Dr. Natalia Pessoa Rocha Written by: Dr. Tam Maiuri
Edited by: Dr. Kaitlyn Deschamps and Dr. Christina Peng
Follow Your Nose: A New Way of Tracking Early HD Changes
It may feel more like a sticker book than a medical test, but the scratch-and-sniff booklet that Dr. Natalia Pessoa Rocha uses in her research may hold important clues about how Huntington’s disease (HD) begins. Sometimes a tool as simple as a booklet can open an unexpected window into the brain.
From Brazil to Houston, by Way of the Brain
Dr. Natalia Pessoa Rocha is a neuroscientist at The University of Texas Health Science Center at Houston and an HDSA Human Biology Project fellow. She first trained as a pharmacist in Brazil, building a strong foundation in chemistry and biology before realizing that her real interest lay in research. From there, she moved into a master’s program in neuroscience, where she studied Alzheimer’s disease. She then shifted to Parkinson’s disease during her PhD, focusing on how inflammation and immune signaling influence cognition, mood, and behaviour. Across each stage of her training, she stayed drawn to the overlap between neurology and psychiatry, where subtle changes in the brain begin to shape how people think and feel.
After completing her PhD, she came to Houston as a postdoctoral fellow in the Department of Psychiatry. It quickly became clear that traditional psychiatry was not the right fit, and her search for work at the intersection of psychiatry and neurology led her to Dr. Erin Furr-Stimming and the UTHealth Houston HD Center of Excellence. Within just a few months, she began working on Huntington’s disease. What made a lasting impression on her was not only the science, but the people. Coming from another country and early in her career, she said that meeting HD families made her feel “hugged” by the community. That sense of welcome and belonging stayed with her, and she sums it up simply: “I found my place.” Meeting HD families in those early days was what ultimately shaped her decision to commit her research career to HD.
What the Nose Can Tell Us About the Brain
Loss of smell is a well-known early feature of Parkinson’s and Alzheimer’s disease, often appearing years before diagnosis. The cells responsible for detecting scent are a unique type of neuron that connect directly to the brain and are especially sensitive to early biological change. In HD, changes in smell have been reported for many years, but they have rarely been studied in depth, and how they relate to disease progression is still not well understood.
Natalia’s question is straightforward: could a simple smell test capture early, meaningful signs of HD progression, long before symptoms are obvious on standard clinical exams? If so, it could give families and clinicians a new, easy-to-use tool for understanding how early changes in the brain unfold over time.
Tracking Change, One Visit at a Time
Natalia’s study relies on a combination of careful observation and long-term follow-up. Participants begin with a scratch-and-sniff test that asks them to identify a series of scents. Years later, Natalia brings them back and repeats the test, then compares their results to cognitive assessments, neurological exams, MRI scans, and blood biomarkers. This allows her to look for patterns that link early smell performance to later changes in thinking, movement, and brain structure.
As each participant returns for their follow-up visit, their results help bring a growing picture into sharper focus. What begins as a small, simple measure in one person can, over time, help shape a broader understanding of how HD changes unfold.
Powered by Participation
Natalia is quick to point out that work like this depends entirely on people who are willing to take part in research, often without any direct benefit to themselves. Observational studies rely on trust, on people showing up, and on a shared belief that small, careful measurements today can lead to a bigger understanding tomorrow. The UTHealth Houston HD Center of Excellence provides the clinical setting where that kind of participation can happen in a thoughtful, supported way.
Her project is also shaped by mentorship and collaboration. Working alongside Dr. Erin Furr-Stimming gives Natalia access to deep clinical experience and long-standing relationships with HD families, which helps guide everything from study design to interpretation. Together, the clinical team, the participants, and the broader HD research community create the conditions where early ideas can be tested with care and rigor.
Why This Tiny Test Could Make a Big Difference
If smell turns out to be a reliable early marker of HD progression, it could become an important tool for clinical care and research. Early indicators help families understand what to expect, help clinicians track changes more sensitively, and help researchers design trials that begin treatment at the right moment. Because a smell test is inexpensive, noninvasive, and easy to use in almost any clinical setting, it also has the potential to broaden who can be included in research, opening the door to studying HD in communities and regions that have historically been underrepresented.
Natalia’s work also reflects a broader shift in HD research toward understanding the earliest changes that unfold over time, so treatments can be tested at the moment they are most likely to help. While the genetics of HD give researchers a unique advantage, determining when meaningful biological change occurs remains one of the field’s biggest challenges. Her study is now moving into a longer follow-up phase, with key imaging and biomarker results expected once participants complete 36-month visits, helping define that timeline with greater precision.
The Next Chapter of HD Research
Natalia sees the next decade of HD research moving toward earlier detection, deeper biological understanding, and a broader set of therapeutic targets. HD affects far more than the huntingtin protein alone, and she believes the field will benefit from exploring inflammation, immune biology, and other interconnected pathways that shape disease progression.
She also plans to remain in HD research long-term. The work matters, but the connection to families is what anchors her. The insights she gains from studying HD, particularly around early biological change, have the potential to inform understanding of other neurodegenerative diseases, including Alzheimer’s and Parkinson’s. That kind of outward impact, rooted in HD research, is exactly what programs like the Human Biology Project are designed to support.
Where Care and Curiosity Meet
For Natalia, the most meaningful part of her work has always been the people behind the data. She spoke often about how much she has learned simply by listening to individuals and families affected by HD, and about the responsibility that comes with being trusted to turn their participation into meaningful insight. That sense of responsibility carries through her work and into her life outside the lab, where days are full with little ones at home. In both places, progress comes from paying attention, showing up consistently, and recognizing that small moments, carefully observed, can add up to something larger.
Fast Facts
Researcher: Dr. Natalia Pessoa Rocha
Institution: The University of Texas Health Science Center at Houston
HDSA Program: Human Biology Project
Mentor: Erin Furr-Stimming
Research Focus: Smell as an early biomarker of Huntington’s disease progression
Approach: Scratch-and-sniff testing paired with clinical exams, MRI, and blood biomarkers
Why It Matters: A simple, low-cost test could help track early changes in HD over time
