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The sense of smell will help diagnose the state of the brain

29.04.2020

Neuroscientists at the University of Cambridge have proposed using olfactory tests to accurately diagnose the condition of patients with severe brain injuries.

It is rather difficult to determine the state of consciousness of the human brain after a serious injury, and existing methods give an erroneous result in about 40% of cases. At the same time, accurate diagnosis is especially important when the patient maintains a minimal mental state or has fallen into a vegetative state. Based on the diagnosed state of the brain, treatment methods are selected, the likelihood of recovery is predicted, and in some cases a decision is made to disconnect from supporting equipment.

Cambridge neuroscientists have suggested that the accuracy of such diagnostics can be improved with the help of olfactory tests. The functions of the brain associated with smell are among the basic ones and are supported by the most ancient departments, and in a healthy person, the brain reacts to smell both in the waking state and in sleep.

To test their hypothesis, the researchers selected 46 unconscious patients with severe brain injuries. They were randomly given to sniff three test tubes ten times - with a pleasant-smelling shampoo, an unpleasant-smelling fish, and no smell at all - and simultaneously measured the volume of inhaled air to detect a reaction. Before the experiment, the essence of the experiment was explained to the patients in order to make sure once again that there were no signs that they heard and understood what they were being told.

Patients who retained minimal mental activity reacted to the smell or its absence, although the reaction was the same for both shampoo and fish. Those who were in a vegetative state reacted only in some cases.

But the scientists got the most interesting results only after a while. Three and a half years after the experiment, 91% of those who reacted to the smell were still alive, and 63% of those who did not show any reaction died. And besides, all the patients who distinguished smells showed a tendency to restore brain activity.

"We found that if patients in a vegetative state showed an olfactory response, then they then recovered to at least minimal mental activity. In some cases, smell discrimination was the only sign of brain recovery, other signs appeared much later - after days, weeks or months" , - says one of the authors of the study, Dr. Anat Artzi.

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