417Neurometabolomics
Role of metabolomics in personalized medicine was described in Chap. 7.
Neurometabolomics is the study of metabolites in the nervous system, many of
which are biomarkers of disease. Neurons in the human CNS perform a wide range
of motor, sensory, regulatory, behavioral, and cognitive functions, which requires
diverse neuronal as well as non-neuronal cell types. Metabolomics can help in
assessing the specifi city-of metabolic traits and their alterations in the brain and in
fl uids such as CSF and plasma. Current applications of metabolomics include dis-
covery of potential biomarkers of aging and neurodegenerative diseases (Jové et al.
2014 ). Neurometabolomics will improve our understanding of the physiology as
well as pathology of the nervous system and facilitate development of personalized
neurology by providing biomarkers for disease monitoring as well as for targets
for therapeutics.
Diagnosis-Guided Therapies for Neurological Disorders
The trend in healthcare in the next decade will be integration of diagnostics and
therapeutics, which is an important component of personalized medicine. If patients
can be diagnosed in terms of DNA mutations, alleles, or polymorphisms pertaining
to a specifi c disease, their response to treatment can be vastly improved. This will
be facilitated by gene-based disease management incorporating genetic tests that
predict the safety and effi cacy of therapeutic products. The identifi cation of genes
that infl uence the penetrance and expressivity of risk would be important in deter-
mining these risk profi les. As treatment becomes more specifi c to the genetic cause
of disease, diagnostic tools that measure the activity of targeted genes will become
crucial for disease management. Eventually, prior to the prescription of therapy, a
diagnostic test must confi rm the existence of diseased genes and their activity levels
in order to improve treatment effi ciency and cut patient care cost.
Personalized Biological Therapies for Neurological Disorders
Personalized biological therapies were described in Chap. 9. Those particularly
relevant to personalized treatment of neurological disorders will briefl y described
here.
Use of autologous stem cells for treatment of neurological disorders or immuno-
therapies of brain tumors involving tumor cells taken from a patient’s tumor are by
defi nition personalized therapies that are also examples of non-genomic approaches.
The patient’s own somatic cells, genetically engineered to release therapeutic sub-
stances are also in clinical trials. This approach overlaps gene therapy.
Personalized Biological Therapies for Neurological Disorders