Category: Technology
Objective: We aimed to: a) determine the effectiveness of two shortened six-item ‘scratch-and-sniff’ smell tests and an alternative novel alginate capsule scent delivery system in a small study composed of cases diagnosed with Parkinson’s disease (PD), and controls; b) demonstrate the stability of the alginate capsules over time.
Background: Previous work suggests that the 40-item University of Pennsylvania Smell Identification Test (UPSIT) may be shortened, with an abbreviated set of scents, whilst not significantly compromising detection of hyposmia in people with PD (1). A test of this kind may be more practical in routine care settings.
Established smell tests have delivered scents either via felt pens or a ‘scratch-and-sniff’ system to release microcapsules. We created a novel delivery mechanism using a bi-nozzle connected to a dual infusion pump system, driving scented oil and alginate through the inner and outer nozzle respectively. The alginate beads expelled from the needle solidify in calcium chloride (CaCl2) solution (1M) whilst simultaneously encapsulating the oil. The alginate capsules containing scented oil can be later ruptured to release the scent.
Method: We tested various alginate viscosities and storage conditions to assess the stability of tests over time. We then undertook a comparative study in 25 PD patients and controls, tested as part of a larger case-control study in East London. The two six-item scratch-and-sniff style tests contain scents determined to be most discriminatory for identifying people with hyposmia (2) and PD (3) derived in previous large-scale data analyses. The third test contains the same six scents as the first scratch-and-sniff, but uses the novel encapsulated delivery method.
Results: Preliminary work demonstrated that 97% of microcapsules remain functional at 3 months and that microcapsules made using medium viscosity alginate (>2000cP) remained relatively constant in weight.
The sensitivity, specificity and other screening characteristics of each test and individual smells will be compared for their ability to identify cases with PD. Qualitative data will also be compared to investigate patient preferences pertaining to the two smell-delivery systems.
Conclusion: This work establishes a proof of concept for shortening smell test batteries and the potential for an alternative scalable delivery method.
References: 1. Auger SD, Kanavou S, Lawton M, Ben-Shlomo Y, Hu MT, Schrag AE, et al. Testing shortened versions of smell tests to screen for hyposmia in Parkinson’s disease. in press 2. Joseph T, Auger SD, Peress L, Rack D, Cuzick J, Giovannoni G, et al. Screening performance of abbreviated versions of the UPSIT smell test. J Neurol. 2019;266(8):1897-906. 3. Bestwick JP, Auger SD, Schrag AE, Grosset DG, Kanavou S, Giovannoni G, et al. Maximising information on smell, quantitative motor impairment and probable REM-sleep behaviour disorder in the prediction of Parkinson’s disease. MEDRXIV reference
To cite this abstract in AMA style:
G. Goodwin, H. Li, A. Ismail, H. Azevedo, G. Giovannoni, A. Schrag, A. Lees, J. Cuzick, J. Bestwick, S. Auger, A. Noyce. Assessing the screening performance of three abbreviated smell tests in Parkinson’s disease [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/assessing-the-screening-performance-of-three-abbreviated-smell-tests-in-parkinsons-disease/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/assessing-the-screening-performance-of-three-abbreviated-smell-tests-in-parkinsons-disease/