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Review
. 2019 Mar 18:10:191.
doi: 10.3389/fneur.2019.00191. eCollection 2019.

Biomarkers of Metabolism in Amyotrophic Lateral Sclerosis

Siobhan E Kirk  1 , Timothy J Tracey  1 , Frederik J Steyn  1   2 , Shyuan T Ngo  1   2   3
Affiliations
Review

Biomarkers of Metabolism in Amyotrophic Lateral Sclerosis

Siobhan E Kirk et al. Front Neurol. .

Abstract

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by the deterioration of motor neurons. However, this complex disease extends beyond the boundaries of the central nervous system, with metabolic alterations being observed at the systemic and cellular level. While the number of studies that assess the role and impact of metabolic perturbations in ALS is rapidly increasing, the use of metabolism biomarkers in ALS remains largely underinvestigated. In this review, we discuss current and potential metabolism biomarkers in the context of ALS. Of those for which data does exist, there is limited insight provided by individual markers, with specificity for disease, and lack of reproducibility and efficacy in informing prognosis being the largest drawbacks. However, given the array of metabolic markers available, the potential exists for a panel of metabolism biomarkers, which may complement other current biomarkers (including neurophysiology, imaging, as well as CSF, blood and urine markers) to overturn these limitations and give rise to new diagnostic and prognostic indicators.

Keywords: ALS; amyotrophic lateral sclerosis; biomarker; metabolism; motor neurone disease.

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Figures

Figure 1
Figure 1
Potential metabolism biomarkers in amyotrophic lateral sclerosis (ALS). Metabolic alterations in ALS offer opportunities to use metabolism biomarkers for the diagnosis, categorization, and tracking of disease. Non-invasive anthropometric measures include body weight, body mass index (BMI), fat free mass, fat mass, and fat distribution. Invasive measures include the use of F18-PET to assess glucose metabolism in the central nervous system, or require the sampling of saliva, blood, cerebrospinal fluid (CSF), muscle tissue, and urine. Although few independent markers are specific, reproducible or able to track disease in ALS, used together with complementary biomarkers (including neurophysiology and imaging), these markers may provide deeper insights into metabolic perturbations that are potentially involved in the onset and progression of disease.
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