Metabolomics in postmortem cerebrospinal fluid diagnostics: a state-of-the-art method to interpret central nervous system-related pathological processes

Int J Legal Med. 2021 Jan;135(1):183-191. doi: 10.1007/s00414-020-02462-2. Epub 2020 Nov 12.

Abstract

In the last few years, quantitative analysis of metabolites in body fluids using LC/MS has become an established method in laboratory medicine and toxicology. By preparing metabolite profiles in biological specimens, we are able to understand pathophysiological mechanisms at the biochemical and thus the functional level. An innovative investigative method, which has not yet been used widely in the forensic context, is to use the clinical application of metabolomics. In a metabolomic analysis of 41 samples of postmortem cerebrospinal fluid (CSF) samples divided into cohorts of four different causes of death, namely, cardiovascular fatalities, isoIated torso trauma, traumatic brain injury, and multi-organ failure, we were able to identify relevant differences in the metabolite profile between these individual groups. According to this preliminary assessment, we assume that information on biochemical processes is not gained by differences in the concentration of individual metabolites in CSF, but by a combination of differently distributed metabolites forming the perspective of a new generation of biomarkers for diagnosing (fatal) TBI and associated neuropathological changes in the CNS using CSF samples.

Keywords: Biomarker; CSF; Cerebrospinal fluid; Forensic neuropathology; Forensic neurotraumatology; Metabolomics.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cause of Death
  • Cerebrospinal Fluid / metabolism*
  • Chromatography, Liquid
  • Female
  • Forensic Medicine / methods*
  • Humans
  • Lipid Metabolism
  • Male
  • Mass Spectrometry
  • Metabolomics*
  • Middle Aged
  • Postmortem Changes*