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<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Neurosci.</journal-id>
<journal-title>Frontiers in Neuroscience</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Neurosci.</abbrev-journal-title>
<issn pub-type="epub">1662-453X</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
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<article-meta>
<article-id pub-id-type="doi">10.3389/fnins.2024.1503069</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Neuroscience</subject>
<subj-group>
<subject>Review</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Olfactory deficits in aging and Alzheimer&#x2019;s&#x2014;spotlight on inhibitory interneurons</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>Elhabbari</surname> <given-names>Kaoutar</given-names></name>
<uri xlink:href="https://loop.frontiersin.org/people/2907261/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
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<contrib contrib-type="author">
<name><surname>Sireci</surname> <given-names>Siran</given-names></name>
<uri xlink:href="https://loop.frontiersin.org/people/2856417/overview"/>
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<contrib contrib-type="author">
<name><surname>Rothermel</surname> <given-names>Markus</given-names></name>
<uri xlink:href="https://loop.frontiersin.org/people/27208/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
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<contrib contrib-type="author" corresp="yes">
<name><surname>Brunert</surname> <given-names>Daniela</given-names></name>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/2717599/overview"/>
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<aff><institution>Institute of Physiology, RG Neurophysiology and Optogenetics, Medical Faculty, Otto-von-Guericke-University</institution>, <addr-line>Magdeburg</addr-line>, <country>Germany</country></aff>
<author-notes>
<fn fn-type="edited-by" id="fn0001">
<p>Edited by: Thomas Heinbockel, Howard University, United States</p>
</fn>
<fn fn-type="edited-by" id="fn0002">
<p>Reviewed by: Arsen Hunanyan, Duke University, United States</p>
<p>Jennifer Whitesell, Cajal Neuroscience Inc., United States</p>
</fn>
<corresp id="c001">&#x002A;Correspondence: Daniela Brunert, <email>daniela.brunert@med.ovgu.de</email></corresp>
</author-notes>
<pub-date pub-type="epub">
<day>16</day>
<month>12</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="collection">
<year>2024</year>
</pub-date>
<volume>18</volume>
<elocation-id>1503069</elocation-id>
<history>
<date date-type="received">
<day>28</day>
<month>09</month>
<year>2024</year>
</date>
<date date-type="accepted">
<day>28</day>
<month>11</month>
<year>2024</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2024 Elhabbari, Sireci, Rothermel and Brunert.</copyright-statement>
<copyright-year>2024</copyright-year>
<copyright-holder>Elhabbari, Sireci, Rothermel and Brunert</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<p>Cognitive function in healthy aging and neurodegenerative diseases like Alzheimer&#x2019;s disease (AD) correlates to olfactory performance. Aging and disease progression both show marked olfactory deficits in humans and rodents. As a clear understanding of what causes olfactory deficits is still missing, research on this topic is paramount to diagnostics and early intervention therapy. A recent development of this research is focusing on GABAergic interneurons. Both aging and AD show a change in excitation/inhibition balance, indicating reduced inhibitory network functions. In the olfactory system, inhibition has an especially prominent role in processing information, as the olfactory bulb (OB), the first relay station of olfactory information in the brain, contains an unusually high number of inhibitory interneurons. This review summarizes the current knowledge on inhibitory interneurons at the level of the OB and the primary olfactory cortices to gain an overview of how these neurons might influence olfactory behavior. We also compare changes in interneuron composition in different olfactory brain areas between healthy aging and AD as the most common neurodegenerative disease. We find that pathophysiological changes in olfactory areas mirror findings from hippocampal and cortical regions that describe a marked cell loss for GABAergic interneurons in AD but not aging. Rather than differences in brain areas, differences in vulnerability were shown for different interneuron populations through all olfactory regions, with somatostatin-positive cells most strongly affected.</p>
</abstract>
<kwd-group>
<kwd>olfaction</kwd>
<kwd>interneurons</kwd>
<kwd>aging</kwd>
<kwd>Alzheimer&#x2019;s disease</kwd>
<kwd>inhibition</kwd>
</kwd-group>
<counts>
<fig-count count="2"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="198"/>
<page-count count="14"/>
<word-count count="14416"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Neurodegeneration</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="sec1">
<title>Introduction</title>
<p>Maintaining cognitive function is a central point in preserving the quality of life in aging individuals (<xref ref-type="bibr" rid="ref90">Majmundar and Hayward, 2018</xref>). Both healthy aging as well as dementia-inducing &#x201C;pathological&#x201D; aging show, to differing degrees, signs of cognitive decline in the form of memory loss, as well as a decrease in attention and executive function (<xref ref-type="bibr" rid="ref54">Harada et al., 2013</xref>). Alzheimer&#x2019;s disease (AD) is a critical public health issue and the leading cause of dementia, with an estimated 32 million persons suffering from AD dementia globally (<xref ref-type="bibr" rid="ref51">Gustavsson et al., 2023</xref>), constituting between 10 and 30% of individuals above the age of 65 (<xref ref-type="bibr" rid="ref94">Masters et al., 2015</xref>; <xref ref-type="bibr" rid="ref128">Prince et al., 2015</xref>). AD is characterized by the buildup of two proteins: Amyloid beta (A&#x03B2;), which accumulates extracellularly as plaques, and hyperphosphorylated <italic>&#x03C4;</italic>, which accumulates intracellularly as neurofibrillary tangles (<xref ref-type="bibr" rid="ref12">Braak and Braak, 1991</xref>). These neuropathological changes are detectable in olfactory areas in the earliest stages of AD, even preceding damage to the entorhinal cortex (<xref ref-type="bibr" rid="ref76">Kov&#x00E1;cs et al., 2001</xref>).</p>
<p>Besides a decrease in cognitive capabilities, olfactory perceptual performance decline is also a widespread occurrence (<xref ref-type="bibr" rid="ref74">Kondo et al., 2020</xref>; <xref ref-type="bibr" rid="ref167">Tzeng et al., 2021</xref>). This decline in olfactory function is associated with various measures of cognition and memory performance decline (<xref ref-type="bibr" rid="ref182">Wilson et al., 2007</xref>; <xref ref-type="bibr" rid="ref34">Devanand, 2016</xref>; <xref ref-type="bibr" rid="ref114">Olofsson et al., 2016</xref>; <xref ref-type="bibr" rid="ref118">Papadatos and Phillips, 2023</xref>). The severity of olfactory dysfunction has been associated with the rate of cognitive decline in patients with dementia (<xref ref-type="bibr" rid="ref39">Dintica et al., 2019</xref>) showed that odor identification impairment has an even higher predictive value for cognitive decline than deficits in verbal episodic memory. Most often, olfactory deficits are noticeable years before the first signs of cognitive decline are apparent (<xref ref-type="bibr" rid="ref161">Swan and Carmelli, 2002</xref>; <xref ref-type="bibr" rid="ref183">Wilson and Mainen, 2006</xref>). As this line of research is of high value for early diagnostics of AD, many publications have investigated the correlation of aging and disease severity with olfactory symptoms, and this topic has been the subject of many reviews (<xref ref-type="bibr" rid="ref6">Attems et al., 2014</xref>; <xref ref-type="bibr" rid="ref40">Doty and Kamath, 2014</xref>; <xref ref-type="bibr" rid="ref102">Mobley et al., 2014</xref>; <xref ref-type="bibr" rid="ref43">Franks et al., 2015</xref>; <xref ref-type="bibr" rid="ref105">Murphy, 2019</xref>; <xref ref-type="bibr" rid="ref74">Kondo et al., 2020</xref>; <xref ref-type="bibr" rid="ref113">Olofsson et al., 2021</xref>). Therefore, we would like to give a brief overview:</p>
<p>Olfactory perceptual decline is highly prevalent in aging individuals, with smell loss experienced by around half the population between 65 and 80&#x202F;years of age and about three-quarters of the population by age 80 (<xref ref-type="bibr" rid="ref40">Doty and Kamath, 2014</xref>). Consequences of this loss in olfactory abilities are dietary changes, i.e., anorexia due to reduced pleasantness of food or obesity, reduced threat detection for environmental hazards or spoiled food, and problems in personal hygiene (<xref ref-type="bibr" rid="ref113">Olofsson et al., 2021</xref>). Additionally, it has been shown that olfactory assessment can identify individuals with a higher risk of developing dementia (<xref ref-type="bibr" rid="ref50">Graves et al., 1999</xref>; <xref ref-type="bibr" rid="ref35">Devanand et al., 2008</xref>; <xref ref-type="bibr" rid="ref27">Conti et al., 2013</xref>; <xref ref-type="bibr" rid="ref163">Tebr&#x00FC;gge et al., 2018</xref>; <xref ref-type="bibr" rid="ref115">Olofsson et al., 2020</xref>). Despite this high relevance of olfactory decline in aging individuals, the characterization of &#x201C;normal&#x201D; olfactory aging is far from complete. It is generally assumed that two major contributing factors to changes in olfactory perception are a reduction in the number of olfactory receptor neurons and a more than 50% reduction in the number of adult-born periglomerular cells within the olfactory bulb due to reduced stem cell proliferation in the subventricular zone (SVZ) (<xref ref-type="bibr" rid="ref101">Mobley et al., 2013</xref>; <xref ref-type="bibr" rid="ref102">Mobley et al., 2014</xref>). These changes in more peripheral olfactory areas, however, cannot fully account for the nature of modifications in olfactory perception, which are more associated with odor identification and odor memory than detection thresholds (<xref ref-type="bibr" rid="ref21">Cerf-Ducastel and Murphy, 2009</xref>; <xref ref-type="bibr" rid="ref151">Sela et al., 2009</xref>).</p>
<p>In AD, similar changes in odor identification as well as odorant detection and discrimination have been shown (<xref ref-type="bibr" rid="ref31">Dan et al., 2021</xref>), which point to defects, especially in central regions, as being responsible for olfactory dysfunction (<xref ref-type="bibr" rid="ref133">Rawson, 2006</xref>). Despite the apparent association between olfactory and cognitive performance, the underlying causes of olfactory deficits in aging and AD are unclear.</p>
<p>Compared to cognitive changes, systematic research on the cellular nature of olfactory dysfunctions is in its infancy. The hippocampus (HC) has been shown to undergo many structural changes in aging and AD, ranging from astrogliosis, microgliosis, changes in mitochondria morphology, and reduction in neurogenesis to cell morphology changes, synaptic and cellular decline, and decrease in volume (<xref ref-type="bibr" rid="ref57">Hullinger and Puglielli, 2017</xref>). Besides these well-established changes, the hippocampus, as well as cortical structures, have been shown to exhibit hyperexcitability manifesting in increased network activity, epileptic activity, slowing of neural oscillations, and reductions in waveform complexity (<xref ref-type="bibr" rid="ref68">Kazim et al., 2021</xref>; <xref ref-type="bibr" rid="ref89">Maest&#x00FA; et al., 2021</xref>; <xref ref-type="bibr" rid="ref164">Tok et al., 2022</xref>).</p>
<p>Changes in the intrinsic properties of excitatory neurons or changes in inhibitory drive could cause these hyperexcitable states. As GABAergic interneurons were initially shown to be resistant to A&#x03B2; toxicity (<xref ref-type="bibr" rid="ref121">Pike and Cotman, 1993</xref>) much research in AD has focused on excitatory neurons in different brain areas. Recent research, however, has strongly implicated a reduction of inhibitory input to local networks (<xref ref-type="bibr" rid="ref188">Xu et al., 2020</xref>; <xref ref-type="bibr" rid="ref164">Tok et al., 2022</xref>) that could either originate in a reduction of long-range inputs or a decrease in local inhibitory tone. Local inhibitory interneurons, here, are the most promising avenue of research as they account for 75% of the total inhibitory input hippocampal neurons receive (<xref ref-type="bibr" rid="ref103">Mody and Pearce, 2004</xref>). Detectable changes in GABAergic interneurons are a reduction of function (<xref ref-type="bibr" rid="ref171">Verret et al., 2012</xref>) but predominantly a loss of neuronal numbers in hippocampal and cortical regions of both AD patients as well as mouse models (<xref ref-type="bibr" rid="ref188">Xu et al., 2020</xref>).</p>
<p>Likewise, aberrant neuronal network activity has been identified as one of the hallmarks of the aging brain (<xref ref-type="bibr" rid="ref95">Mattson and Arumugam, 2018</xref>). This line of research presents the possibility of connecting cellular changes to behavioral dysfunctions (<xref ref-type="bibr" rid="ref89">Maest&#x00FA; et al., 2021</xref>). Despite reports on interneuron loss (<xref ref-type="bibr" rid="ref22">Cha et al., 1997</xref>; <xref ref-type="bibr" rid="ref124">Potier et al., 2006</xref>) the predominant cause for aberrant excitation seems to be a reduction of inhibitory synapses and GABAergic transmission (<xref ref-type="bibr" rid="ref137">Rozycka and Liguz-Lecznar, 2017</xref>). GABAergic interneurons and their influence on local networks are, therefore, believed to play a large part in the occurrence of cognitive deficits and neuropathology in both AD (<xref ref-type="bibr" rid="ref188">Xu et al., 2020</xref>) and aging (<xref ref-type="bibr" rid="ref137">Rozycka and Liguz-Lecznar, 2017</xref>).</p>
<p>Olfactory sensory circuits, so far, have rarely been probed for changes in excitability, although hyperexcitability in the olfactory bulb was shown to lead to impaired olfactory behavior in a mouse model for Fragile X syndrome (<xref ref-type="bibr" rid="ref77">Kuruppath et al., 2023</xref>). However, several reports exist of reduced numbers of inhibitory interneurons in several olfactory areas. As the underlying cause of olfactory decline in AD and aging is still undefined, we felt it was time to spotlight the interneuron populations of the OB and olfactory cortex regions. We will give an overview of the interneuron populations described so far (<xref ref-type="fig" rid="fig1">Figure 1</xref>). This we take as a basis to outline changes to these interneuron populations in AD and aging (<xref ref-type="fig" rid="fig2">Figure 2</xref>).</p>
<fig position="float" id="fig1">
<label>Figure 1</label>
<caption>
<p>Distribution of interneuron markers in primary and secondary olfactory areas. <bold>(A)</bold> Example pictures from the Allen Mouse Brain Atlas showing coronal brain sections containing olfactory areas in reference to Nissl staining of these regions. Images were derived from Allen Mouse Brain Atlas and Allen Reference Atlas, Experiment 77869074 (<ext-link xlink:href="https://mouse.brain-map.org/experiment/show/77869074" ext-link-type="uri">https://mouse.brain-map.org/experiment/show/77869074</ext-link>) for cholecystokinin (<italic>cck</italic>), Experiment 1001 (<ext-link xlink:href="https://mouse.brain-map.org/experiment/show/1001" ext-link-type="uri">https://mouse.brain-map.org/experiment/show/1001</ext-link>) for somatostatin (<italic>sst</italic>), and Experiment 71717640 (<ext-link xlink:href="https://mouse.brain-map.org/experiment/show/71717640" ext-link-type="uri">https://mouse.brain-map.org/experiment/show/71717640</ext-link>) for calbindin (<italic>calb1</italic>) (<xref ref-type="bibr" rid="ref9001">Allen Institute for Brain Science, 2004</xref>; <xref ref-type="bibr" rid="ref9004">Lein et al., 2007</xref>). <bold>(B)</bold> Overview on the distribution of the most common interneuron markers. Data points represent estimates from ISH experiments from the Allen Mouse Brain Atlas but have been matched to reports of protein expression as far as these data are available. <italic>pv</italic>, parvalbumin; <italic>sst</italic>, somatostatin; <italic>vip</italic>, vasoactive intestinal peptide; <italic>cr</italic>, calretinin; <italic>cb</italic>, calbindin; <italic>npy</italic>, neuropeptide y; <italic>cck</italic>, cholecystokinin.</p>
</caption>
<graphic xlink:href="fnins-18-1503069-g001.tif"/>
</fig>
<fig position="float" id="fig2">
<label>Figure 2</label>
<caption>
<p>Alzheimer&#x2019;s Disease <bold>(A)</bold> and aging <bold>(B)</bold> derived changes of interneuron numbers in different olfactory areas. AON, anterior olfactory nucleus; CoA, cortical amygdala; EPL, external plexiform layer; GL, glomerular layer; Grl, granule cell layer; iPL, internal plexiform layer; ML, mitral cell layer; OB, Olfactory bulb; OT, olfactory tubercle; PC, piriform cortex; LEC, lateral entorhinal cortex.</p>
</caption>
<graphic xlink:href="fnins-18-1503069-g002.tif"/>
</fig>
</sec>
<sec id="sec2">
<title>Interneuron composition of the primary olfactory cortex and changes in healthy and pathological aging</title>
<sec id="sec3">
<title>Common interneuron markers</title>
<p>Inhibitory interneurons of different brain areas can be incredibly diverse, with each brain area featuring different populations with unique properties. Inhibitory interneurons, in general, are defined by various morphological, molecular, and physiological features, including their location, morphology, spiking properties, connections, and expression profile (<xref ref-type="bibr" rid="ref69">Kepecs and Fishell, 2014</xref>). The easiest way to broadly classify these neuronal subtypes is through their expression of several specific interneuron markers. The description of interneuron populations through these markers has become more popular as they provide a means to label particular populations with optogenetic tools. According to the Petilla terminology of molecular classification of cortical interneurons (<xref ref-type="bibr" rid="ref9002">Ascoli et al., 2008</xref>), these markers are the calcium-binding protein parvalbumin (PV) and the neuropeptides somatostatin (SST), vasoactive intestinal peptide (VIP), neuropeptide Y (NPY) and cholecystokinin (CCK) (<xref ref-type="bibr" rid="ref33">DeFelipe et al., 2013</xref>) with further subclassification with other calcium-binding proteins like calretinin (CR) and calbindin (CB) (<xref ref-type="bibr" rid="ref33">DeFelipe et al., 2013</xref>). Of these, PV and SST neurons make up the majority of interneurons of the neocortex, but different areas have been shown to exhibit varying ratios of interneuron markers (<xref ref-type="bibr" rid="ref180">Whissell et al., 2015</xref>).</p>
<p>We have gathered information on interneuron subtypes of different olfactory areas and listed them concerning location, morphology, and function, as far as this information is available. We have also gathered information on their changes in AD and aging to provide a starting point for discussing the possible involvement of interneurons in the etiology of olfactory dysfunction.</p>
</sec>
<sec id="sec4">
<title>Olfactory bulb (OB)</title>
<p>The OB is the brain&#x2019;s first relay station of olfactory information. Olfactory receptor neurons in the olfactory epithelium detect odor molecules and send unbranched axons to the OB (<xref ref-type="bibr" rid="ref9003">Klenoff and Greer, 1998</xref>). There, they converge and form synaptic structures called glomeruli with output neurons, tufted and mitral cells, which are located in the external plexiform layer (EPL) and mitral cell layer (ML), respectively (<xref ref-type="bibr" rid="ref107">Nagayama et al., 2004</xref>; <xref ref-type="bibr" rid="ref148">Sarafoleanu et al., 2009</xref>).</p>
<p>The OB is unique as it contains a much higher proportion of interneurons in relation to excitatory neurons than other brain areas [100:1 compared to 1:5 (<xref ref-type="bibr" rid="ref70">Kim and Choe, 2020</xref>)] allowing for robust processing and modulation of olfactory information at this early processing stage (<xref ref-type="bibr" rid="ref172">Wachowiak and Shipley, 2006</xref>; <xref ref-type="bibr" rid="ref14">Brunert and Rothermel, 2021</xref>). Furthermore, it receives adult-born neuroblasts from the subventricular zone (SVZ) through the rostral migratory stream. These neuroblasts get integrated into the glomerular or granule cell layer and constitute a separate population of predominantly CR-positive interneurons (<xref ref-type="bibr" rid="ref70">Kim and Choe, 2020</xref>). The OB exhibits a heterogeneous population of GABAergic interneurons that can be differentiated by their morphology, electrophysiological properties, and connectivity patterns (<xref ref-type="bibr" rid="ref91">Markram et al., 2004</xref>) but are described mainly by their soma location (<xref ref-type="bibr" rid="ref106">Nagayama et al., 2014</xref>) as periglomerular cells (PGCs) (also juxtaglomerular cells), granule cells, or interneurons of the mitral and internal plexiform layer. Though PGCs constitute only about 4% of OB interneurons, they have been well described, especially by their expression profile (<xref ref-type="bibr" rid="ref75">Kosaka and Kosaka, 2005</xref>) and synaptic processing (<xref ref-type="bibr" rid="ref172">Wachowiak and Shipley, 2006</xref>). They are characterized mainly by three different molecular markers: CB, CR, and tyrosine hydroxylase (TH). The latter constitutes a population of approximately 10% of PGCs, also called short axon cells, that are GABAergic and dopaminergic in nature and connect multiple glomeruli. Other PGCs are connected to a single glomerulus, express CB or CR, and about 30% of them receive monosynaptic input from olfactory receptor neurons (<xref ref-type="bibr" rid="ref72">Kiyokage et al., 2010</xref>). Functions of PGC have been shown in presynaptic inhibition of OB input (<xref ref-type="bibr" rid="ref123">P&#x00ED;rez and Wachowiak, 2008</xref>) as well as top-down modulation of OB circuits (<xref ref-type="bibr" rid="ref32">De Saint Jan, 2022</xref>). Neurons in the external plexiform layer, deeper in the OB, only constitute 2% of the neurons and are characterized by the expression of PV or corticotropin-releasing hormone (CRH). PV-expressing interneurons are typically axonless and have electrophysiological properties similar to fast-spiking PV cells found throughout the cortex (<xref ref-type="bibr" rid="ref65">Kato et al., 2013</xref>). They furthermore are strongly connected to mitral cells via dendrodendritic synapses and have been reported to modulate the gain of olfactory bulb output (<xref ref-type="bibr" rid="ref65">Kato et al., 2013</xref>). Another type of interneuron expressing trophoblast glycoprotein gene, 5T4, was found to be located primarily in the mitral cell layer but is low in number (<xref ref-type="bibr" rid="ref190">Yoshihara et al., 2014</xref>) and has been shown to play a role in olfactory detection and discrimination.</p>
<p>Granule cells (GC) of the granule cell layer are the most abundant type of interneurons in the OB. These neurons are axonless, CR-expressing cells that can be divided into three subtypes based on morphology, connectivity, and expression (<xref ref-type="bibr" rid="ref86">Lledo et al., 2008</xref>). They provide strong dendrodendritic inhibition to either tufted cells (superficial GCs) or mitral cells (deep GCs), thus providing the cellular basis for increasing sensory resolution and discrimination through lateral inhibition (<xref ref-type="bibr" rid="ref41">Egger and Kuner, 2021</xref>).</p>
<p>Expression of other typical interneuron markers is distributed within these already described groups. Like the relatively sparse expression of PV, SST expression is also lower in the OB compared to neocortical areas. In the OB, SST is predominantly expressed in CR-positive neurons of the EPL as well as in a subtype of short axon cells in the granule cell layer (<xref ref-type="bibr" rid="ref81">Lepousez et al., 2010</xref>) but ablation of SST receptors significantly affects olfactory discrimination (<xref ref-type="bibr" rid="ref110">Nocera et al., 2019</xref>). Information is also available on VIP-positive interneurons located primarily in the glomerular layer. Knocking out this population of neurons also causes deficiencies in odor detection and discrimination (<xref ref-type="bibr" rid="ref175">Wang et al., 2022</xref>).</p>
<p>Aging in humans has been shown to elicit a substantial reduction in the volume of all cellular layers, most notably the glomerular layer (<xref ref-type="bibr" rid="ref40">Doty and Kamath, 2014</xref>). Despite this apparent change in the human OB, the exact nature of these age-related changes on a cellular level is still largely unclear since aging rodents seem to either show no (<xref ref-type="bibr" rid="ref135">Richard et al., 2010</xref>) or little (<xref ref-type="bibr" rid="ref60">Hwang et al., 2004</xref>) change in cellular composition. While numbers of CB and CR neurons stay constant (<xref ref-type="bibr" rid="ref101">Mobley et al., 2013</xref>), an aging-associated decline in cell numbers has only been shown for PV-interneurons. These decrease by about 30% in rats between the ages of 12 and 24&#x202F;months (<xref ref-type="bibr" rid="ref59">Hwang et al., 2003</xref>) while the amount of SST-positive cells increases strongly, however, exclusively in the granule cell layer (<xref ref-type="fig" rid="fig2">Figure 2B</xref>; <xref ref-type="bibr" rid="ref60">Hwang et al., 2004</xref>). In contrast, it was shown that synaptic density in the glomerular layer strongly decreases in aging mice (<xref ref-type="bibr" rid="ref135">Richard et al., 2010</xref>) with potential effects on olfactory discrimination.</p>
<p>In AD, the OB shows a high number of senile plaques and strong tauopathy in the early stages of the disease (<xref ref-type="bibr" rid="ref76">Kov&#x00E1;cs et al., 2001</xref>). Cellular changes in the OB of an AD mouse model are pronounced (<xref ref-type="bibr" rid="ref139">Saiz-Sanchez et al., 2013</xref>; <xref ref-type="bibr" rid="ref79">La Rosa-Prieto et al., 2016</xref>): Though CB-positive neurons were not altered in number, CR-positive neurons showed a significant reduction in the granule cell layer compared to healthy control mice, at least in younger animals. PV cell numbers were lower in younger animals of an AD mouse model than controls but higher in animals older than a year, thus showing a solid age-dependent modulation. SST-positive neurons, in contrast, showed a substantial decrease, with the strongest reduction occurring in the granule cell layer. At least this substantial reduction in SST-positive cells seems to be present also in AD patients (<xref ref-type="fig" rid="fig2">Figure 2A</xref>; <xref ref-type="bibr" rid="ref143">Saiz-Sanchez et al., 2020</xref>). How these changes would affect olfactory behavior is still unclear.</p>
</sec>
<sec id="sec5">
<title>Anterior olfactory nucleus (AON)</title>
<p>The AON is located in the olfactory stalk between the OB and the piriform cortex. Though the AON receives the predominant amount of olfactory information input from the olfactory bulb (<xref ref-type="bibr" rid="ref23">Chae et al., 2022</xref>) and is intensely connected to olfactory and non-olfactory areas (<xref ref-type="bibr" rid="ref15">Brunjes et al., 2005</xref>; <xref ref-type="bibr" rid="ref13">Brunert et al., 2023</xref>), its role for olfactory perception is still unclear. So far, it has been shown that it can store olfactory contextual memory (<xref ref-type="bibr" rid="ref5">Aqrabawi and Kim, 2020</xref>) can intensely regulate information output from the olfactory bulb (<xref ref-type="bibr" rid="ref97">Medinaceli Quintela et al., 2020</xref>), and might have a role in social recognition (<xref ref-type="bibr" rid="ref112">Oettl et al., 2016</xref>). However, a clear picture has still to emerge. Likewise, the interneurons of the AON have not been tied to a clear behavioral output.</p>
<p>The AON itself is a two-layered structure consisting of a pars principalis (pP) and a pars externa (pE) structure, with pP composed of four different subsections that differ in connectivity and, potentially, function. pP and pE are very different in their composition, though both exhibit a surprising variety of different interneurons (<xref ref-type="bibr" rid="ref67">Kay and Brunjes, 2014</xref>) for such simplified cortical structures. Just a limited characterization of glutamate dehydrogenase 1 positive cells in pP based on their electrophysiology and morphology found at least five possible distinct subtypes, while immunohistochemical characterization showed 13 possible subtypes (<xref ref-type="bibr" rid="ref67">Kay and Brunjes, 2014</xref>). This histochemical characterization showed an overlapping but distinct marker composition compared to the hippocampus or neocortex, with CB, CR, and PV as the most prominent markers. VIP and SST-positive neurons could also be found in significant numbers, while the number of NPY and CCK-positive cells was low in AON pP (<xref ref-type="fig" rid="fig1">Figure 1B</xref>). The number of neurons expressing one of the tested markers was higher in layer I of AON pP and could differ significantly depending on the examined subsection.</p>
<p>While a detailed characterization of pE interneuron composition is still pending, limited experiments have shown a high number of CR-positive cells as well as some cell types with unique properties (<xref ref-type="bibr" rid="ref67">Kay and Brunjes, 2014</xref>).</p>
<p>As the olfactory bulb shows a high density of senile plaques and neurofibrillary tangles in the early phases of AD, efforts have been made to characterize the cellular changes the AON undergoes in this disease for humans and mouse models. Both human (<xref ref-type="bibr" rid="ref141">Saiz-Sanchez et al., 2010</xref>) as well as mouse models (<xref ref-type="bibr" rid="ref139">Saiz-Sanchez et al., 2013</xref>) show a significant reduction of SST-positive cells that manifests in mice as early as 6&#x202F;months of age. In mice, the number of CR-positive cells also showed a substantial reduction in number while PV-positive cells were less vulnerable to disease progression and showed no reduction (<xref ref-type="fig" rid="fig2">Figure 2A</xref>; <xref ref-type="bibr" rid="ref139">Saiz-Sanchez et al., 2013</xref>). Research on other interneuron populations in the AON during AD disease progression is still pending.</p>
<p>Even less is known about the changes the AON undergoes in aging; the only report comes from NPY-positive cells in the AON of rats that decline considerably in number between the ages of 12 and 24&#x202F;months for all subsections of pP (<xref ref-type="fig" rid="fig2">Figure 2B</xref>; <xref ref-type="bibr" rid="ref58">Hwang et al., 2001</xref>).</p>
<p>Despite its predominant role in olfactory processing and contextual memory, functional studies examining the association of olfactory decline in aging and AD to AON are missing so far.</p>
</sec>
<sec id="sec6">
<title>Piriform cortex (PC)</title>
<p>The PC is the largest cortical area receiving olfactory signals from the OB (<xref ref-type="bibr" rid="ref108">Neville and Haberly, 2004</xref>). It consists of two parts, the anterior piriform cortex (APC) and the posterior piriform cortex (PPC), that differ strongly in connectivity (<xref ref-type="bibr" rid="ref53">Hagiwara et al., 2012</xref>) and, most probably, function (<xref ref-type="bibr" rid="ref64">Kadohisa and Wilson, 2006</xref>; <xref ref-type="bibr" rid="ref36">Dhawale et al., 2010</xref>). The PC is a three-layered cortical structure that contains principal neurons in layers II and III, while interneurons are more homogenously distributed throughout all layers (<xref ref-type="bibr" rid="ref7">Bekkers and Suzuki, 2013</xref>).</p>
<p>Odor processing in the PC is governed by strong feedforward as well as feedback inhibition through local recurrent networks (<xref ref-type="bibr" rid="ref44">Franks et al., 2011</xref>; <xref ref-type="bibr" rid="ref160">Suzuki and Bekkers, 2012</xref>). In contrast to other olfactory areas, PC has been well characterized in terms of interneuron composition (<xref ref-type="bibr" rid="ref191">Young and Sun, 2009</xref>; <xref ref-type="bibr" rid="ref46">Gavrilovici et al., 2010</xref>; <xref ref-type="bibr" rid="ref158">Suzuki and Bekkers, 2010a</xref>,<xref ref-type="bibr" rid="ref159">b</xref>; <xref ref-type="bibr" rid="ref7">Bekkers and Suzuki, 2013</xref>; <xref ref-type="bibr" rid="ref2">Agarwal et al., 2014</xref>). Though similar to neocortical composition, PC has a more simple makeup of inhibitory interneurons with just five main classes that can be identified in the APC (<xref ref-type="bibr" rid="ref158">Suzuki and Bekkers, 2010a</xref>,<xref ref-type="bibr" rid="ref159">b</xref>). There, morphologically identified neurogliaform and horizontal cells in layer I seem to provide feedforward inhibition, while bitufted, fast, and regular spiking neurons, as well as chandelier cells and deep neurogliaform cells, are located mainly in layer II and III mediating feedback inhibition (<xref ref-type="bibr" rid="ref160">Suzuki and Bekkers, 2012</xref>). Interestingly, neither neurogliaform nor horizontal cells are positive for common interneuron markers (<xref ref-type="bibr" rid="ref160">Suzuki and Bekkers, 2012</xref>). Neurons located in the deeper layers of APC responsible for feedback inhibition, bitufted cells, fast-spiking multipolar and regular spiking multipolar cells have been shown to stain for VIP, CB, and/or PV and SST, respectively (<xref ref-type="bibr" rid="ref158">Suzuki and Bekkers, 2010a</xref>). Feedback inhibition is far more potent than feedforward inhibition for the PC (<xref ref-type="bibr" rid="ref44">Franks et al., 2011</xref>) and can powerfully shape odor coding.</p>
<p>The PPC gets less olfactory input from the OB than the APC and more associational input, leading to the hypothesis that the APC might be responsible for odor learning and identity coding and the PPC for odor valence coding (<xref ref-type="bibr" rid="ref18">Calu et al., 2007</xref>). Experiments suggest that the inhibitory networks in the PPC seem to be even stronger than in the APC. In the PPC, different interneuron cell types have been identified according to their firing properties (<xref ref-type="bibr" rid="ref191">Young and Sun, 2009</xref>): Late spiking (LS) and irregular spiking (IS) cells that were predominantly located in layer I of the piriform cortex, as well as regular spiking nonpyramidal cells (RSNP) and fast-spiking (FS) neurons. All of these neurons exhibit either no (FS and LS) or minor staining for calcium-binding proteins, though low numbers of CB and CR positive neurons can be seen scattered throughout all layers, and PV cells are located in layer II (<xref ref-type="bibr" rid="ref71">Kiselycznyk et al., 2006</xref>) Only 20% of the IS cells showed to be positive for CR, while 33% of all RSNP were positive for VIP but no calcium-binding proteins.</p>
<p>Multiple functions for inhibitory interneurons in PC have been shown. SST and NPY infusion to APC changed feeding behavior (<xref ref-type="bibr" rid="ref29">Cummings et al., 1998</xref>), and PV-positive.</p>
<p>FS cells are the recipient of top-down dopaminergic inputs (<xref ref-type="bibr" rid="ref125">Potts and Bekkers, 2022</xref>). Furthermore, it was shown that long-term potentiation within APC requires the inactivation of SST or PV-positive neurons by VIP-positive interneurons that act as gatekeepers for sensory processing and learning (<xref ref-type="bibr" rid="ref20">Canto-Bustos et al., 2022</xref>).</p>
<p>Though APC and PPC have been hailed as the new frontier in aging research more than 10&#x202F;years ago (<xref ref-type="bibr" rid="ref102">Mobley et al., 2014</xref>) we still know little about &#x201C;healthy&#x201D; aging processes in the PC. There are reports that PC interneuron populations might change during the life of a mouse (<xref ref-type="bibr" rid="ref142">Saiz-Sanchez et al., 2012</xref>), with the number of CB and PV positive neurons being higher in older mice, these data track the aging process only up until 8&#x202F;months and thus do not cover the &#x201C;aging&#x201D; process. Reports on functional changes report cortical thickness, synaptic density, and cell numbers in layer II to remain stable in PC even in advanced ages (<xref ref-type="bibr" rid="ref30">Curcio et al., 1985</xref>; <xref ref-type="bibr" rid="ref37">Diamond et al., 1977</xref>) which contrasts strongly with the decline seen in the OB and olfactory epithelium (<xref ref-type="bibr" rid="ref102">Mobley et al., 2014</xref>). One reason for this could be that the population of cortical immature neurons (cIN) of the PC is created prenatally and lays dormant inside layer II until needed (<xref ref-type="bibr" rid="ref48">G&#x00F3;mez-Climent et al., 2008</xref>). The cells thus act as a lifelong neurogenic pool that reduces with age but provides new neurons during the lifespan of an animal (<xref ref-type="bibr" rid="ref47">Ghibaudi et al., 2023</xref>).</p>
<p>In AD, the number of interneurons is severely affected in humans and AD mouse models. In mice, CB, CR, PV, and SST cell numbers were significantly decreased at 8&#x202F;months of age (<xref ref-type="fig" rid="fig2">Figure 2A</xref>), with CR and especially SST showing effects in very early stages (<xref ref-type="bibr" rid="ref142">Saiz-Sanchez et al., 2012</xref>). Here, it is interesting that PPC showed more robust effects that manifested slightly later than in the APC. In AD patients, a similar pattern in interneuron decline was shown, except that the number of PV neurons increased (<xref ref-type="bibr" rid="ref140">Saiz-Sanchez et al., 2015</xref>). Numerous functional deficiencies of the PC in AD, including disruption of odor quality coding (<xref ref-type="bibr" rid="ref82">Li et al., 2010</xref>), and reduction of neuromodulatory input due to noradrenergic fiber degeneration (<xref ref-type="bibr" rid="ref131">Rajani and Yuan, 2022</xref>) or decreased excitability of pyramidal cells through activation of 2-HT2c receptors (<xref ref-type="bibr" rid="ref173">Wang X. et al., 2023</xref>) have been shown. None of these defects have been tied to the function of inhibitory interneurons yet.</p>
</sec>
<sec id="sec7">
<title>Tenia tecta (TT)</title>
<p>Another system underrepresented in research on olfactory deficits is the TT. This region consists of two separate three-layered subregions, dorsal and ventral tenia tecta (dTT and vTT), which are evolutionarily derived from two different formations and present distinct cellular compositions. dTT, also called the hippocampal anterior continuation (<xref ref-type="bibr" rid="ref96">McNamara et al., 2004</xref>), contains a more hippocampal-like cell composition (<xref ref-type="bibr" rid="ref52">Haberly and Price, 1978</xref>) and connectivity (<xref ref-type="bibr" rid="ref15">Brunjes et al., 2005</xref>). Reports on the presence of common interneuronal markers show a medium amount of CR-positive (<xref ref-type="bibr" rid="ref129">Qi et al., 2022</xref>) and CB-positive neurons (<xref ref-type="bibr" rid="ref166">Tsuneoka et al., 2017</xref>) as well as a low number of SST-positive neurons (<xref ref-type="bibr" rid="ref110">Nocera et al., 2019</xref>). Though the dTT exhibits robust odor responses, presumed to stem from PC and lateral entorhinal cortex inputs (<xref ref-type="bibr" rid="ref28">Cousens, 2020</xref>), the primary input of the OB is received by the vTT. This area, separated by a thin, cell-free layer from the dTT, shows less robust odor responses (<xref ref-type="bibr" rid="ref28">Cousens, 2020</xref>) but has been shown to integrate odor information with distinct environmental and behavioral contexts of learned behaviors (<xref ref-type="bibr" rid="ref153">Shiotani et al., 2020</xref>). Besides OB, the vTT receives inputs from the APC and PPC and medial prefrontal cortex. Projections of vTT extend to the OB, AON and APC. Cell selective studies have predominantly addressed the pyramidal cells in layers 2 and 3 of the vTT (<xref ref-type="bibr" rid="ref52">Haberly and Price, 1978</xref>). Still, immunohistochemistry for common interneuron markers has shown the presence of these markers, calcium-binding proteins CB, CR, and PV, and neuropeptidergic cells like VIP, NPY, SST, and CCK (<xref ref-type="bibr" rid="ref16">Brunjes et al., 2011</xref>; <xref ref-type="bibr" rid="ref10">Bjerke et al., 2021</xref>).</p>
<p>Research on aging and AD has only recently included TT. Oxytocin receptor mRNA did not show any age-related changes in the rat, different from hypothalamic areas (<xref ref-type="bibr" rid="ref132">Ravenel et al., 2024</xref>), but TT showed substantial A&#x03B2; plaque deposition and amyloid precursor protein deposition in AD mice (<xref ref-type="bibr" rid="ref165">Tsui et al., 2022</xref>; <xref ref-type="bibr" rid="ref117">Ono et al., 2024</xref>). Though there was no measurement of olfactory dysfunction in these studies, it has been shown that neurotoxic exposure to methylmercury leads to olfactory dysfunction while causing strong neuronal loss in the olfactory system, particularly in the vTT (<xref ref-type="bibr" rid="ref62">Iijima et al., 2024</xref>). So far, nothing has been published on the fate of interneurons of the TT during aging or AD. Intense amyloid deposition and the close connection to hippocampal areas suggest that this area might be highly relevant to olfactory dysfunction and potentially disease progression.</p>
</sec>
<sec id="sec8">
<title>Olfactory tubercle (OT)</title>
<p>The OT is part of the ventral striatum and is located at the ventral part of the olfactory peduncle posterior to AON and vTT. It is a three-layered structure that, similar to PC, contains a superficial layer I that receives monosynaptic input from the OB, a cell-dense layer II, and a deeper layer 3 (<xref ref-type="bibr" rid="ref185">Xiong and Wesson, 2016</xref>). Like other striatal regions, OT contains primarily GABAergic neurons, including local interneurons and spiny projection neurons projecting to other striatal regions and into midbrain structures (<xref ref-type="bibr" rid="ref194">Zhang et al., 2017</xref>). It also contains the majority of the &#x201C;islands of Cajella&#x201D; (IC), dense clusters of GABAergic granule cells (<xref ref-type="bibr" rid="ref56">Hsieh and Puche, 2013</xref>), scattered throughout the OT at variable locations with multiple behaviorally relevant functions for motivation and self-reward (<xref ref-type="bibr" rid="ref193">Zhang et al., 2023</xref>). The OT displays odor-specific responses (<xref ref-type="bibr" rid="ref178">Wesson and Wilson, 2010</xref>), is a site of multisensory integration (<xref ref-type="bibr" rid="ref179">Wesson and Wilson, 2011</xref>), and is speculated to play a large part in coding odor valence (<xref ref-type="bibr" rid="ref45">Gadziola et al., 2015</xref>) and the regulation of odor-guided food intake (<xref ref-type="bibr" rid="ref104">Murata, 2020</xref>).</p>
<p>Similar to several other olfactory regions, different morphological types of putative interneurons have been described (<xref ref-type="bibr" rid="ref100">Millhouse and Heimer, 1984</xref>), but these morphological types have not been matched with expression types. The OT shows expression for all of the common interneuron markers (<xref ref-type="bibr" rid="ref16">Brunjes et al., 2011</xref>; <xref ref-type="bibr" rid="ref93">Martin-Lopez et al., 2019</xref>; <xref ref-type="bibr" rid="ref192">Zandt et al., 2019</xref>). Some of these show a pronounced heterogeneity in terms of localization, with CB and PV-positive neurons residing primarily in layer III while reelin-positive cells residing predominantly in layer I (<xref ref-type="bibr" rid="ref93">Martin-Lopez et al., 2019</xref>). Direct functions for GABAergic interneurons in the OT have yet to be shown.</p>
<p>Aging had a measurable effect on OT, predominantly on the IC. The IC receives small numbers of adult-born neuroblasts that decline as a result of aging-related changes in the SVZ (<xref ref-type="bibr" rid="ref102">Mobley et al., 2014</xref>). Potentially due to this process or increased accumulation of autophagosomes (<xref ref-type="bibr" rid="ref154">Soontornniyomkij et al., 2012</xref>), the number and volume of ICs were significantly reduced in older mice (<xref ref-type="bibr" rid="ref1">Adjei et al., 2013</xref>) with the potential to lead to depression-like behaviors (<xref ref-type="bibr" rid="ref193">Zhang et al., 2023</xref>).</p>
<p>The OT of AD mouse models show a high number of senile plaques (<xref ref-type="bibr" rid="ref178">Wesson and Wilson, 2010</xref>; <xref ref-type="bibr" rid="ref139">Saiz-Sanchez et al., 2013</xref>) though the increase is slightly delayed compared to OB and AON in the APP/PS1 mouse line (<xref ref-type="bibr" rid="ref139">Saiz-Sanchez et al., 2013</xref>). Multiple different types of interneurons show a decrease in numbers, like CB (<xref ref-type="bibr" rid="ref152">Selden et al., 1994</xref>), PV, CR, and SST positive neurons (<xref ref-type="fig" rid="fig2">Figure 2A</xref>; <xref ref-type="bibr" rid="ref139">Saiz-Sanchez et al., 2013</xref>). None of these interneuron populations&#x2019; functions are defined, so it remains to be determined whether and how these changes in the OT contribute to olfactory dysfunction.</p>
</sec>
<sec id="sec9">
<title>Cortical amygdala (CoA)</title>
<p>The CoA is, like other paleocortical areas, a three-layered structure consisting of multiple different subnuclei such as the nucleus of the lateral olfactory tract (nLOT), bed nucleus of the accessory olfactory tract (BAOT), anterior cortical amygdala posterolateral (PLCo) and posteromedial nuclei (PMCo). Located between the piriform cortex (rostrally), the entorhinal cortex (caudally), and the medial amygdala, it receives direct olfactory input from the OB in layer I and with projections that seem to maintain spatial patterns of the OB (<xref ref-type="bibr" rid="ref155">Sosulski et al., 2011</xref>). Functionally, it is believed that CoA controls innate odor responses with negative and positive valence (<xref ref-type="bibr" rid="ref63">Iurilli and Datta, 2017</xref>). In contrast to the basolateral amygdala, the cellular composition of CoA has not been studied extensively, but it is well established that it contains few inhibitory interneurons, most of which are CB or PV-positive (<xref ref-type="bibr" rid="ref116">Olucha-Bordonau et al., 2015</xref>).</p>
<p>The nLOT represents a unique structure within CoA due to its developmental origin, cellular composition, and connectivity (<xref ref-type="bibr" rid="ref147">Santiago and Shammah-Lagnado, 2004</xref>). It only comprises about 2,500 neurons and is bi-directionally connected with the OB and PC (<xref ref-type="bibr" rid="ref127">Price, 1973</xref>; <xref ref-type="bibr" rid="ref88">Luskin and Price, 1983</xref>). nLOT-lesioned mice display substantial olfactory defects, including decreased detection and discrimination abilities (<xref ref-type="bibr" rid="ref168">Vaz et al., 2017</xref>). Interestingly, OB input to the nLOT is relatively weak, with more robust input from PC, TT, and basolateral amygdala (<xref ref-type="bibr" rid="ref119">Penker et al., 2024</xref>). Apart from a low number of VIP-positive interneurons in layer 2, the nLOT has also been shown to contain medium to low numbers of PV, CB, and CR-positive neurons vulnerable to stress-mediated cell atrophy (<xref ref-type="bibr" rid="ref169">Vaz et al., 2018</xref>).</p>
<p>Neuropeptidergic cells expressing SST, NPY (<xref ref-type="bibr" rid="ref134">Real et al., 2009</xref>), and VIP (<xref ref-type="bibr" rid="ref146">Salamanca et al., 2024</xref>) can also be found in CoA and nLOT, mostly in meager numbers. nLOT additionally shows a distinct population of small CCK-positive interneurons (<xref ref-type="bibr" rid="ref116">Olucha-Bordonau et al., 2015</xref>).</p>
<p>The effects of aging on the entire CoA have not been well described, except for a slight but significant change in volume (<xref ref-type="bibr" rid="ref3">Aghamohammadi-Sereshki et al., 2018</xref>). In contrast, the volume of nLOT of aged rats showed no noticeable volume reduction. More detailed analysis revealed that aging was associated with a 14% reduction in the total number of nLOT neurons due to cell loss in layers 2 and 3. This included a substantial decline of NPY and VIP positive interneurons with a 55 and 30% reduction, respectively (<xref ref-type="fig" rid="fig2">Figure 2B</xref>; <xref ref-type="bibr" rid="ref170">Vaz et al., 2016</xref>).</p>
<p>The amygdaloid complex also shows substantial atrophy in AD in the early phases of the disease (<xref ref-type="bibr" rid="ref126">Poulin et al., 2011</xref>). Among these structures, CoA seems to be affected most in terms of senile plaque density, increase in astrocyte number, and volume reduction (<xref ref-type="bibr" rid="ref49">Gonzalez-Rodriguez et al., 2023</xref>). This study found no reduction in cell numbers but attributed the reduction in volume to neuropil loss and a decrease in synaptic connectivity.</p>
</sec>
<sec id="sec10">
<title>Lateral entorhinal cortex (LEC)</title>
<p>One main task of the lateral entorhinal cortex (LEC) is to feed nonspatial multisensory information to the hippocampus (<xref ref-type="bibr" rid="ref8">Bilash et al., 2023</xref>). It has been considered transitional between olfactory allocortices and the isocortex, as its six layers do not precisely match the six layers of the isocortex. The superficial layers (I-III) and deep layers (V and VI) differ strongly in terms of connectivity, with layers II and III receiving cortical inputs and innervating dentate gyrus (DG)/CA3 and CA1/subiculum, respectively, and layers V and VI (deep layers) receiving the output from the hippocampus and sending projections to cortical and subcortical areas as well as the superficial layers of the entorhinal cortex (<xref ref-type="bibr" rid="ref174">Wang C. et al., 2023</xref>). The LEC receives olfactory information directly from OB and PC, which are both projecting to layer II. It is essential to rapid discrimination of odor identity and intensity (<xref ref-type="bibr" rid="ref9">Bitzenhofer et al., 2022</xref>) and to be involved in odor-dependent memories and navigation (<xref ref-type="bibr" rid="ref84">Li et al., 2017</xref>; <xref ref-type="bibr" rid="ref130">Radvansky and Dombeck, 2018</xref>). With its function in memory formation and retrieval (<xref ref-type="bibr" rid="ref122">Pilkiw et al., 2022</xref>) and odorant perception (<xref ref-type="bibr" rid="ref9">Bitzenhofer et al., 2022</xref>), the LEC would be the perfect area to bridge olfactory and cognitive deficits.</p>
<p>The LEC contains a diverse array of GABAergic interneurons that, at least for the superficial layers, have been characterized well in terms of morphology, location, and marker expression (<xref ref-type="bibr" rid="ref19">Canto et al., 2008</xref>): Layer I contains multipolar cells that express CR and, in a minority of cells, also CB or NPY, and a population of horizontal cells partially expressing VIP. The cell-dense layer II contains many of the principal cells of LEC, pyramidal, and fan cells. Interneurons within layer II are described as multi-polar neurons that can express VIP, CCK, SST, or NPY, horizontal bipolar cells, expressing CR, VIP, CCK, or NPY, as well as PV positive fast-spiking basket and horizontal and vertical chandelier cells (<xref ref-type="bibr" rid="ref19">Canto et al., 2008</xref>). Layer III also contains chandelier cells and multipolar neurons expressing CCK, SST, or VIP and bipolar cells positive for VIP or CR (<xref ref-type="bibr" rid="ref19">Canto et al., 2008</xref>). PV-positive interneurons are particularly prominent, comprising approximately half of the interneuron population, especially in layer II, and are essential for synchronizing neural activity and contributing to the oscillatory dynamics of the region (<xref ref-type="bibr" rid="ref184">Wouterlood et al., 1995</xref>; <xref ref-type="bibr" rid="ref99">Miettinen et al., 1996</xref>). Furthermore, they can gate information flow in the entorhinal-perirhinal network in a feedforward manner (<xref ref-type="bibr" rid="ref181">Willems et al., 2018</xref>) and control the output of at least some principal cells to the hippocampus (<xref ref-type="bibr" rid="ref109">Nilssen et al., 2018</xref>).</p>
<p>The LEC seems to be especially vulnerable to adverse effects in aging and AD (<xref ref-type="bibr" rid="ref156">Stranahan and Mattson, 2010</xref>) as it shows early changes in aging (<xref ref-type="bibr" rid="ref189">Yassa et al., 2010</xref>) as well as in AD patients (<xref ref-type="bibr" rid="ref61">Igarashi, 2023</xref>). Despite substantial changes in function, surprisingly little is known about GABAergic interneurons in both conditions. So far, changes in LEC function in aging have been attributed to changes in intrinsic pyramidal cell excitability (<xref ref-type="bibr" rid="ref85">Lin et al., 2022</xref>) and expression levels of GABA receptors, as well as GABA synthesizing enzymes, were negligible (<xref ref-type="bibr" rid="ref42">Ethiraj et al., 2021</xref>).</p>
<p>Substantial alterations in GABAergic neurons have, however, been shown in AD. Significant reductions in the densities of SST and CR interneurons were observed in the LEC of an AD mouse model compared to wild-type (WT) mice (<xref ref-type="fig" rid="fig2">Figure 2A</xref>; <xref ref-type="bibr" rid="ref73">Klein et al., 2016</xref>) while fast-spiking PV-expressing interneurons do not show a significant decline (<xref ref-type="bibr" rid="ref138">Ruden et al., 2021</xref>).</p>
</sec>
</sec>
<sec sec-type="discussion" id="sec11">
<title>Discussion</title>
<p>Olfaction, specifically olfactory dysfunction, has been described to be associated with but precede cognitive decline in aging and AD. Despite intense efforts to define the underlying causes of olfactory decline, our grasp on this issue is still tenuous at best. New evidence suggests that local inhibition might play a more significant part in aging and disease-mediated changes in the brain than previously thought. Therefore, we would also like to promote this idea for research on olfactory dysfunction. We thus summarized knowledge on inhibitory interneurons in different primary olfactory cortical areas to build a basis for examining potential changes. As we have shown the various regions of olfactory information processing are very diverse regarding interneuron content (<xref ref-type="fig" rid="fig1">Figure 1</xref>). Furthermore, there are regional differences in the strength of local inhibitory circuits, from the OB consisting predominantly of inhibitory interneurons (<xref ref-type="bibr" rid="ref86">Lledo et al., 2008</xref>) and the PC which has a, though more simple, similar interneuron makeup to other cortical areas while still heavily relying on feedforward and feedback inhibitory connections for information processing (<xref ref-type="bibr" rid="ref44">Franks et al., 2011</xref>), to areas with a very low number of inhibitory interneurons like CoA (<xref ref-type="bibr" rid="ref116">Olucha-Bordonau et al., 2015</xref>).</p>
<p>Changes in interneuron function, like GABA expression and oscillatory activity, as well as changes in interneuron number in AD, have been shown in multiple brain areas (<xref ref-type="bibr" rid="ref188">Xu et al., 2020</xref>). So far, the olfactory areas included in this line of research show similar interneuronal changes as the hippocampus and cortex, with PV&#x2014;and CR-positive neuron decline only detectable in some mouse models and brain areas. In contrast, SST-positive neuron numbers have been shown to decrease invariably.</p>
<p>Research on &#x201C;olfactory aging&#x201D; has been sparse, leaving interneuronal changes poorly defined. The existing literature, however, already reflects that a decrease in interneuron numbers is far less pronounced than in AD. Though a lot more research is required, our review thus shows that changes in inhibitory local networks mirror the current view derived from wider brain areas that neuronal cell loss was found predominantly in pathological aging, such as AD, while normal aging is accompanied by dendritic, synaptic, and axonal degeneration with nearly no cell loss (<xref ref-type="bibr" rid="ref150">Schliebs and Arendt, 2011</xref>). This leads to the question of whether these processes are fundamentally different or just occurrences on a different time scale. Would a better understanding of olfactory changes enable us to create a more detailed battery of olfactory tests to detect neurodegenerative diseases, or is this delineation impossible?</p>
<p>Our review deals with the loss of olfactory interneurons as a proxy and the most apparent sign of reduced inhibitory drive in the different olfactory brain areas. Other detectable signs are, among others, a reduction of iPSCs in patch clamp recordings, a reduction of synaptic connections in local circuits, and an increase in the activity of principal neurons (<xref ref-type="bibr" rid="ref98">Meftah and Gan, 2023</xref>). A decrease in GABA release can cause these changes but they might, at least partially, stem from a reduction in GABA receptor-mediated signaling at the postsynapse (<xref ref-type="bibr" rid="ref145">Sakimoto et al., 2021</xref>). GABA<sub>A</sub> receptors seem to be mainly involved in A&#x03B2;-associated pathology as the expression of several subunits of GABA<sub>A</sub> receptors is changed in AD patients (<xref ref-type="bibr" rid="ref78">Kwakowsky et al., 2018</xref>), and pre-treatment of rat cortical cell cultures with a GABA<sub>A</sub> antagonist was able to inhibit A&#x03B2;-induced neuronal apoptosis (<xref ref-type="bibr" rid="ref80">Lee et al., 2005</xref>). In this respect, it is interesting that expression levels of GABA<sub>A</sub> receptors are very different between different olfactory areas, with, e.g., the AON showing little GABA<sub>A</sub> receptor density and several of the olfactory brain areas showing substantial differences in receptor density in other layers (<xref ref-type="bibr" rid="ref87">Lothmann et al., 2021</xref>). This raises the possibility that different olfactory areas might show similar numbers of senile plaques but are not equally vulnerable to neuronal deterioration due to A&#x03B2; deposition.</p>
<p>Apart from differences in vulnerability, an increase in olfactory interneuron-related research might further be essential to understand olfactory dysfunction as interneurons are involved in the function of local networks in numerous ways.</p>
<sec id="sec12">
<title>Aberrant excitation</title>
<p>We have mentioned previously that a change in local inhibitory drive can lead to aberrant excitation of principal cells in any brain area. This increase in excitation on a single cell level has not only been shown in the hippocampus (<xref ref-type="bibr" rid="ref162">Targa Dias Anastacio et al., 2022</xref>) but also in a slice preparation of the OB (<xref ref-type="bibr" rid="ref83">Li et al., 2019</xref>) and in OB, PC (<xref ref-type="bibr" rid="ref177">Wesson et al., 2011b</xref>) and the lateral entorhinal cortex of anesthetized mice in an AD model (<xref ref-type="bibr" rid="ref186">Xu M. et al., 2015</xref>). An increase in excitatory activity and a decrease in inhibitory drive might explain the effects on discrimination abilities by increasing sensory fields and affect detection due to the reduction in signal-to-noise ratio.</p>
</sec>
<sec id="sec13">
<title>Oscillatory activity</title>
<p>Hyperexcitatory activity can also be seen on the network level in the form of local field potentials (LFP). Olfactory LFP activity is commonly organized into the theta or the &#x201C;respiratory&#x201D; band (2&#x2013;12&#x202F;Hz), the beta band (18&#x2013;30&#x202F;Hz), and the gamma band (30&#x2013;100&#x202F;Hz), with each of those bands representing unique aspects of odor perception (<xref ref-type="bibr" rid="ref66">Kay et al., 2009</xref>). It was shown that OB and PC of transgenic mice of an AD model exhibit a detectable shift in LFP power already at 3&#x2013;4&#x202F;months of age preceding the reduction in olfactory performance (<xref ref-type="bibr" rid="ref177">Wesson et al., 2011b</xref>). A couple of publications were able to confirm changes in LFP in the OB of AD models (<xref ref-type="bibr" rid="ref83">Li et al., 2019</xref>; <xref ref-type="bibr" rid="ref24">Chen et al., 2021</xref>). As at least gamma frequency bands of the LFP stem predominantly from the interplay of granule cells with mitral cells in the EPL, the finding corresponds well with findings of the impairment of dendrodendritic inhibition between these two cell types in an AD model (<xref ref-type="bibr" rid="ref83">Li et al., 2019</xref>; <xref ref-type="bibr" rid="ref24">Chen et al., 2021</xref>).</p>
<p>Changes in gamma band oscillations from the OB have also been shown in aging mice (<xref ref-type="bibr" rid="ref4">Ahnaou et al., 2020</xref>) presumed to stem from a reduction in PV neuron function in the EPL. Gamma band oscillations have been described to be specifically crucial for olfactory discrimination (<xref ref-type="bibr" rid="ref111">Nusser et al., 2001</xref>) and olfactory processing (<xref ref-type="bibr" rid="ref92">Martin and Ravel, 2014</xref>) and, therefore, may account for the decline in olfactory performance.</p>
</sec>
<sec id="sec14">
<title>Olfactory bulb plasticity</title>
<p>The olfactory bulb is one of the few brain areas that exhibit lifelong regeneration. Neuronal progenitor cells from the rostral migratory stream are integrated into the glomerular and granule cell layer and differentiate into mostly calretinin-positive neurons in an input-dependent manner (<xref ref-type="bibr" rid="ref70">Kim and Choe, 2020</xref>). As we have mentioned above, a decrease in neuro-regeneration in the OB is supposed to be one of the main underlying factors of olfactory dysfunction in aging and AD (<xref ref-type="bibr" rid="ref38">Dibattista et al., 2020</xref>). Proliferation in the subventricular zone and rostral migratory stream declines with age and in AD. That this dwindling number of migrating neuroblasts is causing changes in the OB circuit is, however, far from clear and seems to stem mainly from notions gained from HC neurogenesis (<xref ref-type="bibr" rid="ref26">Choi and Tanzi, 2023</xref>). Changes in CR-positive neurons have not been shown for the aging OB (<xref ref-type="bibr" rid="ref101">Mobley et al., 2013</xref>) while in an AD mouse model, the OB seems to exhibit a smaller amount of adult-born neurons in the glomerular layer that does, however, not significantly affect the numbers of CR-positive neurons (<xref ref-type="bibr" rid="ref79">La Rosa-Prieto et al., 2016</xref>). More research is required to clarify this critical issue as newly integrated neurons have been shown to affect gamma-band oscillations in the OB and affect olfactory discrimination and odor memory (<xref ref-type="bibr" rid="ref144">Sakamoto et al., 2014</xref>).</p>
</sec>
<sec id="sec15">
<title>Interneurons as targets for top-down cholinergic input</title>
<p>A hallmark of brain dysfunction in aging and neurodegenerative diseases is reduced cholinergic input from the basal forebrain to different brain areas. This reduction is well described in AD as well as in aging (<xref ref-type="bibr" rid="ref149">Schliebs and Arendt, 2006</xref>; <xref ref-type="bibr" rid="ref157">Sultzer, 2018</xref>; <xref ref-type="bibr" rid="ref25">Chen et al., 2022</xref>). As these neuromodulatory inputs also target local inhibitory interneurons, they can strongly affect the function of inhibitory interneurons (<xref ref-type="bibr" rid="ref120">Picciotto et al., 2012</xref>). The role of acetylcholine (ACh) in the olfactory system has yet to be clarified. For the olfactory bulb, it has been shown that cholinergic input increases activity in output neurons indiscriminately (<xref ref-type="bibr" rid="ref136">Rothermel et al., 2013</xref>; <xref ref-type="bibr" rid="ref11">Boehm et al., 2020</xref>). Therefore, a decrease in input would be expected to dampen OB output. In the piriform cortex, ACh has been shown to inhibit recurrent excitatory activity, specifically (<xref ref-type="bibr" rid="ref55">Hasselmo and Bower, 1992</xref>) Therefore, reducing ACh would mean increased recurrent excitation and a more robust gating of olfactory information at this processing level. As the cholinergic system innervates all other levels of olfactory processing, the net effect of reduced cholinergic modulation is hard to predict. Still, it is feasible that cholinergic decline is also an underlying factor for olfactory dysfunction.</p>
</sec>
</sec>
<sec sec-type="conclusions" id="sec16">
<title>Conclusion</title>
<p>Inhibitory interneurons and their function in regulating local circuit functions are of great importance for cognitive function in the hippocampus and, as we have shown in this review, for olfactory function. Olfactory information processing relies heavily on local inhibitory effects, especially in the early stages like the OB (<xref ref-type="bibr" rid="ref17">Burton, 2017</xref>). This inhibition might play a large part in the manifestation of olfactory behavioral symptoms in AD and aging.</p>
<p>Our comparison of reports on interneuron changes in aging and AD shows that these alterations are different between the two conditions but similar to those shown for cortical and hippocampal regions. In this respect, neuronal populations expressing SST and PV seem most vulnerable to AD pathological aging. As these neurons are not expressed in higher numbers in the olfactory system, these changes cannot explain the early and robust manifestation of olfactory dysfunction.</p>
<p>Previous reports have shown that hyperexcitability in various olfactory areas like OB, PC (<xref ref-type="bibr" rid="ref176">Wesson et al., 2011a</xref>), and LEC (<xref ref-type="bibr" rid="ref187">Xu W. et al., 2015</xref>) precedes behavioral and hippocampal dysfunction and a detectable decrease in cell numbers in an AD mouse model. Therefore, one might speculate that the earliest symptoms are GABAergic dysfunctions on a synaptic level, similar to what has been shown for aging (<xref ref-type="bibr" rid="ref137">Rozycka and Liguz-Lecznar, 2017</xref>). The increase in hyperexcitability on both peripheral and central olfactory circuits also raises the possibility that not one olfactory area is responsible for olfactory deficits but that a concerted effort of all olfactory regions is required to enable discrimination, detection, and recognition. This would explain why experimental disturbances on every level of the olfactory processing and many neurodegenerative diseases create similar deficits. This theory of &#x201C;wholistic&#x201D; perception, under robust inhibitory control, might help us to further our understanding of the olfactory system as a warning system for changes in brain function.</p>
</sec>
</body>
<back>
<sec sec-type="author-contributions" id="sec18">
<title>Author contributions</title>
<p>KE: Conceptualization, Writing &#x2013; original draft. SS: Writing &#x2013; review &#x0026; editing. MR: Writing &#x2013; review &#x0026; editing. DB: Conceptualization, Writing &#x2013; original draft, Writing &#x2013; review &#x0026; editing.</p>
</sec>
<sec sec-type="funding-information" id="sec19">
<title>Funding</title>
<p>The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by grants of the DFG (German Research Foundation) to MR (445965029/RO4046/5-1, 466488864/RO4046/6-1, 466488864/RO4046/7-1, and 362321501/GRK2413) and MR and SS (520617944, 520287065/RO4046/8-1).</p>
</sec>
<sec sec-type="COI-statement" id="sec20">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
<p>The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.</p>
</sec>
<sec sec-type="ai-statement" id="sec17">
<title>Generative AI statement</title>
<p>The author(s) declare that no Generative AI was used in the creation of this manuscript.</p>
</sec>
<sec sec-type="disclaimer" id="sec21">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<fn-group>
<title>Abbreviations</title>
<fn fn-type="abbr"><p>Ab, Amyloid beta; ACh, Acetylcholine; AD, Alzheimer&#x2019;s disease; APC, Anterior piriform cortex; AON, Anterior olfactory nucleus; BAOT, Bed nucleus of the accessory olfactory tract; CB, Calbindin; CCK, Cholecystokinin; cIN, Cortical immature neurons; CR, Calretinin; CRH, Corticotropin-releasing hormone; CoA, Cortical amygdala; DG, Dentate gyrus; dTT, Dorsal tenia tecta; EPL, External plexiform layer; FS, Fast spiking; GCs, Granule cells; HC, Hippocampus; IC, Islands of Cajella; iPL, Internal plexiform layer; iPSCs, Inhibitory postsynaptic currents; IS, Irregular spiking; LEC, Lateral entorhinal cortex; LFP, Local field potentials; LS, Late spiking; ML, Mitral cell layer; nLOT, Nucleus of the lateral olfactory tract; NPY, Neuropeptide Y; OB, Olfactory bulb; OT, Olfactory tubercle; pE, Pars externa; PC, Piriform cortex; PGCs, Periglomerular cells; PLCo, Cortical amygdala posterolateral; PMCo, Posteromedial nuclei; pP, Pars principalis; PPC, Posterior piriform cortex; pTau, Hyperphosphorylated Tau; PV, Parvalbumin; RSNP, Regular spiking nonpyramidal; SST, Somatostatin; SVZ, Subventricular zone; TH, Tyrosine hydroxylase; TT, Tenia tecta; VIP, Vasoactive intestinal peptide; vTT, Ventral tenia tecta; WT, Wild type</p></fn>
</fn-group>
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