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Olfactory dysfunction in neuromyelitis optica spectrum disorders

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Abstract

Few data were available for the understanding of olfactory function in neuromyelitis optica spectrum disorders (NMOSDs). The aims of our study were to investigate the incidence of olfactory dysfunction and characterize olfactory structures, using MRI, in patients with NMOSDs. Olfactory function was evaluated by olfactometer in 49 patients with NMOSDs and 26 matched healthy controls. MRI parameters such as olfactory bulb (OB) and the olfactory-related gray matter volume changes were assessed. The frequency of olfactory dysfunction was 53 % in patients with NMOSDs. Olfactory detection thresholds were positively correlated with serum aquaporin-4 antibodies (fluorescent units) tested by fluorescent immunoprecipitation assay (FIPA) in NMOSDs (p = 0.009). Patients with olfactory dysfunction had smaller OB volume than did patients without olfactory dysfunction or controls (p < 0.01). Both detection and recognition thresholds for olfaction were negatively correlated with OB volume (p = 0.018, p < 0.01). The significant gray matter volume reduction in NMOSDs was found in the bilateral piriform cortex, orbitofrontal cortex, and parahippocampal gyri (FDR correction, p < 0.05, cluster size >200 voxels). Our data suggested that olfactory function deficits are prevalent in patients with NMOSDs. Reduced OB and olfactory-related cortex volume may be responsible for the olfactory dysfunction.

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Acknowledgments

We thank our patients as well as healthy volunteers for participating in this study and members of the Neuroimmunology Team for critical support; we thank Drs A. Vincent and D. Beeson for providing plasmids for AQP-4 antibody detection. This research was supported in part by the National Natural Science Foundation of China (81171183, 81471221 to L.Y.), the National Basic Research Program of China (2013CB966900 to F. D. S.), and the National Key Clinical Specialty Construction Project of China.

Conflicts of interest

The authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Tianjin Neurological Institute, Radiology, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, China

    Lin-Jie Zhang, Ning Zhao, Ying Fu, Da-Qi Zhang, Jing Wang, Wen Qin, Ningnannan Zhang, Yaou Liu, Chunshui Yu, Fu-Dong Shi & Li Yang

  2. Department of Neurology, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, 85013, USA

    Kristofer Wood & Fu-Dong Shi

  3. Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, 1007 MB, The Netherlands

    Yaou Liu

  4. Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China

    Yaou Liu

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  1. Lin-Jie Zhang
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Correspondence to Li Yang.

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Zhang, LJ., Zhao, N., Fu, Y. et al. Olfactory dysfunction in neuromyelitis optica spectrum disorders. J Neurol 262, 1890–1898 (2015). https://doi.org/10.1007/s00415-015-7787-3

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  • DOI: https://doi.org/10.1007/s00415-015-7787-3

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