Cerebrospinal fluid metabolomics identifies 19 brain-related phenotype associations

Advances in technology have allowed for the study of metabolomics in the context of disease, enabling the discovery of new potential risk factors, diagnostic markers, and drug targets. For neurological and psychiatric phenotypes, the cerebrospinal fluid (CSF) is of particular biomedical importance as it is in direct contact with the brain and spinal cord. However, the CSF metabolome is difficult to study on a large scale due to the relative complexity of the procedure needed to collect the fluid compared to blood or urine studies. Here, we present a metabolome-wide association study (MWAS), an analysis using individual-level genetic and metabolomic data from two cohorts to impute metabolites into large samples with genome-wide association summary statistics. We conducted a metabolome-wide genome-wide association analysis with 338 CSF metabolites, identifying 16 genotype-metabolite associations, 6 of which were novel. Using these results, we then built prediction models for all available CSF metabolites and tested for associations with 27 neurological and psychiatric phenotypes in large cohorts, identifying 19 significant CSF metabolite-phenotype associations. Our results demonstrate the potential of MWAS to overcome the logistic challenges inherent in cerebrospinal fluid research to study the role of metabolomics in brain-related phenotypes and the feasibility of this framework for similar studies of omic data in scarce sample types.