Foreword Thomas R. Swift Preface Acknowledgements 1. Anatomy and physiology 2. Clinical evaluation 3. Disorders of olfaction 4. Neurodegenerative diseases that affect olfaction 5. Investigation, treatment and general management of olfactory disease Index.

The Neurology of Olfaction

Taste disorders in general, and dysgeusia in particular, are relatively common disorders that may be a sign of a more complex acute or chronic medical condition. During the COVID-19 pandemic, taste disorders have found their way into the realm of general as well as specialty dentistry, with significance in screening for patients who potentially may have the virus.The authors searched electronic databases (PubMed, Embase, Web of Science, Google Scholar) for studies focused on dysgeusia, ageusia, and other taste disorders and their relationship to local and systemic causes.The authors found pertinent literature explaining the normal physiology of taste sensation, proposals for suggested new tastes, presence of gustatory receptors in remote tissues of the body, and etiology and pathophysiology of taste disorders, in addition to the valuable knowledge gained about gustatory disorders in the context of COVID-19. Along with olfactory disorders, taste disorders are one of the earliest suggestive symptoms of COVID-19 infection.Gustatory disorders are the result of local or systemic etiology or both. Newer taste sensations, such as calcium and fat tastes, have been discovered, as well as taste receptors that are remote from the oropharyngeal area. Literature published during the COVID-19 pandemic to date reinforces the significance of early detection of potential patients with COVID-19 by means of screening for recent-onset taste disorders.Timely screening and identification of potential gustatory disorders are paramount for the dental care practitioner to aid in the early diagnosis of COVID-19 and other serious systemic disorders. 

Dysgeusia

Trigeminal nerve injury is one of the causes of chronic orofacial pain. Patients suffering from this condition have a significantly reduced quality of life. The currently available management modalities are associated with limited success. This article reviews some of the common causes and clinical features associated with post-traumatic trigeminal neuropathic pain (PTNP). A cascade of events in the peripheral and central nervous system function is involved in the pathophysiology of pain following nerve injuries. Central and peripheral processes occur in tandem and may often be co-dependent. Due to the complexity of central mechanisms, only peripheral events contributing to the pathophysiology have been reviewed in this article. Future investigations will hopefully help gain insight into trigeminal-specific events in the pathophysiology of the development and maintenance of neuropathic pain secondary to nerve injury and enable the development of new therapeutic modalities.

/pdf/pathophysiology-of-post-traumatic-trigeminal-neuropathic-3dbd16rj.pdf

Pathophysiology of Post-Traumatic Trigeminal Neuropathic Pain

Recently, anosmia and ageusia (and their variations) have been reported as frequent symptoms of COVID-19. Olfactory and gustatory stimuli are essential in the perception and pleasure of eating. Disorders in sensory perception may influence appetite and the intake of necessary nutrients when recovering from COVID-19. In this short commentary, taste and smell disorders were reported and correlated for the first time with food science.The objective of this short commentary is to report that taste and smell disorders resulted from COVID-19 may impact eating pleasure and nutrition. It also points out important technologies and trends that can be considered and improved in future studies.Firmer food textures can stimulate the trigeminal nerve, and more vibrant colors are able to increase the modulation of brain metabolism, stimulating pleasure. Allied to this, encapsulation technology enables the production of new food formulations, producing agonist and antagonist agents to trigger or block specific sensations. Therefore, opportunities and innovations in the food industry are wide and multidisciplinary discussions are needed. 

https://doi.org/10.1016/j.tifs.2022.01.022

Olfactory and gustatory disorders caused by COVID-19: How to regain the pleasure of eating?

Recent studies have demonstrated the contribution of non-coding RNAs (ncRNAs) to neuropathic pain. However, the expression profile of ncRNAs in the trigeminal ganglion (TG) and their functional mechanism underlying trigeminal neuropathic pain are still unclear.In the present study, the trigeminal neuropathic pain model induced by chronic constriction injury of the infraorbital nerve (CCI-ION) was used to study the expression profile and potential regulatory mechanism of miRNAs, lncRNAs, circRNAs, and mRNAs in the TG by RNA-sequencing (RNA-seq) and bioinformatics analysis. CCI-ION mice suffered from mechanical allodynia from 3 days to 28 days after surgery.The RNA-seq results discovered 67 miRNAs, 216 lncRNAs, 14 circRNAs, 595 mRNAs, and 421 genes were differentially expressed (DE) in the TG of CCI-ION mice 7 days after surgery. And 39 DEGs were known pain genes. Besides, 5 and 35 pain-related DE mRNAs could be targeted by 6 DE miRNAs and 107 DE lncRNAs, respectively. And 23 pain-related DEGs had protein-protein interactions (PPI) with each other. GO analysis indicated membrane-related cell components and binding-related molecular functions were significantly enriched. KEGG analysis showed that nociception-related signaling pathways were significantly enriched for DE ncRNAs and DEGs. Finally, the competing endogenous RNA (ceRNA) regulatory network of DE lncRNA/DE circRNA-DE miRNA-DE mRNA existed in the TG of mice with trigeminal neuropathic pain.Our findings demonstrate ncRNAs are involved in the development of trigeminal neuropathic pain, possibly through the ceRNA mechanism, which brings a new bright into the study of trigeminal neuropathic pain and the development of novel treatments targeting ncRNAs. 

Interactions Among Non-Coding RNAs and mRNAs in the Trigeminal Ganglion Associated with Neuropathic Pain

Background Anosmia/hyposmia is a relatively rare sensory disorder that could indicate an underlying more serious cause In the context of the current COVID 19 pandemic, this could be one of the red flags for the dental practitioner in terms of screening potential COVID 19 patients Methods The authors searched electronic databases with regards to anosmia/hyposmia and their relation to local and systemic causes Results The authors found articles relating to the physiology and significance of normal olfaction, etiology, and pathophysiology of olfaction and disorders of the same Also, we found the most recent literature of anosmia/hyposmia linked to early symptoms of this pandemic Conclusions Anosmia/hyposmia is most likely indicative of a local or systemic pathology affecting the olfactory system Recent evidence suggests the importance of this as related to the new global pandemic of COVID 19 Practical Implications The dental professional must be cognizant of the fact that anosmia/hyposmia could indicate a more serious underlying local or systemic issue In the coming months of the new reality of COVID 19, dental practitioners have an additional role of potential early screening of these infections

Anosmia: A review in the context of coronavirus disease 2019 and orofacial pain.

Diagnosis and management of persistent posttraumatic trigeminal neuropathic pain secondary to implant therapy: A review.

Melanocortin-4 receptor (MC4R) has been investigated as a potential drug target for the treatment of neuropathic pain. The objective of the study was to systematically identify the effects of MC4R antagonists on hypersensitivity in rat models of neuropathic pain. A systematic search was conducted using the following databases: WoS, PubMed, SCOPUS, and MEDLINE. Inclusion criteria were: rat hypersensitivity induced by models of neuropathic pain with reported effects of MC4R antagonist. Two researchers performed the selection process and data extraction. SYRCLE risk of bias tool was used. Standard mean differences (SMD) were calculated and pooled by meta-analysis using random effect models. Ten articles met the eligibility criteria and were included in the systematic review and meta-analysis. The results reveal that, in animals exposed to neuropathic pain, administration of MC4R antagonists significantly increased paw withdrawal threshold (SHU9119 SMD = 1.67, 95% CI: [0.91, 2.44], I2  = 0%; HS014 SMD = 2.2, 95% CI: [0.53, 3.87], I2  = 71%) and heat withdrawal latency (HS014 SMD = 3.35, 95% CI: [0.56, 6.14], I2  = 83%) compared to vehicle-treated animals. MC4R antagonists are effective in the alleviation of hypersensitivity in rodent neuropathic pain models. SHU9119 and HS014 antagonists showed the most prominent results. However, further investigation is needed to determine the optimal dose and time of treatment.

Effects of melanocortin-4 receptor (MC4R) antagonist on neuropathic pain hypersensitivity in rats - A systematic review and meta-analysis

Glossopharyngeal neuropathy: A case report.

Background and Overview Trigeminal neuralgia due to a metastatic lesion is a relatively rare occurrence. These cases pose a diagnostic challenge for the clinician due to a complex clinical presentation. Case Description The authors describe the case of a 65-year-old woman with left-sided facial pain and occasional numbness. The patient also reported autonomic features associated with facial pain, facial muscular weakness, and hearing and visual impairment. The patient's history of breast cancer, for which she was receiving treatment for bone metastasis, warranted diagnostic imaging. Magnetic resonance imaging with and without contrast was performed and revealed a possible metastatic lesion. Conclusions and Practical Implications Unusual clinical features must be identified, and prompt appropriate imaging is instrumental in making at an accurate diagnosis and management plan.

Facial pain and trigeminal neuralgia secondary to metastasis: A case report.

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