci, 2020, 14: 792. doi:10.3389/fnins.2020.00792
[6] Morrison C, Rabipour S, Taler V, et al. Visual event-related potentials in mild cognitive impairment and alzheimer's disease: a literature review[J]. Curr Alzheimer Res, 2019, 16(1): 67-89. doi:10.2174/1567205015666181022101036
[7] Olofsson JK, Larsson M, Roa C, et al. Interaction between odor identification deficit and APOE4 predicts 6-year cognitive decline in elderly individuals[J]. Behav Genet, 2020, 50(1): 3-13. doi:10.1007/s10519-019-09980-9
[8] Devanand DP, Michaels-Marston KS, Liu X, et al. Olfactory deficits in patients with mild cognitive impairment predict Alzheimer's disease at follow-up[J]. Am J Psychiatry, 2000, 157(9): 1399-1405. doi:10.1176/appi.ajp.157.9.1399
[9] Dintica CS, Marseglia A, Rizzuto D, et al. Impaired olfaction is associated with cognitive decline and neurodegeneration in the brain[J]. Neurology, 2019, 92(7): e700-e709. doi:10.1212/WNL.0000000000006919
[10] 李丹, 陈腾宇, 黄演芬, 等. 国内嗅觉障碍相关研究: 基于Citespace的可视化分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 40-48. doi: 10.6040/j.issn.1673-3770.0.2021.349 LI Dan, CHEN Tengyu, HUANG Yanfen, et al. Research in the field of olfactory disorders in China—an analysis based on Citespace[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 40-48. doi: 10.6040/j.issn.1673-3770.0.2021.349
[11] 刘庆华, 李志春. 嗅感觉神经元的再生调控及与嗅觉障碍的关系[J]. 山东大学耳鼻喉眼学报, 2006, 20(2): 179-182. doi: 10.3969/j.issn.1673-3770.2006.02.028 LIU Qinghua, LI Zhichun. Regeneration regulation of olfactory sensory neurons and its relationship with olfactory dysfunction[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2006, 20(2): 179-182. doi: 10.3969/j.issn.1673-3770.2006.02.028
[12] Rombaux P, Duprez T, Hummel T. Olfactory bulb volume in the clinical assessment of olfactory dysfunction[J]. Rhinology, 2009, 47(1): 3-9
[13] Han P, Zang Y, Akshita J, et al. Magnetic resonance imaging of human olfactory dysfunction[J]. Brain Topogr, 2019, 32: 987-997. doi:10.1007/s10548-019-00729-5
[14] Trimmer C, Mainland JD. Simplifying the odor landscape[J]. Chem Senses, 2017, 42(3): 177-179. doi:10.1093/chemse/bjx002
[15] Kondo K, Kikuta S, Ueha R, et al. Age-related olfactory dysfunction: epidemiology, pathophysiology, and clinical management[J]. Front Aging Neurosci, 2020, 12: 208. doi:10.3389/fnagi.2020.00208
[16] Roalf DR, Moberg MJ, Turetsky BI, et al. A quantitative meta-analysis of olfactory dysfunction in mild cognitive impairment[J]. J Neurol Neurosurg Psychiatry, 2017, 88(3): 226-232. doi:10.1136/jnnp-2016-314638
[17] Murphy C. Olfactory and other sensory impairments in Alzheimer disease[J]. Nat Rev Neurol, 2019, 15(1): 11-24. doi:10.1038/s41582-018-0097-5
[18] Devanand DP, Michaels-Marston KS, Liu X, et al. Olfactory deficits in patients with mild cognitive impairment predict Alzheimer's disease at follow-up[J]. Am J Psychiatry, 2000, 157(9): 1399-1405. doi:10.1176/appi.ajp.157.9.1399
[19] Rahayel S, Frasnelli J, Joubert S. The effect of Alzheimer's disease and Parkinson's disease on olfaction: a meta-analysis[J]. Behav Brain Res, 2012, 231(1): 60-74. doi:10.1016/j.bbr.2012.02.047
[20] Makizako M, Makizako H, Doi T, et al. Olfactory identification and cognitive performance in community-dwelling older adults with mild cognitive impairment[J]. Chem Senses, 2014, 39(1): 39-46. doi:10.1093/chemse/bjt052
[21] Mi Y, Ma XJ, Du S, et al. Olfactory function changes and the predictive performance of the Chinese Smell Identification Test in patients with mild cognitive impairment and Alzheimer's disease[J]. Front Aging Neurosci, 2023, 15: 1068708. doi:10.3389/fnagi.2023.1068708
[22] Hummel T, Pfetzing U, Lötsch J. A short olfactory test based on the identification of three odors[J]. J Neurol, 2010, 257(8): 1316-1321. doi:10.1007/s00415-010-5516-5
[23] Jung HJ, Shin IS, Lee JE. Olfactory function in mild cognitive impairment and Alzheimer's disease: a meta-analysis[J]. Laryngoscope, 2019, 129(2): 362-369. doi:10.1002/lary.27399
[24] 李楠, 徐心. 嗅觉障碍及其临床检测方法[J]. 中华临床医师杂志(电子版), 2013(21): 9759-9761. doi:10.3877/cma.j.issn.1674-0785.2013.21.087
[25] Scherfler C, Schocke MF, Seppi K, et al. Voxel-wise analysis of diffusion weighted imaging reveals disruption of the olfactory tract in Parkinson's disease[J]. Brain, 2006, 129(Pt 2): 538-542. doi:10.1093/brain/awh674
[26] Invitto S, Piraino G, Ciccarese V, et al. Potential role of OERP as early marker of mild cognitive impairment[J]. Front Aging Neurosci, 2018, 10: 272. doi:10.3389/fnagi.2018.00272
[27] Morgan CD, Murphy C. Olfactory event-related potentials in Alzheimer's disease[J]. J Int Neuropsychol Soc, 2002, 8(6): 753-763. doi:10.1017/s1355617702860039
[28] Li W, Howard JD, Gottfried JA. Disruption of odour quality coding in piriform cortex mediates olfactory deficits in Alzheimer's disease[J]. Brain, 2010, 133(9): 2714-2726. doi:10.1093/brain/awq209
[29] 陈红, 吴亚琳, 龙淼淼, 等. 嗅觉功能磁共振成像评估对非痴呆老年人认知下降的预测价值[J]. 中国医学影像学杂志, 2021, 29(10): 961-967. doi:10.3969/j.issn.1005-5185.2021.10.002
[30] Doty RL, Shaman P, Dann M. Development of the university of Pennsylvania smell identification test: a standardized microencapsulated test of olfactory function[J]. Physiol Behav, 1984, 32(3): 489-502. doi:10.1016/0031-9384(84)90269-5
[31] Doty RL, Shaman P, Kimmelman CP, et al. University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic[J]. Laryngoscope, 1984, 94(2 Pt 1): 176-178. doi:10.1288/00005537-198402000-00004
[32] 杨斯闵, 李璐迪, 曹月, 等. 基于3D脑结构MRI定量分析对轻度认知障碍及阿尔茨海默病患者嗅觉皮层的研究[J]. 磁共振成像, 2023, 14(1): 20-24. doi: 10.12015/issn.1674-8034.2023.01.004 YANG Simin, LI Ludi, CAO Yue, et al. The study of structural magnetic resonance imaging on gray matter volumes of olfactory brain regions in patients with mild cognitive impairment and Alzheimer's disease[J]. Chinese Journal of Magnetic Resonance Imaging, 2023, 14(1): 20-24. doi: 10.12015/issn.1674-8034.2023.01.004
[33] Vasavada MM, Wang JL, Eslinger PJ, et al. Olfactory cortex degeneration in Alzheimer's disease and mild cognitive impairment[J]. J Alzheimers Dis, 2015, 45(3): 947-958. doi:10.3233/JAD-141947
[34] Vassilaki M, Christianson TJ, Mielke MM, et al. Neuroimaging biomarkers and impaired olfaction in cognitively normal individuals[J]. Ann Neurol, 2017, 81(6): 871-882. doi:10.1002/ana.24960
[35] Devanand DP, Lee S, Luchsinger JA, et al. Intact global cognitive and olfactory ability predicts lack of transition to dementia[J]. Alzheimers Dement, 2020, 16(2): 326-334. doi:10.1016/j.jalz.2019.08.200
[36] Kobal G, Hummel T, Sekinger B, et al. “Sniffin' sticks”: screening of olfactory performance[J]. Rhinology, 1996, 34(4): 222-226
[37] Hummel T, Kobal G, Gudziol H, et al. Normative data for the “Sniffin’ Sticks” including tests of odor identification, odor discrimination, and olfactory thresholds: an upgrade based on a group of more than 3, 000 subjects[J]. Eur Arch Otorhinolaryngol, 2007, 264(3): 237-243. doi:10.1007/s00405-006-0173-0
[38] Doorduijn AS, de van der Schueren MAE, van de Rest O, et al. Olfactory and gustatory functioning and food preferences of patients with Alzheimer's disease and mild cognitive impairment compared to controls: the NUDAD project[J]. J Neurol, 2020, 267(1): 144-152. doi:10.1007/s00415-019-09561-0
[39] 郭文静, 赵傲楠, 闫艺, 等. 嗅觉检测对中国阿尔茨海默病和轻度认知功能障碍患者的诊断价值[J]. 中国医药导报, 2023, 20(2): 60-64. doi: 10.20047/j.issn1673-7210.2023.02.13 GUO Wenjing, ZHAO Aonan, YAN Yi, et al. Diagnostic value of olfactory tests in patients with Alzheimer's disease and mild cognitive impairment in China[J]. China Medical Herald, 2023, 20(2): 60-64. doi: 10.20047/j.issn1673-7210.2023.02.13
[40] Dong Y, Wang Y, Liu K, et al. Dementia screening in rural-dwelling Chinese older adults: the utility of a smell test and the self-rated AD8[J]. J Am Geriatr Soc, 2022, 70(4): 1106-1116. doi:10.1111/jgs.17586
[41] Feng G, Zhuang Y, Yao FS, et al. Development of the Chinese smell identification test[J]. Chem Senses, 2019, 44(3): 189-195. doi:10.1093/chemse/bjz006
[42] Tu LH, Wang ZJ, Lv XZ, et al. Characteristics of odor identification and hedonics and their association with piriform cortex-based resting-state functional connectivity in amnestic mild cognitive impairment[J]. J Alzheimers Dis, 2023, 94(1): 247-258. doi:10.3233/JAD-221163
[43] Wu XQ, Geng Z, Zhou SS, et al. Brain structural correlates of odor identification in mild cognitive impairment and Alzheimer's disease revealed by magnetic resonance imaging and a Chinese olfactory identification test[J]. Front Neurosci, 2019, 13: 842. doi:10.3389/fnins.2019.00842
[44] 梁维, 王岚, 耿皓, 等. 中国简短嗅觉识别测试在早期阿尔茨海默病筛查中的应用[J]. 中国心理卫生杂志, 2023, 37(5): 380-387. doi: 10.3969/j.issn.1000-6729.2023.05.004 LIANG Wei, WANG Lan, GENG Hao, et al. Application of the Brief Chinese Smell Identification in early Alzheimer's disease screening[J]. Chinese Mental Health Journal, 2023, 37(5): 380-387. doi: 10.3969/j.issn.1000-6729.2023.05.004
[45] 米颜. 嗅觉识别功能评估在轻度认知障碍筛查中的应用[D]. 延安: 延安大学, 2022
[46] Hagemeier J, Woodward MR, Rafique UA, et al. Odor identification deficit in mild cognitive impairment and Alzheimer's disease is associated with hippocampal and deep gray matter atrophy[J]. Psychiatry Res Neuroimaging, 2016, 255: 87-93. doi:10.1016/j.pscychresns.2016.08.003
[47] Nussbaum JM, Seward ME, Bloom GS. Alzheimer disease: a tale of two prions[J]. Prion, 2013, 7(1): 14-19. doi:10.4161/pri.22118
[48] 王治国, 战莹, 张国旭, 等. β-淀粉样蛋白沉积与轻度认知障碍患者认知功能的相关性[J]. 中华老年多器官疾病杂志, 2020, 19(5): 331-335. doi: 10.11915/j.issn.1671-5403.2020.05.023 WANG Zhiguo, ZHAN Ying, ZHANG Guoxu, et al. Correlation of β-amyloid deposition with cognitive function in mild cognitive impairment patients[J]. Chinese Journal of Multiple Organ Diseases in the Elderly, 2020, 19(5): 331-335. doi: 10.11915/j.issn.1671-5403.2020.05.023
[49] Murphy C. Olfactory and other sensory impairments in Alzheimer disease[J]. Nat Rev Neurol, 2019, 15(1): 11-24. doi:10.1038/s41582-018-0097-5
[50] Hagemeier J, Woodward MR, Rafique UA, et al. Odor identification deficit in mild cognitive impairment and Alzheimer's disease is associated with hippocampal and deep gray matter atrophy[J]. Psychiatry Res Neuroimaging, 2016, 255: 87-93. doi:10.1016/j.pscychresns.2016.08.003
[51] Jobin B, Boller B, Frasnelli J. Volumetry of olfactory structures in mild cognitive impairment and alzheimer's disease: a systematic review and a meta-analysis[J]. Brain Sci, 2021, 11(8): 1010. doi:10.3390/brainsci11081010
[52] Pinto TCC, Machado L, Bulgacov TM, et al. Is the Montreal Cognitive Assessment(MoCA)screening superior to the Mini-Mental State Examination(MMSE)in the detection of mild cognitive impairment(MCI)and Alzheimer's Disease(AD)in the elderly?[J]. Int Psychogeriatr, 2019, 31(4): 491-504. doi:10.1017/S1041610218001370
[53] Yoo SH, Woo SW, Shin MJ, et al. Diagnosis of mild cognitive impairment using cognitive tasks: a functional near-infrared spectroscopy study[J]. Curr Alzheimer Res, 2020, 17(13): 1145-1160. doi:10.2174/1567205018666210212154941
[54] 魏霞霞, 郝志梅, 陈玲, 等. 简版CSI-D与MMSE在我国中老年人痴呆筛查中的应用效果比较研究[J]. 中国全科医学, 2022, 25(31): 3866-3871. doi: 10.12114/j.issn.1007-9572.2022.0272 WEI Xiaxia, HAO Zhimei, CHEN Ling, et al. Comparison of the brief CSI-D and MMSE scales in screening for dementia in middle-aged and elderly Chinese people[J]. Chinese General Practice, 2022, 25(31): 3866-3871. doi: 10.12114/j.issn.1007-9572.2022.0272
[55] Velayudhan L, Gasper A, Pritchard M, et al. Pattern of smell identification impairment in Alzheimer's disease[J]. J Alzheimers Dis, 2015, 46(2): 381-387. doi:10.3233/JAD-142838
[56] Quarmley M, Moberg PJ, Mechanic-Hamilton D, et al. Odor identification screening improves diagnostic classification in incipient alzheimer's disease[J]. J Alzheimers Dis, 2017, 55(4): 1497-1507. doi:10.3233/JAD-160842
[57] Park H, Kim H, Kim S, et al. The association between olfactory function and cognitive impairment in older persons with cognitive impairments: a cross-sectional study[J]. Healthcare(Basel), 2021, 9(4): 399. doi:10.3390/healthcare9040399
[1] 金婧, 冷辉. SARS-CoV-2感染后嗅觉功能障碍治疗的研究进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 162-174.
[2] 朱锦祥,周敏,王睿智,李丹,方彩珊,陈腾宇,林曼青,阮岩. 中医古籍中治疗嗅觉障碍的用药规律分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 86-95.
[3] 李丹, 陈腾宇, 黄演芬, 周敏, 周熠星, 阮岩, 闫亚杰. 国内嗅觉障碍相关研究——基于Citespace的可视化分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 40-48.
[4] 王欢,胡俐,余洪猛. 慢性鼻窦炎相关嗅觉功能障碍研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 43-49.
[5] 宜若男,陈福权. 嗜酸性粒细胞与嗅觉功能障碍[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 50-55.
[6] 喻超,陈敬国,米白冰,祝康,夏翠,高天喜,张燕妮,孙斌,任晓勇. 基于REDCap嗅觉障碍患者交互式电子数据库的设计[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 15-19.
[7] 陶丹丹,董红军,褚云锋,黄超,胡磊. 慢性鼻-鼻窦炎伴鼻息肉患者组织嗜酸性粒细胞与嗅觉功能障碍的相关性研究[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 16-20.
[8] 潘宏光,王菊梅,陈国威,吴泽斌. 深圳小学高年级学生嗅觉功能的初步调查及与成绩的相关性初探[J]. 山东大学耳鼻喉眼学报, 2017, 31(3): 71-74.
[9] 訾晓雪,赵莉,金鹏,屠燕怡,李昂,史丽. 伴有嗅觉障碍的慢性鼻-鼻窦炎患者鼻内镜术后嗅觉及生活质量转归的研究[J]. 山东大学耳鼻喉眼学报, 2016, 30(1): 21-25.
[10] 何清泉,李振安,余凤慈. 鼻内镜鼻窦手术对鼻窦炎鼻息肉患者嗅觉功能及鼻腔容积的影响[J]. 山东大学耳鼻喉眼学报, 2016, 30(1): 58-60.
[11] 刘庆华1，李志春2. 慢性鼻窦炎嗅觉障碍嗅上皮中IGF-1R和Ki-67的表达及意义[J]. 山东大学耳鼻喉眼学报, 2011, 25(3): 55-.
[12] 刘婷婷 张念凯. 药物治疗慢性鼻-鼻窦炎嗅觉障碍的疗效观察[J]. 山东大学耳鼻喉眼学报, 2009, 23(4): 45-47.
[13] 杨彩虹1 ， 肖二彬2
. 功能性鼻内镜手术对慢性鼻窦炎
患者嗅觉的影响[J]. 山东大学耳鼻喉眼学报, 2009, 23(2): 56-58 .
[14] 邱恩惠,李志春,方文旭 . 嗅觉障碍的中西医治疗[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 253-257 .
[15] 刘庆华,李瑞玉,李志春,林昶 . 成纤维生长因子2在慢性鼻窦炎嗅觉障碍嗅上皮中的表达[J]. 山东大学耳鼻喉眼学报, 2006, 20(5): 410-412 .
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发