Man with parkinsons disease using a cane

Science

‘Extremely Transformative’ — Researchers May Have Produced a Skin-Swab Test to Detect Parkinson’s Disease in Early Stages

A potentially groundbreaking advancement in diagnosing Parkinson’s disease has emerged in the U.K., where researchers have developed a test that uses skin swabs. They found that people with Parkinson’s carry certain lipids of high-molecular weight in their sebum—an oily substance found on the skin—that are more active, compared to those who do not have Parkinson’s.

Scientists pursued this strategy after studying Joy Milne, who has hereditary hyperosmia, or a heightened sense of smell. She has worked with Parkinson’s disease doctors and researchers in the U.K. since her husband’s death in 2015. She made headlines with the ability to detect Parkinson’s from a distinct body odor emanating from the skin on the upper back of patients.

 

For this test in the new study, clinicians collected a skin swab from the upper backs of patients and sent in the samples for analysis. The study has been published in the Journal of the American Chemical Society. Previous research has indicated the potential ability to detect differences in types of sebum in people with Parkinson’s.

Sameea Husain Wilson, D.O., director of Movement Disorder Neurology for Marcus Neuroscience Institute at Boca Raton Regional Hospital, explains the potential importance of this latest development.

“This research looking at the skin–swab test would be extremely transformative given that it may provide the ability down the line for patients’ family members, friends, home-health aides, or anyone that is exposed to them, to be able to utilize the test,” explains Dr. Husain. “And perhaps be able to help in making the diagnosis of Parkinson’s disease much earlier than it is typically made.”

Parkinson’s disease is a neurodegenerative disorder that affects predominately dopamine-producing (“dopaminergic”) neurons in a specific area of the brain. Symptoms generally develop slowly over years. The progression of symptoms is often a bit different from one person to another due to the diversity of the disease, but people with Parkinson’s may experience: tremors, mainly at rest; Bradykinesia; limb rigidity; and gait and balance problems.

An earlier diagnosis of Parkinson’s would enable neurologists to start their patients on medications earlier, “which would translate into motoric stability and an improved quality of life,” she adds.

Despite the transformative potential of the skin-swab test, Dr. Husain urges caution in expectations.

“I do not see this type of test becoming a reality soon,” she said. “The reason being there is so much subjectivity to a person’s sense of smell and what they perceive when they smell something, versus another person. Therefore, the number of research subjects that they will have to enroll in the research clinical trials studying this test will have to be extremely large, which will take quite some time to accomplish.”

There is no definitive test yet to diagnose Parkinson’s disease. However, Marcus Neuroscience Institute, which is part of Baptist Health South Florida, is one of just a handful of highly specialized centers of excellence in the region to offer the Syn-One Test, which spots abnormal alpha-synuclein proteins in nerve fibers of the skin. Experts say these proteins are linked to Parkinson’s and a variety of other movement disorders. The Syn-One Test involves three small and painless skin-punch biopsies.

A more complicated test – the Dopamine Transporter Scan (DaTscan) – allows clinicians to see if your body is manufacturing dopamine properly. It has also proven to be highly accurate in confirming Parkinson’s disease diagnoses but the results can take months, according to Dr. Husain.

“For a well-trained, movement disorder neurologist, making the diagnosis of Parkinson’s disease is not difficult,” said Dr. Husain. “But what is difficult is capturing Parkinson’s patients at such an early stage that they have not yet developed any motoric features and are still in the prodromal phase. This skin–swab test could make it possible for movement disorder Neurologists to capture Parkinson’s patients much earlier than we typically do — which would be incredible.”

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