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Smell and taste in cervical dystonia

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The pathophysiology of cervical dystonia is not completely understood. Current concepts of the pathophysiology propose that it is a network disorder involving the basal ganglia, cerebellum and sensorimotor cortex. These structures are primarily concerned with sensorimotor control but are also involved in non-motor functioning such as the processing of information related to the chemical senses. This overlap lets us hypothesize a link between cervical dystonia and altered sense of smell and taste. To prove this hypothesis and to contribute to the better understanding of cervical dystonia, we assessed olfactory and gustatory functioning in 40 adults with idiopathic cervical dystonia and 40 healthy controls. The Sniffin Sticks were used to assess odor threshold, discrimination and identification. Furthermore, the Taste Strips were applied to assess the combined taste score. Motor and non-motor deficits of cervical dystonia including neuropsychological and psychiatric alterations were assessed as cofactors for regression analyses. We found that cervical dystonia subjects had lower scores than healthy controls for odor threshold (5.8 ± 2.4 versus 8.0 ± 3.2; p = 0.001), odor identification (11.7 ± 2.3 versus 13.1 ± 1.3; p = 0.001) and the combined taste score (9.5 ± 2.2 versus 11.7 ± 2.7; p < 0.001), while no difference was found in odor discrimination (12.0 ± 2.5 versus 12.9 ± 1.8; p = 0.097). Regression analysis suggests that age is the main predictor for olfactory decline in subjects with cervical dystonia. Moreover, performance in the Montreal Cognitive Assessment is a predictor for gustatory decline in cervical dystonia subjects. Findings propose that cervical dystonia is associated with diminished olfactory and gustatory functioning.

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We thank Professor Ulf Schminke, Department of Neurology, University of Greifswald, Greifswald, Germany for critical comments on the manuscript. Additionally, we would like to thank Rosalie L. Donaldson-Kronenbuerger for English language editing. The study was funded by internal grants of the Department of Neurology, University of Greifswald, Greifswald, Germany.

Author information

Conceptualization: TH, MK, TH, BL; methodology: TH, MK, TH, BL; formal analysis and investigation: TH, MK, TH, MV; writing—original draft preparation: TH; writing—review and editing: TH, TH, MV, CW, BV, JG, RF, BL, MJ-U, AS, MK; funding acquisition: MK; resources: TH, MK; supervision: MK.

Correspondence to Martin Kronenbuerger.

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The authors declare that they have no conflict of interest.

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All procedures performed in this study were in accordance with the ethical standards of the University of Greifswald, Faculty of Medicine (study reference number: BB 188/17) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All study participants gave their informed consent prior to their inclusion in the study.

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Herr, T., Hummel, T., Vollmer, M. et al. Smell and taste in cervical dystonia. J Neural Transm (2020). https://doi.org/10.1007/s00702-020-02156-4

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  • Olfaction
  • Gustatory functioning
  • Network disorder
  • Cerebellum
  • Basal ganglia
  • Sensorimotor cortex