The test has been in place for years since academics realized Joy Milne could smell the disease. The 72-year-old from Perth, Scotland has a rare condition that gives her a heightened sense of smell. She noticed that her late husband Les developed a different sense of smell when he was 33 – about 12 years before he was diagnosed with the disease – which causes parts of the brain to suffer progressive damage over many years. Ms Milne, dubbed “the woman who can smell Parkinson’s disease”, described a “musky” scent, different from his normal smell. Her observation piqued the interest of scientists, who decided to investigate what she could smell and whether this could be harnessed to help identify people with the neurological condition. Years later, academics at the University of Manchester have made a breakthrough by developing a test that can identify people with Parkinson’s disease using a simple cotton bud on the back of the neck. Image: Joy and Les Milne Possible disposition of the NHS Researchers can examine the sample to identify molecules associated with the disease to help diagnose whether someone has the disease. While still in the early stages of research, scientists are excited at the prospect of the NHS being able to develop a simple test for the disease. There is currently no definitive test for Parkinson’s disease, with a diagnosis based on the patient’s symptoms and medical history. If the new skin swab is successful outside the laboratory, it could be developed to achieve faster diagnosis. Read more: Frequent nightmares may be an early warning sign of Parkinson’s disease Ms Milne said it was “unacceptable” that people with Parkinson’s had such high levels of neurological damage at the time of diagnosis. “I think it should be detected much earlier – the same with cancer and diabetes,” he said. “Early diagnosis means much more effective treatment and a better lifestyle for people.” He added: “It’s been found that exercise and changing your diet can make an amazing difference.” She said her husband, a former doctor, was “determined” to find the right researcher to look at the link between stench and Parkinson’s, and they sought out Dr Tilo Kunath at the University of Edinburgh in 2012. T-shirts that smell Dr Kunath spoke with Professor Perdita Barran to examine Mrs Milne’s sense of smell. Scientists thought the scent might be caused by a chemical change in the skin’s oil, known as sebum, caused by the disease. In their preliminary work, they asked Ms Milne to smell T-shirts worn by people with and without Parkinson’s. Ms Milne correctly identified the T-shirts worn by the Parkinson’s patients, but also said one of the non-Parkinson’s group smelled like the disease – eight months later the person wearing the T-shirt was diagnosed with Parkinson’s. The researchers hoped the finding could lead to a test being developed to detect Parkinson’s disease, hypothesizing that if they were able to identify a unique chemical signature in the skin linked to Parkinson’s disease, it might eventually be able to diagnose the condition from simple skin smears. In 2019, researchers at the University of Manchester, led by Professor Barran, announced that they had identified molecules linked to the disease found in skin swabs. And now scientists have developed a test using this information. The right treatment faster Tests have been successfully conducted in research laboratories and evaluations are being made as to whether they can be used in hospital settings. If successful, the test could potentially be used in the NHS so that GPs can refer patients for Parkinson’s tests. The findings, published in the Journal of the American Chemical Society, detail how sebum can be analyzed by mass spectrometry – a method that weighs molecules – to identify the disease. Some molecules are only present in people with Parkinson’s disease. The researchers compared smears from 79 people with Parkinson’s disease to a control group of 71 people. More than 10 million people worldwide live with Parkinson’s disease, including musician Ozzy Osbourne, comedian Sir Billy Connolly and actor Michael J. Fox, who was diagnosed at age 29. The degenerative disease is the fastest growing neurological condition in the world. It has a variety of symptoms including tremors – particularly in the hands – walking and balance problems, slowness and excessive stiffness in the arms and legs. Professor Barran said there was currently no cure for it, but a confirmatory diagnosis would allow patients to receive the right treatment and medication more quickly. Image: Sir Billy Connolly lives with Parkinson’s disease Read more: Scientists take ‘vital step’ towards finding cure for Parkinson’s disease He said exercise and dietary changes will also be recommended, but “most critically, it will allow them to have a confirmed diagnosis to really know what’s going on with them.” He added: “Right now in Greater Manchester there are around 18,000 people waiting for a neurological consultation and just to clear that list, without new people joining, it will take up to two years. “Of these, 10-15% are suspected of having Parkinson’s. Our test could tell them if they did or did not (suffer from Parkinson’s) and allow them to be referred to the right specialist. “So right now, we’re talking about being able to refer people to the right specialty early, and that’s going to be transformative.” Can it smell other diseases? Ms Milne is now working with scientists around the world to see if she can smell other diseases such as cancer and tuberculosis (TB). “I have to go shopping very early or very late because of people’s perfumes, I can’t go to the chemical aisle in the supermarket, so yes, I’ve cursed a few times, but I’ve also been to Tanzania and researched TB and on cancer in the US – just preliminary work. “So it’s a curse and a boon.” She said she can sometimes smell people who have Parkinson’s while in the supermarket or walking down the street, but has been told by medical ethics that she can’t tell them. “What GP would accept a man or woman walking in, saying ‘the woman who smells like Parkinson’s told me I have it’? Maybe in the future, but not now.”
