Abstract Details

Title Subjective and Objective Findings of Anosmia are Discordant and Persist for Six Months in Hospitalized Individuals With Traumatic Brain Injury

Topic Neuro Trauma and Critical Care

Presentation(s) P3 - Poster Session 3 (5:00 PM-6:00 PM)

Poster/Presentation
Number 3-007

Objective To examine olfaction following traumatic brain injury (TBI).

Background Longitudinal assessment of olfactory function is understudied in TBI. We hypothesized that olfaction varies by initial head CT, Glasgow Coma Scale (GCS) score, and smoking status and improves over time.

Design/Methods In this ongoing, prospective observational study, hospitalized individuals with TBI were recruited from a Level 1 trauma center. Demographic, clinical, and injury data was collected at enrollment. Objective olfactory function was assessed at 2-weeks and 6-months post-injury using Sniffin’ Sticks (16-item odor identification test). Individuals subjectively rated their sense of smell on a 5-point Likert scale. Change in olfaction over time was analyzed with Wilcoxon signed rank tests and group differences in olfaction score by demographic and clinical variables were examined with Mann-Whitney U-tests and Kruskal-Wallis tests. Percent agreement between subjective (poor/fair versus good/very good/excellent) and objective (defined using published age- and sex-specific thresholds for normosmia/anosmia) olfaction was examined.

Results Thirty participants (mean age 38.4 [SD=14.7] years, 70% male, 47% Black race, 41% current smokers) were included. Participants had a median GCS of 15 (IQR=14-15) and 53% had trauma-related abnormalities on head CT. Thirty-nine percent of individuals self-reported their smell poor/fair; 33% had anosmia on objective testing. At 2-weeks, median (IQR) olfaction score was 12 (10-13) and at 6-months, was 12.5 (10.5-13.5). In nine individuals with paired data, olfaction scores did not significantly change over time (difference=0.5; p=0.71). There were no differences in olfaction scores by sex (p=0.06), head CT status (p=0.12), GCS score (p=0.43), or smoking status (p=0.08). Agreement between subjective and objective olfaction was 36.7%.

Conclusions Olfactory dysfunction is present in a subset of individuals after TBI and remains stable over 6-months. This work also suggests that certain demographic factors may be important variables to consider and that subjective and objective olfaction measures are inconsistent.

Authors/Disclosures
Trevor McCutcheon PRESENTER	Mr. McCutcheon has nothing to disclose.
Justin Desprebiteres, BA	Mr. Desprebiteres has nothing to disclose.
Amber Erich	Miss Erich has nothing to disclose.
Kate Deppen	Mrs. Deppen has nothing to disclose.
Stefanie Darnley	Ms. Darnley has nothing to disclose.
Danielle Sandsmark, MD	The institution of Dr. Sandsmark has received research support from NINDS. The institution of Dr. Sandsmark has received research support from BrainBox Solutions Inc. The institution of Dr. Sandsmark has received research support from Department of Defense.
Ramon R. Diaz-Arrastia, MD, PhD, FAAN (University of Pennsylvania)	Dr. Diaz-Arrastia has stock in BrainBox, LLC. Dr. Diaz-Arrastia has stock in Nia Therpeutics. The institution of Dr. Diaz-Arrastia has received research support from National Institutes of Health. The institution of Dr. Diaz-Arrastia has received research support from Department of Defense.
Vidyulata Kamath, PhD	The institution of Dr. Kamath has received research support from NIH.
Jeffrey Ware, MD	Dr. Ware has nothing to disclose.
Andrea L. Schneider, MD, PhD (University of Pennsylvania)	Dr. Schneider has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN - Neurology.
Alexa E. Walter, PhD	Dr. Walter has nothing to disclose.

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