The sense of smell essentially contributes to social communication, guides nutrition behaviour and elicits avoidance towards environmental hazards. Olfactory smell impairment may hence entail severe consequences for affected individuals. Compared with sensory loss in other modalities, reduced olfactory function is often unnoticed by those affected and diagnosed late. Those patients seeking help frequently suffer from long-term impairments resulting in reduced well-being and quality of life. The current review provides an overview of aetiology, prevalence and specifics of diagnostics in acquired and congenital olfactory loss and focusses on short- and long-term consequences. Compensation strategies are elaborated, and treatment options are mentioned. Individual characteristics associated with the development of serious mental health impairment are discussed in order to help practitioners identifying populations at risk.

Mothers are able to identify the body odour (BO) of their own child and prefer this smell above other BOs. It has hence been assumed that the infantile BO functions as a chemosignal promoting targeted parental care. We tested this hypothesis and examined whether children's BOs signal genetic similarity and developmental status to mothers. In addition, we assessed whether BOs facilitate inbreeding avoidance (Westermarck effect). In a cross-sectional design, N = 164 mothers participated with their biological children ( N = 226 children, aged 0–18 years) and evaluated BO probes of their own and four other, sex-matched children. Those varied in age and in genetic similarity, which was assessed by human leucocyte antigen profiling. The study showed not only that mothers identified and preferred their own child's BO, but also that genetic similarity and developmental status are transcribed in BOs. Accordingly, maternal preference of their own child's odour changes throughout development. Our data partly supported the Westermarck effect: mothers' preference of pubertal boys' BOs was negatively related to testosterone for the own son, but not for unfamiliar children. This article is part of the Theo Murphy meeting issue ‘Olfactory communication in humans’.

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Posttraumatic stress disorder (PTSD) is characterized by sleep impairment and nightmares. As pleasant odors presented during sleep affect the emotional tone of dreams without inducing arousal, we investigated whether sleep patterns in PTSD can be improved via nocturnal olfactory stimulation. Participants were 40 inpatients with PTSD (n = 35 women; age range: 20–59 years) who completed a randomized, patient‐blind, placebo‐controlled trial. Baseline measurement for 5 consecutive nights was followed by a 5‐night experimental intervention or placebo trial. During the intervention, patients received nocturnal stimulation with a pleasant odor (odor condition) or clean air (placebo condition) via an olfactometer that delivered inspiration‐triggered stimuli in a nasal tube or via an odorized nasal clip. After each night, the patients completed standardized questionnaires that assessed sleep parameters and dream content. Each night, sleep efficiency, sleep onset latency, and wakefulness after sleep onset were monitored with a motion biosensor. Baseline assessment revealed that PTSD severity was associated with poorer sleep outcomes. An interaction effect showed that nocturnal odorization affected dream intensity. Post hoc tests revealed an improvement in the group that used the nasal clip as compared to baseline, d = 0.68. No negative effects were observed after odorization with the nasal clip. Considering the limited sample size, the study indicates that nocturnal olfactory stimulation may serve as a low‐cost concomitant intervention to improve sleep quality in PTSD.

Functional magnetic resonance imaging of body odors is challenging due to methodological obstacles of odor presentation in the scanner and low intensity of body odors. Hence, few imaging studies investigated neural responses to body odors. Those differ in design characteristics and have shown varying results. Evidence on central processing of baby body odors has been scarce but might be important in order to detect neural correlates of bonding in mothers. A suitable paradigm for investigating perception of baby body odors has still to be established. We compared neural responses to baby body odors in a new to a conventional block design in a sample of ten normosmic mothers. For the new short design, 6 s of continuous odor presentation were followed by 19 s baseline and 13 repetitions were performed. For the conventional long design, 15 s of pulsed odor presentation were followed by 30 s of baseline and eight repetitions were performed. Neural responses were observed in brain structures related to basal and higher-order olfactory processing, such as insula, orbitofrontal cortex, and amygdala. Neural responses following the short design were significantly higher in comparison to the long design. This effect was based on higher number of repetitions but affected olfactory areas differently. The BOLD signal in the primary olfactory structures was enhanced by short and continuous stimulation, secondary structures did profit from longer stimulations with many repetitions. The short design is recommended as a suitable paradigm in order to detect neuronal correlates of baby body odors.

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