Losing your sense of smell may be more than just a nuisance, it could be an early sign of serious brain disease. In Parkinson’s disease and dementia with Lewy bodies, abnormal protein deposits known as Lewy bodies often begin in the brain’s olfactory regions, making smell loss one of the earliest and easiest symptoms to test.
Fortunately, not all problems with reduced sense of smell are caused by Lewy body diseases. A more specific way of detecting these conditions is to measure traces of the protein α-synuclein in the spinal fluid. However, this method is both costly and more invasive for patients.
Now, researchers at MultiPark have found a way to reduce the number of invasive spinal fluid tests by 43% while still achieving 94% accuracy in predicting Lewy body pathology. Their new approach consists of a two-step diagnostic workflow: first, patients take a simple smell test. Only those who show reduced smell then undergo a lumbar puncture to measure levels of α-synuclein and thereby confirm or rule out the presence of Lewy body disease.
“This is a cost-effective way to increase diagnostic accuracy of diseases like Parkinson’s while reducing patient burden,” explains Sophie Mastenbroek.
“This is a cost-effective way to increase diagnostic accuracy of diseases like Parkinson’s while reducing patient burden,” explains Sophie Mastenbroek, PhD student at the Clinical Memory Research Unit and the first author of the study.
While the spinal fluid assay is still mainly used in research, smell tests are already available in clinics. Before the combined approach can be widely implemented in healthcare, the protocol needs to be validated in diverse patient groups and approved by regulatory authorities.
“We hope to see our combined strategy, with smell-function testing as a pre-screening method, become routine in patient care as soon as possible.
“We hope to see our combined strategy, with smell-function testing as a pre-screening method, become routine in patient care as soon as possible. More accessible diagnostics would make it possible to identify patients at earlier stages and provide better care,” concludes Rik Ossenkoppele and Oskar Hansson, senior authors of the study published in Nature Communications.
