Nevertheless, up to date none of these CSF markers can be recommended for routine implementation in clinical practice, mainly because of methodological limitations, invasiveness of the spinal tap, absence of conclusive data from small studies or other technical problems. Therefore large multicentre studies are needed to confirm the importance of CSF biomarkers as a tool in the clinical practice . CSF is the compartment in the closest proximity to CNS parenchyma and might reflect immunopathology in CNS. However, studies usually fail to provide longitudinal CSF data because repeated lumbar punctures are difficult to justify. Therefore, single CSF samples are only snapshots of immune response at the time of collection.