Researchers at Duke University have demonstrated that a minimally invasive nasal swab can detect biological signals associated with Alzheimer’s disease prior to the onset of cognitive symptoms, according to a study published in Nature Communications.
The procedure involves applying a topical anaesthetic and using a small brush to collect olfactory nerve and immune cells from the upper nasal cavity, a region with direct proximity to the central nervous system. Single-cell gene expression analysis was then performed on the collected samples, generating millions of data points across hundreds of thousands of individual cells from 22 participants.
The analysis identified distinct gene activity patterns that differentiated individuals with early or clinically diagnosed Alzheimer’s from healthy controls, including participants who had laboratory-confirmed Alzheimer’s biomarkers but no symptoms. A combined nasal tissue gene score correctly classified early and clinical Alzheimer’s cases with approximately 81% accuracy.
The authors highlight a key advantage over current blood-based diagnostics: existing blood tests detect markers that emerge later in the disease process, whereas the nasal swab captures active neural and immune cell activity, potentially providing a more direct and earlier biological signal. The procedure is also outpatient-compatible and takes only a few minutes to perform.
Lead author Vincent D’Anniballe noted that the approach enables the study of living neural tissue, which has historically only been available post-mortem. The Duke team is now expanding the study to larger cohorts and investigating whether the method could serve as a tool for monitoring treatment response over time.
Source: D’Anniballe V. et al., Nature Communications (2026). DOI: 10.1038/s41467-026-70099-7
