A Comparative Study of Iranian Smell Identification Test (Iran-SIT) and Single-photon Emission Computed Tomography (SPECT) Results in Discrimination of Anosmia and Malingering in Forensic Cases

  • S. Pouraghaei Amirkabir University of Technology
  • B. Samadirad Eastern Azerbaijan Province-General Office of Legal Medicine
  • E. Baybordi Academic Center for Education, Culture and Research
  • AA. Seyffarshad Eastern Azerbaijan Province-General Office of Legal Medicine
  • J.Mehdizadeh Seraj Tehran University of Medical Sciences
  • F. Kolahi Eastern Azerbaijan Province-General Office of Legal Medicine
  • S. Taherkhani Amirkabir University of Technology
Keywords: Olfactory dysfunction, Forensic medicine, Anosmia, Malingering, SPECT, Iran-SIT

Abstract

Purpose: Olfactory dysfunction is a common complaint following head trauma. Few subjective and objective tests had been proposed for purposes of litigation. Currently, the two most common methodologies for separating malingerers from genuine anosmics are single-photon emission computed tomography (SPECT) and smell identification tests as objective and subjective tests, respectively. The objective of the present study was to compare the efficacy of the SPECT and Iranian Smell Identification Test (Iran-SIT) in discrimination of anosmia and malingering in forensic cases. Method: All of the 16 subjects that fulfilled the requirements completely, underwent both SPECT imaging and Iran-SIT assessment. Results: The sensitivity of SPECT in diagnosing malingering and anosmia was estimated to be 66.6% and 87.5%, respectively. That of Iran-SIT was estimated to be 90% and 75%, respectively. In addition, the sensitivity and specificity of Iran-SIT in diagnosing hyposmia were 100%. Conclusion: Because of the higher sensitivity of Iran-SIT in diagnosing anosmia and higher specificity in diagnosing malingering, it is recommended for directly ruling out the suspicious cases.

References

Doty, R. The Olfactory System and Its Disorders. Semin. Neurol. 29, 074–081 (2009).

DOTY, R. L. Influence of Age and Age-Related Diseases on Olfactory Function. Ann. N. Y. Acad. Sci. 561, 76–86 (1989).

Reden, J. et al. Recovery of Olfactory Function Following Closed Head Injury or Infections of the Upper Respiratory Tract. Arch. Otolaryngol. Neck Surg. 132, 265 (2006).

Kovács, T. Mechanisms of olfactory dysfunction in aging and neurodegenerative disorders. Ageing Res. Rev. 3, 215–232 (2004).

Landis, B. N., Hummel, T. & Lacroix, J.-S. in 69–105 (Springer Vienna, 2005). doi:10.1007/3-211-27208-9_3

Doty, R. L., Shaman, P., Kimmelman, C. P. & Dann, M. University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic. Laryngoscope 94, 176–178 (1984).

Doty, R. L. Olfactory dysfunction and its measurement in the clinic and workplace. Int. Arch. Occup. Environ. Health 79, 268–282 (2006).

Gottfried, J. A. in Handbook of Olfaction and Gustation 279–304 (John Wiley & Sons, Inc, 2015). doi:10.1002/9781118971758.ch13

Osman, A. & Silas, J. in Handbook of Olfaction and Gustation 261–278 (John Wiley & Sons, Inc, 2015). doi:10.1002/9781118971758.ch12

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. (American Psychiatric Association, 2013). doi:10.1176/appi.books.9780890425596

Delank, K. W., Nieschalk, M., Schmäl, F. & Stoll, W. [Special characteristics of expert assessment of olfactory and taste disorders]. Laryngorhinootologie. 78, 365–72 (1999).

Green, P. & Iverson, G. L. Effects of injury severity and cognitive exaggeration on olfactory deficits in head injury compensation claims. NeuroRehabilitation 16, 237–43 (2001).

Kurtz, D. B., White, T. L., Hornung, D. E. & Belknap, E. What a tangled web we weave: discriminating between malingering and anosmia. Chem. Senses 24, 697–700 (1999).

Linschoten, M. R. & Harvey, L. O. Detecting malingerers by means of response-sequence analysis. Percept. Psychophys. 66, 1190–201 (2004).

Rahmim, A. & Zaidi, H. PET versus SPECT: strengths, limitations and challenges. Nucl. Med. Commun. 29, 193–207 (2008).

Doty, R. L. & Crastnopol, B. Correlates of chemosensory malingering. Laryngoscope 120, 707–711 (2010).

Taherkhani, S. et al. Iran Smell Identification Test (Iran-SIT): a Modified Version of the University of Pennsylvania Smell Identification Test (UPSIT) for Iranian Population. Chemosens. Percept. 8, 183–191 (2015).

Catafau, a M. Brain SPECT in clinical practice. Part I: perfusion. J. Nucl. Med. 42, 259–71 (2001).

Shiga, H. et al. Assessment of Olfactory Nerve by SPECT-MRI Image with Nasal Thallium-201 Administration in Patients with Olfactory Impairments in Comparison to Healthy Volunteers. PLoS One 8, 1–8 (2013).

Kang, W. et al. The predictive value of SS-16 in clinically diagnosed Parkinson’s disease patients: comparison with 99mTc-TRODAT-1 SPECT scans. Transl. Neurodegener. 5, 15 (2016).

McGee, S. Simplifying likelihood ratios. J. Gen. Intern. Med. 17, 647–650 (2002).

J. Cohen. A coefficient of agreement for nominal scales. Educ. Psychol. Meas. 20, (1960).

Eibenstein, A. et al. Modern psychophysical tests to assess olfactory function. Neurol. Sci. 26, 147–155 (2005).

S., A., A., Z., M., B. & M., D. Estimation of sensitivity and specificity of brain magnetic resonance imaging and single photon emission computed tomography in the diagnosis of olfactory dysfunction after head traumas. Am. J. Rhinol. Allergy 27, 403–406 (2013).

Published
2018-08-03
Section
Original Research Article