Parosmia Beyond Olfactory Loss: A Propensity Score-Matched Study of Central Sensitization-Associated Comorbidities

Parosmia is linked to migraine, chronic pain, fibromyalgia, and hypersomnia beyond anosmia. Central sensitization comorbidities distinguish parosmia from quantitative olfactory loss. Findings support parosmia as a disorder of altered central sensory processing.

Audiologists and ENT-adjacent clinicians should be aware that patients presenting with parosmia may carry a higher burden of central sensitization-related comorbidities (migraine, fibromyalgia, chronic pain, hypersomnia); screen accordingly, though this finding does not yet change direct audiology practice.

Repositioning parosmia as a central sensitization disorder rather than a purely peripheral olfactory condition could reshape how multidisciplinary teams assess and manage patients with smell distortion, with potential implications for understanding tinnitus and hyperacusis via shared central sensitization pathways.

1. 01Parosmia (distorted smell) is significantly associated with migraine, chronic pain, fibromyalgia, and hypersomnia after propensity score matching.
2. 02These comorbidities reflect central sensitization patterns rather than simple quantitative smell loss.
3. 03Parosmia is distinguished from anosmia (total smell loss) in its neurological comorbidity profile.
4. 04Propensity score matching strengthens causal inference by controlling for confounding variables.
5. 05Findings suggest a systemic, central nervous system component to parosmia beyond the olfactory nerve.

PMID

42461823

DOI

10.1002/alr.70222.

Journal

International Forum of Allergy & Rhinology

Publication type

research_article

Evidence level

3

Population

Individuals with parosmia compared to matched controls via propensity score matching

Intervention

Presence of parosmia (distorted smell perception)

Comparator

Propensity score-matched individuals with quantitative olfactory loss (anosmia) or no olfactory disorder