Evaluation of cerebrospinal fluid proteins as potential biomarkers for early stage Parkinson's disease diagnosis

PLoS One. 2018 Nov 1;13(11):e0206536. doi: 10.1371/journal.pone.0206536. eCollection 2018.

Abstract

Cerebrospinal fluid (CSF) has often been used as the source of choice for biomarker discovery with the goal to support the diagnosis of neurodegenerative diseases. For this study, we selected 15 CSF protein markers which were identified in previously published clinical investigations and proposed as potential biomarkers for PD diagnosis. We aimed at investigating and confirming their suitability for early stage diagnosis of the disease. The current study was performed in a two-fold confirmatory approach. Firstly, the CSF protein markers were analysed in confirmatory cohort I comprising 80 controls and 80 early clinical PD patients. Through univariate analysis we found significant changes of six potential biomarkers (α-syn, DJ-1, Aβ42, S100β, p-Tau and t-Tau). In order to increase robustness of the observations for potential patient differentiation, we developed-based on a machine learning approach-an algorithm which enabled identifying a panel of markers which would improve clinical diagnosis. Based on that model, a panel comprised of α-syn, S100β and UCHL1 were suggested as promising candidates. Secondly, we aimed at replicating our observations in an independent cohort (confirmatory cohort II) comprising 30 controls and 30 PD patients. The univariate analysis demonstrated Aβ42 as the only reproducible potential biomarker. Taking into account both technical and clinical aspects, these observations suggest that the large majority of the investigated CSF proteins currently proposed as potential biomarkers lack robustness and reproducibility in supporting diagnosis in the early clinical stages of PD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers / cerebrospinal fluid
  • Cerebrospinal Fluid Proteins*
  • Cohort Studies
  • Early Diagnosis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / cerebrospinal fluid*
  • Sensitivity and Specificity

Substances

  • Biomarkers
  • Cerebrospinal Fluid Proteins

Grants and funding

This work was supported by grants from the German Federal Ministry for Education and Research (BMBF) within the BioPharma initiative Neuroallianz, project D13 B and by UCB Pharma GmbH (Monheim, Germany). The D13B study supports the investigation of biomarkers in prodromal and clinical phases of Parkinson's disease, and supports specifically the TREND study of the Neurology Department of the University of Tübingen, Germany. Samples were obtained from the Neuro-Biobank of the University of Tuebingen, Germany. This biobank is supported by the local University, the Hertie Institute and the DZNE. UCB Biopharma SPRL, Consultancy Neuropharm, UCB Pharma SA and Analytik Jena provided support in the form of salaries for authors MCTDS, RB, CB, ANDC, DS, IRM, PC, SRB, LTP and IL, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.