OLFACTION IN MULTIPLE SCLEROSIS

描述（改编自研究者摘要）：多种 硬化症（MS）可导致瘫痪和死亡，影响数百万人， 美国人，往往在他们的生命的黄金。 虽然有充分的证据表明 MS会改变视力、听力、语言和平衡， 嗅觉-确定食品风味的关键感官， 防止食物变质、天然气泄漏、火灾和其他 环境污染，一直备受争议。 事实上， 医学教科书指出嗅觉在MS中幸免， 错误地认为嗅觉系统是无髓鞘的。 一九八四年， 主要研究者发现31名MS患者中有23% 在宾夕法尼亚大学的考试中得分低于正常水平 测试（UPSIT）。 去年，他报告了一系列案例研究， 证明嗅觉功能障碍可能是 女士 在一项针对14名多发性硬化症患者的试点研究中，主要研究者 显示UPSIT分数和数量之间的显着关系， 与嗅觉功能相关的脑区域内的斑块（即，的 眶额皮质和下颞叶）。 没有这种关系 在非嗅觉相关的脑区中观察到。 这些新颖 研究结果表明，与MS相关的嗅觉功能障碍 直接反映了中枢神经病变的程度 嗅觉结构 在拟议的研究中，主要研究者 将决定一些经过验证的嗅觉系统 在一个大的MS患者队列中改变了测试，包括 气味检测、识别、辨别和记忆。 他会（1） 描述MS在鼻子两侧的嗅觉功能障碍 使用心理物理和电生理测量，（2） 使用高分辨率MRI确定测试措施是否 与嗅觉相关斑块的数量/体积相关 （3）确定嗅觉措施是否与 MS症状的加重或缓解（包括出现或 （4）确定女性是否比男性更容易 比男性更容易受到MS相关嗅觉丧失的影响，以及（5）建立 嗅觉测试指标是否与神经心理学有关 认知功能的测量，重点是测量 眶额和下颞叶神经处理。 鉴于 嗅觉功能和大脑皮层之间的密切关系的初步发现， 嗅觉相关结构内MS相关斑块的数量， 首席研究员预计，这项研究将解释，为 第一次，嗅觉功能障碍的发病机制与 常见的神经系统疾病 重要的是，这项研究将提供 关于嗅觉功能的不同测量如何与 特定中枢神经系统内的病理改变 结构，以及临床医生合理咨询的信息 MS相关缺陷的患者在这一未被重视的初级感觉 模态

DESCRIPTION (Adapted from the Investigator's Abstract): Multiple sclerosis (MS) can lead to paralysis and death and affects millions of Americans, often in the prime of their lives. While it is well documented that MS alters vision, hearing, speech and balance, its influence on olfaction - a sense critical for determination of food flavor and protection from spoiled food, leaking natural gas, fire, and other environmental hazards - has been controversial. Indeed, a number of medical textbooks state that the sense of smell is spared in MS, erroneously assuming that the olfactory system is unmyelinated. In 1984, the principal investigator discovered that 23 percent of 31 MS patients scored below normal on the University of Pennsylvania Smell Identification Test (UPSIT). Last year, he reported a series of case studies demonstrating that olfactory dysfunction can be the presenting symptom of MS. In a pilot study of 14 MS patients, the principal investigator has shown a significant relationship between UPSIT scores and the number of plaques within brain regions related to olfactory function (i.e., the orbitofrontal cortex and inferior temporal lobe). No such relationship was observed within non-olfactory related brain regions. These novel findings suggest that the olfactory dysfunction associated with MS directly reflects the degree of neuropathological involvement of central olfactory structures. In the proposed study, the principal investigator will determine the degree to which a number of well-validated olfactory tests are altered in a large cohort of MS patients, including tests of odor detection, identification, discrimination, and memory. He will (1) characterize the olfactory dysfunction of MS on each side of the nose using both psychophysical and electrophysiological measures, (2) determine, using high resolution MRI, whether the test measures are correlated with the number/volume of plaques in olfactory-related structures, (3) establish if olfactory measures are related to the exacerbation or remission of the MS symptoms (including appearance or disappearance of plaques), (4) ascertain whether women are more susceptible than men to MS-related olfactory loss, and (5) establish whether the olfactory test measures are related to neuropsychological measures of cognitive function, with an emphasis on tests which measure orbitofrontal and inferior temporal lobe neural processing. Given the pilot findings of a close relationship between olfactory function and the number of MS-related plaques within olfactory-related structures, the principal investigator expects that this research will explicate, for the first time, the pathogenesis of an olfactory dysfunction associated with a common neurological disorder. Importantly, this study will provide insight as to how different measures of olfactory function are related to pathological alterations within specific central nervous system structures, as well as information for the clinician to rationally counsel patients with MS-related deficits in this underappreciated primary sensory modality.