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Detection of neurodegenerative disease using olfaction

2017; Elsevier BV; Volume: 16; Issue: 6 Linguagem: Inglês

10.1016/s1474-4422(17)30125-4

1474-4465

Michael S. Xydakis, Leonardo Belluscio,

Biochemical Analysis and Sensing Techniques

Clinical manifestations of cognitive, sensory, or motor impairment detected by a routine examination routinely serve as beacons or pointers that alert and orient neurologists to the possibility of an ongoing and often covert neurodegenerative disease process, and they subsequently assist in differential diagnosis. Many chronic neurological diseases (eg, Parkinson's disease or Alzheimer's disease) are still diagnosed in the same way they were diagnosed a century ago, by carefully listening to and observing patients and their symptoms. Yet, the underlying neuropathology responsible for these neurodegenerative diseases probably develops decades before overt detectable clinical signs or symptoms. However, these disease processes are clinically defined only when the emergence of motor signs or the presence of cognitive impairment become evident. Preclinical neurodegenerative disease is undetectable using currently available clinical methods. Olfactory dysfunction in neurodegenerative diseases: is there a common pathological substrate?In patients with neurodegenerative diseases, there is a spectrum of smell dysfunction ranging from severe loss, as seen in Alzheimer's disease and Parkinson's disease, to relatively little loss, as seen in progressive supranuclear palsy. Given the ubiquitous but varying degrees of olfactory dysfunction among such diseases, it is conceivable that differential disruption of a common primordial neuropathological substrate causes these differences in olfactory function. For example, the amount of damage to forebrain neurotransmitter and neuromodulator circuits, most notably those involving cholinergic transmission, appears to be correlated with quantitative smell test scores across a wide range of neurodegenerative diseases. Full-Text PDF