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J Neurol. 2019 Nov 1. doi: 10.1007/s00415-019-09604-6. [Epub ahead of print]

Machine-learning-derived rules set excludes risk of Parkinson's disease in patients with olfactory or gustatory symptoms with high accuracy.

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Institute of Clinical Pharmacology, Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany.
Fraunhofer Institute of Molecular Biology and Applied Ecology-Project Group Translational Medicine and Pharmacology (IME-TMP), Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.



Chemosensory loss is a symptom of Parkinson's disease starting already at preclinical stages. Their appearance without an identifiable etiology therefore indicates a possible early symptom of Parkinson's disease. Supervised machine-learning was used to identify parameters that predict Parkinson's disease among patients having sought medical advice for chemosensory symptoms.


Olfactory, gustatory and demographic parameters were analyzed in 247 patients who had reported for chemosensory symptoms. Unsupervised machine-learning, implanted as so-called fast and frugal decision trees, was applied to map these parameters to a diagnosis of Parkinson's disease queried for in median 9 years after the first interview.


A symbolic hierarchical decision rule-based classifier was created that comprised d = 5 parameters, including scores in tests of odor discrimination, odor identification and olfactory thresholds, the age at which the chemosensory loss has been noticed, and a familial history of Parkinson's disease. The rule set provided a cross-validated negative predictive performance of Parkinson's disease of 94.1%; however, its balanced accuracy to predict the disease was only 58.9% while robustly above guessing.


Applying machine-learning techniques, a classifier was developed that took the shape of a set of six hierarchical rules with binary decisions about olfaction-related features or a familial burden of Parkinson's disease. Its main clinical strength lies in the exclusion of the possibility of developing Parkinson's disease in a patient with olfactory or gustatory loss.


Data science; Decision trees; Machine-learning; Olfaction; Parkinson’s disease


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