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February 26, 2026Neurology International0 citationsOpen Access

Olfactory and Cognitive Performance Improvement After Oxygen–Ozone Major Autohemotherapy in Mild Cognitive Impairment: A Retrospective Cohort Study

AMAlessandro MicarelliMSMrakic-Sposta SimonaSMSandro Malacrida

Key Points

  • Examining the relationship between oxygen–ozone major autohemotherapy and improvements in olfactory and cognitive performance in individuals with mild cognitive impairment.
  • Analyzed 81 individuals with mild cognitive impairment receiving 10 sessions of oxygen–ozone therapy.
  • Measured olfactory function with Sniffin’ Sticks® TDI scores and cognitive performance with MMSE and MoCA.
  • Compared the MCI group with 93 matched healthy controls.
  • Evaluated pre–post changes and used Spearman correlations for olfactory–cognitive coupling.
  • MCI participants had lower baseline TDI and MoCA scores compared to controls and exhibited more hyposmia/anosmia.
  • Post-MAH, the proportion of normosmic patients increased from 32.1% to 50.6%, and there were fewer cases of anosmia.
  • TDI scores improved but remained lower than those in controls; MMSE scores did not change, while MoCA total scores increased with notable gains in Language Repetition.
  • TDI score improvements correlated modestly with MoCA total and select domain changes.

Abstract

Background/Objectives: Mild cognitive impairment (MCI) is accompanied by olfactory dysfunction, and few interventions target shared chemosensory–cognitive mechanisms. We retrospectively examined whether a 5-week oxygen–ozone 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’ Sticks® threshold–discrimination–identification (TDI) scores; global cognition was assessed with the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). We evaluated between-group and pre–post changes and used Spearman correlations to assess olfactory–cognitive 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–cognitive changes were observed within the treated MCI group; however, causal attribution to O2–O3 MAH cannot be established without randomized, double-blind, sham-controlled trials with coupled olfactory–cognitive gains consistent with a shared, potentially modifiable substrate. Prospective randomized trials are needed to confirm efficacy and clinical utility.

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Cite This Study

Micarelli et al. (2026) studied this question.

synapsesocial.com/papers/699fe2fe95ddcd3a253e6793https://doi.org/10.3390/neurolint18030041
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