{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T05:40:59Z","timestamp":1793511659403,"version":"4.5.0"},"reference-count":88,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Background\/Objectives: Mild cognitive impairment (MCI) is accompanied by olfactory dysfunction, and few interventions target shared chemosensory\u2013cognitive mechanisms. We retrospectively examined whether a 5-week oxygen\u2013ozone major autohemotherapy (MAH) cycle is associated with coupled improvements in olfactory and cognitive performance in adults with MCI. Methods: We analyzed 81 individuals with MCI who completed 10 MAH sessions (twice weekly) and 93 matched healthy controls. In the MCI group, olfactory function was measured before and after MAH using Sniffin\u2019 Sticks\u00ae threshold\u2013discrimination\u2013identification (TDI) scores; global cognition was assessed with the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). We evaluated between-group and pre\u2013post changes and used Spearman correlations to assess olfactory\u2013cognitive coupling. Results: At baseline, MCI participants showed lower TDI and MoCA scores than controls and more hyposmia\/anosmia. Following MAH, the proportion of normosmic patients increased from 32.1% to 50.6%, with fewer anosmic cases. TDI scores improved but remained lower than in controls. MMSE scores were unchanged, whereas MoCA total scores increased, with domain-level gains and a significant improvement in Language Repetition. TDI gains were modestly correlated with MoCA total and selected domain changes. Conclusions: In this retrospective cohort, MAH was associated with partial restoration improvements of olfactory function and improved cognitive performance. Correlated olfactory\u2013cognitive changes were observed within the treated MCI group; however, causal attribution to O2\u2013O3 MAH cannot be established without randomized, double-blind, sham-controlled trials with coupled olfactory\u2013cognitive gains consistent with a shared, potentially modifiable substrate. Prospective randomized trials are needed to confirm efficacy and clinical utility.<\/jats:p>","DOI":"10.3390\/neurolint18030041","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T12:19:23Z","timestamp":1771935563000},"page":"41","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Olfactory and Cognitive Performance Improvement After Oxygen\u2013Ozone Major Autohemotherapy in Mild Cognitive Impairment: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0495-5272","authenticated-orcid":false,"given":"Alessandro","family":"Micarelli","sequence":"first","affiliation":[{"name":"Unit of Neuroscience, Rehabilitation and Sensory Organs, UNITER ONLUS, 00153 Rome, Italy"},{"name":"EPOCA HEALTH, 00153 Rome, Italy"},{"name":"ALTAMEDICA, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Mrakic-Sposta","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council (CNR), 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4775-3857","authenticated-orcid":false,"given":"Sandro","family":"Malacrida","sequence":"additional","affiliation":[{"name":"Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0277-163X","authenticated-orcid":false,"given":"Alessandra","family":"Vezzoli","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council (CNR), 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo Xavier","family":"Micarelli","sequence":"additional","affiliation":[{"name":"Unit of Neuroscience, Rehabilitation and Sensory Organs, UNITER ONLUS, 00153 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Micarelli","sequence":"additional","affiliation":[{"name":"Unit of Neuroscience, Rehabilitation and Sensory Organs, UNITER ONLUS, 00153 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Granito","sequence":"additional","affiliation":[{"name":"Unit of Neuroscience, Rehabilitation and Sensory Organs, UNITER ONLUS, 00153 Rome, Italy"},{"name":"EPOCA HEALTH, 00153 Rome, Italy"},{"name":"ALTAMEDICA, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Alessandrini","sequence":"additional","affiliation":[{"name":"Ear-Nose-Throat Unit, Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1001\/archneur.56.3.303","article-title":"Mild cognitive impairment: Clinical characterization and outcome","volume":"56","author":"Petersen","year":"1999","journal-title":"Arch. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1097\/00019052-200208000-00001","article-title":"Mild cognitive impairment","volume":"15","author":"Chertkow","year":"2002","journal-title":"Curr. Opin. Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1007\/s10072-005-0453-2","article-title":"Olfactory screening test in mild cognitive impairment","volume":"26","author":"Eibenstein","year":"2005","journal-title":"Neurol. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1212\/WNL.56.1.37","article-title":"Classification criteria for mild cognitive impairment: A population-based validation study","volume":"56","author":"Ritchie","year":"2001","journal-title":"Neurology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.neurobiolaging.2006.11.014","article-title":"Olfaction in patients with mild cognitive impairment and Alzheimer\u2019s disease","volume":"29","author":"Djordjevic","year":"2008","journal-title":"Neurobiol. Aging"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1136\/jnnp-2016-314638","article-title":"A quantitative meta-analysis of olfactory dysfunction in mild cognitive impairment","volume":"88","author":"Roalf","year":"2017","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1176\/appi.ajp.157.9.1399","article-title":"Olfactory deficits in patients with mild cognitive impairment predict Alzheimer\u2019s disease at follow-up","volume":"157","author":"Devanand","year":"2000","journal-title":"Am. J. Psychiatry"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1001\/archneur.55.1.84","article-title":"Olfaction in neurodegenerative disease: A meta-analysis of olfactory functioning in Alzheimer\u2019s and Parkinson\u2019s diseases","volume":"55","author":"Mesholam","year":"1998","journal-title":"Arch. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1007\/s00401-014-1261-7","article-title":"Olfactory bulb involvement in neurodegenerative diseases","volume":"127","author":"Attems","year":"2014","journal-title":"Acta Neuropathol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/bs.apha.2025.03.001","article-title":"Oxygen-ozone adjunct therapy in aging and senescence-related disorders","volume":"104","author":"Chirumbolo","year":"2025","journal-title":"State of art. Adv. Pharmacol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Travagli, V., and Iorio, E.L. (2023). The Biological and Molecular Action of Ozone and Its Derivatives: State-of-the-Art, Enhanced Scenarios, and Quality Insights. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24108465"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"101138","DOI":"10.1016\/j.arr.2020.101138","article-title":"Ozone: A natural bioactive molecule with antioxidant property as potential new strategy in aging and in neurodegenerative disorders","volume":"63","author":"Scassellati","year":"2020","journal-title":"Ageing Res. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"de Sire, A., Marotta, N., Ferrillo, M., Agostini, F., Sconza, C., Lippi, L., Respizzi, S., Giudice, A., Invernizzi, M., and Ammendolia, A. (2022). Oxygen-Ozone Therapy for Reducing Pro-Inflammatory Cytokines Serum Levels in Musculoskeletal and Temporomandibular Disorders: A Comprehensive Review. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23052528"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.neuroscience.2019.07.027","article-title":"Ozone Inhibits APP\/A\u03b2 Production and Improves Cognition in an APP\/PS1 Transgenic Mouse Model","volume":"418","author":"Lin","year":"2019","journal-title":"Neuroscience"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1177\/039463201402700308","article-title":"Ozone autohemotherapy induces long-term cerebral metabolic changes in multiple sclerosis patients","volume":"27","author":"Molinari","year":"2014","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"7511","DOI":"10.4081\/ozone.2018.7511","article-title":"New frontiers in rehabilitation. Oxygen-ozone therapy and neuronal plasticity in the treatment of Parkinson\u2019s symptoms","volume":"3","author":"Morelli","year":"2018","journal-title":"Ozone Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/2045-9912-1-29","article-title":"Mechanisms of Action Involved in Ozone Therapy: Is healing induced via a mild oxidative stress?","volume":"1","author":"Sagai","year":"2011","journal-title":"Med. Gas. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"102737","DOI":"10.1016\/j.tice.2025.102737","article-title":"Anatomy, histology and ultrastructure of the adult human olfactory peduncle: Blood vessel and corpora amylacea assessment","volume":"93","author":"Insausti","year":"2025","journal-title":"Tissue Cell"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Imamura, F., and Hasegawa-Ishii, S. (2016). Environmental Toxicants-Induced Immune Responses in the Olfactory Mucosa. Front. Immunol., 7.","DOI":"10.3389\/fimmu.2016.00475"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.jalz.2011.03.008","article-title":"The diagnosis of mild cognitive impairment due to Alzheimer\u2019s disease: Recommendations from the National Institute on Aging-Alzheimer\u2019s Association workgroups on diagnostic guidelines for Alzheimer\u2019s disease","volume":"7","author":"Albert","year":"2011","journal-title":"Alzheimers Dement."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.jalz.2011.03.005","article-title":"The diagnosis of dementia due to Alzheimer\u2019s disease: Recommendations from the National Institute on Aging-Alzheimer\u2019s Association workgroups on diagnostic guidelines for Alzheimer\u2019s disease","volume":"7","author":"McKhann","year":"2011","journal-title":"Alzheimers Dement."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Trzepacz, P.T., Hochstetler, H., Wang, S., Walker, B., and Saykin, A.J. (2015). Relationship between the Montreal Cognitive Assessment and Mini-mental State Examination for assessment of mild cognitive impairment in older adults. BMC Geriatr., 15.","DOI":"10.1186\/s12877-015-0103-3"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e14337","DOI":"10.1002\/alz.14337","article-title":"The Alzheimer\u2019s Association clinical practice guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer\u2019s Disease and Related Disorders (DETeCD-ADRD): Executive summary of recommendations for specialty care","volume":"21","author":"Dickerson","year":"2025","journal-title":"Alzheimers Dement."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"101971","DOI":"10.1016\/j.xcrm.2025.101971","article-title":"Chemosensory and cardiometabolic improvements after a fasting-mimicking diet: A randomized cross-over clinical trial","volume":"6","author":"Micarelli","year":"2025","journal-title":"Cell Rep. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1007\/s40520-017-0727-6","article-title":"Italians do it worse. Montreal Cognitive Assessment (MoCA) optimal cut-off scores for people with probable Alzheimer\u2019s disease and with probable cognitive impairment","volume":"29","author":"Bosco","year":"2017","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1007\/s10072-024-07775-3","article-title":"Validation and convergent validity of the Boston cognitive assessment (BOCA) in an Italian population: A comparative study with the Montreal cognitive assessment (MoCA) in Alzheimer\u2019s disease spectrum","volume":"46","author":"Padovani","year":"2025","journal-title":"Neurol. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Ginieis, R., Abeywickrema, S., Oey, I., and Peng, M. (2022). Testing Links of Food-Related Olfactory Perception to Peripheral Ghrelin and Leptin Concentrations. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.888608"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1093\/chemse\/22.1.39","article-title":"\u2018Sniffin\u2019 sticks\u2019: Olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold","volume":"22","author":"Hummel","year":"1997","journal-title":"Chem. Senses"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1080\/13803391003683070","article-title":"Cognitive factors in odor detection, odor discrimination, and odor identification tasks","volume":"32","author":"Hedner","year":"2010","journal-title":"J. Clin. Exp. Neuropsychol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Poessel, M., Breuer, N., Joshi, A., Pampel, A., Villringer, A., Hummel, T., and Horstmann, A. (2020). Reduced Olfactory Bulb Volume in Obesity and Its Relation to Metabolic Health Status. Front. Hum. Neurosci., 14.","DOI":"10.3389\/fnhum.2020.586998"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.anorl.2015.08.004","article-title":"How to assess olfactory performance with the Sniffin\u2019 Sticks test\u00ae","volume":"133","author":"Rumeau","year":"2016","journal-title":"Eur. Ann. Otorhinolaryngol. Head. Neck Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1007\/s00405-006-0173-0","article-title":"Normative data for the \u201cSniffin\u2019 Sticks\u201d including tests of odor identification, odor discrimination, and olfactory thresholds: An upgrade based on a group of more than 3000 subjects","volume":"264","author":"Hummel","year":"2007","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1007\/s00405-020-06442-5","article-title":"Correlates of olfactory impairment in middle-aged non-diabetic Caucasian subjects with stage I-II obesity","volume":"278","author":"Campolo","year":"2021","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1007\/s00405-018-5248-1","article-title":"Updated Sniffin\u2019 Sticks normative data based on an extended sample of 9139 subjects","volume":"276","author":"Oleszkiewicz","year":"2019","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"113751","DOI":"10.1016\/j.intimp.2024.113751","article-title":"SIOOT recommendations for the optimal application of the oxygen-ozone therapy in clinical medicine","volume":"145","author":"Franzini","year":"2025","journal-title":"Int. Immunopharmacol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Chirumbolo, S., Valdenassi, L., Franzini, M., Pandolfi, S., Ricevuti, G., and Tirelli, U. (2021). Male vs. Female Differences in Responding to Oxygen\u2013Ozone Autohemotherapy (O2-O3-AHT) in Patients with Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS). J. Clin. Med., 11.","DOI":"10.3390\/jcm11010173"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Tirelli, U., Franzini, M., Valdenassi, L., Pandolfi, S., Berretta, M., Ricevuti, G., and Chirumbolo, S. (2021). Patients with Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome (ME\/CFS) Greatly Improved Fatigue Symptoms When Treated with Oxygen-Ozone Autohemotherapy. J. Clin. Med., 11.","DOI":"10.3390\/jcm11010029"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1007\/s00296-025-05827-1","article-title":"Short- and Medium-Term effects of major Ozone therapy on disease parameters in fibromyalgia syndrome: A retrospective study","volume":"45","author":"Kocyigit","year":"2025","journal-title":"Rheumatol. Int."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.arcmed.2005.08.006","article-title":"Scientific and medical aspects of ozone therapy. State of the art","volume":"37","author":"Bocci","year":"2006","journal-title":"Arch. Med. Res."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Bocci, V. (2010). OZONE, Springer. [2nd ed.].","DOI":"10.1007\/978-90-481-9234-2"},{"key":"ref_42","unstructured":"(2020). Madrid Declaration on Ozone Therapy, ISCO3."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1007\/s00415-019-09561-0","article-title":"Olfactory and gustatory functioning and food preferences of patients with Alzheimer\u2019s disease and mild cognitive impairment compared to controls: The NUDAD project","volume":"267","author":"Doorduijn","year":"2020","journal-title":"J. Neurol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/obr.12800","article-title":"Systematic review of olfactory shifts related to obesity","volume":"20","author":"Peng","year":"2019","journal-title":"Obes. Rev."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Micarelli, A., Vezzoli, A., Malacrida, S., Micarelli, B., Misici, I., Carbini, V., Iennaco, I., Caputo, S., Mrakic-Sposta, S., and Alessandrini, M. (2023). Taste Function in Adult Humans from Lean Condition to Stage II Obesity: Interactions with Biochemical Regulators, Dietary Habits, and Clinical Aspects. Nutrients, 15.","DOI":"10.3390\/nu15051114"},{"key":"ref_46","unstructured":"Conover, W.J. (1999). Practical Nonparametric Statistics, John Wiley & Sons."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Zar, J. (2005). Spearman Rank Correlation, Wiley.","DOI":"10.1002\/0470011815.b2a15150"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.2517-6161.1995.tb02031.x","article-title":"Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing","volume":"57","author":"Benjamini","year":"1995","journal-title":"J. R. Stat. Soc. Ser. B (Methodol.)"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1213\/ANE.0000000000002864","article-title":"Correlation Coefficients: Appropriate Use and Interpretation","volume":"126","author":"Schober","year":"2018","journal-title":"Anesth. Analg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"105425","DOI":"10.1016\/j.archger.2024.105425","article-title":"The role of olfactory dysfunction in mild cognitive impairment and Alzheimer\u2019s disease: A meta-analysis","volume":"123","author":"Bouhaben","year":"2024","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Gali\u00e8, M., Covi, V., Tabaracci, G., and Malatesta, M. (2019). The Role of Nrf2 in the Antioxidant Cellular Response to Medical Ozone Exposure. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20164009"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1164\/rccm.201011-1813OC","article-title":"Lung function and inflammatory responses in healthy young adults exposed to 0.06 ppm ozone for 6.6 hours","volume":"183","author":"Kim","year":"2011","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"593","DOI":"10.3109\/08958371003596587","article-title":"Low-level ozone exposure induces airways inflammation and modifies cell surface phenotypes in healthy humans","volume":"22","author":"Alexis","year":"2010","journal-title":"Inhal. Toxicol."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Dolgacheva, L.P., Zinchenko, V.P., Nadeev, A.D., and Goncharov, N.V. (2025). Serotonergic Regulation in Alzheimer\u2019s Disease. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26115218"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.4103\/1673-5374.327337","article-title":"Role of serotonin in modulating the development and function of adult-born neurons in the olfactory bulb","volume":"17","author":"Garaschuk","year":"2022","journal-title":"Neural Regen. Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"44","DOI":"10.4103\/mgr.MEDGASRES-D-24-00005","article-title":"Ozone: Complicated effects in central nervous system diseases","volume":"15","author":"Zhang","year":"2025","journal-title":"Med. Gas. Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s10072-014-1921-3","article-title":"Montreal Cognitive Assessment (MoCA)-Italian version: Regression based norms and equivalent scores","volume":"36","author":"Conti","year":"2015","journal-title":"Neurol. Sci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1111\/jgs.12742","article-title":"Montreal Cognitive Assessment Memory Index Score (MoCA-MIS) as a predictor of conversion from mild cognitive impairment to Alzheimer\u2019s disease","volume":"62","author":"Julayanont","year":"2014","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1001\/jamaneurol.2015.2952","article-title":"Association Between Olfactory Dysfunction and Amnestic Mild Cognitive Impairment and Alzheimer Disease Dementia","volume":"73","author":"Roberts","year":"2016","journal-title":"JAMA Neurol."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-Benavides, G., Iranzo, A., Grau-Rivera, O., Giraldo, D.M., and Buongiorno, M. (2025). Olfactory Dysfunction as a Clinical Marker of Early Glymphatic Failure in Neurodegenerative Diseases. Diagnostics, 15.","DOI":"10.20944\/preprints202502.0913.v1"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"15333175251385615","DOI":"10.1177\/15333175251385615","article-title":"Olfactory Testing With Focus on Odor Identification for Early Detection of Alzheimer\u2019s Disease in Mild Cognitive Impairment","volume":"40","author":"Zhou","year":"2025","journal-title":"Am. J. Alzheimer\u2019s Dis. Other Dement."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1002\/ana.21910","article-title":"Olfactory epithelium amyloid-beta and paired helical filament-tau pathology in Alzheimer disease","volume":"67","author":"Arnold","year":"2010","journal-title":"Ann. Neurol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1523\/JNEUROSCI.4622-09.2010","article-title":"Olfactory dysfunction correlates with amyloid-beta burden in an Alzheimer\u2019s disease mouse model","volume":"30","author":"Wesson","year":"2010","journal-title":"J. Neurosci."},{"key":"ref_64","first-page":"1081","article-title":"Olfactory deficits and amyloid-\u03b2 burden in Alzheimer\u2019s disease, mild cognitive impairment, and healthy aging: A PiB PET study","volume":"22","author":"Villemagne","year":"2010","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"107777","DOI":"10.1016\/j.intimp.2021.107777","article-title":"Insights on the mechanisms of action of ozone in the medical therapy against COVID-19","volume":"96","author":"Chirumbolo","year":"2021","journal-title":"Int. Immunopharmacol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Napi\u00f3rkowska-Baran, K., Slawatycki, J., Klemenska, P., Treichel, P., Najarian, A., Margossian, G.A., Szota, M., Plocka-Karpinska, M., and Ku\u0142akowski, M. (2025). Ozone as an Immunomodulator-New Therapeutic Possibilities in the Treatment of Immunodeficiencies-A Narrative Review. Curr. Issues Mol. Biol., 47.","DOI":"10.3390\/cimb47121016"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Milardi, D., Cacciola, A., Calamuneri, A., Ghilardi, M.F., Caminiti, F., Cascio, F., Andronaco, V., Anastasi, G., Mormina, E., and Arrigo, A. (2017). The Olfactory System Revealed: Non-Invasive Mapping by using Constrained Spherical Deconvolution Tractography in Healthy Humans. Front. Neuroanat., 11.","DOI":"10.3389\/fnana.2017.00032"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e47177","DOI":"10.7554\/eLife.47177","article-title":"Characterizing functional pathways of the human olfactory system","volume":"8","author":"Zhou","year":"2019","journal-title":"eLife"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Su, M.W., Ni, J.N., Cao, T.Y., Wang, S.S., Shi, J., and Tian, J.Z. (2021). The Correlation Between Olfactory Test and Hippocampal Volume in Alzheimer\u2019s Disease and Mild Cognitive Impairment Patients: A Meta-Analysis. Front. Aging Neurosci., 13.","DOI":"10.3389\/fnagi.2021.755160"},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Masala, C., Loy, F., Pinna, I., Manis, N.A., Ercoli, T., and Solla, P. (2024). Olfactory Function as a Potential Predictor of Cognitive Impairment in Men and Women. Biology, 13.","DOI":"10.3390\/biology13070503"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Tan, S., Chen, W., Kong, G., Wei, L., and Xie, Y. (2023). Peripheral inflammation and neurocognitive impairment: Correlations, underlying mechanisms, and therapeutic implications. Front. Aging Neurosci., 15.","DOI":"10.3389\/fnagi.2023.1305790"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Rinaldi, C., Donato, L., Alibrandi, S., Scimone, C., D\u2019Angelo, R., and Sidoti, A. (2021). Oxidative Stress and the Neurovascular Unit. Life, 11.","DOI":"10.3390\/life11080767"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Nazzi, C., Avenanti, A., and Battaglia, S. (2024). The Involvement of Antioxidants in Cognitive Decline and Neurodegeneration: Mens Sana in Corpore Sano. Antioxidants, 13.","DOI":"10.3390\/antiox13060701"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"745","DOI":"10.3233\/JAD-215257","article-title":"The Effect of Olfactory Training on Olfaction, Cognition, and Brain Function in Patients with Mild Cognitive Impairment","volume":"85","author":"Chen","year":"2022","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Cheng, H., Lu, R., Du, J., Zhao, X., and Zhuang, Z. (2025). A clinical study on ozone autohemotherapy for the treatment of acute ischemic stroke. Front. Med., 12.","DOI":"10.3389\/fmed.2025.1595568"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Farruggia, M.C., Pellegrino, R., and Scheinost, D. (2022). Functional Connectivity of the Chemosenses: A Review. Front. Syst. Neurosci., 16.","DOI":"10.3389\/fnsys.2022.865929"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.neuron.2009.03.024","article-title":"Neurodegenerative diseases target large-scale human brain networks","volume":"62","author":"Seeley","year":"2009","journal-title":"Neuron"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1016\/S1474-4422(12)70191-6","article-title":"Cognitive reserve in ageing and Alzheimer\u2019s disease","volume":"11","author":"Stern","year":"2012","journal-title":"Lancet. Neurol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1837","DOI":"10.1212\/01.wnl.0000219668.47116.e6","article-title":"Neuropathology of older persons without cognitive impairment from two community-based studies","volume":"66","author":"Bennett","year":"2006","journal-title":"Neurology"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"111210","DOI":"10.1016\/j.mad.2020.111210","article-title":"Molecular mechanisms in cognitive frailty: Potential therapeutic targets for oxygen-ozone treatment","volume":"186","author":"Scassellati","year":"2020","journal-title":"Mech. Ageing Dev."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"e700","DOI":"10.1212\/WNL.0000000000006919","article-title":"Impaired olfaction is associated with cognitive decline and neurodegeneration in the brain","volume":"92","author":"Dintica","year":"2019","journal-title":"Neurology"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"15898","DOI":"10.18632\/aging.203213","article-title":"Facility-based and home-based multidomain interventions including cognitive training, exercise, diet, vascular risk management, and motivation for older adults: A randomized controlled feasibility trial","volume":"13","author":"Moon","year":"2021","journal-title":"Aging"},{"key":"ref_83","first-page":"Cd011459","article-title":"Aspirin and other non-steroidal anti-inflammatory drugs for the prevention of dementia","volume":"4","author":"Jordan","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_84","first-page":"Cd006378","article-title":"Aspirin, steroidal and non-steroidal anti-inflammatory drugs for the treatment of Alzheimer\u2019s disease","volume":"2012","author":"Jaturapatporn","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"264","DOI":"10.21053\/ceo.2024.00345","article-title":"Diagnosis of Anosmia in Middle Age, But Not in Older Adulthood, Increases Alzheimer Dementia Risk","volume":"18","author":"Kim","year":"2025","journal-title":"Clin. Exp. Otorhinolaryngol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1080\/13854046.2015.1087596","article-title":"Longitudinal Change in Performance on the Montreal Cognitive Assessment in Older Adults","volume":"29","author":"Cooley","year":"2015","journal-title":"Clin. Neuropsychol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1093\/chemse\/bjp057","article-title":"High test-retest reliability of the extended version of the \u201cSniffin\u2019 Sticks\u201d test","volume":"34","author":"Haehner","year":"2009","journal-title":"Chem. Senses"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1093\/chemse\/bjn013","article-title":"Test-retest reliability of the olfactory detection threshold test of the Sniffin\u2019 sticks","volume":"33","author":"Albrecht","year":"2008","journal-title":"Chem. Senses"}],"container-title":["Neurology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2035-8377\/18\/3\/41\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T13:16:10Z","timestamp":1771938970000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2035-8377\/18\/3\/41"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,24]]},"references-count":88,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["neurolint18030041"],"URL":"https:\/\/doi.org\/10.3390\/neurolint18030041","relation":{},"ISSN":["2035-8377"],"issn-type":[{"value":"2035-8377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,24]]}}}