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Decoding the neural basis of olfactory dysfunction: a multimodal MRI study in CRS-OD.

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  • 1Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, P.R. China.

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|January 23, 2026
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Chronic rhinosinusitis with olfactory dysfunction (CRS-OD) causes olfactory bulb atrophy and gray matter loss in olfactory brain regions. This neuroimaging study reveals disrupted brain connectivity, suggesting central nervous system changes in CRS-OD patients.

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Area of Science:

  • Neuroscience
  • Radiology
  • Otolaryngology

Background:

  • Chronic rhinosinusitis with olfactory dysfunction (CRS-OD) impacts peripheral and central olfactory pathways.
  • Persistent olfactory loss in CRS-OD may trigger neuroplastic brain changes.
  • Hypothesis: CRS-OD is linked to gray matter atrophy and altered functional connectivity in olfactory regions.

Purpose of the Study:

  • To investigate gray matter volume and functional connectivity alterations in CRS-OD patients.
  • To correlate neuroimaging findings with olfactory dysfunction severity.

Main Methods:

  • Prospective study of 23 CRS-OD patients and 23 healthy controls (HCs).
  • MRI analysis including Voxel-Based Morphometry (VBM) for gray matter differences and seed-based functional connectivity (FC).
  • Assessment of olfactory function using TDI, QOD, and OECS tests.

Main Results:

  • CRS-OD patients showed significantly reduced olfactory bulb (OB) volumes compared to HCs.
  • Gray matter atrophy was observed in the inferior frontal orbital gyrus, parahippocampal gyrus, hippocampus, thalamus, and putamen.
  • Decreased FC in sensory-integration networks and increased FC in the superior occipital gyrus were noted, suggesting compensatory reorganization.

Conclusions:

  • CRS-OD is associated with OB atrophy, gray matter loss, and disrupted FC, indicating peripheral and central neural alterations.
  • Multimodal MRI offers insights into CRS-OD pathophysiology.
  • Further longitudinal studies are warranted to understand the progression of these neural changes.