山东大学耳鼻喉眼学报 ›› 2025, Vol. 39 ›› Issue (5): 132-138.doi: 10.6040/j.issn.1673-3770.0.2023.445

• 综述 • 上一篇    

嗅觉训练改善认知功能的研究进展

李晗1,乔晓峰2   

  1. 1.山西医科大学 第五临床医学院, 山西 太原 030000;
    2.山西省人民医院 耳鼻咽喉头颈外科, 山西 太原 030000
  • 发布日期:2025-09-19
  • 通讯作者: 乔晓峰. E-mail: qxf_fred@126.com
  • 基金资助:
    山西省中医药管理局科研课题(2022ZYYC064);山西省卫生健康委科研课题(2023XG015)

Advances in research on olfactory training that improves cognitive function

LI Han1, QIAO Xiaofeng2   

  1. 1. The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan 030000, Shanxi, China2. Department of Otorhinolaryngology & Head and Neck Surgery, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan 030000, Shanxi, China
  • Published:2025-09-19

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摘要： 在各种神经退行性疾病中,嗅觉功能下降与认知功能下降具有相关性。嗅觉训练(olfactory training, OT)旨在通过重复暴露于不同气味物质,刻意产生神经可塑性效应,以期改善或修复嗅觉功能。已有许多研究证实OT对改善嗅觉障碍显著有效,且OT可以引发大脑结构及功能的变化。嗅觉通路与认知功能相关脑区存在交互作用,可以对认知功能产生影响,OT增加大脑多个区域皮层厚度、功能连接,益于缓解认知功能减退。本文系统地回顾了OT治疗嗅觉障碍的临床进展以及OT对认知功能的影响,为认知功能障碍的临床治疗提供依据。

关键词: 嗅觉训练, 认知功能, 磁共振成像, 灰质体积, 功能网络, 嗅觉障碍

Abstract: In various neurodegenerative diseases, olfactory dysfunction and cognitive decline is correlated. Olfactory training(OT)aims to induce neuroplasticity through repetitive exposure to various odorants, thereby cultivating neural adaptability to improve or restore olfactory function. Numerous studies have shown the significant effectiveness of OT in ameliorating olfactory impairments. OT has also been reported to induce changes in brain structure and function. The olfactory pathway interacts with brain regions associated with cognitive function, thus affecting cognitive abilities. OT enhances cortical thickness and functional connectivity in multiple brain regions, thereby alleviating cognitive decline. This review systematically addresses the clinical progress of OT in treating olfactory impairments and its impact on cognitive function, thus providing a basis for the clinical treatment of cognitive function disorders.

Key words: Olfactory training, Cognitive function, Magnetic resonance imaging, Gray matter volume, Functional networks, Olfactory impairment

中图分类号: 

  • R765.6+3
[1] 朱锦祥, 周敏, 王睿智, 等. 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. doi:10.6040/j.issn.1673-3770.0.2022.203 ZHU Jinxiang, ZHOU Min, WANG Ruizhi, et al. Prescription regularity analysis in treating olfactory dysfunction from ancient Chinese medicine literature[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(4): 86-95. doi:10.6040/j.issn.1673-3770.0.2022.203
[2] Albers MW, Tabert MH, Devanand DP. Olfactory dysfunction as a predictor of neurodegenerative disease[J]. Curr Neurol Neurosci Rep, 2006, 6(5): 379-386. doi:10.1007/s11910-996-0018-7
[3] Dan XL, Wechter N, Gray S, et al. Olfactory dysfunction in aging and neurodegenerative diseases[J]. Ageing Res Rev, 2021, 70: 101416. doi:10.1016/j.arr.2021.101416
[4] Mankin EA, Fried I. Modulation of human memory by deep brain stimulation of the entorhinal-hippocampal circuitry[J]. Neuron, 2020, 106(2): 218-235. doi:10.1016/j.neuron.2020.02.024
[5] Kikuta S, Sakamoto T, Nagayama S, et al. Sensory deprivation disrupts homeostatic regeneration of newly generated olfactory sensory neurons after injury in adult mice[J]. J Neurosci, 2015, 35(6): 2657-2673. doi:10.1523/JNEUROSCI.2484-14.2015
[6] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 嗅觉障碍诊断和治疗专家共识(2017年)[J]. 中华耳鼻咽喉头颈外科杂志, 2018, 53(7): 484-494. doi:10.3760/cma.j.issn.1673-0860.2018.07.002 Rhinology, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Subspecialty Croup of Rhinology, Sociey of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association. Expert consensus on diagnosis and treatment of olfactory dysfunction(2017)[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2018, 53(7): 484-494. doi:10.3760/cma.j.issn.1673-0860.2018.07.002
[7] 陈敬华, 武琦琦, 江凤仙. 嗅觉训练对慢性鼻窦炎患者嗅觉障碍的治疗效果[J]. 吉林医药学院学报, 2019, 40(2): 110-111. doi:10.14163/j.cnki.11-5547/r.2017.17.085 CHEN Jinghua, WU Qiqi, JIANG Fengxian. Therapeutic effect of olfactory training on olfactory dysfunction in patients with chronic sinusitis[J]. Journal of Jilin Medical University, 2019, 40(2): 110-111. doi:10.14163/j.cnki.11-5547/r.2017.17.085
[8] Park JY, Choi BY, Kim H, et al. Olfactory training assists in olfactory recovery after sinonasal surgery[J]. Laryngoscope Investig Otolaryngol, 2022, 7(6): 1733-1739. doi:10.1002/lio2.955
[9] Zhang JF, Feng Y, Liu W, et al. Effect of early olfactory training on olfactory recovery after nasal endoscopy in patients with chronic rhinosinusitis and olfactory impairment[J]. Am J Transl Res, 2022, 14(4): 2600-2608
[10] Qiao XF, Wang GP, Li X, et al. Analysis of the clinical effect of olfactory training on olfactory dysfunction after upper respiratory tract infection[J]. Acta Otolaryngol, 2019, 139(7): 643-646. doi:10.1080/00016489.2019.1614224
[11] Fleiner F, Lau L, Göktas Ö. Active olfactory training for the treatment of smelling disorders[J]. Ear Nose Throat J, 2012, 91(5): 198-203, 215. doi:10.1177/014556131209100508
[12] Pieniak M, Oleszkiewicz A, Avaro V, et al. Olfactory training-Thirteen years of research reviewed[J]. Neurosci Biobehav Rev, 2022, 141: 104853. doi:10.1016/j.neubiorev.2022.104853
[13] Damm M, Pikart LK, Reimann H, et al. Olfactory training is helpful in postinfectious olfactory loss: a randomized, controlled, multicenter study[J]. Laryngoscope, 2014, 124(4): 826-831. doi:10.1002/lary.24340
[14] Lamira JM, Soler ZM, Schlosser RJ. A pilot study of olfactory training in older hyposmic adults[J]. Am J Rhinol Allergy, 2019, 33(6): 650-656. doi:10.1177/1945892419858793
[15] Altundag A, Yilmaz E, Kesimli MC. Modified olfactory training is an effective treatment method for COVID-19 induced Parosmia[J]. Laryngoscope, 2022, 132(7): 1433-1438. doi:10.1002/lary.30101
[16] Yaylacı A, Azak E, Önal A, et al. Effects of classical olfactory training in patients with COVID-19-related persistent loss of smell[J]. Eur Arch Otorhinolaryngol, 2023, 280(2): 757-763. doi:10.1007/s00405-022-07570-w
[17] Ojha P, Dixit A. Olfactory training for olfactory dysfunction in COVID-19: a promising mitigation amidst looming neurocognitive sequelae of the pandemic[J]. Clin Exp Pharmacol Physiol, 2022, 49(4): 462-473. doi:10.1111/1440-1681.13626
[18] D'Ascanio L, Vitelli F, Cingolani C, et al. Randomized clinical trial “olfactory dysfunction after COVID-19: olfactory rehabilitation therapy vs. intervention treatment with Palmitoylethanolamide and Luteolin”: preliminary results[J]. Eur Rev Med Pharmacol Sci, 2021, 25(11): 4156-4162. doi:10.26355/eurrev_202106_26059
[19] Le Bon SD, Konopnicki D, Pisarski N, et al. Efficacy and safety of oral corticosteroids and olfactory training in the management of COVID-19-related loss of smell[J]. Eur Arch Otorhinolaryngol, 2021, 278(8): 3113-3117. doi:10.1007/s00405-020-06520-8
[20] Marwa A, Safaa Mostafa AE. Efficacy of olfactory training program in conjunction with nasal steroid irrigation in treating persistent smell loss in COVID-19 patients[J]. Arch Otolaryngol Rhinol, 2022, 8(1): 1-6. doi:10.17352/2455-1759.000144
[21] Pellegrino R, Han PF, Reither N, et al. Effectiveness of olfactory training on different severities of posttraumatic loss of smell[J]. Laryngoscope, 2019, 129(8): 1737-1743. doi:10.1002/lary.27832
[22] Jiang RS, Twu CW, Liang KL. The effect of olfactory training on odor identification in patients with traumatic anosmia[J]. Int Forum Allergy Rhinol, 2019, 9(11): 1244-1251. doi:10.1002/alr.22409
[23] Poletti SC, Michel E, Hummel T. Olfactory training using heavy and light weight molecule odors[J]. Perception, 2017, 46(3/4): 343-351. doi:10.1177/0301006616672881
[24] Bratt M, Moen KG, Nordgård S, et al. Treatment of posttraumatic olfactory dysfunction with corticosteroids and olfactory training[J]. Acta Otolaryngol, 2020, 140(9): 761-767. doi:10.1080/00016489.2020.1767301
[25] de Freitas Cardoso MG, Faleiro RM, de Paula JJ, et al. Cognitive impairment following acute mild traumatic brain injury[J]. Front Neurol, 2019, 10: 198. doi:10.3389/fneur.2019.00198
[26] Mahmut MK, Musch M, Han P, et al. The effect of olfactory training on olfactory bulb volumes in patients with idiopathic olfactory loss[J]. Rhinology, 2020, 58(4): 410-412. doi:10.4193/Rhin20.223
[27] Oleszkiewicz A, Hanf S, Whitcroft KL, et al. Examination of olfactory training effectiveness in relation to its complexity and the cause of olfactory loss[J]. Laryngoscope, 2018, 128(7): 1518-1522. doi:10.1002/lary.26985
[28] Chen B, Espin M, Haussmann R, et al. The effect of olfactory training on olfaction, cognition, and brain function in patients with mild cognitive impairment[J]. J Alzheimers Dis, 2022, 85(2): 745-754. doi:10.3233/JAD-215257
[29] Haehner A, Tosch C, Wolz M, et al. Olfactory training in patients with Parkinson's disease[J]. PLoS One, 2013, 8(4): e61680. doi:10.1371/journal.pone.0061680
[30] Knudsen K, Flensborg Damholdt M, Mouridsen K, et al. Olfactory function in Parkinson's Disease-effects of training[J]. Acta Neurol Scand, 2015, 132(6): 395-400. doi:10.1111/ane.12406
[31] Gürbüz D, Kesimli MC, Bilgili AM, et al. Olfactory rehabilitation and olfactory bulb volume changes in patients after total laryngectomy: a prospective randomized study[J]. Braz J Otorhinolaryngol, 2022, 88(4): 607-612. doi:10.1016/j.bjorl.2021.02.013
[32] Negoias S, Pietsch K, Hummel T. Changes in olfactory bulb volume following lateralized olfactory training[J]. Brain Imaging Behav, 2017, 11(4): 998-1005. doi:10.1007/s11682-016-9567-9
[33] Al Aïn S, Poupon D, Hétu S, et al. Smell training improves olfactory function and alters brain structure[J]. NeuroImage, 2019, 189: 45-54. doi:10.1016/j.neuroimage.2019.01.008
[34] Gellrich J, Han PF, Manesse C, et al. Brain volume changes in hyposmic patients before and after olfactory training[J]. Laryngoscope, 2018, 128(7): 1531-1536. doi:10.1002/lary.27045
[35] Han PF, Musch M, Abolmaali N, et al. Improved odor identification ability and increased regional gray matter volume after olfactory training in patients with idiopathic olfactory loss[J]. i-Perception, 2021, 12(2): 20416695211005811. doi:10.1177/20416695211005811
[36] Cha H, Kim S, Seo MS, et al. Effects of olfactory stimulation on cognitive function and behavior problems in older adults with dementia: a systematic literature review[J]. Geriatr Nurs, 2021, 42(5): 1210-1217. doi:10.1016/j.gerinurse.2021.07.003
[37] Watanabe K, Kokubun K, Yamakawa Y. Altered grey matter-brain healthcare quotient: interventions of olfactory training and learning of neuroplasticity[J]. Life, 2023, 13(3): 667. doi:10.3390/life13030667
[38] Hosseini K, Zare-Sadeghi A, Sadigh-Eteghad S, et al. Effects of olfactory training on resting-state effective connectivity in patients with posttraumatic olfactory dysfunction[J]. Acta Neurobiol Exp, 2020, 80(4): 381-388. doi: 10.21307/ane-2020-035
[39] Jiramongkolchai P, Jones MS, Peterson A, et al. Association of olfactory training with neural connectivity in adults with postviral olfactory dysfunction[J]. JAMA Otolaryngol Head Neck Surg, 2021, 147(6): 502-509. doi:10.1001/jamaoto.2021.0086
[40] Kollndorfer K, Kowalczyk K, Hoche E, et al. Recovery of olfactory function induces neuroplasticity effects in patients with smell loss[J]. Neural Plast, 2014, 2014: 140419. doi:10.1155/2014/140419
[41] Birte-Antina W, Ilona C, Antje H, et al. Olfactory training with older people[J]. Int J Geriatr Psychiatry, 2018, 33(1): 212-220. doi:10.1002/gps.4725
[42] Oleszkiewicz A, Abriat A, Doelz G, et al. Beyond olfaction: beneficial effects of olfactory training extend to aging-related cognitive decline[J]. Behav Neurosci, 2021, 135(6): 732-740. doi:10.1037/bne0000478
[43] Oleszkiewicz A, Bottesi L, Pieniak M, et al. Olfactory training with Aromastics: olfactory and cognitive effects[J]. Eur Arch Otorhinolaryngol, 2022, 279(1): 225-232. doi:10.1007/s00405-021-06810-9
[44] Cha H, Kim S, Kim H, et al. Effect of intensive olfactory training for cognitive function in patients with dementia[J]. Geriatr Gerontol Int, 2022, 22(1): 5-11. doi:10.1111/ggi.14287
[45] Pieniak M, Seidel K, Oleszkiewicz A, et al. Olfactory training effects in children after mild traumatic brain injury[J]. Brain Inj, 2023, 37(11): 1272-1284. doi:10.1080/02699052.2023.2237889
[46] Jimbo D, Kimura Y, Taniguchi M, et al. Effect of aromatherapy on patients with Alzheimer’s disease[J]. Psychogeriatrics, 2009, 9(4): 173-179. doi:10.1111/j.1479-8301.2009.00299.x
[47] Ball EL, Owen-Booth B, Gray A, et al. Aromatherapy for dementia[J]. Cochrane Database Syst Rev, 2020, 8(8): CD003150. doi:10.1002/14651858.CD003150.pub3
[48] 董慈, 马丽, 刘少娜, 等. 芳香疗法对躯体疾病相关性失眠治疗作用的Meta分析[J]. 临床荟萃, 2016, 31(12): 1357-1361. doi:10.3969/j.issn.1004-583X.2016.12.020 DONG Ci, MA Li, LIU Shaona, et al. Effectiveness of aromatherapy for somatopathy comorbided insomnia: a meta-analysis of randomized controlled trials[J]. Clinical Focus, 2016, 31(12): 1357-1361. doi:10.3969/j.issn.1004-583X.2016.12.020
[49] Liu BN, Kou JY, Li FY, et al. Lemon essential oil ameliorates age-associated cognitive dysfunction via modulating hippocampal synaptic density and inhibiting acetylcholinesterase[J]. Aging, 2020, 12(9): 8622-8639. doi:10.18632/aging.103179
[50] Gao NX, Liu HQ, Li SQ, et al. Volatile oil from Acorus gramineus ameliorates the injury neurons in the hippocampus of amyloid beta 1-42 injected mice[J]. Anat Rec, 2019, 302(12): 2261-2270. doi:10.1002/ar.24236
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