Clinical Neurochemistry and Neurochemical Dementia Diagnostics

PhD Students: Ellen Huber, Christine Schamber, Natalia Lelental

Research group "Clinical Neurochemistry and Neurochemical Dementia Diagnostics" works on analysis of cerebrospinal fluid (CSF) from the point of view of its diagnostic role in neurologic and psychiatric disorders, with a special focus on diagnosis of neurodegenerating syndromes, for example Alzheimer's disease (AD).

The head of the group, Prof. Dr. med. Piotr Lewczuk, leads the Laboratory for Clinical Neurochemistry and Neurochemical Dementia Diagnostics at the Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen. This ISO 9001:2008-certified lab is one of the mostly internationally-recognized, European leading centers for neurochemical diagnosis of dementia.

The Laboratory is one of the five world-wide reference centers, together with the laboratories in Göteborg (S), Amsterdam (NL), Ghent (B), and Philadelphia (USA), in the "Alzheimer's Association"-supported project on CSF biomarkers international quality control (coordinated by Prof. Dr. K. Blennow), and Prof. Dr. med. Lewczuk is a member of the Steering Committee of this project.

For more than ten years Prof. Dr. med. Lewczuk has been working on diagnostic and research aspects of the CSF, including a large panel of neurologic and psychiatric disorders (multiple sclerosis and other neuroinflammations, acute and chronic neuroinfections, stroke, etc.), with a particular scope on neurodegenerating conditions, like Alzheimer's disease. In 2004, Prof. Dr. med. Lewczuk obtained the Certificate of Expertise from the German Society of Clinical Neurochemistry, to become one of seventy certified clinical neurochemists in Germany, and currently he is a member of the Extended Board of the German Society of Clinical Neurochemistry.

Prof. Dr. med. Lewczuk and his group are particularly interested in biomarkers' discovery, validation, and transfer into routine analytical programs. Furthermore, we work on application of multiplexing technologies (Luminex® and MSD® platforms) and assays for clinical routine and research projects, as well as their standardization and quality control. In the context of transnational promotion of NDD methods and protocols, Prof. Dr. med. Lewczuk is also a member of the Scientific Advisory Board of the "Alzheimer Diagnostic and Therapy Center" established at the Medical University of Wroclaw (Poland) in Scinawa. Recently, Prof. Dr. med. Lewczuk joined the Editorial Board of the Journal of Alzheimer's Disease (IF2012=4.2) as an Associate Editor.

Facts on neurochemical dementia diagnostics and its diagnostic role Alzheimer's disease:

• With ageing of populations, Alzheimer's disease and other forms of dementia are one of the greatest health care problems in Western industrialized countries.

• Although currently AD is still untreatable, several promising therapeutic strategies are being tested now.

• NDD plays a crucial role (sine qua non) as a routine diagnostic tool in diagnosis of dementia.

• Not only AD diagnosis is possible with sensitivity and specificity around 85%, which is extremely high level for non-neuropathologically confirmed cases, but also differential diagnosis among dementia conditions is (or in short will be) possible, e.g. Tau>1200pg/mL drives the differential diagnosis in the direction of CJD, etc.

• Altered NDD biomarkers are observed in MCI subjects and subjects at risk years (maybe even decades!) before clinical onset of symptoms -> these subjects can be directed into 'Extended advice system', closer medical control, etc.

• There are also many evidences that NDD biomarkers can predict the course of the disease.

• Diseases with symptomatic dementia (neuroborreliosis, neuro-AIDS, MS) are curable or well-controlled; diagnosis of these diseases cannot be achieved without CSF investigation.

• As soon as blood assays are validated, not only diagnosis but also follow up controls (e.g. every year visit) is much easier.

• There is urgent need for standardization of NDD-SOP among laboratories worldwide.


The most relevant publications of Prof. Dr. med. Lewczuk you can find here.