Progress Towards A Skin Swab Test
These early findings were exciting and encouraging. The scientists knew that if they were able to identify a unique chemical signature in the skin linked to Parkinsons, they may eventually be able to diagnose the condition from simple skin swabs.
There is currently no definitive test for Parkinsons disease, with diagnosis based on a patients symptoms and medical history, a process that can take several years. The development of a test like this would therefore be a game-changer for the Parkinsons community.
With Joys help, the research team, now led by Perdita at the University of Manchester, continued to make progress. In 2019, they announced a major breakthrough the discovery of chemicals enriched in skin swabs from people with Parkinsons.
This key discovery led to further research to profile the complex chemical signature in sebum of people with Parkinsons. Through this work, scientists found subtle but fundamental changes as the condition progressed.
This meant that a skin swab could potentially not only be used to diagnose Parkinsons, but could also be used to monitor the development of the condition.
Professor Perdita Barran said: We believe that our results are an extremely encouraging step towards tests that could be used to help diagnose and monitor Parkinsons. Not only is the test quick, simple and painless but it should also be extremely cost-effective because it uses existing technology that is already widely available.
Managing Loss Of Smell
There are not any treatments for lost sense of smell. However, if reduced ability to smell is affecting your appetite and you find yourself gaining or losing weight, you may want to learn more about diet and nutrition. You can also call our Helpline for tips: 1-800-4PD-INFO .
Page reviewed by Dr. Addie Patterson, Movement Disorders Neurologist at the Norman Fixel Institute for Neurological Diseases at the University of Florida, a Parkinsons Foundation Center of Excellence.
A Rapid Diagnostic For Parkinsons
To take the smell test, the capsules are crushed between the fingers and the tape strip is peeled. This releases an aroma, and researchers can then score a persons ability to recognise the smell.
In a study, published in the Journal of the Royal Society Interface, a small group of eight people with Parkinsons disease took the capsule smell test, as well as a scratch and sniff smell test. In both tests, they were asked to identify six different scents: coconut, menthol, cherry, orange, clove and onion. In each round, patients were asked to share what they smelled.
The results showed that odours were easier to identify in the capsule smell test. The participants also highlighted the ease of crushing capsules compared to the scratching method, particularly for those with tremors. Although smell tests for diagnosis already exist, they are expensive and not widely available.
Dr Ahmed Ismail, lead researcher of the study, said: Our capsule-based smell test can assist in the rapid diagnostic of various diseases linked to the loss of smell.
Dr Ahmed Ismail, lead researcher of the study.
He continued: Most of the smell tests on the market depend on using paperboard items treated with a fragrant coating called scratch and sniff, in which you need to scratch a card to release the odour. The problem with this approach is that the amount of odour released depends on the extent to which the individual scratches, something that might affect the outcome of the test.
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Discovering The Smell Of Parkinsons
In 2012, stem cell biologist Dr Tilo Kunath had just finished a public talk about his research on Parkinsons disease when he was asked a surprising question Why arent you using smell to detect Parkinsons? Nine years on, this simple question has led to ground-breaking research into new ways to detect this devastating disease.
By Ellie Roger, Communication and Engagement Officer, Centre for Regenerative Medicine, Institute for Regeneration and Repair
Role Of Smell In The Pd Pathological Process And Relationship With The Microbiota
According to Braak’s model , the pathological process of PD starts at the same time in two sites, the olfactory bulb/anterior olfactory nucleus, and the enteric nerve cell plexuses. This pathogenic explanation is known as the âdual-hitâ hypothesis. Constipation is actually another well-characterized, early prodromal manifestation of PD.
The alfa-synuclein pathology spreads in a caudal-rostral fashion from the lower brainstem through mid- and forebrain, up to the cerebral cortex in the final stages. Always according to this hypothesis , a yet unknown pathogen could be responsible for this stereotypical sequential damage of the nervous system areas, accessing the Central Nervous System via the olfactory bulb and the myenteric plexus of the enteric nervous system . Those two sites are especially vulnerable due to their lack of a blood brain barrier , that surrounds the CNS . This alleged pathogen could trigger neurodegeneration through a prion-like diffusion of misfolded proteins along neural pathways, or by provoking neuroinflammation leading to degeneration .
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A New Way To Diagnose Parkinsons
The team is now working on training dogs to home in on the scents, as well as developing machinated diagnostic tests that could identify the presence of the tell-tale compounds, called biomarkers.
Milne isnt the only one who can detect the smell Barran says that many clinicians, even a hairdresser, have reached out to her to say they smell it too. Though Barran is a non-smeller a head injury left her own sniffer out of whack she says people always describe the smell in a similar way: Musky, reminiscent of how a beaver smells, yet unlike anything else.
Whether a new diagnostic test from the biomarkers comes from canines, super-smelling nurses or laboratory machines, the scientists goal is the same: Diagnose Parkinsons earlier possibly years earlier than current methods.
Theres not currently much or any early treatment for Parkinsons but, Barran points out, there was never a way to catch it early enough to develop early treatments. This might soon change, though, all thanks to a retiree with an exceptional nose.
Anna Funk is Assistant Editor at Discover. Follow her on Twitter @DrAnnaFunk.
Losing My Sense Of Smell To Parkinsons
Barrie talks about how losing his sense of smell was one of the first Parkinsons symptoms he experienced. We also meet Dr Clara OBrien who talks about managing this symptom.
I was around 30 when I first went to the GP. I remember smelling something awful, like electrical burning an ionised, smouldering aroma.
It had happened a couple of times, until one day I lost my sense of smell completely.
My GP put it down to scuba diving when I was younger, and how the pressure may have damaged something. He said there was little they could do, and Id just have to get used to it.
Almost 20 years later, after developing a tremor in my finger, I was given a diagnosis of Parkinsons. It was only then that I found out the two were linked.
Your sense of smell affects your sense of taste, so I cant really taste things either. Ive mostly gotten used to it, but I have had to adapt the way I do things.
In the kitchen, Im a very heavy seasoner. You really need to love garlic and spice if you want to try my cooking. I live with my wife and grown-up daughter. My wife usually taste-tests things and deems if theyre passable for other people.
We have lots of carbon monoxide detectors in the house. Its a worry, but you have to just deal with it.
Not having a sense of smell does have its advantages. Our dog creates some very bad odours, none of which I have to worry about. I also went to Glastonbury, and not being able to smell the toilets is nothing short of a super power.
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A New Way To Detect Parkinsonsby Smell
Discovery of odorous markers for neurodegenerative disease
Scent has been used as a diagnostic tool by physicians for thousands of years. But smell tests are not common in modern medicinewhens the last time you were smelled by your doctor or received a batch of smell results back from the lab? Now, new research suggests that odors can be used to screen for Parkinsons disease, which currently is without a definitive diagnostic.
In the animal kingdom, scents emitted from a body often signal information about an individuals mental or physical state. For example, stressed rodents have been shown to excrete distinctive odors. Human body odors also have this function, emitting a wide array of odor and non-odor related chemicals called volatile organic compounds. These compounds are emitted from different areas of the human body and vary with age, diet, sex and possibly genetic background. Moreover, disease processes can influence our daily odor by changing these compounds.
Could Other Diseases Also Be Sniffed Out
Milnes ability to sniff out disease is not limited to Parkinsons the 68-year-old super smeller is also able to smell Alzheimers and certain cancers . She is working with the researchers to identify chemicals that produce a signature odour for tuberculosis.
Milnes ability could be linked to the fact that she has synaesthesia, a neurological condition that results in a joining or merging of senses that aren’t normally connected. This means she can visualise the flow of smells and even experience them as sensations. Some smells make my back go cold, she said. She has to avoid soaps and make-up in supermarkets because they are too overpowering.
Im in a tiny, tiny branch of the population somewhere between a dog and a human, she jokingly told the BBC last year. Milne has been named in a paper on the research published in ACS Central Science and been made an honorary lecturer at Manchester University in recognition of her work.
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What More Research Needs To Be Done
The scientists subsequently teamed up with researchers in Austria who study people with REM sleep disorders in an effort to discover whether the test can spot Parkinsons before doctors can. The Guardian reports that a separate study found people with a specific kind of such disorder have a 50% risk of developing Parkinsons in later life.
If we can detect the disease early on, that would be very good news, commented Barran. It would mean we have a test that picks it up before motor symptoms appear.
In parallel, more than 1,000 Parkinsons patients and hundreds of healthy people are having their sebum analysed in order to assess how reliable the test is. Scientists will also look at whether changes in the odour reflect the progression of the disease, or even different forms of Parkinsons.
Speaking to coincide with the publication of the Manchester University findings in ACS Central Science, Professor David Dexter, deputy director of Research at Parkinsons UK, said: More research is needed to find out at what stage a skin test could detect Parkinsons, or whether it is also occurs in other Parkinsons related disorders, but the results so far hold real potential.
Both to change the way we diagnose the condition and it may even help in the development of new and better treatments for the 145,000 people living with Parkinsons in the UK.
Finding A Super Smeller
Lead author on the study, Perdita Barran, says she first learned about the woman who can smell Parkinsons from her colleague Tito Kunath at the University of Edinburgh. He had given a public talk on his Parkinsons research, and the woman was in the audience. As Barran tells it, she got up at the end of presentation and said thats all well and good that youre doing this, but why arent you doing something about the fact that people with Parkinsons smell?
Initially shrugging it off, Kunath called Barran, professor of mass spectrometry at the University of Manchester, the next day and they talked it over. Was the woman referring to the fact that Parkinsons patients often lose their sense of smell? Or making a rude comment about a patients personal hygiene? It wasnt until another friend also with a great sense of smell heard the story and encouraged them to seek out the woman.
They tracked her down. She was Joy Milne, a retired nurse living in Perth, a town near Edinburgh. Decades earlier, Milne had noticed a sudden onset of a strange odor in her now-late husband. He was diagnosed with Parkinsons disease many years later.
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Sebum Smell Could Be A Biomarker For Parkinsons Disease
Dear Doctors: I have read that dogs can tell when someone has cancer just by sniffing them. Thats already hard to believe. But when I heard about a nurse who smelled it when her husband got Parkinsons disease, I was sure it was an urban myth. Is it true? What would she be smelling?
Dear Reader: With a sense of smell thats estimated to be at least 10,000 times more sensitive than a humans, dogs are consummate scent detectives.
Whereas we humans have 6 million olfactory receptors within our noses, dogs have 300 million. This, along with a much larger portion of their brains devoted to analyzing scent, makes it possible for dogs to pick up smells at the molecular level. This includes not just narcotics and explosives, as we have come to expect, but scents associated with ill health.
In 1989, a woman decided to have a mole examined because her dog kept sniffing and biting it. It turned out to be malignant melanoma. Diabetes-alert dogs, known as DADs, identify high or low blood sugar levels by smelling changes in their owners breath. More recently, specially trained dogs have proven surprisingly accurate at sniffing out infection with the coronavirus that causes COVID-19. All of this is possible because disease processes and illness produce volatile organic compounds. When these compounds are released via the sweat, breath or urine, they generate a distinct and identifiable scent.
Parkinson’s Smell Test Explained By Science
Joy Milne can smell Parkinson’s disease before it is medically diagnosed
A Scottish woman who astonished doctors with her ability to detect Parkinson’s disease through smell has helped scientists find what causes the odour.
Researchers in Manchester said they had identified the molecules on the skin linked to the smell and hope it could lead to early detection.
The study was inspired by Joy Milne, a 68-year-old retired nurse from Perth.
She first noticed the “musky” smell on her husband Les, who was years later diagnosed with Parkinson’s disease.
Joy, who has worked with the University of Manchester on the research for three years, has been named in a paper being published in the journal ACS Central Science.
She has also been made an honorary lecturer at the university because of her efforts to help identify the telltale smell.
The research revealed that a number of compounds, particularly hippuric acid, eicosane, and octadecanal, were found in higher than usual concentrations on the skin of Parkinson’s patients.
They are contained in sebum – the oily secretion that coats everybody’s skin, but which is often produced in greater quantity by people with Parkinson’s, making them more likely to develop a skin complaint called seborrheic dermatitis.
“She could smell people who’ve got Parkinson’s disease.
“So we designed some experiments to mimic what Joy does, to use a mass spectrometer to do what Joy can do when she smells these things on people with Parkinson’s.”
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What Does Disease Smell Like
Joy Milne is a super-smeller. These people have a superior sense of smell and are sometimes sought after by perfume or wine manufacturers.
For Joy, however, her sensitive nose meant that she detected an unusual odour on her husband, Les. Initially she thought that perhaps he wasnt showering enough, but 12 years later he was diagnosed with Parkinsons disease. She only made the connection between the condition and the aroma after noticing the same smell on people at a Parkinsons disease support group.
Read more about smelling disease:
She has since worked with scientists at the University of Manchester to identify the chemicals underlying what she says is the characteristic smell of the condition, which could help lead to earlier diagnosis. Joy is now the linchpin for ongoing smell research. This is what she says about some common diseases:
What Causes Smell Loss
Smell loss happens when any part of the pathway that enables smell is affected. Problems with smell can range from decreased to complete loss . Because the ability to taste is linked to smell, changes in taste often accompany changes in smell. In some people, taste loss can lead to decreased appetite and weight.
There are many possible causes of smell loss, including:
- Upper respiratory infection, such as the common cold
- Nasal problems, such as seasonal allergies or chronic sinus disease
- Head injury, if it damages the olfactory nerve or brains smell-processing centres
- Cigarette smoking
- Parkinsons or other neurological diseases, such as Alzheimers
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Engaging The Parkinsons Community
Having started his career as a developmental biologist, over time Tilos work became focused on Parkinsons disease a degenerative brain disorder for which there are currently no tests or cures. He now runs his own laboratory at the Universitys Centre for Regenerative Medicine, where he pioneers work into the development of cell replacement therapies to treat the disease.
It was as his research became more centred on Parkinsons that Tilo began to engage more with the Parkinsons community, regularly meeting with patient and charity groups to share his research. He soon found that this interaction was a two-way process and he was learning as much from them as they were from him.
Interacting with the patient community, for me, is an extremely important activity, Tilo says. Not only do I get massive enthusiasm and encouragement but I also get ideas for experiments. Through interaction with the patients, you really understand what would most benefit them going forward.
It was at one such meeting in Edinburgh that Tilo had a chance encounter with Joy Milne.