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On the scent of Parkinson’s disease

Friday October 30, 2015

That shaking that you felt over the last few weeks was the Parkinson’s Disease world getting rocked by the news that a Scottish woman can detect PD by a subtle “musky” odor given off by those afflicted with the disorder. This is good, if typically weird, Parkinson’s news.

One theory explaining this development is that skin changes that the disease causes bring on the telltale odor. Whatever the cause, this has significant ramifications.

Hnwpf Blog Illo 23First it gives us a shot at earlier diagnosis of the disease than we are capable of now. The woman, Joy Milne, noticed a change in the way her husband smelled six years before he was diagnosed with PD through standard methods. This is important as the earlier we intervene with exercise and appropriate medication, the better the long-term outlook is for the patient. A six-year head start on working to slow the disease would give those who got the early diagnosis a huge window to work within on mitigating disease progression.

Another benefit of this discovery is in the way it helps us as we rethink Parkinson’s Disease. The apparent origin of the odor as a result of skin changes is more evidence, along with the changes in the health of the gut and the olfactory system (sense of smell), that Parkinson’s is undermining us long before the damage that it inflicts on the brain becomes apparent. Yes, Parkinson’s is a disease of the brain, but it is more than that, it affects our bodies far beyond the dopamine-making cells of the Substantia Nigra where it finally betrays its presence in the familiar motor symptoms now used to diagnose the disease.

This is all predicated on the idea that the sniff test is accurate. So just how good is Ms. Milne at diagnosing PD? A small test suggests her ability is uncanny. According to the Washington Post “Researchers at the University of Edinburgh gave T-shirts to six people with Parkinson’s and six people without the disease. After the subjects wore the shirts, they were passed on to Milne, who then had to determine by smell whether each wearer had Parkinson’s... Milne made correct assessments for 11 out of the 12 cases. In the one case she got “wrong,” she insisted that a T-shirt worn by a member of the control group had the warning scent. Eight months after the study was conducted, she was proven right, bringing her accuracy rate up to one hundred. The supposedly healthy individual contacted one of the doctors and informed him that he had, in fact, just been diagnosed with Parkinson’s.”

But where are we to find supersmellers like Ms. Milne? The fact that she is the only one to have been discovered in the entire history of human interaction with PD suggests people like her are few.

People maybe. But we do have plenty of supersmellers around who would excel at the  job: our partners in life, dogs. Dogs have noses that put the human schnozz to shame. Canines are busy indexing, analyzing, savoring, and learning from subtle odors humans are simply oblivious to all the time. Dogs have proved themselves capable of detecting drugs and explosives, and in the medical field, cancer.

Canines surely can be trained to diagnose Parkinson’s disease years before it can be detected by a neurologist. And given the insensitive and often ham-handed and callous treatment people get when they are delivered the life-changing news of a Parkinson’s diagnosis, the question must be asked: would you rather get a PD diagnosis from your average neurologist or your average golden retriever?

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