嗅球形态、体积变化与嗅觉恢复之间的关联

文献信息

中文摘要

目的： 探讨在COVID-19相关嗅觉丧失个体中，嗅球（OB）形态是否与嗅觉训练（OT）后的嗅觉恢复相关。
研究设计： 前瞻性观察性研究。
地点： 大学医院与研究中心。
方法： 20名COVID-19相关嗅觉功能障碍女性和19名健康对照接受为期3个月的OT。使用高分辨率磁共振成像（MRI）对OB形态（椭圆形与非椭圆形）进行分类，并在OT前后手动分割双侧OB体积。采用Sniffin' Sticks测试评估嗅觉表现。统计分析包括独立样本t检验、多模态协方差分析、相关性分析和广义估计方程。
结果： 基线时，OB体积与嗅觉表现显著相关。左侧OB体积的变化与气味阈值的变化呈正相关。OT后，与椭圆形OB者相比，非椭圆形OB形态患者的阈值+辨别+识别（TDI）评分改善更大，且左侧OB体积增大。然而，在患者和对照中，OB形态随时间均未发生显著变化。
结论： OB形态可能为预测OT后预后提供新视角。需要更大样本量和更长训练时间的进一步研究来验证这些初步观察。

英文摘要

OBJECTIVE: To investigate whether olfactory bulb (OB) morphology is associated with olfactory recovery following olfactory training (OT) in individuals with COVID-19-related smell loss.
STUDY DESIGN: Prospective observational study.
SETTING: University hospital and research center.
METHODS: Twenty women with COVID-19-associated olfactory dysfunction and 19 healthy controls underwent OT for 3 months. OB shape (oval vs non-oval) was classified using high-resolution magnetic resonance imaging (MRI), and bilateral OB volumes were manually segmented before and after OT. Olfactory performance was assessed with the Sniffin' Sticks test. Statistical analyses included independent t tests, multimodal analysis of covariance, correlation analyses, and generalized estimating equations.
RESULTS: At baseline, OB volume correlated significantly with olfactory performance. Changes in left OB volume were positively correlated with changes in odor threshold. Following OT, patients with non-oval OB shapes showed greater improvement in Threshold + Discrimination + Identification (TDI) scores and enlargement of left OB volume compared to those with oval-shaped OB. However, OB morphology did not significantly change over time in both patients and controls.
CONCLUSION: OB shape may provide a novel perspective for predicting prognosis after OT. Further studies with larger cohorts and extended training durations are warranted to validate these preliminary observations.