Sense of smell key to predicting recovery after brain injury, say scientists

Obviously it is your responsibility to be able to do this while in a locked-in state otherwise you may be cut off from rehab. Not your doctor's responsibility, YOURS.  You do know that this will never get to your hospital.

Does your hospital have an employee whose only function is to scan for stroke related research and information and create rehab protocols and distribute them to the staff? If not, YOU HAVE A FUCKING INCOMPETENT HOSPITAL.

Like this from August 2013;

Brain Shaking Technique - strong magnetic stimulation - Offers Measure of Consciousness

 

Or this, November 2017;

New brainwave-reading technique may unlock ‘locked-in’ patients 

 

Or this, January 2019;

Electroencephalography-based endogenous brain–computer interface for online communication with a completely locked-in patient

 

Because you don't want this to happen!

Stroke Patient Hears Doctors Discuss Organ Donation

 

The latest here:

Sense of smell key to predicting recovery after brain injury, say scientists

Tests revealed 100 per cent of patients who reacted to 'sniff test' eventually regained consciousness

By Sally Guyoncourt

Wednesday, 29th April 2020, 9:31 pm

Updated Wednesday, 29th April 2020, 9:32 pm

Sense of smell may hold key to diagnosis and treatment of brain injury patients, say scientists (Photo: Getty)

Sense of smell may hold the key to predicting the recovery of people with severe brain injury, according to scientists.

A simple "sniff test", trialled by researchers at the University of Cambridge, could help doctors diagnose and determine treatment for patients who are in a vegetative state or have minimal consciousness following brain injuries.

Patients in a vegetative state can open their eyes, wake up and fall asleep regularly and have basic reflexes but don't show signs of awareness.

Minimally conscious patients can have periods where they can show signs of awareness or respond to commands.

'Sniff test'

"The accuracy of the sniff test is remarkable - I hope it will help in the treatment of severely brain injured patients around the world," said Dr Anat Arzi, a researcher in the University of Cambridge's Department of Psychology and the Weizmann Institute of Science Israel, who led the study.

Results published in the journal Nature revealed 100 per cent of patients who reacted to the sniff test went on to regain consciousness and more than 91 per cent of these patients were still alive three and a half years after injury.

Doctors often find it difficult to determine a patient's state of consciousness after a severe brain injury but accurate diagnosis is critical for treatment strategies, such as pain management, and for end-of-life decisions.

Sense of smell relies on structures deep within the brain and works whether we are awake or asleep.

Accurate diagnosis

The brain automatically changes the way we sniff in response to different smells, with shorter and shallower breaths for unpleasant smells.

Scientists carried out the ‘sniff test’ on 43 patients with severe brain injury, presenting them different jars of smell for five seconds.

One jar contained a pleasant smell of shampoo, one an unpleasant smell of rotten fish, and one had no smell at all.

Each jar was presented ten times in a random order and the volume of air sniffed by the patient was measured using a nasal cannula.

Jars of smell

Trials were carried out on patients with minimal consciousness and in a vegetative state (Photo: Getty)

Researchers found minimally conscious patients inhaled significantly less in response to smells but did not discriminate between nice and nasty.

These patients also modified their nasal airflow in response to the jar with no smell, suggesting they were aware of the jar or anticipated a smell.

Vegetative state patients had a more varied response, some did not change their breathing in response to the smells but others did.

A follow-up investigation three and a half years later found more than 91% of the patients who had a sniff response shortly after injury were still alive, but 63% of those who had showed no response had died.

Sniff response

"We found that if patients in a vegetative state had a sniff response, they later transitioned to at least a minimally conscious state”, said Dr Arzi, “In some cases, this was the only sign that their brain was going to recover - and we saw it days, weeks and even months before any other signs.”

Dr Tristan Bekinschtein, from the University of Cambridge's Department of Psychology who was also involved in the study, said:"This new and simple method to assess the likelihood of recovery should be immediately incorporated in the diagnostic tools for patients with disorders of consciousness."

For Some, Smell Test May Signal Parkinson’s Disease up to 10 Years Before Diagnosis

When will your doctor implement this for all stroke survivors? And then what interventions are being done to prevent Parkinsons from occurring? Or is your doctor so fucking incompetent that s/he doesn't even know about the risk of getting Parkinsons after stroke? But I'm not medically trained so don't listen to me, listen to your doctor who may or may not know one damn thing.
Is your doctor also smell testing for your dementia risk?

Sniff Out Alzheimer’s Risk with Powerful New Smell Test

Parkinson’s Disease May Have Link to Stroke

 For Some, Smell Test May Signal Parkinson’s Disease up to 10 Years Before Diagnosis

MINNEAPOLIS, Minn -- September 6, 2017 -- A simple scratch-and-sniff test may one day be able to help identify some people at greater risk of developing Parkinson’s disease up to 10 years before the disease could be diagnosed, according to a study published in the September 6, 2017, online issue of Neurology.
The study found that older adults with a poor sense of smell are more likely to develop Parkinson’s disease than people who perform better on the smell test. The researchers also found that the link was stronger in men than in women.
The test asks people to smell 12 common odours, such as cinnamon, lemon, gasoline, soap, and onion, and pick the correct answer from 4 choices.
The study was one of the first to look at the sense of smell and Parkinson’s disease in black people. Recent studies have shown the link in Asian and white people.
“Previous studies have shown that black people are more likely to have a poor sense of smell than whites and yet may be less likely to develop Parkinson’s disease,” said Honglei Chen, MD, Michigan State University College of Human Medicine, East Lansing, Michigan. “We found no statistical significance for a link between poor sense of smell and Parkinson’s disease in black people, but that may have been due to the small sample size. More research is needed to further investigate a possible link.”
The study involved 1,510 white people and 952 black people with an average age of 75 years who took the scratch-and-sniff test and were then followed for an average of 10 years. Then researchers looked to see who had developed Parkinson’s disease during that time. The participants were divided into 3 groups based on their scores on the smell test: poor sense of smell, medium, and good.
During the study, 42 people developed Parkinson’s disease: 30 white people and 12 black people. People in the poor sense of smell group were nearly 5 times more likely to develop the disease than people in the good sense of smell group. Of the 764 people with a poor sense of smell, 26 people developed Parkinson’s disease, compared with 7 of the 835 people with a good sense of smell and 9 of the 863 people with a medium sense of smell.
The results stayed the same after researchers adjusted for other factors that could affect risk of Parkinson’s disease, such as smoking, coffee drinking, and history of head injury.
The study showed a strong association between the smell test and development of Parkinson’s up to 6 years later. The association remained beyond 6 years, but was not as strong.
“Earlier studies had shown prediction of Parkinson’s disease about 4 to 5 years after the smell test was taken,” said Dr. Chen. “Our study shows that this test may be able to inform the risk much earlier than that.”
Dr. Chen noted that not everyone with low scores on the smell test will develop Parkinson’s disease. He said more research is needed before the smell test can be used to screen for Parkinson’s disease in the general population because the disease affects a low percentage of the population and because a low score on the test does not rule out other causes of problems with smelling.
He added that a limitation of the study was that while the study participants were followed over time, determining which participants developed Parkinson’s disease occurred at the end of the study, so it’s possible that some cases may have been missed or mistakes made, especially since the disease can take a long time to diagnose in some cases.
Reference: DOI: 10.1212/WNL.0000000000004382
SOURCE: American Academy of Neurology

Olfaction and risk of dementia in a biracial cohort of older adults

Your doctor should be administering something like this to establish a baseline for you. You have a fairly good chance of getting dementia post-stroke. But I bet your doctor has NO dementia prevention protocol, so you are screwed even if they do identify a possible risk for you getting dementia.

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.

3. A 20% chance in this research.   July 2013.

4. A 2-fold increase in dementia risk in this study    Jan. 2017 

Olfaction and risk of dementia in a biracial cohort of older adults

1. Kristine Yaffe, MD,
2. Daniel Freimer, BA,
3. Honglei Chen, MD, PhD,
4. Keiko Asao, MD, MPH, PhD,
5. Andrea Rosso, MPH, PhD,
6. Susan Rubin, MPH,
7. Greg Tranah, PhD,
8. Steve Cummings, MD and
9. Eleanor Simonsick, PhD

+Show Affiliations

| + Show Full Disclosures

1. Correspondence to Dr. Yaffe: kristine.yaffe@ucsf.edu

1. Published online before print December 30, 2016, doi: http:/​/​dx.​doi.​org/​10.​1212/​WNL.​0000000000003558 Neurology January 31, 2017 vol. 88 no. 5 456-462

• Abstract
• Full Text
• Full Text (PDF)

1. Also available:
2. Figures Only
3. CME Course
4. PPT Slides of All Figures

Abstract

Objective: Prior studies indicate that olfactory function may be an early marker for cognitive impairment, but the body of evidence has been largely restricted to white populations.

Methods: We studied 2,428 community-dwelling black and white older adults (baseline age 70–79 years) without dementia enrolled in the Health, Aging, and Body Composition (Health ABC) study. Olfaction was measured as odor identification (OI) with the 12-item Cross Cultural Smell Identification Test in year 3. We defined incident dementia over 12 years on the basis of hospitalization records, prescription for dementia medication, or 1.5-SD decline in race-stratified global cognition score. We assessed dementia risk associated with OI score (by tertile) using Cox proportional hazards models. All analyses were stratified by race.

Results: Poorer OI in older adults without dementia was associated with increased risk of dementia. After adjustment for demographics, medical comorbidities, and lifestyle characteristics, white participants in the poor or moderate OI tertile had greater risk of dementia (adjusted hazard ratio [HR] 3.34, 95% confidence interval [CI] 2.45–4.54; and HR 1.84, 95% CI 1.33–2.54, respectively) compared to those in the good tertile of function. Among blacks, worse OI was associated with an increased risk of dementia, but the magnitude of the effect was weaker (p for interaction = 0.04) for the poor OI tertile (adjusted HR 2.03, 95% CI 1.44–2.84) and for the moderate tertile (adjusted HR 1.42, 95% CI 0.97–2.10). There was no interaction between OI and APOE ε4 and risk of dementia.

Conclusions: While the magnitude of the association was stronger in whites, we found that poor OI was associated with increased risk of dementia among both black and white older adults.

Sniff Out Alzheimer’s Risk with Powerful New Smell Test

If your doctor documenting your sniffer as a baseline for checking your dementia descent? Or doing nothing at all?
1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.
3. A 20% chance in this research.   July 2013.

Sniff Out Alzheimer’s Risk with Powerful New Smell Test