clinical diagnostics
Spinal fluid test can
detect Lewy body disease early Researchers from Lund University have shown that Lewy body disease — the second most common neurodegenerative disease after Alzheimer’s disease — can be detected before symptoms appear, using a spinal fluid test. They also demonstrated that reduced sense of smell is strongly linked to Lewy body disease even before other clear symptoms have developed. age with a smell test and then proceed with testing spinal fluid if one wants to detect Lewy body disease early, according to Hansson. “Several drugs targeted at Lewy bodies are currently being developed, with the hope of slowing down the disease,” Hansson said. “Most likely, this type of medication has the best chance of being effective if administered early in the course of the disease. If symptom-free individuals with reduced sense of smell were identified, and the test for Lewy iStock.com/Marcin Klapczynski
bodies was positive, they could participate in drug trials aimed at developing new medications that can halt the disease early.” In a second publication, also in Nature Medicine, the research group studied over 800 individuals with cognitive difficulties and found that around one-fourth of them had a test result
L
ewy body disease is an umbrella term
for Parkinson’s disease and Lewy body dementia. When movement difficulties are more dominant, the disease is called Parkinson’s disease; when cognitive impairments are dominant, the term Lewy body dementia is used. “Lewy body disease is caused by the misfolding
indicative of Lewy body disease. Approximately Hansson’s research group recently completed
50% of those with Lewy body disease also had
a large study involving over 1100 individuals,
accumulation of the proteins amyloid and tau,
none of whom initially showed any cognitive
which are associated with Alzheimer’s disease. For
impairments or motor difficulties. However, it
individuals who had both amyloid and tau, as well
turned out that nearly 10% had Lewy bodies in
as Lewy bodies, the disease progressed faster. This
their brains according to the spinal fluid test. Their
suggests that these brain changes interact, which
results, published in the journal Nature Medicine,
is of great clinical importance for predicting the
thus showed that it is possible to detect Lewy body
patient’s prognosis.
disease even before the first symptoms appear.
Hansson hopes that, just like for Alzheimer’s
”Despite the participants not having any
disease, it will be possible to develop a blood test
cognitive or neurological problems at the beginning
for Lewy body disease. One of the challenges with
of the alpha-synuclein protein in the brain,” said
of the study, we observed that those with Lewy bodies
this is that the concentration of proteins originating
Oskar Hansson, Professor of Neurology at Lund
in the brain subsequently experienced a decline in
from the brain is often 100–1000 times lower in
University. “When this happens, the protein clumps
their cognitive functions over time,” Hansson said.
the blood than in the spinal fluid, which can make
together and forms what are called Lewy bodies,
“They were also the ones who developed Parkinson’s
it difficult to detect Lewy body changes. In the
which damage the nerve cells.”
disease or Lewy body dementia in the coming years.”
meantime, the spinal fluid test is a big step forward
Until very recently, it was not possible to
A second finding was that Lewy bodies are
determine with certainty whether a person with
strongly associated with a reduced sense of smell
“I believe that this test for Lewy body disease
movement difficulties or cognitive impairments
even before other symptoms have developed.
will start being used relatively soon to improve the
had Lewy bodies in the brain until after their death.
The sense of smell also deteriorates as the disease
diagnostic and prognostic work-up in clinics that
But now, with a spinal fluid test, it is possible to see
progresses. The correlation is so clear that it could
take care of individuals with movement disorders
if the person has the misfolded protein.
be justified to screen individuals over 60 years of
and cognitive symptoms,” Hansson said.
18 | LAB+LIFE SCIENTIST - Aug/Sep 2023
for early diagnosis.
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