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  1. Article ; Online: Review: Exteroceptive Sensory Abnormalities in Childhood and Adolescent Anxiety and Obsessive-Compulsive Disorder: A Critical Review.

    Houghton, David C / Stein, Dan J / Cortese, Bernadette M

    Journal of the American Academy of Child and Adolescent Psychiatry

    2019  Volume 59, Issue 1, Page(s) 78–87

    Abstract: Objective: Childhood anxiety and obsessive-compulsive disorder (OCD) are defined by fear, worry, and uncertainty, but there is also evidence that affected children possess exteroceptive sensory abnormalities. These sensory features may often instigate ... ...

    Abstract Objective: Childhood anxiety and obsessive-compulsive disorder (OCD) are defined by fear, worry, and uncertainty, but there is also evidence that affected children possess exteroceptive sensory abnormalities. These sensory features may often instigate symptoms and cause significant distress and functional impairment. In addition, a purported class of conditions known as "sensory processing disorders" may significantly overlap with childhood anxiety and OCD, which provides further support for a connection between abnormal sensation and fear-based psychopathology.
    Method: The current review was conducted to synthesize and to critically evaluate the existing research on exteroceptive sensory abnormalities in childhood anxiety and OCD. Because of the paucity of research in this area, studies with adult populations were also briefly reviewed.
    Results: The review found significant support for the notion that sensory abnormalities are common in children with anxiety disorders and OCD, but there are significant limitations to research in this area that prevent firm conclusions.
    Conclusion: Potential avenues for future research on sensory features of pediatric anxiety and OCD are discussed.
    MeSH term(s) Adolescent ; Anxiety/complications ; Anxiety/physiopathology ; Anxiety/psychology ; Child ; Child Behavior Disorders/physiopathology ; Child Behavior Disorders/psychology ; Fear ; Humans ; Obsessive-Compulsive Disorder/complications ; Obsessive-Compulsive Disorder/physiopathology ; Obsessive-Compulsive Disorder/psychology ; Perceptual Disorders/complications ; Perceptual Disorders/physiopathology ; Perceptual Disorders/psychology
    Language English
    Publishing date 2019-06-29
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 392535-3
    ISSN 1527-5418 ; 0890-8567
    ISSN (online) 1527-5418
    ISSN 0890-8567
    DOI 10.1016/j.jaac.2019.06.007
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  2. Article ; Online: Exploratory Investigation of a Brief Cognitive Behavioral Intervention and Transcranial Direct Current Stimulation on Odor Sensitivity.

    Houghton, David C / Uhde, Thomas W / Borckardt, Jeffrey J / Cortese, Bernadette M

    Psychosomatic medicine

    2019  Volume 81, Issue 4, Page(s) 389–395

    Abstract: Objective: Enhanced odor sensitivity is a phenomenon that potentially underlies conditions such as multiple chemical sensitivity (MCS). Currently, there are no treatments that have been shown to effectively decrease odor sensitivity. Given similarities ... ...

    Abstract Objective: Enhanced odor sensitivity is a phenomenon that potentially underlies conditions such as multiple chemical sensitivity (MCS). Currently, there are no treatments that have been shown to effectively decrease odor sensitivity. Given similarities of odor hypersensitivity/MCS to pain sensitization disorders such as fibromyalgia, there may be a potential for interventions that improve pain tolerance to modulate odor sensitivity.
    Methods: This exploratory study randomized 72 healthy community adult volunteers to receive one of six treatments in between two assessments of thermal pain tolerance and odor threshold. Participants were randomized to receive either cathodal, anodal, or sham transcranial direct current stimulation (tDCS) aimed at dorsolateral prefrontal cortex. In addition, participants were provided a brief cognitive behavioral intervention (CBI) for pain consisting of task framing, cognitive restructuring, and distraction technique training, or a control intervention consisting of information about pain.
    Results: Persons who received a brief CBI showed significantly increased odor thresholds (reduced sensitivity) during intervention (F (1,62) = 7.29, p = .009, ηp = .11), whereas the control intervention was not associated with altered odor thresholds. Moreover, in those who received brief CBI, more severe anxiety associated with larger reductions in odor sensitivity (ρ = .364, p = .035). There was no effect of tDCS (F (2,62) = .11, p = .90) nor interaction between tDCS and CBI (F (2,62) = .32, p = .73).
    Conclusions: Given the connection between anxiety and MCS, results suggest that CBT techniques for somatic processes may show promise in treating conditions characterized by increased sensitivity to odors (e.g., MCS).
    MeSH term(s) Adult ; Aged ; Cognitive Behavioral Therapy/methods ; Female ; Humans ; Male ; Middle Aged ; Odorants ; Olfaction Disorders/therapy ; Pain Threshold ; Sensory Thresholds ; Smell ; Transcranial Direct Current Stimulation/methods ; Young Adult
    Language English
    Publishing date 2019-02-13
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
    ZDB-ID 3469-1
    ISSN 1534-7796 ; 0033-3174
    ISSN (online) 1534-7796
    ISSN 0033-3174
    DOI 10.1097/PSY.0000000000000679
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  3. Article ; Online: Anxiety-related shifts in smell function in children and adolescents.

    Cortese, Bernadette M / Uhde, Thomas W / Schumann, Aicko Y / McTeague, Lisa M / Sege, Christopher T / Calhoun, Casey D / Danielson, Carla Kmett

    Chemical senses

    2021  Volume 46

    Abstract: Anxious adults show changes in smell function that are consistent with a durable shift in sensitivity toward particular odorants and away from others. Little is known regarding the development of these changes, including whether they exist in youth, are ... ...

    Abstract Anxious adults show changes in smell function that are consistent with a durable shift in sensitivity toward particular odorants and away from others. Little is known regarding the development of these changes, including whether they exist in youth, are stable during the transition from childhood to adolescence, and whether odorant properties (e.g. trigeminal features, hedonic valence) affect anxiety-related differences in detection. To address this, we measured smell detection thresholds to phenyl ethyl alanine (PEA), a rose-like odorant with little trigeminal properties, and guaiacol (GUA), a smoke-like odorant with high trigeminal properties. These thresholds were measured at baseline and after an acute stress challenge, the Trier Social Stress Tests, in 131 healthy youth (in 4th, 7th, and 10th grades, age 9-16 years) that reported normal to elevated levels of anxiety. At baseline, high anxious youth exhibited heightened sensitivity to GUA coupled with reduced sensitivity to PEA, as well as a further exaggeration of this bias with acute stress. Importantly, sex, age, and hedonic valence moderated the relationship between trait anxiety and sensitivity to both odorants. Smell function and its aberrations are often overlooked in the literature on biomarkers of stress and anxiety. Taken together with the extant literature, these findings suggest that greater attention is warranted to characterize potential novel olfactory therapeutic targets-across the lifespan.
    MeSH term(s) Adolescent ; Adult ; Anxiety ; Child ; Humans ; Odorants ; Sensory Thresholds ; Smell
    Language English
    Publishing date 2021-12-27
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 754122-3
    ISSN 1464-3553 ; 0379-864X
    ISSN (online) 1464-3553
    ISSN 0379-864X
    DOI 10.1093/chemse/bjab051
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  4. Article ; Online: Electrical stimulation of the trigeminal nerve improves olfaction in healthy individuals: A randomized, double-blind, sham-controlled trial.

    Badran, Bashar W / Gruber, Elise M / O'Leary, Georgia H / Austelle, Chris W / Huffman, Sarah M / Kahn, Alex T / McTeague, Lisa M / Uhde, Thomas W / Cortese, Bernadette M

    Brain stimulation

    2022  Volume 15, Issue 3, Page(s) 761–768

    Abstract: Background: Both activated by environmental odorants, there is a clear role for the intranasal trigeminal and olfactory nerves in smell function. Unfortunately, our ability to perceive odorants decreases with age or with injury, and limited ... ...

    Abstract Background: Both activated by environmental odorants, there is a clear role for the intranasal trigeminal and olfactory nerves in smell function. Unfortunately, our ability to perceive odorants decreases with age or with injury, and limited interventions are available to treat smell loss.
    Objective: We investigated whether electrical stimulation of the trigeminal nerve via trigeminal nerve stimulation (TNS) or transcranial direct current stimulation (tDCS) modulates odor sensitivity in healthy individuals.
    Methods: We recruited 20 healthy adults (12 Female, mean age = 27) to participate in this three-visit, randomized, double-blind, sham-controlled trial. Participants were randomized to receive one of three stimulation modalities (TNS, tDCS, or sham) during each of their visits. Odor detection thresholds were obtained at baseline, immediately post-intervention, and 30-min post-intervention. Furthermore, participants were asked to complete a sustained attention task and mood assessments before odor detection testing.
    Results: Findings reveal a timeXcondition interaction for guaiacol (GUA) odorant detection thresholds (F (3.188, 60.57) = 3.833, P = 0.0125), but not phenyl ethyl alcohol (PEA) odorant thresholds. At 30-min post-stimulation, both active TNS and active tDCS showed significantly increased sensitivity to GUA compared to sham TNS (Sham TNS = -8.30% vs. Active TNS = 9.11%, mean difference 17.43%, 95% CI 5.674 to 29.18, p = 0.0044; Sham TNS = -8.30% vs. Active tDCS = 13.58%, mean difference 21.89%, 95% CI 10.47 to 33.32, p = 0.0004).
    Conclusion: TNS is a safe, simple, noninvasive method for boosting olfaction. Future studies should investigate the use of TNS on smell function across different stimulation parameters, odorants, and patient populations.
    MeSH term(s) Adult ; Double-Blind Method ; Electric Stimulation ; Female ; Humans ; Smell ; Transcranial Direct Current Stimulation/methods ; Trigeminal Nerve/physiology
    Language English
    Publishing date 2022-05-11
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 2394410-9
    ISSN 1876-4754 ; 1935-861X
    ISSN (online) 1876-4754
    ISSN 1935-861X
    DOI 10.1016/j.brs.2022.05.005
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    Zs.A 6740: Show issues Location:
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  5. Article ; Online: Differential odor sensitivity in PTSD: Implications for treatment and future research.

    Cortese, Bernadette M / Leslie, Kimberly / Uhde, Thomas W

    Journal of affective disorders

    2015  Volume 179, Page(s) 23–30

    Abstract: Background: Given that odors enhance the retrieval of autobiographical memories, induce physiological arousal, and trigger trauma-related flashbacks, it is reasonable to hypothesize that odors play a significant role in the pathophysiology of ... ...

    Abstract Background: Given that odors enhance the retrieval of autobiographical memories, induce physiological arousal, and trigger trauma-related flashbacks, it is reasonable to hypothesize that odors play a significant role in the pathophysiology of posttraumatic stress disorder (PTSD). For these reasons, this preliminary study sought to examine self-reported, odor-elicited distress in PTSD.
    Methods: Combat veterans with (N=30) and without (N=22) PTSD and healthy controls (HC: N=21), completed an olfactory questionnaire that provided information on the hedonic valence of odors as well as their ability to elicit distress or relaxation.
    Results: Two main findings were revealed: Compared to HC, CV+PTSD, but not CV-PTSD, reported a higher prevalence of distress to a limited number of select odors that included fuel (p=.004), blood (p=.02), gunpowder (p=.03), and burning hair (p=.02). In contrast to this increased sensitivity, a blunting effect was reported by both groups of veterans compared to HC that revealed lower rates of distress and relaxation in response to negative hedonic odors (p=.03) and positive hedonic odors (p<.001), respectively.
    Limitations: The study is limited by its use of retrospective survey methods, whereas future investigations would benefit from laboratory measures taken prior, during, and after deployment.
    Conclusion: The present findings suggest a complex role of olfaction in the biological functions of threat detection. Several theoretical models are discussed. One possible explanation for increased sensitivity to select odors with decreased sensitivity to other odors is the co-occurrence of attentional bias toward threat odors with selective ignoring of distractor odors. Working together, these processes may optimize survival.
    MeSH term(s) Adult ; Attention ; Case-Control Studies ; Female ; Humans ; Male ; Memory, Episodic ; Middle Aged ; Odorants ; Olfactory Perception ; Retrospective Studies ; Stress Disorders, Post-Traumatic/psychology ; Veterans/psychology ; Young Adult
    Language English
    Publishing date 2015-07-01
    Publishing country Netherlands
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 135449-8
    ISSN 1573-2517 ; 0165-0327
    ISSN (online) 1573-2517
    ISSN 0165-0327
    DOI 10.1016/j.jad.2015.03.026
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  6. Article: Paradoxical olfactory function in combat veterans: The role of PTSD and odor factors.

    Wilkerson, Allison K / Uhde, Thomas W / Leslie, Kimberly / Freeman, W Connor / LaRowe, Steven D / Schumann, Aicko / Cortese, Bernadette M

    Military psychology : the official journal of the Division of Military Psychology, American Psychological Association

    2018  Volume 30, Issue 2, Page(s) 120–130

    Abstract: Stress- and trauma-related disorders, including posttraumatic stress disorder (PTSD), are characterized by an increased sensitivity to threat cues. Given that threat detection is a critical function of olfaction and that combat trauma is commonly ... ...

    Abstract Stress- and trauma-related disorders, including posttraumatic stress disorder (PTSD), are characterized by an increased sensitivity to threat cues. Given that threat detection is a critical function of olfaction and that combat trauma is commonly associated with burning odors, we sought a better understanding of general olfactory function as well as response to specific trauma-related (i.e. burning) odors in combat-related PTSD. Trauma-exposed combat veterans with (
    Language English
    Publishing date 2018-04-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2021130-2
    ISSN 1532-7876 ; 0899-5605
    ISSN (online) 1532-7876
    ISSN 0899-5605
    DOI 10.1080/08995605.2018.1425063
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  7. Article ; Online: Depression in chronic rhinosinusitis: A controlled cohort study.

    Schlosser, Rodney J / Storck, Kristina / Cortese, Bernadette M / Uhde, Thomas W / Rudmik, Luke / Soler, Zachary M

    American journal of rhinology & allergy

    2016  Volume 30, Issue 2, Page(s) 128–133

    Abstract: Background: Depression in patients with chronic rhinosinusitis (CRS) is underdiagnosed but significantly impacts treatment outcomes and health care utilization.: Objective: To compare undiagnosed depression in a CRS cohort with a healthy, non-CRS ... ...

    Abstract Background: Depression in patients with chronic rhinosinusitis (CRS) is underdiagnosed but significantly impacts treatment outcomes and health care utilization.
    Objective: To compare undiagnosed depression in a CRS cohort with a healthy, non-CRS control cohort.
    Methods: A case-control study of patients with symptomatic CRS and a non-CRS control cohort was performed. Demographic and comorbidity factors were correlated to depression-specific outcomes by using the Beck Depression Inventory II (BDI).
    Results: We enrolled 42 patients with CRS and 88 control patients with no history of CRS. Physician-diagnosed depression was equivalent in CRS and control patients (6% and 9%, respectively). BDI-detected depression was higher among patients with CRS compared with controls (31% versus 14.8%, respectively; p = 0.031). BDI scores were higher in patients with CRS even when controlling for comorbid asthma, allergy, and aspirin sensitivity. When examined by polyp status, the patients without polyps had more depression than did the controls (38% versus 14.8%; p = 0.048). The somatic subscale scores of the BDI were worse in patients with CRS (p = 0.004), whereas the cognitive subscale trended toward significance (p = 0.081).
    Conclusion: Depression may be more common in CRS than previously recognized, especially in patients without polyps. Somatic subscale scores of the BDI are increased in CRS and may impact future treatment outcomes.
    MeSH term(s) Adult ; Aged ; Asthma/epidemiology ; Canada/epidemiology ; Case-Control Studies ; Chronic Disease ; Cohort Studies ; Comorbidity ; Depression/epidemiology ; Drug Hypersensitivity/epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Rhinitis/epidemiology ; Sinusitis/epidemiology ; United States/epidemiology
    Language English
    Publishing date 2016-03
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2482804-X
    ISSN 1945-8932 ; 1945-8924
    ISSN (online) 1945-8932
    ISSN 1945-8924
    DOI 10.2500/ajra.2016.30.4290
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    Zs.A 2542: Show issues Location:
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  8. Article: Odor sensitivity impairment: a behavioral marker of psychological distress?

    Houghton, David C / Howard, Samuel L / Uhde, Thomas W / Paquet, Caitlin / Schlosser, Rodney J / Cortese, Bernadette M

    CNS spectrums

    2018  Volume 24, Issue 4, Page(s) 404–412

    Abstract: Objective: Enhanced odor sensitivity, particularly toward threat-related cues, may be adaptive during periods of danger. Research also suggests that chronic psychological distress may lead to functional changes in the olfactory system that cause ... ...

    Abstract Objective: Enhanced odor sensitivity, particularly toward threat-related cues, may be adaptive during periods of danger. Research also suggests that chronic psychological distress may lead to functional changes in the olfactory system that cause heightened sensitivity to odors. Yet, the association between self-reported odor sensitivity, objective odor detection, and affective psychopathology is currently unclear, and research suggests that persons with affective problems may only be sensitive to specific, threat-related odors.
    Methods: The current study compared adults with self-reported odor sensitivity that was described as functionally impairing (OSI; n = 32) to those who reported odor sensitivity that was non-impairing (OS; n = 17) on affective variables as well as quantitative odor detection.
    Results: Increased anxiety sensitivity, trait anxiety, depression, and life stress, even while controlling for comorbid anxiety and depressive disorders, was found for OSI compared to OS. While OSI, compared to OS, demonstrated only a trend increase in objective odor detection of a smoke-like, but not rose-like, odor, further analysis revealed that increased detection of that smoke-like odor was positively correlated with anxiety sensitivity.
    Conclusion: These findings suggest that persons with various forms of psychological distress may find themselves significantly impaired by an intolerance of odors, but that self-reported odor sensitivity does not necessarily relate to enhanced odor detection ability. However, increased sensitivity to a smoke-like odor appears to be associated with sensitivity to aversive anxiogenic stimuli. Implications for the pathophysiology of fear- and anxiety-related disorders are discussed.
    MeSH term(s) Adult ; Aged ; Anxiety/diagnosis ; Anxiety/psychology ; Depressive Disorder/diagnosis ; Depressive Disorder/psychology ; Diagnostic Self Evaluation ; Female ; Humans ; Male ; Middle Aged ; Olfactory Perception ; Psychological Distress ; Smell
    Language English
    Publishing date 2018-09-27
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2008418-3
    ISSN 2165-6509 ; 1092-8529
    ISSN (online) 2165-6509
    ISSN 1092-8529
    DOI 10.1017/S1092852918001177
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  9. Article: Immobilization panic.

    Cortese, Bernadette M / Uhde, Thomas W

    The American journal of psychiatry

    2006  Volume 163, Issue 8, Page(s) 1453–1454

    MeSH term(s) Fear/physiology ; Freezing Reaction, Cataleptic/physiology ; Humans ; Immobility Response, Tonic/physiology ; Panic Disorder/diagnosis ; Panic Disorder/epidemiology ; Panic Disorder/psychology ; Sleep Paralysis/diagnosis ; Sleep Paralysis/epidemiology ; Surveys and Questionnaires
    Language English
    Publishing date 2006-08
    Publishing country United States
    Document type Letter
    ZDB-ID 280045-7
    ISSN 1535-7228 ; 0002-953X
    ISSN (online) 1535-7228
    ISSN 0002-953X
    DOI 10.1176/ajp.2006.163.8.1453a
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  10. Article ; Online: Preliminary evidence for differential olfactory and trigeminal processing in combat veterans with and without PTSD.

    Cortese, Bernadette M / Schumann, Aicko Y / Howell, Ashley N / McConnell, Patrick A / Yang, Qing X / Uhde, Thomas W

    NeuroImage. Clinical

    2017  Volume 17, Page(s) 378–387

    Abstract: Structural and functional changes in the olfactory system are increasingly implicated in the expression of PTSD. Still, very little is known about the neurobiological networks of trauma-related odor sensitivity or how they relate to other objective and ... ...

    Abstract Structural and functional changes in the olfactory system are increasingly implicated in the expression of PTSD. Still, very little is known about the neurobiological networks of trauma-related odor sensitivity or how they relate to other objective and subjective measures of olfaction and PTSD. The purpose of this study was to replicate prior findings and further characterize olfactory function in trauma-exposed combat veterans with and without PTSD. We also sought to extend this area of research by exploring the effects of time since the combat-related index trauma (TST) on post-trauma olfactory function, as well as by correlating odor-elicited brain activity to general olfactory ability and odor-elicited PTSD symptoms. Participants included combat veterans with PTSD (CV+PTSD;
    MeSH term(s) Adult ; Brain/physiopathology ; Brain Mapping ; Combat Disorders/physiopathology ; Combat Disorders/psychology ; Female ; Humans ; Magnetic Resonance Angiography ; Male ; Odorants ; Olfactory Pathways ; Olfactory Perception/physiology ; Sensory Thresholds ; Smell ; Stress Disorders, Post-Traumatic/physiopathology ; Stress Disorders, Post-Traumatic/psychology ; Trigeminal Nerve/physiopathology ; Veterans
    Language English
    Publishing date 2017-09-28
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2701571-3
    ISSN 2213-1582 ; 2213-1582
    ISSN (online) 2213-1582
    ISSN 2213-1582
    DOI 10.1016/j.nicl.2017.09.018
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