Thursday, 26 January 2017

Dementia 'smell test': Scientists develop an effective means of diagnosing the disease through a special scan involving the nose

A test for people who lose their sense of smell in the early stages of Alzheimer's could diagnose the condition before it strikes.

Scientists have developed a simple scan which may be able to pinpoint dementia before memory loss even begins.
The key is in someone's sense of smell, which starts to deteriorate in many neurological conditions, from Down's syndrome and schizophrenia to Alzheimer's and Parkinson's disease.
It is why there is a so-called 'peanut butter test' for people with Alzheimer's who are less able to sniff out the spread from a distance.
Scientists have developed a simple scan which may be able to pinpoint dementia before memory loss even begins. The key is in someone's sense of smell, which starts to deteriorate in many neurological conditions

However simple smell tests, according to a team led by Massachusetts General Hospital and Harvard Medical School, offer an incomplete picture, monitoring the sense of smell only after it is detected by the brain.
They have developed a PET scan, called Neuroflux, which avoids the need for a painful biopsy, and picks up the early signs of Alzheimer's in the nose.
The breakthrough, found to work effectively in mice, is hoped to lead to a test for all kinds of memory loss in adults, and not just Alzheimer's.
Lead author Dr Jacob Hooker said: 'I heard about the peanut test for Alzheimer's years ago. 
'A lot of beautiful research with smell tests has been published with many geared towards making them more robust, but there are lots of reasons that might not work very well, for example if someone has sinus inflammation due to a cold.
'By looking more directly at olfactory sensory neurons between the nose and brain, we can learn more about the health of the cells that are responsible for smell and extend into the brain. 
The breakthrough, found to work effectively in mice, is hoped to lead to a test for all kinds of memory loss in adults, and not just Alzheimer's
'This may provide a window into the brain and we hope this will ultimately help with early diagnosis.'
The link between the nose and the brain explains why people's memories are more strongly triggered by a smell, like an ex-partner's perfume, than by a photograph. 
Previous studies have shown smell tests can flag up everything from very mild memory loss to full-blown Alzheimer's disease.

That is because in many people hyposmia or anosmia – a partial or complete loss of the sense of smell – happens before cognitive problems in Alzheimer's and years before the tremors and loss of motor function caused by Parkinson's disease.
Charity Parkinson's UK said a new test could be a 'significant step forward' in diagnosing the condition earlier when people are most likely to benefit from treatment.
A PET scan is said by the researchers, whose study is published in the Journal of Clinical Investigation, to be better than sniff tests. 
Noisy hospitals can accelerate the course of dementia in elderly patients, experts found last week.
The confusion of busy waiting rooms or seeing different doctors and nurses can send patients into a rapid decline, according to a major study.
The research, led by University College London and the University of Cambridge, is the first to show that becoming acutely confused and disorientated - a condition known as delirium - can accelerate cognitive decline among patients with dementia. 
That is because it finds initial problems with odour detection and not just the higher-level processing of smells in the brain.
Biopsies work better by showing if olfactory sensory neurons have been lost, but are painful and technically difficult. 
MRI scans, also used to check for these neurons, can be challenging because they detect water and there is very little in the nose.
The new scan, which tracks a radioactive molecule injected into the body which flows through the nose, is hoped to hold the answer. 
If its signal reduces a few months between scans, this is a sign that there are fewer olfactory neurons. 
Dr Doug Brown, director of research at the Alzheimer's Society, said: 'There is evidence to suggest that someone's sense of smell could be impacted in the early stages of dementia. 
'This study looks at a new technique for detecting changes in the brain cells that are important for our sense of smell, and could help to explore this link further.
'However, because this method has only been tested in animals and not humans, it is too early to tell if this test could help improve diagnosis.'

SOURCE: Mail Online, Victoria Allen

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