A nose to diagnose: improving Parkinson’s diagnosis

A nose to diagnose: improving Parkinson's diagnosisParkinson’s is a complex disease to diagnose and relies on practitioners’ ability to recognise a myriad of different symptoms. University of Manchester Professor Perdita Barran and Joy Milne are working on ways to improve Parkinson’s diagnosis.

Joy Milne is a ‘super smeller’, she has a rare condition called hyperosmia that gives her an extremely sensitive sense of smell. Throughout her life she has experienced the world differently from those with a regular nose, so much so that when she became a nurse, she noticed people with different diseases had different smells. Initially she didn’t connect the smells to the diseases but when her husband, Les, was diagnosed with Parkinson’s Disease (PD) that’s when it all clicked into place.

“My husband’s smell changed when he was about 30, it went from a fairly standard musky-man-smell to quite an unpleasant musty smell”, she tells us. “He was diagnosed with Parkinson’s about 12 years later and it was when we attended a Parkinson’s support group that I realised everyone else there had the same smell”.

It is this unique ability that caught the attention of Perdita Barran, Professor of Mass Spectrometry in the Manchester Institute of Biotechnology at The University of Manchester. “We realised that if Joy could smell Parkinson’s, there must be something unique happening in people with Parkinson’s (PwP), and so we set about trying to identify what ever it was that created the smell”.

Perdita and Joy have worked closely together over the last few years to identify the particular molecules that give Parkinson’s its smell. By using mass spectrometry, a technique that measures the weight of molecules, they have found that there are distinctive Parkinson’s markers in sebum – an oily substance secreted from the skin.

This breakthrough has led them to develop a non-invasive swab test that can, in conjunction with the onset of early Parkinson’s symptoms, identify Parkinson’s disease with around a 95% accuracy. What’s even more astounding is the speed with which the test can return a result; around 3 minutes under lab conditions. A fast test is a cheaper test, a key factor if it is to be rolled out in a clinical setting, but it would also help to reduce patient wait times.

Currently in the UK it can take many months to see a Parkinson’s disease specialist, which is the only way to receive an official diagnosis. But if the swab test could pre-select those who need to be referred for an official diagnosis, the number of people on the waiting list would decrease and so too would the waiting time.