Paradoxical olfactory function in combat Veterans: The role of PTSD and odor factors

Wilkerson, Allison K.; Uhde, Thomas W.; Leslie, Kimberly; Freeman, Wilson C.; LaRowe, Steven D.; Schumann, Aicko Y.; Cortese, Bernadette M.

doi:10.1080/08995605.2018.1425063

Cited by 17 publications

(16 citation statements)

References 69 publications

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“…Apart from the well-known neurological findings including sensory and motor deficits [ 6 ], some symptoms that we found, such as impairment of the senses (hearing, smell, taste), headache, vertigo, epilepsy and psychiatric symptoms, are rarely described in literature [ 31 , 38 ] and are often overlooked when treating patients with polytrauma. These should be actively screened for in patients with war injuries.…”

Section: Discussionmentioning

confidence: 90%

Better be prepared: the spectrum of neuropsychiatric impairment among Libyan war victims transferred to Germany for trauma rehabilitation

Dootz

Stackelberg

Abaya

et al. 2021

Neurol. Res. Pract.

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Background The current Libyan civil war has originated many casualties, imposing medical challenges. War injuries are complex, requiring specialized knowledge and interdisciplinary assessment for adequate patient and intercultural management. Methods This retrospective study analyzed records of 78 Libyan patients admitted from July 2016 to November 2017 to neurological and trauma surgical departments of Krankenhaus Nordwest, Frankfurt, Germany. Issues of system preparation of the hospital, demographics, injury patterns and therapies were analyzed. The chi-squared test was used to analyze differences in injury patterns in explosion and gunshot injuries. Results Seventy-seven of seventy-eight patients were male (mean age 30.6 years). The patients received primary and secondary treatment in Tunisia (n = 39), Libya (n = 36) and Turkey (n = 23). Forty-eight patients had gunshot injuries, 37 explosion injuries, 11 both. Preparation for management of injuries included hygienic and isolation protocols, organization of interpreters and intercultural training. Patients presented with a broad variety of neurological, psychiatric and trauma surgical injuries. Fifty-six patients had sensory, 47 motor deficits. Nine reported headache, 5 vertigo, 13 visual impairment, 28 psychiatric symptoms. Eighteen patients had central nervous damage, 50 peripheral nervous damage. Central nervous damage was significantly more common in gunshot than explosion injuries (p = 0.015). Peripheral nervous damage was more common in explosion than gunshot injuries (p < 0.1). Fifty-one patients had polytrauma and 49 suffered from fractures. Therapy included surgical interventions (n = 56) and physiotherapy. Structured rehabilitation programs were often indicated. Conclusion Specialized knowledge about war injuries and their management including hospital preparation and planning regarding infrastructure may be required anytime. Injuries include a broad variety of neurological, psychiatric and trauma surgical injuries. Therefore, an interdisciplinary approach is crucial.

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Section: Discussionmentioning

confidence: 90%

Better be prepared: the spectrum of neuropsychiatric impairment among Libyan war victims transferred to Germany for trauma rehabilitation

Dootz

Stackelberg

Abaya

et al. 2021

Neurol. Res. Pract.

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“…Individuals with neurotic personality tendencies have been found to be both more susceptible to odor sensitization [92,93], and the development of PTSD [94]. The findings of Cortese et al [95] and Wilkerson et al [96] discussed in Section 6.1 also indicate that increased sensitivity to threat-relevant odors occurs in PTSD. Therefore, when using an odor habituation paradigm, it is important to monitor PTSD patients for odor sensitization to prevent maladaptive effects from arising.…”

Section: Inducing Adaptation and Habituation To Potential Trauma Odorsmentioning

confidence: 95%

“…Another important consideration for the use of OVR in PTSD therapy is that the condition of PTSD itself appears to alter odor processing. In several studies, Cortese and colleagues [95,96] found that veterans with PTSD exhibited elevated sensitivity to threatrelated odors (e.g., burning rubber, burning hair, diesel fuel, and gunpowder) as measured both by self-reported and objective odor testing. However, sensitivity to odors that were not associated with trauma were reduced in PTSD patients, and grey matter volume in both piriform and orbitofrontal areas (primary and secondary olfactory cortex) was also found to be diminished [95,96].…”

Section: Odor Perception Considerationsmentioning

confidence: 99%

“…In several studies, Cortese and colleagues [95,96] found that veterans with PTSD exhibited elevated sensitivity to threatrelated odors (e.g., burning rubber, burning hair, diesel fuel, and gunpowder) as measured both by self-reported and objective odor testing. However, sensitivity to odors that were not associated with trauma were reduced in PTSD patients, and grey matter volume in both piriform and orbitofrontal areas (primary and secondary olfactory cortex) was also found to be diminished [95,96]. Interestingly, these abnormal responses to odors may be specifically related to the current presence of PTSD and not just the experience of trauma.…”

Section: Odor Perception Considerationsmentioning

confidence: 99%

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Olfactory Virtual Reality: A New Frontier in the Treatment and Prevention of Posttraumatic Stress Disorder

Herz

2021

Brain Sciences

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This perspective piece reviews the clinical condition of posttraumatic stress disorder (PTSD), which is currently increasing due to the COVID-19 pandemic, and recent research illustrating how olfaction is being incorporated into virtual reality (VR) platforms. I then discuss the latest work examining the potential of olfactory virtual reality (OVR) for the treatment of PTSD. From this foundation I suggest novel ways in which OVR may be implemented in PTSD therapy and harnessed for preventing the development of PTSD. Perceptual and chemical features of olfaction that should be considered in OVR applications are also discussed.

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“…Another study observed significant reductions of olfactory bulb volume and olfactory function in women with a history of CM (37). Moreover, olfactory dysfunctions and altered processing of non-social olfactory threat cues have been observed in individuals with posttraumatic stress disorder (PTSD) (38)(39)(40). However, whether CM modulates the processing of social olfactory cues remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Childhood Maltreatment Alters the Neural Processing of Chemosensory Stress Signals

et al. 2020

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Accumulating evidence suggests that childhood maltreatment (CM) confers risk for psychopathology later in life by inducing hypervigilance to social threat cues such as fearful faces. However, it remains unclear whether the modulatory impact of CM extents to the olfactory domain of social communication in humans. To address this question, we examined whether CM modulates the neural processing of chemosensory threat signals in sweat and whether CM affects the stress-reducing effects of oxytocin (OXT) in this context. In a randomized, double-blind within-subject functional MRI study design, 58 healthy participants (30 females) received intranasal OXT (40 IU) or placebo (PLC) and completed a forced-choice emotion recognition task with faces of varying emotion intensities (neutral to fearful) while exposed to sweat stimuli and a non-social control odor. Axillary sweat samples were collected from 30 healthy male donors undergoing an acute psychosocial stressor (stress) and ergometer training (sport) as control in a prestudy. CM was assessed by the 25-item Childhood Trauma Questionnaire (CTQ). The final fMRI analysis included 50 healthy participants (26 females). Regression analysis showed a stress-specific association of CTQ scores with amygdala hyperreactivity, hippocampal deactivation, and increased functional connectivity between the amygdala and the hippocampus, medial orbitofrontal cortex, and the anterior cingulate cortex (ACC) under PLC. Furthermore, we observed a positive association of CTQ scores and the dampening effects of OXT on stress-related amygdala responses. Our findings suggest that CM may induce hypervigilance to chemosensory threat cues in a healthy sample due to inefficient frontolimbic inhibition of amygdala activation. Future studies should investigate whether increased recruitment of the intralimbic amygdala-hippocampus complex reflects a compensatory mechanism that prevents the development of psychopathology in those who have experienced CM. Furthermore, the results reveal that the stress-specific effects of OXT in the olfactory domain are more pronounced in participants with increasing levels of CM exposure.

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Paradoxical olfactory function in combat Veterans: The role of PTSD and odor factors

Cited by 17 publications

References 69 publications

Better be prepared: the spectrum of neuropsychiatric impairment among Libyan war victims transferred to Germany for trauma rehabilitation

Better be prepared: the spectrum of neuropsychiatric impairment among Libyan war victims transferred to Germany for trauma rehabilitation

Olfactory Virtual Reality: A New Frontier in the Treatment and Prevention of Posttraumatic Stress Disorder

Childhood Maltreatment Alters the Neural Processing of Chemosensory Stress Signals

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