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October 03, 2017; 89 (14) Editorial

Biomarkers for early detection of Parkinson disease

A scent of consistency with olfactory dysfunction

Gene L. Bowman
First published September 6, 2017, DOI: https://doi.org/10.1212/WNL.0000000000004383
Gene L. Bowman
From the Department of Nutrition and Brain Health, Nestlé Institute of Health Sciences, Lausanne, Switzerland; and the Brain Institute, Department of Neurology, Oregon Health & Science University, Portland.
ND, MPH
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Biomarkers for early detection of Parkinson disease
A scent of consistency with olfactory dysfunction
Gene L. Bowman
Neurology Oct 2017, 89 (14) 1432-1434; DOI: 10.1212/WNL.0000000000004383

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There are approximately 1,000 genes involved in odor recognition and 347 that code for functional receptors. This enables our distinguishing of approximately 4,000–10,000 distinct odorous ligands, a scientific discovery that earned a Nobel Prize in 2004.1 The olfactory nerve (CN1) contains 6–10 million receptor cells whose ciliated dendrites and cell bodies are contained within a specialized (neuro)epithelium located within the posterior nasal cavity (figure).2 These olfactory receptor cells are interspersed with sustentacular cells for stability of the epithelium and basal cells (stem cells) that provide a regenerative capacity. Also in residence are the Bowman glands, which secrete and maintain the mucous layer upon the cilia that float just beneath the (neuro)epithelium. This mucous contains several proteins that may help metabolize xenobiotics and support epithelial integrity (e.g., mucin, lysozyme, amylase, immunoglobulin G).2 Once an odorant enters the nose, it interacts with the receptors located on the surface of the olfactory cilia and a chemical signature generates a crescendo of action potentials in the olfactory neuron axon (figure). These project to higher brain regions involved in conscious thought processes and the limbic system, generating the emotional, motivational, and memory context.3 Olfactory dysfunction presenting as hyposmia impairs the satisfaction gained from foods and inhibits the detection of environmental hazards (e.g., toxins, fire, spoiled foods, and natural gas leaks). Diminished olfactory inputs also dampen the neural/cephalic phase of digestion responsible for stimulating exocrine secretions in the mouth (e.g., amylase), stomach (e.g., hydrochloric acid, digestive enzymes), and small intestine (e.g., lipase).4,5 These secretions facilitate the absorption and assimilation of micronutrients and fatty acids and contribute to the nature of the microbiome in the host by governing the gut pH.6

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  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the author, if any, are provided at the end of the editorial.

  • See page 1441

  • © 2017 American Academy of Neurology
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