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The lateralized smell test for detecting Alzheimer's disease: Failure to replicate

  • Richard L. Doty
    Correspondence
    Corresponding author at: Smell and Taste Center, University of Pennsylvania School of Medicine, 5 Ravdin Pavilion, 3400 Spruce Street, Philadelphia, PA 19104, USA. Tel.: +1 215 662 6580; fax: +1 349 5266.
    Affiliations
    Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, 5 Ravdin Pavilion, 3400 Spruce Street, Philadelphia, PA 19104, USA
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  • Edgardo A. Bayona
    Affiliations
    Neuronet, Clinical Neuroscience Laboratory, Unicolciencias, Carrera 45 No. 26-85, Bogota, Colombia

    Mediciencias, Unicolciencias/Universidad Nacional, Bogota, Colombia
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  • Daniel S. Leon-Ariza
    Affiliations
    School of Medicine, UDES, Lagos Cacique, Bucaramanga, Colombia
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  • Juan Cuadros
    Affiliations
    Fundacion Pura Vida, Finca La Suiza, Vereda Bojaca, Chia, Cundinamarca, Colombia
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  • Inna Chung
    Affiliations
    Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, 5 Ravdin Pavilion, 3400 Spruce Street, Philadelphia, PA 19104, USA
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  • Britney Vazquez
    Affiliations
    Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, 5 Ravdin Pavilion, 3400 Spruce Street, Philadelphia, PA 19104, USA
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  • Fidias E. Leon-Sarmiento
    Affiliations
    Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, 5 Ravdin Pavilion, 3400 Spruce Street, Philadelphia, PA 19104, USA

    Mediciencias, Unicolciencias/Universidad Nacional, Bogota, Colombia
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Published:April 16, 2014DOI:https://doi.org/10.1016/j.jns.2014.03.022

      Highlights

      • Clear demonstration of the lack of asymmetry in olfaction with AD
      • Reaffirmation of early smell loss in AD
      • Clarified disparities in disparate findings of olfactory laterality in AD

      Abstract

      Objectives

      A widely publicized study by Stamps, Bartoshuk and Heilman (2013) reported that a simple measure of left:right naris differences in the ability to detect the odor of peanut butter is a sensitive marker of Alzheimer's disease (AD). AD patients were said to have abnormal smell function on the left side of the nose and normal function on right side of the nose. In light of its implications for medical practice and the world-wide publicity that it engendered, we sought to replicate and expand this work.

      Methods

      Two studies were performed. In the first, 15 AD patients were tested according to the procedures described by Stamps et al. in which the nostril contralateral to the tested side was occluded by the patient using lateral pressure from the index finger. Since this can potentially distort the contralateral naris, we repeated the testing using tape for naris occlusion. In the second, 20 AD patients were administered 20 odors of the University of Pennsylvania Smell Identification Test (UPSIT) to each side of the nose, with the contralateral naris being closed with tape. In both studies, the order of the side of testing was systematically counterbalanced.

      Results

      No evidence of a left:right asymmetry on any test measure was observed.

      Conclusion

      Although hyposmia is well-established in AD, no meaningful asymmetry in smell perception is apparent. If olfactory function on the right side of the nose was normal as claimed, then AD patients should exhibit normal function when tested bilaterally, a phenomenon not seen in dozens of AD-related olfactory studies.

      Keywords

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