Skip to main content

Advertisement

SpringerLink
Log in

Olfactory Testing in Temporal Lobe Epilepsy: a Systematic Review

  • Epilepsy (C W Bazil, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Olfactory testing is a potentially safe, cost-effective, bedside evaluation tool for diagnosis, monitoring, and risk assessment for surgery in temporal lobe epilepsy (TLE) patients, but testing methods and relevant olfactory domains are not standardized. We conducted a systematic review to evaluate olfactory tests in TLE and summarize the results of the literature.

Recent Findings

Olfactory tests varied significantly in odorant administration tools and devices, target odorants, evaluation timing, and grading scales. The Smell Threshold Test and University of Pennsylvania Smell Identification Test were the most validated single-domain tests for odor detection and odor identification, respectively. For multi-domain tests, Odor Memory/Discrimination Test and the Sniffin’ Sticks test were the most validated. Results of olfactory tests in TLE are presented by domain.

Summary

Rigorous validation, standardization, and comparative analysis of existing olfactory tests by domain is urgently needed to establish the utility and efficacy of olfactory testing in TLE.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data Availability

Not applicable.

Code Availability

Not applicable.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Zack MM, Kobau R. National and state estimates of the numbers of adults and children with active epilepsy - United States, 2015. MMWR Morb Mortal Wkly Rep. 2017;66:821–5. https://doi.org/10.15585/mmwr.mm6631a1.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Fiest KM, Sauro KM, Wiebe S, Patten SB, Kwon CS, Dykeman J, et al. Prevalence and incidence of epilepsy: a systematic review and meta-analysis of international studies. Neurology. 2017;88:296–303. https://doi.org/10.1212/WNL.0000000000003509.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Picot MC, Baldy-Moulinier M, Daures JP, Dujols P, Crespel A. The prevalence of epilepsy and pharmacoresistant epilepsy in adults: a population-based study in a Western European country. Epilepsia. 2008;49:1230–8. https://doi.org/10.1111/j.1528-1167.2008.01579.x.

    Article  PubMed  Google Scholar 

  4. Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000;342:314–9. https://doi.org/10.1056/NEJM200002033420503.

    Article  CAS  PubMed  Google Scholar 

  5. Zhao F, Kang H, You L, Rastogi P, Venkatesh D, Chandra M. Neuropsychological deficits in temporal lobe epilepsy: a comprehensive review. Ann Indian Acad Neurol. 2014;17:374–82. https://doi.org/10.4103/0972-2327.144003.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Gaitatzis A, Johnson AL, Chadwick DW, Shorvon SD, Sander JW. Life expectancy in people with newly diagnosed epilepsy. Brain. 2004;127:2427–32. https://doi.org/10.1093/brain/awh267.

    Article  PubMed  Google Scholar 

  7. Kanner AM. Mood disorder and epilepsy: a neurobiologic perspective of their relationship. Dialogues Clin Neurosci. 2008;10:39–45.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Rochet M, El-Hage W, Richa S, Kazour F, Atanasova B. Depression, olfaction, and quality of life: a mutual relationship. Brain Sci 2018;8. https://doi.org/10.3390/brainsci8050080.

  9. Finkel D, Pedersen NL, Larsson M. Olfactory functioning and cognitive abilities: a twin study. J Gerontol B Psychol Sci Soc Sci. 2001;56:P226–33. https://doi.org/10.1093/geronb/56.4.p226.

    Article  CAS  PubMed  Google Scholar 

  10. Sullivan RM, Wilson DA, Ravel N, Mouly AM. Olfactory memory networks: from emotional learning to social behaviors. Front Behav Neurosci. 2015;9:36. https://doi.org/10.3389/fnbeh.2015.00036.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Zhou G, Lane G, Cooper SL, Kahnt T, Zelano C. Characterizing functional pathways of the human olfactory system. Elife. 2019;8. https://doi.org/10.7554/eLife.47177.

  12. Escanilla O, Arrellanos A, Karnow A, Ennis M, Linster C. Noradrenergic modulation of behavioral odor detection and discrimination thresholds in the olfactory bulb. Eur J Neurosci. 2010;32:458–68. https://doi.org/10.1111/j.1460-9568.2010.07297.x.

    Article  PubMed  Google Scholar 

  13. Wesson DW, Wilson DA. Sniffing out the contributions of the olfactory tubercle to the sense of smell: hedonics, sensory integration, and more? Neurosci Biobehav Rev. 2011;35:655–68. https://doi.org/10.1016/j.neubiorev.2010.08.004.

    Article  PubMed  Google Scholar 

  14. Soudry Y, Lemogne C, Malinvaud D, Consoli SM, Bonfils P. Olfactory system and emotion: common substrates. Eur Ann Otorhinolaryngol Head Neck Dis. 2011;128:18–23. https://doi.org/10.1016/j.anorl.2010.09.007.

    Article  CAS  PubMed  Google Scholar 

  15. Aqrabawi AJ, Kim JC. Olfactory memory representations are stored in the anterior olfactory nucleus. Nat Commun. 2020;11:1246. https://doi.org/10.1038/s41467-020-15032-2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Schoenbaum G, Chiba AA, Gallagher M. Neural encoding in orbitofrontal cortex and basolateral amygdala during olfactory discrimination learning. J Neurosci. 1999;19:1876–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. •• Khurshid K, AJD C, Rupert PE, Minniti NL, Carswell MA, Mechanic-Hamilton DJ, et al. A quantitative meta-analysis of olfactory dysfunction in epilepsy. Neuropsychol Rev. 2019;29:328–37. https://doi.org/10.1007/s11065-019-09406-7. This study showed the presence of olfactory dysfunction in epilepsy patients in identification, memory, discrimination, and detection domains.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Savic I, Bookheimer SY, Fried I, Engel J Jr. Olfactory bedside test. A simple approach to identify temporo-orbitofrontal dysfunction. Arch Neurol. 1997;54:162–8. https://doi.org/10.1001/archneur.1997.00550140038010.

    Article  CAS  PubMed  Google Scholar 

  19. • Doty RL, Tourbier I, Neff JK, Silas J, Turetsky B, Moberg P, et al. Influences of temporal lobe epilepsy and temporal lobe resection on olfaction. J Neurol. 2018;265:1654–65. https://doi.org/10.1007/s00415-018-8891-y. This study identified odor dysfunction in identification, detection, and discrimination/memory domains among patients with TLE and temporal lobe resection.

    Article  PubMed  PubMed Central  Google Scholar 

  20. •• Kang J, Yenokyan G, Hawng BY, Chen M, Penn R, Mampre D et al. Odor identification predicts postoperative seizure control following magnetic resonance-guided laser interstitial thermal therapy. Epilepsia. 2020. This study demonstrated clinical utility for olfactory measurements in predicting surgical outcomes.

  21. Dade LA, Zatorre RJ, Jones-Gotman M. Olfactory learning: convergent findings from lesion and brain imaging studies in humans. Brain. 2002;125:86–101. https://doi.org/10.1093/brain/awf003.

    Article  PubMed  Google Scholar 

  22. Jones-Gotman M, Zatorre RJ, Cendes F, Olivier A, Andermann F, McMackin D, et al. Contribution of medial versus lateral temporal-lobe structures to human odour identification. Brain. 1997;120(Pt 10):1845–56. https://doi.org/10.1093/brain/120.10.1845.

    Article  PubMed  Google Scholar 

  23. Jones-Gotman M, Zatorre RJ. Olfactory identification deficits in patients with focal cerebral excision. Neuropsychologia. 1988;26:387–400. https://doi.org/10.1016/0028-3932(88)90093-0.

    Article  CAS  PubMed  Google Scholar 

  24. Jacek S, Stevenson RJ, Miller LA. Olfactory dysfunction in temporal lobe epilepsy: a case of ictus-related parosmia. Epilepsy Behav. 2007;11:466–70. https://doi.org/10.1016/j.yebeh.2007.05.016.

    Article  PubMed  Google Scholar 

  25. Pouliot S, Jones-Gotman M. Medial temporal-lobe damage and memory for emotionally arousing odors. Neuropsychologia. 2008;46:1124–34. https://doi.org/10.1016/j.neuropsychologia.2007.10.017.

    Article  PubMed  Google Scholar 

  26. Eskenazi B, Cain WS, Novelly RA, Friend KB. Olfactory functioning in temporal lobectomy patients. Neuropsychologia. 1983;21:365–74. https://doi.org/10.1016/0028-3932(83)90023-4.

    Article  CAS  PubMed  Google Scholar 

  27. Juran SA, Lundstrom JN, Geigant M, Kumlien E, Fredrikson M, Ahs F, et al. Unilateral resection of the anterior medial temporal lobe impairs odor identification and valence perception. Front Psychol. 2015;6:2015. https://doi.org/10.3389/fpsyg.2015.02015.

    Article  PubMed  Google Scholar 

  28. Hummel T, Henkel S, Negoias S, Galvan JR, Bogdanov V, Hopp P, et al. Olfactory bulb volume in patients with temporal lobe epilepsy. J Neurol. 2013;260:1004–8. https://doi.org/10.1007/s00415-012-6741-x.

    Article  PubMed  Google Scholar 

  29. Lehrner J, Baumgartner C, Serles W, Olbrich A, Pataraia E, Bacher J, et al. Olfactory prodromal symptoms and unilateral olfactory dysfunction are associated in patients with right mesial temporal lobe epilepsy. Epilepsia. 1997;38:1042–4. https://doi.org/10.1111/j.1528-1157.1997.tb01490.x.

    Article  CAS  PubMed  Google Scholar 

  30. Eskenazi B, Cain WS, Novelly RA, Mattson R. Odor perception in temporal lobe epilepsy patients with and without temporal lobectomy. Neuropsychologia. 1986;24:553–62. https://doi.org/10.1016/0028-3932(86)90099-0.

    Article  CAS  PubMed  Google Scholar 

  31. Martinez BACain WSde Wijk RASpencer DDNovelly RASass KJ. Olfactory functioning before and after temporal lobe resection for intractable seizures. Neuropsychology. 1993;7:7351–63. https://doi.org/10.1037/0894-4105.7.3.351.

    Article  Google Scholar 

  32. Hudry J, Ryvlin P, Saive AL, Ravel N, Plailly J, Royet JP. Lateralization of olfactory processing: differential impact of right and left temporal lobe epilepsies. Epilepsy Behav. 2014;37:184–90. https://doi.org/10.1016/j.yebeh.2014.06.034.

    Article  PubMed  Google Scholar 

  33. Eichenbaum H, Morton TH, Potter H, Corkin S. Selective olfactory deficits in case H.M. Brain. 1983;106(Pt 2):459–72. https://doi.org/10.1093/brain/106.2.459.

    Article  PubMed  Google Scholar 

  34. Hudry J, Perrin F, Ryvlin P, Mauguiere F, Royet JP. Olfactory short-term memory and related amygdala recordings in patients with temporal lobe epilepsy. Brain. 2003;126:1851–63. https://doi.org/10.1093/brain/awg192.

    Article  PubMed  Google Scholar 

  35. Kohler CG, Moberg PJ, Gur RE, O'Connor MJ, Sperling MR, Doty RL. Olfactory dysfunction in schizophrenia and temporal lobe epilepsy. Neuropsychiatry Neuropsychol Behav Neurol. 2001;14:83–8.

    CAS  PubMed  Google Scholar 

  36. Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G. “Sniffin' sticks”: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses. 1997;22:39–52. https://doi.org/10.1093/chemse/22.1.39.

    Article  CAS  PubMed  Google Scholar 

  37. Carroll B, Richardson JT, Thompson P. Olfactory information processing and temporal lobe epilepsy. Brain Cogn. 1993;22:230–43. https://doi.org/10.1006/brcg.1993.1036.

    Article  CAS  PubMed  Google Scholar 

  38. Rausch R, Serafetinides EA. Specific alterations of olfactory function in humans with temporal lobe lesions. Nature. 1975;255:557–8. https://doi.org/10.1038/255557a0.

    Article  CAS  PubMed  Google Scholar 

  39. Rausch R, Serafetinides EA, Crandall PH. Olfactory memory in patients with anterior temporal lobectomy. Cortex. 1977;13:445–52. https://doi.org/10.1016/s0010-9452(77)80024-5.

    Article  CAS  PubMed  Google Scholar 

  40. •• Espinosa-Jovel C, Toledano R, Jimenez-Huete A, Aledo-Serrano A, Garcia-Morales I, Campo P, et al. Olfactory function in focal epilepsies: Understanding mesial temporal lobe epilepsy beyond the hippocampus. Epilepsia Open. 2019;4:487–92. https://doi.org/10.1002/epi4.12343. This study found different olfactory performance in patients with mTLE compared to patients with extra-mesial epilepsy.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Haehner A, Henkel S, Hopp P, Hallmeyer-Elgner S, Reuner U, Heinz R, et al. Olfactory function in patients with and without temporal lobe resection. Epilepsy Behav. 2012;25(4):477–80. https://doi.org/10.1016/j.yebeh.2012.09.011.

    Article  PubMed  Google Scholar 

  42. • Turk BG, Metin B, Tekeli H, Sayman OA, Kizilkilic O, Uzan M, et al. Evaluation of olfactory and gustatory changes in patients with mesial temporal lobe epilepsy. Seizure. 2020;75:110–4. https://doi.org/10.1016/j.seizure.2020.01.001. This study showed olfactory dysfunction in mTLE patients in detection, discrimination, and identification.

    Article  PubMed  Google Scholar 

  43. Caminiti F, De Salvo S, Nunnari D, Bramanti P, Ciurleo R, Granata F, et al. Effect of the antiepileptic therapy on olfactory disorders associated with mesial temporal sclerosis. Neurocase. 2016;22:357–61. https://doi.org/10.1080/13554794.2016.1176203.

    Article  PubMed  Google Scholar 

  44. Zatorre RJ, Jones-Gotman M. Human olfactory discrimination after unilateral frontal or temporal lobectomy. Brain. 1991;114(Pt 1A):71–84.

    PubMed  Google Scholar 

  45. Jones-Gotman M, Zatorre RJ. Odor recognition memory in humans: role of right temporal and orbitofrontal regions. Brain Cogn. 1993;22:182–98. https://doi.org/10.1006/brcg.1993.1033.

    Article  CAS  PubMed  Google Scholar 

  46. Doty RL, Shaman P, Kimmelman CP, Dann MS. University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic. Laryngoscope. 1984;94:176–8. https://doi.org/10.1288/00005537-198402000-00004.

    Article  CAS  PubMed  Google Scholar 

  47. Desai M, Agadi JB, Karthik N, Praveenkumar S, Netto AB. Olfactory abnormalities in temporal lobe epilepsy. J Clin Neurosci. 2015;22:1614–8. https://doi.org/10.1016/j.jocn.2015.03.035.

    Article  CAS  PubMed  Google Scholar 

  48. Buchanan TW, Tranel D, Adolphs R. A specific role for the human amygdala in olfactory memory. Learn Mem. 2003;10:319–25. https://doi.org/10.1101/lm.62303.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Hummel T, Pauli E, Schuler P, Kettenmann B, Stefan H, Kobal G. Chemosensory event-related potentials in patients with temporal lobe epilepsy. Epilepsia. 1995;36:79–85. https://doi.org/10.1111/j.1528-1157.1995.tb01670.x.

    Article  CAS  PubMed  Google Scholar 

  50. Cain WS, Gent J, Catalanotto FA, Goodspeed RB. Clinical evaluation of olfaction. Am J Otolaryngol. 1983;4:252–6. https://doi.org/10.1016/s0196-0709(83)80068-4.

    Article  CAS  PubMed  Google Scholar 

  51. Ciumas C, Lindstrom P, Aoun B, Savic I. Imaging of odor perception delineates functional disintegration of the limbic circuits in mesial temporal lobe epilepsy. Neuroimage. 2008;39:578–92. https://doi.org/10.1016/j.neuroimage.2007.09.004.

    Article  PubMed  Google Scholar 

  52. Doty RL, McKeown DA, Lee WW, Shaman P. A study of the test-retest reliability of ten olfactory tests. Chem Senses. 1995;20:645–56. https://doi.org/10.1093/chemse/20.6.645.

    Article  CAS  PubMed  Google Scholar 

  53. Albrecht J, Anzinger A, Kopietz R, Schopf V, Kleemann AM, Pollatos O, et al. Test-retest reliability of the olfactory detection threshold test of the Sniffin' sticks. Chem Senses. 2008;33:461–7. https://doi.org/10.1093/chemse/bjn013.

    Article  PubMed  Google Scholar 

  54. Abraham A, Mathai KV. The effect of right temporal lobe lesions on matching of smells. Neuropsychologia. 1983;21:277–81. https://doi.org/10.1016/0028-3932(83)90045-3.

    Article  CAS  PubMed  Google Scholar 

  55. Hughes JR, Andy OJ. The human amygdala II: neurophysiological correlates of olfactory perception before and after amygdalotomy. Electroencephalogr Clin Neurophysiol. 1979;46:444–51. https://doi.org/10.1016/0013-4694(79)90145-7.

    Article  CAS  PubMed  Google Scholar 

  56. Vaughan DN, Jackson GD. The piriform cortex and human focal epilepsy. Front Neurol. 2014;5:259. https://doi.org/10.3389/fneur.2014.00259.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Royet JP, Plailly J. Lateralization of olfactory processes. Chem Senses. 2004;29(8):731–45. https://doi.org/10.1093/chemse/bjh067.

    Article  PubMed  Google Scholar 

  58. Goncalves EB, de Oliveira Cardoso TAM, Yasuda CL, Cendes F. Depressive disorders in patients with pharmaco-resistant mesial temporal lobe epilepsy. J Int Med Res. 2018;46(2):752–60. https://doi.org/10.1177/0300060517717825.

    Article  PubMed  Google Scholar 

  59. Zald DH, Pardo JV. Emotion, olfaction, and the human amygdala: amygdala activation during aversive olfactory stimulation. Proc Natl Acad Sci U S A. 1997;94:4119–24. https://doi.org/10.1073/pnas.94.8.4119.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Young JC, Vaughan DN, Nasser HM, Jackson GD. Anatomical imaging of the piriform cortex in epilepsy. Exp Neurol. 2019;320:113013. https://doi.org/10.1016/j.expneurol.2019.113013.

    Article  PubMed  Google Scholar 

  61. Vismer MS, Forcelli PA, Skopin MD, Gale K, Koubeissi MZ. The piriform, perirhinal, and entorhinal cortex in seizure generation. Front Neural Circuits. 2015;9:27. https://doi.org/10.3389/fncir.2015.00027.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Bensafi M. The role of the piriform cortex in human olfactory perception: insights from functional neuroimaging studies. Chemosens Percept. 2012;5:4–10. https://doi.org/10.1007/s12078-011-9110-8.

    Article  Google Scholar 

  63. Krettek JE, Price JL. Projections from the amygdaloid complex and adjacent olfactory structures to the entorhinal cortex and to the subiculum in the rat and cat. J Comp Neurol. 1977;172:723–52. https://doi.org/10.1002/cne.901720409.

    Article  CAS  PubMed  Google Scholar 

  64. Rupp CI, Fleischhacker WW, Kemmler G, Kremser C, Bilder RM, Mechtcheriakov S, et al. Olfactory functions and volumetric measures of orbitofrontal and limbic regions in schizophrenia. Schizophr Res. 2005;74(2–3):149–61. https://doi.org/10.1016/j.schres.2004.07.010.

    Article  PubMed  Google Scholar 

  65. Dahmani L, Patel RM, Yang Y, Chakravarty MM, Fellows LK, Bohbot VD. An intrinsic association between olfactory identification and spatial memory in humans. Nat Commun. 2018;9(1):4162. https://doi.org/10.1038/s41467-018-06569-4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Rolls ET, Grabenhorst F, Parris BA. Neural systems underlying decisions about affective odors. J Cogn Neurosci. 2010;22(5):1069–82. https://doi.org/10.1162/jocn.2009.21231.

    Article  PubMed  Google Scholar 

  67. Jiang H, Schuele S, Rosenow J, Zelano C, Parvizi J, Tao JX, et al. Theta oscillations rapidly convey odor-specific content in human piriform cortex. Neuron. 2017;94:207–19 e4. https://doi.org/10.1016/j.neuron.2017.03.021.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Momjian S, Tyrand R, Landis BN, Boex C. Intraoperative monitoring of olfactory function: a feasibility study. J Neurosurg. 2019;132:1–6. https://doi.org/10.3171/2019.1.JNS182731.

    Article  Google Scholar 

  69. Martzke JS, Kopala LC, Good KP. Olfactory dysfunction in neuropsychiatric disorders: review and methodological considerations. Biol Psychiatry. 1997;42:721–32. https://doi.org/10.1016/s0006-3223(96)00442-8.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Brian Y. Hwang and David Mampre contributed equally to this work.

Authors and Affiliations

  1. Division of Functional Neurosurgery, Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Meyer 8-181, Baltimore, MD, 21287, USA

    Brian Y. Hwang, David Mampre & William S. Anderson

  2. Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Rachel Penn & Joon Kang

  3. Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Vidyulata Kamath

Authors
  1. Brian Y. Hwang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Mampre
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rachel Penn
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. William S. Anderson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joon Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Vidyulata Kamath
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Brian Y. Hwang.

Ethics declarations

Conflict of Interest

Brian Y. Hwang, David Mampre, Rachel Penn, and Joon Kang each declare no potential conflicts of interest. William S. Anderson has received personal fees from Globus Medical and is on the Advisory Board of NeuroLogic and Longeviti NeuroSolutions. Vidyulata Kamath reports grants from National Institute of Health.

Ethics Approval

Not applicable.

Consent to Participate

Not applicable.

Consent for Publication

Not applicable.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Epilepsy

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hwang, B.Y., Mampre, D., Penn, R. et al. Olfactory Testing in Temporal Lobe Epilepsy: a Systematic Review. Curr Neurol Neurosci Rep 20, 65 (2020). https://doi.org/10.1007/s11910-020-01083-x

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11910-020-01083-x

Keywords

Search

Navigation