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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Tate, Jillian R. / Tsongalis, Gregory J.

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Inter-laboratory variation in cerebrospinal fluid biomarkers for Alzheimer's disease: united we stand, divided we fall

Niklas Mattsson1 / Kaj Blennow1 / Henrik Zetterberg1

1Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Göteborg and Mölndal, Sweden

Corresponding author: Dr. Niklas Mattsson, Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital/Mölndal, 431 80 Mölndal, Sweden Phone: +46 31 3432377, Fax: +46 31 3432426,

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 48, Issue 5, Pages 603–607, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2010.131, March 2010

Publication History

Published Online:


Several drug candidates for Alzheimer's disease are being evaluated in clinical trials, with the goal of finding a drug with disease-modifying effects. When such a drug finally reaches the market, there will be a demand for accurate diagnostic tools useful for early detection of disease and for monitoring biochemical effects. The core cerebrospinal fluid (CSF) biomarkers amyloid peptides (Aβ42), total-tau and phospo-tau are promising in this respect. However, inter-center variation (caused by pre-analytical, analytical and post-analytical factors), and inter-laboratory variation (caused by analytical factors), particularly for CSF Aβ42, lowers their utility in multicenter studies. Here, we discuss the causes of these variations, and present a global quality control program to overcome them.

Clin Chem Lab Med 2010;48:603–7.

Keywords: Alzheimer's disease; amyloid; cerebrospinal fluid; quality control; variations

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