On the scent: how one woman sniffed out Parkinson’s diagnosis
Research impact and institutes 11th April 2019
Today is Parkinson’s Awareness Day – an event to highlight the realities of living with a disease that, it’s estimated, affects one in 500 people in the UK. And yet no one is really sure what the true figure is. This is because there is no definitive test used to diagnose the disease – but that could soon change.
Research conducted at The University of Manchester has revealed that people with Parkinson’s produce a higher concentration of certain compounds on their skin – and the discovery is all thanks to one woman and her extraordinary sense of smell.
An early diag-nose-is?
Right now, Parkinson’s is diagnosed using a combination of a physical examination, a thorough investigation of the patient’s medical history and a discussion about their symptoms. This means that those symptoms are often quite pronounced by the time a patient seeks advice or a doctor is willing to consider Parkinson’s as a probable cause.
However, there may soon be a way to diagnose a patient far earlier – even a decade earlier than the current norm. This would mean therapy could be administered much sooner, with the hope of reducing or preventing altogether some of the more serious degeneration the disease prompts. And it all started when Joy Milne noticed her husband smelled different.
A new scent
Joy’s late husband Les was diagnosed with Parkinson’s disease at the age of 45, although, like many people with Parkinson’s, there had been tell-tale signs for some time before. However, Joy never thought that the unusual “musky” smell she had started to notice on her husband was linked to his condition.
Speaking to the BBC, Joy admits that when she first picked up the strange scent, it caused some “contention” in the marriage, because she thought her husband wasn’t showering or brushing his teeth properly.
All this was six years before Les was told he had Parkinson’s. Following the diagnosis, the couple started to attend support groups for people with the disease, and it was there she put two and two together. “My nose just thought ‘wow’,” she explained.
Joy’s super smell power was brought to life when she took part in research conducted by The University of Manchester’s School of Chemistry in collaboration with Edinburgh University. By chance, Joy mentioned that the people with Parkinson’s she had come into contact with all had the same scent.
Prof Perdita Barran, lead author of the study and Professor of Mass Spectrometry at the Manchester Institute of Biotechnology, and her team organised an early test and invited in six subjects with Parkinson’s disease and six control subjects. Joy, who is now an Honorary Lecturer at The University of Manchester, was able to detect the scent on all six of the subjects with Parkinson’s.
“One of the test subjects she scored as a low hit as a Parkinson’s sufferer,” Prof Barran notes. “So that was a false result, an incorrect result, but we thought that this is still a pretty good hit rate. Then, remarkably, about nine months after that, that person who was our control was diagnosed with Parkinson’s.”
On the scent of a cure?
While Joy undoubtedly has a keen sense of smell, telling the BBC “I’m in a tiny, tiny branch of the population – somewhere between a dog and a human”, she isn’t a superhero sniffer (that we know of). This means that Parkinson’s does have its own unique scent – and working out exactly what it is made up of could help doctors diagnose people with the condition years earlier.
Prof Barran and her team collected samples from a group of 60 – half of the subjects had Parkinson’s and half were controls. By analysing the data, they discovered that the subjects with Parkinson’s had higher levels of hippuric acid, eicosane and octadecanal compounds on their skin, indicating altered levels of neurotransmitters. Using this information, the scientists created a model that can be used to diagnose people at far earlier stages of the condition.
While this isn’t a cure, an earlier diagnosis of Parkinson’s potentially has profound benefits. “This could have a huge impact not only for earlier and conclusive diagnosis, but also to help patients monitor the effect of therapy. We hope to apply this to at-risk patient groups to see if we can diagnose pre-motor symptoms and assist with potential early treatment,” Prof Barran explains.
Professor David Dexter, Deputy Director of Research at Parkinson’s UK, adds: “More research is needed to find out at what stage a skin test could detect Parkinson’s, or whether it also occurs in other Parkinson’s 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 127,000 people living with Parkinson’s in the UK.”
You can find out more about Joy and the team’s breakthrough in this short film.
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Words – Hayley Cox
Images – The Telegraph
The University of Manchester