Detection of neurodegenerative disease using olfaction

• Published in: Lancet neurology Vol. 16; no. 6; pp. 415 - 416
• Main Authors: Xydakis, Michael S, Belluscio, Leonardo
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-06-2017; Elsevier Limited
• Subjects: Alzheimer's disease; Anosmia; Basal ganglia; Brain mapping; Brain research; Central nervous system diseases; Clinical trials; Cognitive ability; Defensive behavior; Dementia; Dementia disorders; Developmental stages; Environmental factors; FDA approval; Humans; Identification; Inflammation; Movement disorders; Neurodegenerative Diseases; Neurology; Olfaction; Olfactory system; Parkinson's disease; Pathology; Respiratory tract; Rhinitis; Smell; Somatosensory cortex; Tobacco; Traumatic brain injury; β-Amyloid
• ISSN: 1474-4422; 1474-4465
• DOI: 10.1016/S1474-4422(17)30125-4

Tests for detecting olfactory impairment might offer a sensory-based approach for presymptomatic detection of concealed intracranial pathology and, as such, opportunities for large-scale screening in a primary care setting.1 With well validated mapping of this neurosensory deficit onto a region of the brain that is selectively susceptible to a specific type of neurodegenerative disease (eg, the prefrontal cortex), olfactory tests offer the possibility of both predicting pathology in particular areas of the brain and monitoring disease progression.2 Such testing also has the additional potential to select and stratify patients in treatment trials of neurodegenerative disease or prevention trials in cognitively intact individuals at risk of developing a neurodegenerative disease.3 Olfactory impairment potentially allows the study of disease at a very early stage in people at risk.4-9 A basic understanding of olfactory function is central to determining its association with neurodegenerative disorders. Olfactory studies in patients with neurodegenerative disease are further confounded by the use of outcome measures with limited psychometric properties, reliance on autobiographical self-report symptomatology, frequent use of olfactory screening tests (eg, Brief Smell Identification Test) with low test-retest reliability and construct validity, and lack of any sort of rhinoscopy during physical examination to rule out infectious, inflammatory, or...