Neuroscience Department, Bruce Rappaport Faculty of Medicine , Technion - Israel Institute of Technology , Haifa 3200003 , Israel.
Bruce Rappaport Faculty of Medicine , Technion - Israel Institute of Technology , Haifa 3200003 , Israel.
ACS Chem Neurosci. 2018 Nov 21;9(11):2548-2553. doi: 10.1021/acschemneuro.8b00245. Epub 2018 Jul 13.
Early diagnosis of Parkinson's disease (PD) is important because it affects the choice of therapy and is subject to a relatively high degree of error. In addition, early detection of PD can potentially enable the start of neuroprotective therapy before extensive loss of dopaminergic neurons of the substantia nigra occurs. However, until now, studies for early detection of PD using volatile biomarkers sampled only treated and medicated patients. Therefore, there is a great need to evaluate untreated patients for establishing a real world screening and diagnostic technology. Here we describe for the first time a clinical trial to distinguish between de novo PD and control subjects using an electronic system for detection of volatile molecules in exhaled breath (sensor array). We further determine for the first time the association to other common tests for PD diagnostics as smell, ultrasound, and nonmotor symptoms. The test group consisted of 29 PD patients after initial diagnosis by an experienced neurologist, compared with 19 control subjects of similar age. The sensitivity, specificity, and accuracy values of the sensor array to detect PD from controls were 79%, 84%, and 81% respectively, in comparison with midbrain ultrasonography (93%, 90%, 92%) and smell detection (62%, 89%, 73%). The results confirm previous data showing the potential of sensor arrays to detect PD.
帕金森病 (PD) 的早期诊断很重要，因为它影响治疗方案的选择，并且存在相对较高的错误率。此外，PD 的早期发现可能使我们能够在黑质多巴胺能神经元广泛丢失之前开始神经保护治疗。然而，到目前为止，使用挥发性生物标志物进行的 PD 早期检测研究仅针对经过治疗和用药的患者进行。因此，非常有必要评估未经治疗的患者，以建立一种真正的用于筛选和诊断的技术。在这里，我们首次描述了一项临床试验，该试验使用电子系统检测呼出气中的挥发性分子（传感器阵列）来区分新发 PD 患者和对照者。我们进一步首次确定了与其他常见 PD 诊断测试（嗅觉、超声和非运动症状）的关联。试验组由 29 名经经验丰富的神经科医生初步诊断为 PD 的患者组成，与 19 名年龄相仿的对照组患者进行比较。与中脑超声（93%、90%、92%）和嗅觉检测（62%、89%、73%）相比，传感器阵列检测对照组中 PD 的敏感性、特异性和准确性值分别为 79%、84%和 81%。结果证实了先前的数据，表明传感器阵列具有检测 PD 的潜力。
