Chemosensory function and response in idiopathic environmental intolerance.

This chapter reviews the current literature on the possible role of olfactory and trigeminal chemosensory function in idiopathic environmental intolerances (IEI). Two general points emerge from the review. First, studies of chemosensory function in IEI patients indicate that, despite their self-reported "heightened sensitivity" and enhanced responsivity to environmental odors, when compared to healthy controls they generally are found to be equally or even less sensitive to odors as measured by objective psychophysical and electrophysiological measures of olfactory function. These studies point towards alterations in the cognitive processing of olfactory information as the major characteristic of IEI. Second, studies of the role of sensitivity and bias in olfactory and trigeminal chemosensory functioning indicate that nonsensory factors (e.g., attention, bias, personality) can dramatically alter the self-reported impact of exposure to volatile chemicals. Together, these general points suggest a perspective on IEI that views many symptoms of the disorder to primarily reflect the influence of nonsensory, cognitive processes on responses to environmental odors.