Parkinson’s Disease - 3-Minute Test Detects the Disease

Parkinson’s disease (PD) is one of the most pervasive and widespread neurological disorders in the world. This chronic disease affects a person’s movement and cognition, and it has no known cure. Existing Parkinson’s medications and other treatments are more effective at the early stages of the disease, so a reliable and quick diagnostic tool remains a key priority in Parkinson’s research. 

 

Scientists from the United Kingdom took an unusual route to diagnose Parkinson’s. They developed a noninvasive skin test that only takes 3 minutes to process and can accurately identify the disease, even in its early stages. 

 

Why Diagnosing Parkinson’s Disease is Challenging

Around sixty thousand Americans are diagnosed with PD annually, and many more fly under the radar. Younger people are most likely to be misdiagnosed or underdiagnosed, even though 10-20% of all PD patients experience the first symptoms before 50 years of age. 

 

At present, diagnosing a person with Parkinson’s is a lengthy and complicated process. A specialist examines brain images, tests symptoms with neurological tests like a tapping or walking test, and looks at a patient’s medical history before making a final diagnosis. 

 

Since PD has many mutual symptoms with other neurological issues, it often takes several visits to establish a Parkinson’s diagnosis. This, of course, takes a lot of time from the patient and the doctor. And for a disease that affects nearly a million Americans, this seems to be a pretty inefficient diagnostic approach. 

 

Researchers from the University of Manchester, in the UK, say that they can change that once and for all. They developed a quick test that is able to detect PD based on a person’s skin secretions. The results of the study were published in the Journal of the American Chemical Society.

Scientists Develop a 3-Minute Test for Parkinson’s

First observed in 1927, increased production of sebum (an oily substance in the skin) is a known symptom of Parkinson’s disease. But the research in question was inspired by the first-person account of one Joy Milne. A retired nurse with hereditary hyperosmia, or the heightened sense of smell, Milne observed that her husband Les’ scent had suddenly changed. 

 

More than a decade later, Les was diagnosed with PD. The couple started going to a Parkinson’s support group, and right away, Milne noticed that the people in the group had the same body smell as her husband Les. 

 

Sadly, Les passed away in 2015, but Milne decided to collaborate with medical researchers to use her observation as a way to improve the diagnosis of the disease. Biofluid analyses supported her estimation, as these have revealed that the composition of sebum indeed changes with the onset of the disease. But the research didn’t stop there. 

 

Researchers from the University of Manchester found out that a simple sebum sample taken from the skin with a cotton swab can help them detect unique biomarkers associated with Parkinson’s disease. This is the first chemical test of PD, and the researchers are planning to collaborate with hospitals in the Manchester area to implement the test in the next two years.

 

How Does the Test Work?

The researchers report that they recruited participants from 27 clinics in the UK. All in all, they collected 150 sebum samples taken by simply swiping the cotton swab over the skin in the mid-back area. 79 samples were taken from PD patients, and 71 were taken from individuals without the disease and used as controls. 

 

The samples were transported to a lab, where the sebum was isolated onto filter paper. The lab specialists then added a solvent and voltage to prepare it to be used in a mass spectrometer, which is a device used to identify unknown chemical compounds. Overall, the samples contained 4,200 unique features, 500 of which were uniquely found in individuals with PD but not in the control group. 

 

The unique chemical markers can now be used to test new samples in PD diagnoses and to further confirm the test’s reliability. As neurologist Prof. Monty Silverdale, the clinical lead author of the study, pointed out, “This test has the potential to massively improve the diagnosis and management of people with Parkinson’s disease.” Parkinson’s Disease Test doctor

Like any study, the research presented here has some limitations. We are yet to find out if this rapid and affordable test is sensitive enough to diagnose all PD patients, especially those in the early stages of the disease. Another open question is if this test can be used in people who produce less sebum. For example, conditions like seborrhea or seborrheic dermatitis lower one’s sebum production, and it is commonly found in people with PD. 

 

We eagerly await the UK researchers to address these questions in their further research.

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Is Vomiting a Symptom of COVID-19? Here's What Doctors Say

The most common symptoms of COVID-19 are pretty much what you’d expect from a respiratory disease: fever, persistent cough, fatigue, and muscle pain. But according to the Centers for Disease Control and Prevention (CDC), many people with COVID-19 experience gastrointestinal symptoms such as nausea, vomiting, or diarrhea—sometimes even before developing the respiratory tract symptoms. 

"COVID-19 can present in many ways. I have seen patients who only have symptoms of vomiting and diarrhea, but they usually also have a fever," Jorge Vournas, MD, medical director of the Emergency Department at Providence Little Company of Mary Medical Centerin Torrance, California, tells Health.

Anecdotally, vomiting has been linked to COVID-19. In March, 22-year-old Amy Shircel from Madison, Wisconsin, began detailing her COVID-19 symptoms in a series of tweets. "I'm 22 and I tested positive for COVID-19. Take it from me - you do NOT want to catch this," she wrote. Shircel shared that the first few days of her illness were manageable, with a mild cough, headache, chills, and a runny nose. Because she had just visited Europe recently, her state allowed her to get tested for COVID-19 with minor symptoms. But things progressed on the third day. "I couldn't keep anything down. I was vomiting constantly. I couldn't sleep, I obviously couldn't eat," she wrote. The next day, she received a positive COVID-19 diagnosis. She detailed her symptoms through day 12 of her illness—after being hospitalized for dehydration—and still had "all the major symptoms" even then, but is apparently recovered now.

Shircel's not the only one: In an opinion piece for The New York Times, writer Abigail Tarttelin detailed her experience with what she thinks was the coronavirus and the symptoms that accompanied it. "Here's what happened to me," she wrote. "On the morning of Friday, March 6, I woke up with a mild sore throat and, to put it delicately, digestive issues." Just four days later, she came down with what seemed like norovirus. "Profuse vomiting. I spent the day alternating between the couch and the bathroom, feeling sorry for myself," she wrote. Days after that, she developed a cough, muscle aches, and lung pain—and though she never got tested for COVID-19, she believes it's what caused her symptoms.

Research, too, has found gastrointestinal issues, including nausea and vomiting, to be symptoms of COVID-19, in addition to other respiratory symptoms. Some of the earliest research on gastrointestinal issues as related to COVID-19 came from China, and was published in the BMJ's Gut in March. Study authors from Zhejiang University found that, among 651 patients admitted to hospitals in China's Zhejiang province between January 17 and February 8, 74 patients—or 11.4%—presented with at least one gastrointestinal symptom of nausea, vomiting, or diarrhea. 

 Other research from Beijing, published in the journal Alimentary Pharmacology & Therapeutics in May, analyzed all COVID-19 clinical studies and case reports relating to digestive issues published between December 2019 and February 2020. Researchers found that 3.6% to 15.9% of adults with COVID-19 experienced vomiting, along with other gastrointestinal issues like loss of appetite, nausea, abdominal pain, and even gastrointestinal bleeding. The study also uncovered that vomiting was more common in children with COVID-19 than adults, with 6.5% to 66.7% of infected children presenting with the symptom.

And sometimes, vomiting and other gastrointestinal issue were the only sign of a COVID-19 infection, or a precursor to the infection. According to research published in The American Journal of Gastroenterology in April, more than 50% of 204 COVID-19 patients hospitalized in China's Hubei province between January 18 and February 28 reported digestive symptoms like lack of appetite, diarrhea, vomiting, or abdominal pain. Six of those patients had no respiratory symptoms whatsoever. Research published in the Journal of the American Medical Association, too, identified 14 coronavirus patients who had diarrhea and nausea before they showed any signs of fever or respiratory symptoms—that was equal to about 10% of the study's 138-person sample size.

While experts aren't entirely sure why or how COVID-19 may cause vomiting or other gastrointestinal symptoms, researchers have a theory: Because the molecule that the coronavirus attacks in the body—angiotensin-converting enzyme 2, or ACE2—exists not only in the lungs, but in the gastrointestinal tract as well, that may explain why some people experience stomach issues. Another study published The American Journal of Gastroenterology suggests that the virus can enter the digestive system through cell surface receptors for ACE2. Receptors for this enzyme are 100 times more common in the gastrointestinal tract than the respiratory tract. Still, more research needs to be done to identify the exact mechanism. 

All of this research and anecdotal evidence suggests that vomiting and other gastrointestinal issues shouldn't be ignored during the COVID-19 pandemic, and that the symptoms may warrant a test to see if you have the virus. "It would be wise to consider that you may have COVID-19 if you develop vomiting and diarrhea and have no other obvious cause," says Dr. Vournas. "In which case, getting tested would be the next best step."

If you experience vomiting, and have been tested for COVID-19, the best thing you can do is self-isolate while you wait for your results and treat yourself at home. The CDC advises staying hydrated, getting as much rest as possible, avoiding foods that upset your stomach, and keeping an eye on your symptoms. But "if you have vomiting, you should seek medical attention if your symptoms are lasting for more than 24 hours, or if you are experiencing high fevers, abdominal pain or have blood or a dark 'coffee-ground’ appearance of your vomiting," says Dr. Vournas, as that can be a sign of a more serious issue that needs immediate care. 

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

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