Abstract
Background Tourette syndrome (TS) is a chronic neuropsychiatric disorder, characterized by abnormal movements and phonations, tics, but accurate TS diagnosis remains challenging and indeed depends on its description of clinical symptoms. Our study was to identify some metabolites biomarkers based on non-targeted and targeted metabolomics. Methods We conducted untargeted ultra-high-performance liquid chromatography -quadrupole time-off light mass spectrometry (UHPLC-Q-TOF/MS) for preliminary screening of potential biomarkers from 30 TS patients and 10 healthy controls. And then performed validation experiments based on targeted ultra-high-performance liquid Chromatography-Triple Quadrupole-MS (UHPLC/MS/MS).Results 1775 differentially metabolites were identified by partial least squares discriminant analysis (PLS-DA), fold change analysis, T-tests, and hierarchical clustering analysis (Adjusted p-value < 0.05 and |logFC| >1). TS plasma samples were found differentiated from healthy samples in our approach. Further, the aspartate and asparagine metabolism pathway was considered as a significant enrichment pathway in TS progression based on the metabolite pathway enrichment analysis. For the 8 metabolites involved in this pathway that we detected, we then performed validation experiments based on targeted UHPLC/MS/MS from 35 TS patients and 14 healthy controls. T-test, Mann-Whitney U test, and receiver operating characteristic (ROC) curve analysis were used to determine potential biomarkers. Ultimately, L-Arginine and L-Pipecolic acid were validated as significantly differentiated metabolites (p<0.05) with an AUC of 70% and 87%.Conclusions L-Arginine and L-Pipecolic acid were defined as potential biomarkers for TS diagnosis by the combined application of non-targeted and targeted metabolomics analysis.