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Altered glucose metabolism of the olfactory-related cortices in anosmia patients with traumatic brain injury

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Impaired brain cortices contribute significantly to the pathophysiological mechanisms of post-traumatic olfactory dysfunction (PTOD). This study aimed to use 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to measure cerebral cortices' metabolism activity and then to explore their associations with olfaction in patients with PTOD.

Methods

Ethics committee-approved prospective studies included 15 patients with post-traumatic anosmia and 11 healthy volunteers. Olfactory function was assessed using the Sniffin’ Sticks. Participants underwent 18F-FDG PET/CT scan and the image data were collected for the voxel-based whole brain analysis. Furthermore, the standardized uptake value ratio (SUVR) of the whole brain regions was measured and correlated with olfactory function.

Results

Patients with post-traumatic anosmia showed significantly reduced glucose metabolism in bilateral rectus, bilateral superior and medial orbitofrontal cortex (OFC), bilateral thalamus, left hippocampus and parahippocampus and left superior temporal pole (all p < 0.001). In contrast, patients with post-traumatic anosmia had significantly increased glucose metabolism in the bilateral insula (all p < 0.001). SUVR values among a total of 17 cerebral cortices including frontal, limbic, and temporal regions were significantly and positively correlated with olfactory function. The cerebral cortices with the top three correlations were the right middle frontal OFC (r = 0.765, p = 0.001), right caudate (r = 0.652, p = 0.010) and right putamen (r = 0.623, p = 0.002).

Conclusion

Patients with post-traumatic anosmia presented with distinct patterns of brain metabolism and key cortices that highly associated with the retained olfactory function were identified. The preliminary results further support the potential use of PET imaging for precisely assessing brain metabolism in patients with PTOD.

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Acknowledgments

We thank Junqi Li, Ziwei Zhu and other technicians from the Nuclear Medicine Department of Beijing Anzhen Hospital, for their help and support during the experimental scanning.

Funding

This study was supported by Beijing Hospitals Authority Youth Program (QML20190617), Beijing Science and Technology Nova Program (Z201100006820086), Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support (XMLX202136), Natural Science Foundation of China (82000954), Beijing Hospitals Authority' Mission Plan (SML20190601), and Beijing Scholars Program (No. 051).

Author information

Authors and Affiliations

  1. Department of Otolaryngology, Smell and Taste Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

    Xing Gao, Dawei Wu, Baihan Su, Zhifu Sun & Yongxiang Wei

  2. Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria

    Xiang Li

  3. Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China

    Binbin Nie

  4. Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

    Xiaoli Zhang

  5. Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Children’s Hospital, Capital Institute of Pediatrics, Beijing, China

    Yongxiang Wei

Authors
  1. Xing Gao
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  2. Dawei Wu
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  3. Xiang Li
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  4. Baihan Su
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  5. Zhifu Sun
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  6. Binbin Nie
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  7. Xiaoli Zhang
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  8. Yongxiang Wei
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Contributions

XG drafted the manuscript and analyzed the date. DW revised the manuscript, designed the study and analyzed the date. XL contributed to the methodology. BS analyzed the date. ZS and BN contributed to the methodology and interpretation of data. XZ contributed to the vital instruments and medicines. YW designed the study, revised the manuscript, supervised the study, and obtained the funding.

Corresponding author

Correspondence to Yongxiang Wei.

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Conflict of interest

None of the authors has a potential conflict of interest.

Ethics approval

This study was approved by the Ethics Committee at Beijing Anzhen Hospital (Beijing, China; Approval No.2019015X). The study design complied with the criteria of the Declaration of Helsinki for Medical Research involving Human Subjects.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent to publish

The authors affirm that human research participants provided informed consent for publication of the images in figures.

Software

MATLAB 2013a, Medical image Analysis, RRID:SCR_013499.

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Gao, X., Wu, D., Li, X. et al. Altered glucose metabolism of the olfactory-related cortices in anosmia patients with traumatic brain injury. Eur Arch Otorhinolaryngol 278, 4813–4821 (2021). https://doi.org/10.1007/s00405-021-06754-0

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  • DOI: https://doi.org/10.1007/s00405-021-06754-0

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