A Proactive Approach to Parkinson’s Disease

The University of Pennsylvania Smell Identification Test (UPSIT) is the most widely used–and useful–clinical olfactory test in the world. Developed and practiced at the university’s renowned Smell and Taste Center, the UPSIT consists of four booklets containing ten microencapsulated odors, each accompanied by four possible responses from which the participant is asked to choose. Studies using the UPSIT have positively linked olfactory dysfunction to a variety of causes ranging from head trauma and respiratory infection to neurological disorders like Alzheimer’s and Parkinson’s disease. The value of the test in assessing olfactory damage after-the-fact has been apparent almost since its introduction by Dr. Richard Doty in the 1980s, but only recently has the UPSIT begun to demonstrate its potential as a predictive tool. A study concluded just last month revealed that, even in the absence of any other symptoms, olfactory defects may indicate a genetic predisposition to schizophrenia. Now, the researchers are working on a similar study to determine the value of olfactory dysfunction as a risk marker for Parkinson’s disease.

As with the schizophrenia study, unaffected first-degree relatives of patients diagnosed with the disease will be divided into two groups based on UPSIT testing–those with a normal sense of smell and those without. Both groups will then undergo neuroimaging analysis to identify differences in brain functions related to Parkinson’s. The results of the study, which could provide necessary preliminary data for clinical trials to prevent the occurrence of Parkinson’s in at-risk indivicuals, could have a significant impact on the 1 in 100 of us who will be affected by the disease at some point after the age of sixty. “Ultimately, we hope this will enable us to think about Parkinson’s disease in the way we think about heart disease,” says Dr. Matthew Stern, director of the university’s Parkinson’s Disease and Movement Disorder Center, “as a condition that can be diagnosed before it becomes clinically manifest and disabling.”