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Editors Selection IGR 12-3
Bloodflow: Odor identification
Comment by Nathan Radcliffe on:
25857 Smell perception in normal tension glaucoma patients, Mozaffarieh M; Hauenstein D; Schoetzau A et al., Molecular Vision, 2010; 16: 506-510
Primary vascular dysregulation is a condition defined by inappropriate vascular constriction or dilation to extrinsic (physical) or intrinsic (emotional) stimuli. Vascular dysregulation is associated with symptoms (increased thirst), physical examination findings (cold hands) and biomarkers (increased endothelin-1 levels) as well as several diseases, including myocardial ischemia and normal pressure glaucoma (NPG). In this investigation by Mozaffarieh et al. (IGR 12-2: 1015) a validated twelve-item odor identification test was administered to 72 patients in whom the presence and absence of NPG and vascular dysregulation were equally distributed and counterbalanced. Patients had vascular dysregulation if they indicated three or more symptoms including difficulty falling asleep, lack of thirst, tinnitus, sensitivity to medications as well as more traditional vasospasm symptoms including migraine, cold extremities and hypotension. The authors found no relationship between odor perception and NPG. Patients with vascular dysregulation demonstrated better odor identification than those without vascular dysregulation regardless of glaucoma diagnosis. While the finding of superior olfactory perception in vascular dysregulation might seem counterintuitive, this is consistent with reports of hypersensitivity to a variety of stimuli (e.g., cold temperatures, medications) in these patients. The authors hypothesize that differential expression of ABC transport proteins found in vascular dysregulation patients may account for altered olfactory sensitivity. The main challenge in this line of work is that vascular dysregulation has not been consistently defined in the literature, limiting the ability to generalize these findings. While the operational definition of vascular dysregulation used in this work is not inconsistent with the investigator's previous research, a standardized definition of vascular dysregulation would help accelerate this interesting line of research.
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