Olfactory testing in clinical settings - is there additional benefit from unilateral testing?

In clinical settings, olfactory testing is usually performed bilaterally; thus, unilateral olfactory loss may go unnoticed. The aims of this study were to evaluate 1) whether patients presenting with self-reported olfactory disorders demonstrate significant side differences in odour perception, depending on the prevalance of measured unilateral disorder, and 2) to evaluate the existing testing procedure. In 518 patients presenting with olfactory disorders, olfactory testing was performed using the "Sniffin' Sticks" test battery (consisting of a threshold, discrimination, and odour identification test) examining each nostril separately. According to the history and results from the clinical examination, olfactory disorders were classified as related to trauma, sinunasal disease, upper respiratory tract infection (URTI), tumour, congenital, idiopathic, and other. A difference of three or more points in one of the subtests or six or more points in the composite olfactory test score was considered a side difference. In almost one quarter of all presenting patients (23.4%), a side difference was detected. To not to miss lateralized disorders, we recommend testing each nostril separately. Depending on the presence or absence of a significant difference, testing then can be continued birhinally or separately for each nostril

Cerebrospinal Fluid Neurochemical Phenotypes in Vascular Dementias: Original Data and Mini-Review

Background/Aims: The study evaluated the patterns of cerebrospinal fluid (CSF), amyloid- _ (A _ ) peptides, total tau and phospho-tau among Alzheimer’s disease (AD) and vascular dementias (VAD). Methods: A _ -SDS-PAGE immunoblot and commercially available ELISAs were applied to the CSF analysis of 52 patients with probable (n = 21) and possible (n = 16) VAD, AD with cerebrovascular disease (n = 15), 30 patients with probable AD and 30 nondemented disease controls. Results: AD and AD with cerebrovascular disease displayed a similar neurochemical phenotype in contrast to nondemented disease controls and probable VAD with regard to tau, p-tau, A _ 1–40 ox and A _ 1–42%. Possible VAD displayed AD-like changes only for A _ 1–40 ox and A _ 1–42%. Conclusion: CSF neurochemical phenotypes sufficiently discriminate probable AD and VAD from each other, but their diagnostic value is limited in case of no clear-cut clinical ap- pearance, such as possible VAD. Conversely, CSF A _ peptides and p-tau levels may help estimate the involvement of ADlike pathophysiological pathways in VAD subgroups