Something in the air

A breakthrough in early detection of Parkinson’s could diagnose the condition years before we notice any visible symptoms. But would you want/have wanted to know sooner? I’m not sure.

I was 67 years old when I discovered my glabella. It sounds like an erogenous zone, but this particular G-spot is actually that flat point between the eyebrows where ET touches Elliott in their parting scene and promises “I’ll be right here”.

The glabellar reflex is a diagnostic test for Parkinson’s. When the practitioner taps the spot repeatedly, people with Parkinson’s keep blinking for longer than people without. That, and watching me shuffle slowly and awkwardly down the corridor, were just two of the puzzle pieces that helped my hospital doctor confirm my GP’s suspicions.

Currently, a diagnosis of Parkinson’s depends heavily on a subjective observation of motor symptoms such as slow movement, tremor, rigidity and facial masking. But by the time these symptoms are evident, the degeneration of dopamine-producing cells is well advanced.

So wouldn’t it be just perfect if there was a simple, non-invasive, measurable test you could do that detected Parkinson’s years before the damage was done?  

Nose to diagnose

Two papers published this week suggest we are edging closer to such a test. Collecting samples of sebum, the oily substance our skin produces as its own moisturiser, researchers can extract the gases we give off through our skin.  These volatile organic compounds (VOCs) are different for people with Parkinson’s, and they change over time.  We smell different.

At the Manchester Institute of Biotechnology[1],  a key player in the research team is  Joy Milne from Perth, Scotland, who’s been identified as a ‘super sniffer’. A rare condition called hyperosmia makes her oversensitive to smells.  Joy first noticed that her husband smelled different some 10 years before he developed motor symptoms and was diagnosed with Parkinson’s. She took him to a support group and her nose went crazy as she realised all the other people with Parkinson’s had the same odour.

At Bristol University Veterinary School[2], two medical detection dogs, Peanut and Bumper, have reached a high level of accuracy in distinguishing Parkinson’s odour, without too many false positives.

A screening test would be a simple matter of swabbing an area of skin from a sebum-rich area and sending it off the lab. It would be non-invasive and relatively cheap to implement.  

Do you really want to know?

Would I want to have known sooner? If the test was for cancer, I would jump at the chance to find out and fast-track into treatment. For Parkinson’s, I’m not so sure. I cherish those maybe 6-7 years of blissful ignorance in which I thought the slow, daffy thing was just my age. I was still working and earning money. If I’d been younger, with a mortgage to pay, a car to run, and responsibilities for the generation above and/or below, my world might have fallen apart.

Contributing on Facebook, Sylvia Humphrey agrees:

“Not me! I’ve already realised I’ve had it at least 15 years and I’m glad I didn’t know.”

A ‘simple’ test could create a huge problem, launching newly-worried but otherwise well patients into an already overstretched health service. Neurologist and Parkinson’s nurse appointments are like gold dust. Who would get priority? There could be all sorts of legal implications with driving and insurance.  Would there be enough Sinemet to go round?

In a 2018 paper, Rees et al[3] invite us to consider ‘early’ as one part of a spectrum of  ‘timely’ diagnosis (see their Figure 2).

They say:

“The best time for a ‘timely’ diagnosis depends on what the patient wants, whether there are treatments that can slow the disease, and if health systems can support people at all stages… In the end, decisions about when to diagnose should be made together by doctors and patients, respecting each person’s needs and values.”

For me it is what it is, and I manage my Parkinson’s symptoms as best I can, with exercise, music, fresh air, great support and good humour. It’s working so far.

1. Walton-Doyle, C, Heim, B, Sinclair, E et al. Classification of Parkinson’s disease and isolated REM sleep behaviour disorder: delineating progression markers from the sebum volatilome. npj Parkinsons Dis. 11, 202 (2025). https://doi.org/10.1038/s41531-025-01026-8
2. Rooney N, Trivedi DK, Sinclair E, et al. Trained dogs can detect the odor of Parkinson’s disease. Journal of Parkinson’s Disease. 2025;0(0). doi:10.1177/1877718X251342485
3. Rees RN, Acharya AP, Schrag A and Noyce AJ. An early diagnosis is not the same as a timely diagnosis of Parkinson’s disease [version 1; peer review: 2 approved]. F1000Research 2018, 7(F1000 Faculty Rev):1106 (https://doi.org/10.12688/f1000research.14528.1)

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