According to current diagnostic criteria, Alzheimer´s disease (AD) cannot be diagnosed before the disease has progressed so far that clinical dementia is present. The disease process, however, probably starts 20-30 years before first clinical signs emerge. Hence we are in need of new diagnostic tools that are capable of detecting preclinical signs of neurodegenerative disorders.
Mosaiques performed proteome-analysis of cerebrospinal fluid (CSF) using capillary electrophoresis coupled to an electrospray ionisation time of flight mass spectrometer (CE-MS). CSF is a clear and colourless liquid that surrounds the brain and the spine, serving as a mechanical protection of the brain and also carries nutrients and waste.
In a recent study we defined disease specific peptide patterns allowing the early identification and differentiation between various dementias such as Alzheimer´s disease and frontotemporal dementia with high sensitivity and specificity. Using the defined peptide pattern we were able to diagnose Alzheimer´s disease in a prospective patient sample with >85% sensitivity and >80% specificity. In comparison CSF measurements of beta-amyloid 1-42, total-tau and phospho-tau AD diagnosis had a sensitivity of ~85% and a specificity of ~65% in the same sample.
Our results suggest that CE-MS provides a useful tool for the analysis of CSF-proteins in the context of dementia and is therefore well suited for the early identification of a developing Alzheimer´s disease.