Olfactory Stimulation and the Diagnosis of Patients With Disorders of Consciousness: A Double-Blind, Randomized Clinical Trial
ObjectivesThe aim of this study was to determine whether behavioral responses elicited by olfactory stimulation are a predictor of conscious behavioral response and prognosis of patients with disorders of consciousness (DOC).MethodsTwenty-three DOC patients (8 unresponsive wakefulness syndrome [UWS]...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-02-01
|
| Series: | Frontiers in Neuroscience |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2022.712891/full |
| _version_ | 1818281492617363456 |
|---|---|
| author | Jing Wang Jing Wang Shaoming Zhang Wenbin Liu Yao Zhang Zhouyao Hu Ziwei Sun Haibo Di |
| author_facet | Jing Wang Jing Wang Shaoming Zhang Wenbin Liu Yao Zhang Zhouyao Hu Ziwei Sun Haibo Di |
| author_sort | Jing Wang |
| collection | DOAJ |
| description | ObjectivesThe aim of this study was to determine whether behavioral responses elicited by olfactory stimulation are a predictor of conscious behavioral response and prognosis of patients with disorders of consciousness (DOC).MethodsTwenty-three DOC patients (8 unresponsive wakefulness syndrome [UWS]; 15 minimally conscious state [MCS]) were recruited for this study in which 1-Octen-3-ol (familiar neutral odor) and pyridine were used to test odor behavioral responses, and water was used as an odorless stimulus. One rater presented the three odors in front of each patient’s nose randomly, and another one videotaped all behavioral responses (e.g., pouting, wrinkling nose, slightly shaking head, frowning, etc.). Two independent raters, blind to the stimuli and the patient’s diagnosis, gave the behavioral results according to the recorded videos. One-, 3-, and 6-month follow-up evaluations were conducted to obtain a good prognostic value.ResultsAll MCS patients showed behavioral responses to the 1-Octen-3-ol stimulus; nine MCS and one UWS showed olfactory emotional responses to the pyridine, and two MCS showed olfactory emotional responses to the water stimulus. The incidence of behavioral response was significantly higher using 1-Octen-3-ol than it was for water by McNemar test (p < 0.001), significantly higher using pyridine than it was for water (p < 0.01). The χ2 test results indicated that there were significant differences between MCS and UWS to 1-Octen-3-ol (p < 0.001). For MCS patients, the incidence of behavioral response was no different between using 1-Octen-3-ol and pyridine (p > 0.05). There was no significant relationship between the olfactory behavioral response and the improvement of consciousness based on the χ2 test analysis (p > 0.05).ConclusionOlfactory stimuli, especially for the familiar neutral odor, might be effective for eliciting a conscious behavioral response and estimating the clinical diagnosis of DOC patients.Clinical Trial Registration[https://clinicaltrials.gov/ct2/show/NCT03732092], [identifier NCT03732092]. |
| first_indexed | 2024-12-13T00:05:59Z |
| format | Article |
| id | doaj.art-55dd907606204d59acbb26cd5c6009ee |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-12-13T00:05:59Z |
| publishDate | 2022-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-55dd907606204d59acbb26cd5c6009ee2022-12-22T00:06:14ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2022-02-011610.3389/fnins.2022.712891712891Olfactory Stimulation and the Diagnosis of Patients With Disorders of Consciousness: A Double-Blind, Randomized Clinical TrialJing Wang0Jing Wang1Shaoming Zhang2Wenbin Liu3Yao Zhang4Zhouyao Hu5Ziwei Sun6Haibo Di7International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, ChinaShanghai Yongci Rehabilitation Hospital, Shanghai, ChinaShanghai Yongci Rehabilitation Hospital, Shanghai, ChinaShanghai Yongci Rehabilitation Hospital, Shanghai, ChinaShanghai Yongci Rehabilitation Hospital, Shanghai, ChinaInternational Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, ChinaInternational Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, ChinaInternational Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, ChinaObjectivesThe aim of this study was to determine whether behavioral responses elicited by olfactory stimulation are a predictor of conscious behavioral response and prognosis of patients with disorders of consciousness (DOC).MethodsTwenty-three DOC patients (8 unresponsive wakefulness syndrome [UWS]; 15 minimally conscious state [MCS]) were recruited for this study in which 1-Octen-3-ol (familiar neutral odor) and pyridine were used to test odor behavioral responses, and water was used as an odorless stimulus. One rater presented the three odors in front of each patient’s nose randomly, and another one videotaped all behavioral responses (e.g., pouting, wrinkling nose, slightly shaking head, frowning, etc.). Two independent raters, blind to the stimuli and the patient’s diagnosis, gave the behavioral results according to the recorded videos. One-, 3-, and 6-month follow-up evaluations were conducted to obtain a good prognostic value.ResultsAll MCS patients showed behavioral responses to the 1-Octen-3-ol stimulus; nine MCS and one UWS showed olfactory emotional responses to the pyridine, and two MCS showed olfactory emotional responses to the water stimulus. The incidence of behavioral response was significantly higher using 1-Octen-3-ol than it was for water by McNemar test (p < 0.001), significantly higher using pyridine than it was for water (p < 0.01). The χ2 test results indicated that there were significant differences between MCS and UWS to 1-Octen-3-ol (p < 0.001). For MCS patients, the incidence of behavioral response was no different between using 1-Octen-3-ol and pyridine (p > 0.05). There was no significant relationship between the olfactory behavioral response and the improvement of consciousness based on the χ2 test analysis (p > 0.05).ConclusionOlfactory stimuli, especially for the familiar neutral odor, might be effective for eliciting a conscious behavioral response and estimating the clinical diagnosis of DOC patients.Clinical Trial Registration[https://clinicaltrials.gov/ct2/show/NCT03732092], [identifier NCT03732092].https://www.frontiersin.org/articles/10.3389/fnins.2022.712891/fulldisorders of consciousnessminimally conscious stateolfactory stimulationdiagnosisprognosis |
| spellingShingle | Jing Wang Jing Wang Shaoming Zhang Wenbin Liu Yao Zhang Zhouyao Hu Ziwei Sun Haibo Di Olfactory Stimulation and the Diagnosis of Patients With Disorders of Consciousness: A Double-Blind, Randomized Clinical Trial Frontiers in Neuroscience disorders of consciousness minimally conscious state olfactory stimulation diagnosis prognosis |
| title | Olfactory Stimulation and the Diagnosis of Patients With Disorders of Consciousness: A Double-Blind, Randomized Clinical Trial |
| title_full | Olfactory Stimulation and the Diagnosis of Patients With Disorders of Consciousness: A Double-Blind, Randomized Clinical Trial |
| title_fullStr | Olfactory Stimulation and the Diagnosis of Patients With Disorders of Consciousness: A Double-Blind, Randomized Clinical Trial |
| title_full_unstemmed | Olfactory Stimulation and the Diagnosis of Patients With Disorders of Consciousness: A Double-Blind, Randomized Clinical Trial |
| title_short | Olfactory Stimulation and the Diagnosis of Patients With Disorders of Consciousness: A Double-Blind, Randomized Clinical Trial |
| title_sort | olfactory stimulation and the diagnosis of patients with disorders of consciousness a double blind randomized clinical trial |
| topic | disorders of consciousness minimally conscious state olfactory stimulation diagnosis prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2022.712891/full |
| work_keys_str_mv | AT jingwang olfactorystimulationandthediagnosisofpatientswithdisordersofconsciousnessadoubleblindrandomizedclinicaltrial AT jingwang olfactorystimulationandthediagnosisofpatientswithdisordersofconsciousnessadoubleblindrandomizedclinicaltrial AT shaomingzhang olfactorystimulationandthediagnosisofpatientswithdisordersofconsciousnessadoubleblindrandomizedclinicaltrial AT wenbinliu olfactorystimulationandthediagnosisofpatientswithdisordersofconsciousnessadoubleblindrandomizedclinicaltrial AT yaozhang olfactorystimulationandthediagnosisofpatientswithdisordersofconsciousnessadoubleblindrandomizedclinicaltrial AT zhouyaohu olfactorystimulationandthediagnosisofpatientswithdisordersofconsciousnessadoubleblindrandomizedclinicaltrial AT ziweisun olfactorystimulationandthediagnosisofpatientswithdisordersofconsciousnessadoubleblindrandomizedclinicaltrial AT haibodi olfactorystimulationandthediagnosisofpatientswithdisordersofconsciousnessadoubleblindrandomizedclinicaltrial |