The Utility of Breath Analysis in the Diagnosis and Staging of Parkinson's Disease

Background: The analysis of volatile organic compounds (VOCs) collected in breath samples has the potential to be a rapid, non-invasive test to aid in the clinical diagnosis and tracking of chronic conditions such as Parkinson's disease (PD). Objective: To assess the feasibility and utility of breath sample analysis done, both at point of collection in clinic and when sent away to be analyzed remotely, to diagnose, stratify and monitor disease course in a moderately large cohort of patients with PD. Methods: Breath samples were collected from 177 people with PD and 37 healthy matched control individuals followed over time. Standard clinical data (MDS-UPDRS & cognitive assessments) from the PD patients were collected at the same time as the breath sample was taken, these measures were then correlated with the breath test analysis of exhaled VOCs. Results: The breath test was able to distinguish patients with PD from healthy control participants and correlated with disease stage. The off-line system (remote analysis) gave good results with overall classification accuracies across a range of clinical measures of between 73.6% to 95.6%. The on-line (in clinic) system showed comparable results but with lower levels of correlation, varying between 33.5% to 82.4%. Chemical analysis identified 29 potential molecules that were different and which may relate to pathogenic pathways in PD. Conclusion: Breath analysis shows potential for PD diagnostics and monitoring. Both off-line and on-line sensor systems were easy to do and provided comparable results which will enable this technique to be easily adopted in clinic if larger studies confirm our findings.