The Journey From Metabolic Profiling to Biomarkers: The Potential of NMR Spectroscopy Based Metabolomics in Neurodegenerative Disease Research

Neurodegenerative diseases have become a "hot" topic in recent years. A major factor for this is that as life expectancy of the population in developed countries increases, so does the probability of developing neurodegenerative disorders such as Alzheimer's disease (AD) and Parkinson's disease (PD), to name the two most well-known. In many cases, however, neurological and mental diseases are poorly understood. In particular, there is a lack of specific biomarkers which would allow early unambiguous identification of a neurodegenerative disease, distinguishing between e.g. AD; PD; PD with dementia; and Dementia with Lewy bodies, or indicating therapeutic effects. Ultimately, this complicates the search for effective treatments. Thus, there is a high demand for preclinical work to elucidate underlying disease mechanisms and pave the way for disease management.In terms of biomarker research, hope has been set on small molecules that participate in metabolism, since they provide a closer link between cellular mechanisms (with genetic as well as environmental inputs) and the disease phenotype. More specifically, it is expected that not one but a combination of several metabolites may serve as an indicator for disease onset and progression, given that neurodegenerative diseases, whilst often described as "idiopathic", are understood to arise from complex pathologies expressing themselves with a broad spectrum of phenotypes. Therefore, non-targeted metabolic profiling appears to offer great potential for biomarker discovery in this area.One of the major technical platforms for non-targeted metabolic profiling is high resolution nuclear magnetic resonance (NMR) spectroscopy, a technique that is also available for the non-invasive application in vivo. Hence, in theory, biomarker discovery research using NMR spectroscopy based metabolomics provides a promising means for translation from in vitro/ex vivo research to eventual clinical use. This review will therefore discuss the potential for NMR spectroscopy based metabolomics to be applied to biomarker discovery in the field of neurodegenerative disease.