High-sensitivity quantification of acetylcholine and choline in human cerebrospinal fluid with a validated LC-MS/MS method

Acetylcholine is the neurotransmitter of the parasympathetic nervous system, synthesized from choline and involved in several neurodegenerative diseases. Exploration of cholinergic neurotransmission in the human central nervous system is limited by the lack of a sensitive and specific method for the determination of acetylcholine and choline expression. We developed an hydrophilic interaction liquid chromatography – mass spectrometry method for the quantification of both molecules in human cerebrospinal fluid samples. An extensive selectivity study towards endogenous interfering compounds, in particular γ-butyrobetain, was performed and the method was validated according to the European Medicine Agency and Food and Drug Administration guidelines for the validation of bioanalytical methods. The performance of the method was excellent with a lower limit of quantification at 5 ng/L (34.2 pmol/L) for acetylcholine and 5 μg/L for choline, a precision in the range 1.3–11.9% and an accuracy between 85.2 and 113.1%. This suitability of the method for the quantification of acetylcholine and choline in clinical samples was demonstrated with the analysis of patient cerebrospinal fluid samples. Altogether, this validated method allows the simultaneous quantitative analysis of acetylcholine and choline in human cerebrospinal fluid with high sensitivity and selectivity. It will allow to better characterize the cholinergic neurotransmission in human pathologies and to study the effects of drugs acting on this system.