A consensus protocol for the standardization of cerebrospinal fluid collection and biobanking

Abstract

There is a long history of research into body fluid biomarkers in neurodegenerative and neuroinflammatory diseases. However, only a few biomarkers in CSF are being used in clinical practice. One of the most critical factors in CSF biomarker research is the inadequate powering of studies because of the lack of sufficient samples that can be obtained in single-center studies. Therefore, collaboration between investigators is needed to establish large biobanks of well-defined samples. Standardized protocols for biobanking are a prerequisite to ensure that the statistical power gained by increasing the numbers of CSF samples is not compromised by preanalytical factors. Here, a consensus report on recommendations for CSF collection and biobanking is presented, formed by the BioMS-eu network for CSF biomarker research in multiple sclerosis. We focus on CSF collection procedures, preanalytical factors, and high-quality clinical and paraclinical information. The biobanking protocols are applicable for CSF biobanks for research targeting any neurologic disease.

Figure Results of inventory of collection procedures among 14 European centers with CSF biobanks for multiple sclerosis research in 2006 (A) Other body fluids that are collected simultaneously with CSF. (B) Storage temperature of CSF and serum. (C) Average volume of CSF that is collected per patient per CSF withdrawal. Bars indicate the average and range of volume per center. (D) Time delay between CSF withdrawal, spinning, and storage in the freezer. Bars indicate the average and range of time per center. EDTA = ethylenediaminetetraacetic acid; PBMC = peripheral blood mononuclear cell.