American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 32, Issue 1 , Pages 38-46, January 2011

Improvement in smell and taste dysfunction after repetitive transcranial magnetic stimulation

  • Robert I. Henkin, MD, PhD

      Affiliations

    • The Taste and Smell Clinic, Washington, DC, USA
    • Corresponding Author InformationCorresponding author. Center for Molecular Nutrition and Sensory Disorders, 5125 MacArthur Blvd NW, #20, Washington, DC 20016, USA. Tel.: +1 202 364 4180; fax: +1 202 364 9727.
    • ,
  • Samuel J. Potolicchio Jr., MD

      Affiliations

    • Department of Neurology, George Washington University Medical Center, Washington, DC, USA
    • ,
  • Lucien M. Levy, MD, PhD

      Affiliations

    • Department of Radiology, George Washington University Medical Center, Washington, DC, USA

Received 14 July 2009 published online 21 December 2009.

Abstract 

Background

Olfactory and gustatory distortions in the absence of odors or tastants (phantosmia and phantageusia, respectively) with accompanying loss of smell and taste acuity are relatively common symptoms that can occur without other otolaryngologic symptoms. Although treatment of these symptoms has been elusive, repetitive transcranial magnetic stimulation (rTMS) has been suggested as an effective corrective therapy.

Objective

The objective of the study was to assess the efficacy of rTMS treatment in patients with phantosmia and phantageusia.

Methods

Seventeen patients with symptoms of persistent phantosmia and phantageusia with accompanying loss of smell and taste acuity were studied. Before and after treatment, patients were monitored by subjective responses and with psychophysical tests of smell function (olfactometry) and taste function (gustometry). Each patient was treated with rTMS that consisted of 2 sham procedures followed by a real rTMS procedure.

Results

After sham rTMS, no change in measurements of distortions or acuity occurred in any patient; after initial real rTMS, 2 patients received no benefit; but in the other 15, distortions decreased and acuity increased. Two of these 15 exhibited total inhibition of distortions and return of normal sensory acuity that persisted for over 5 years of follow-up. In the other 13, inhibition of distortions and improvement in sensory acuity gradually decreased; but repeated rTMS again inhibited their distortions and improved their acuity. Eighty-eight percent of patients responded to this therapeutic method, although repeated rTMS was necessary to induce these positive changes.

Interpretation

These results suggest that rTMS is a potential future therapeutic option to treat patients with the relatively common problems of persistent phantosmia and phantageusia with accompanying loss of taste and smell acuity. Additional systematic studies are necessary to confirm these results.

 

PII: S0196-0709(09)00220-8

doi:10.1016/j.amjoto.2009.10.001

American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 32, Issue 1 , Pages 38-46, January 2011

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