Olfactory and Trigeminal Functions in Patients With Multiple Sclerosis: Case-control Study

NCT ID: NCT06020937

Last Updated: 2024-05-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-10-30

Study Completion Date

2026-12-30

Brief Summary

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The sensation of smell is influenced by the somatosensory and chemesthetic sensati¬ons of the nose: for example, the cooling sensation of menthol or the prickle of carbon dioxide from carbonated drinks. These sensations are mediated in the nose by the trigeminal nerve and there is increasing evidence that trigeminal and olfactory functions are closely linked and potentially interdependent. In addition, trigeminal activation is crucial to the perception of nasal airflow. Some researchers speculate about the impact of trigeminal nerve on the entire olfactory sensation and about the presence of some specific "trigeminal cells" into the nose.Patients with Multiple sclerosis (MS) can suffer from quantitative olfactory disorders that generally are of light entity and do not interfere with daily life activities but it is important to underline that olfactory loss can be an onset sign of the MS. Considering the "trigeminal component" in the olfaction, because trigeminal nerve inflammation is quite common in MS patients due to central and peripheral inflammation, it could be possible that these patients suffer from changes in the quantitative, but more in the qualitative smell functions that are generally not identified because poorly investigated.

Detailed Description

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From a theoretically point of view pain in the trigeminal nerve increases the surrounding perception, including the perception of the odors. It has been shown that by using sweet food it is possible to reduce the level of pain; on the other side, sweet food in contrast to the bitter one was able to reduce the sensation of odor unpleasantness present with pain increase.

To date no studies have investigated the relationship between trigeminal inflammation, odors and pain in a cohort of patients with MS. This study aims at investigating the possible correlation between alteration in trigeminal functions and perception of odors using Sniffin' Stick Threshold, Detection and Identification test and quality smell questionnaire in a sample of healthy patients compared to MS patients.

Conditions

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Multiple Sclerosis

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Control

Healthy patients

TDI

Intervention Type DIAGNOSTIC_TEST

Sniffin' Sticks Threshold and Identification Test

Trigeminal Test

Intervention Type DIAGNOSTIC_TEST

Test the trigeminal smell answer by a device that releases air and a substance that stimulates the trigeminal response

Visual Analogue Scale Ratings

Intervention Type DIAGNOSTIC_TEST

* Smell ability (How is your sense of smell right now? 0 cannot smell, 1-3 severe impairment, 4-6 moderate impairment, 7-9 mild impairment, 10 normal)
* Nasal breathing (How well can you breathe through your nose right now? 0 complete nasal obstruction, 1-3 severe impairment, 4-6 moderate impairment, 7-9 mild impairment, 10 normal)

Quality of smell Questionnaire

Intervention Type DIAGNOSTIC_TEST

Patients will answer to a validated questionnaire

Multiple Sclerosis 1

Patients with multiple Sclerosis and Trigeminal disorders

TDI

Intervention Type DIAGNOSTIC_TEST

Sniffin' Sticks Threshold and Identification Test

Trigeminal Test

Intervention Type DIAGNOSTIC_TEST

Test the trigeminal smell answer by a device that releases air and a substance that stimulates the trigeminal response

Cognitive Evaluation by Montreal Cognitive Assessment

Intervention Type DIAGNOSTIC_TEST

Montreal Cognitive assessment

Anxiety and Depression questionnaire

Intervention Type DIAGNOSTIC_TEST

Specific test to evaluate patient's mood

Visual Analogue Scale Ratings

Intervention Type DIAGNOSTIC_TEST

* Smell ability (How is your sense of smell right now? 0 cannot smell, 1-3 severe impairment, 4-6 moderate impairment, 7-9 mild impairment, 10 normal)
* Nasal breathing (How well can you breathe through your nose right now? 0 complete nasal obstruction, 1-3 severe impairment, 4-6 moderate impairment, 7-9 mild impairment, 10 normal)

Quality of smell Questionnaire

Intervention Type DIAGNOSTIC_TEST

Patients will answer to a validated questionnaire

Multiple Sclerosis 2

Patients with Multiple Sclerosis without trigeminal concerns

TDI

Intervention Type DIAGNOSTIC_TEST

Sniffin' Sticks Threshold and Identification Test

Trigeminal Test

Intervention Type DIAGNOSTIC_TEST

Test the trigeminal smell answer by a device that releases air and a substance that stimulates the trigeminal response

Cognitive Evaluation by Montreal Cognitive Assessment

Intervention Type DIAGNOSTIC_TEST

Montreal Cognitive assessment

Anxiety and Depression questionnaire

Intervention Type DIAGNOSTIC_TEST

Specific test to evaluate patient's mood

Visual Analogue Scale Ratings

Intervention Type DIAGNOSTIC_TEST

* Smell ability (How is your sense of smell right now? 0 cannot smell, 1-3 severe impairment, 4-6 moderate impairment, 7-9 mild impairment, 10 normal)
* Nasal breathing (How well can you breathe through your nose right now? 0 complete nasal obstruction, 1-3 severe impairment, 4-6 moderate impairment, 7-9 mild impairment, 10 normal)

Quality of smell Questionnaire

Intervention Type DIAGNOSTIC_TEST

Patients will answer to a validated questionnaire

Interventions

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TDI

Sniffin' Sticks Threshold and Identification Test

Intervention Type DIAGNOSTIC_TEST

Trigeminal Test

Test the trigeminal smell answer by a device that releases air and a substance that stimulates the trigeminal response

Intervention Type DIAGNOSTIC_TEST

Cognitive Evaluation by Montreal Cognitive Assessment

Montreal Cognitive assessment

Intervention Type DIAGNOSTIC_TEST

Anxiety and Depression questionnaire

Specific test to evaluate patient's mood

Intervention Type DIAGNOSTIC_TEST

Visual Analogue Scale Ratings

* Smell ability (How is your sense of smell right now? 0 cannot smell, 1-3 severe impairment, 4-6 moderate impairment, 7-9 mild impairment, 10 normal)
* Nasal breathing (How well can you breathe through your nose right now? 0 complete nasal obstruction, 1-3 severe impairment, 4-6 moderate impairment, 7-9 mild impairment, 10 normal)

Intervention Type DIAGNOSTIC_TEST

Quality of smell Questionnaire

Patients will answer to a validated questionnaire

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

Adult women (age 18 to 55) diagnosed with multiple sclerosis using the 2017 McDonald Criteria under treatment with Disease Modifying Therapy (DMTs) with or without trigeminal concerns, or newly diagnosed with MS

Exclusion Criteria

* Chronic rhinosinusitis with and without nasal polyposis; current allergic rhinitis; other nasal issues that lead to olfactory dysfunction
* anamnestic COVID with incomplete recovery
* Neurodegenerative disorders (Parkinson, Alzheimer, Fronto-temporal Dementia, cognitive impairment and brain vascular diseases)
* History of stroke in the last three years
* Depression or any psychiatric condition
* intake of drugs with sedating side effects
* major health issues that might affect olfactory function (e.g., significant renal insufficiency, uncontrolled diabetes)
* Chronic alcoholism / drug abuse
* Severe head trauma
* Severe facial injuries
* Smoker over 20 cigarettes day or smoking from more than 15 years
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of Roma La Sapienza

OTHER

Sponsor Role collaborator

Hospital General Universitario Santa Lucia

OTHER

Sponsor Role collaborator

Klinik und Poliklinik fur Kinderheilkunde

OTHER

Sponsor Role collaborator

University of Catania

OTHER

Sponsor Role lead

Responsible Party

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Arianna Di Stadio

Associate Professor (temporary)

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Arianna Di Stadio

Catania, Sicily, Italy

Site Status

Countries

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Italy

Facility Contacts

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Arianna Di Stadio

Role: primary

References

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Hummel T, Frasnelli J. The intranasal trigeminal system. Handb Clin Neurol. 2019;164:119-134. doi: 10.1016/B978-0-444-63855-7.00008-3.

Reference Type BACKGROUND
PMID: 31604542 (View on PubMed)

Frasnelli J, Manescu S. The intranasal trigeminal system. In: Buettner A, editor. Dordrecht; 2017. p. 881-95

Reference Type BACKGROUND

Hummel T, Iannilli E, Frasnelli J, Boyle J, Gerber J. Central processing of trigeminal activation in humans. Ann N Y Acad Sci. 2009 Jul;1170:190-5. doi: 10.1111/j.1749-6632.2009.03910.x.

Reference Type BACKGROUND
PMID: 19686136 (View on PubMed)

Daiber P, Genovese F, Schriever VA, Hummel T, Mohrlen F, Frings S. Neuropeptide receptors provide a signalling pathway for trigeminal modulation of olfactory transduction. Eur J Neurosci. 2013 Feb;37(4):572-82. doi: 10.1111/ejn.12066. Epub 2012 Dec 3.

Reference Type BACKGROUND
PMID: 23205840 (View on PubMed)

Doty RL, Brugger WE, Jurs PC, Orndorff MA, Snyder PJ, Lowry LD. Intranasal trigeminal stimulation from odorous volatiles: psychometric responses from anosmic and normal humans. Physiol Behav. 1978 Feb;20(2):175-85. doi: 10.1016/0031-9384(78)90070-7. No abstract available.

Reference Type BACKGROUND
PMID: 662939 (View on PubMed)

Mihara S, Shibamoto T. The role of flavor and fragrance chemicals in TRPA1 (transient receptor potential cation channel, member A1) activity associated with allergies. Allergy Asthma Clin Immunol. 2015 Mar 16;11(1):11. doi: 10.1186/s13223-015-0074-0. eCollection 2015.

Reference Type BACKGROUND
PMID: 25897313 (View on PubMed)

Scheibe M, Schulze S, Mueller CA, Schuster B, Hummel T. Intranasal trigeminal sensitivity: measurements before and after nasal surgery. Eur Arch Otorhinolaryngol. 2014 Jan;271(1):87-92. doi: 10.1007/s00405-013-2466-4. Epub 2013 Apr 9.

Reference Type BACKGROUND
PMID: 23568039 (View on PubMed)

Zhao K, Jiang J, Blacker K, Lyman B, Dalton P, Cowart BJ, Pribitkin EA. Regional peak mucosal cooling predicts the perception of nasal patency. Laryngoscope. 2014 Mar;124(3):589-95. doi: 10.1002/lary.24265. Epub 2013 Jun 28.

Reference Type BACKGROUND
PMID: 23775640 (View on PubMed)

Li C, Farag AA, Maza G, McGhee S, Ciccone MA, Deshpande B, Pribitkin EA, Otto BA, Zhao K. Investigation of the abnormal nasal aerodynamics and trigeminal functions among empty nose syndrome patients. Int Forum Allergy Rhinol. 2018 Mar;8(3):444-452. doi: 10.1002/alr.22045. Epub 2017 Nov 22.

Reference Type BACKGROUND
PMID: 29165896 (View on PubMed)

Konstantinidis I, Tsakiropoulou E, Chatziavramidis A, Ikonomidis C, Markou K. Intranasal trigeminal function in patients with empty nose syndrome. Laryngoscope. 2017 Jun;127(6):1263-1267. doi: 10.1002/lary.26491. Epub 2017 Feb 22.

Reference Type BACKGROUND
PMID: 28224626 (View on PubMed)

Atalar AC, Erdal Y, Tekin B, Yildiz M, Akdogan O, Emre U. Olfactory dysfunction in multiple sclerosis. Mult Scler Relat Disord. 2018 Apr;21:92-96. doi: 10.1016/j.msard.2018.02.032. Epub 2018 Mar 3.

Reference Type BACKGROUND
PMID: 29529530 (View on PubMed)

Zorzon M, Ukmar M, Bragadin LM, Zanier F, Antonello RM, Cazzato G, Zivadinov R. Olfactory dysfunction and extent of white matter abnormalities in multiple sclerosis: a clinical and MR study. Mult Scler. 2000 Dec;6(6):386-90. doi: 10.1177/135245850000600605.

Reference Type BACKGROUND
PMID: 11212134 (View on PubMed)

da Silva CJ, da Rocha AJ, Mendes MF, Maia AC Jr, Braga FT, Tilbery CP. Trigeminal involvement in multiple sclerosis: magnetic resonance imaging findings with clinical correlation in a series of patients. Mult Scler. 2005 Jun;11(3):282-5. doi: 10.1191/1352458505ms1186oa.

Reference Type BACKGROUND
PMID: 15957508 (View on PubMed)

Riello M, Cecchini MP, Zanini A, Di Chiappari M, Tinazzi M, Fiorio M. Perception of phasic pain is modulated by smell and taste. Eur J Pain. 2019 Nov;23(10):1790-1800. doi: 10.1002/ejp.1453. Epub 2019 Jul 29.

Reference Type BACKGROUND
PMID: 31291496 (View on PubMed)

Di Stadio A, Bernitsas E, La Mantia I, Brenner MJ, Ralli M, Vaira LA, Colizza A, Cavaliere C, Laudani M, Frohman TC, De Vincentiis M, Frohman EM, Altieri M. Targeting Neuroinflammation to Alleviate Chronic Olfactory Dysfunction in Long COVID: A Role for Investigating Disease-Modifying Therapy (DMT)? Life (Basel). 2023 Jan 13;13(1):226. doi: 10.3390/life13010226.

Reference Type RESULT
PMID: 36676175 (View on PubMed)

Other Identifiers

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UniCT192023

Identifier Type: -

Identifier Source: org_study_id

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