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Alzheimers Dement. 2016 Feb;12(2):154-163. doi: 10.1016/j.jalz.2015.08.003. Epub 2015 Sep 11.

Performance and complications of lumbar puncture in memory clinics: Results of the multicenter lumbar puncture feasibility study.

Author information

1
Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
2
Department of Neurology, Fundacion CITA-Alzheimer Fundazioa, San Sebastián, Spain.
3
INSERM, U942, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, UMRS 942, Paris, France; Research Memory Center Paris North AP-HP, Hopital Lariboisière, Paris, France.
4
Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium.
5
Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain.
6
Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany.
7
Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, ICN Hospital Clinic i Universitari and Pasqual Maragall Foundation, Barcelona, Spain.
8
Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
9
Centro Disturbi della Memoria, Clinica Neurologica, Università degli Studi di Perugia, Perugia, Italy.
10
Alzheimer Center Limburg, Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
11
3rd Department of Neurology, Aristotle University of Thessaloniki, Macedonia, Greece.
12
The Department of Geriatrics, Kalmar County Hospital, Kalmar, Sweden.
13
Department of Cognitive Medicine, Karlstad Central Hospital, Karlstad, Sweden.
14
Memory Clinic at Department of Neuropsychiatry, Sahlgrenska University Hospital, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.
15
Memory Clinic, Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic; International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.
16
Department of Geriatrics, Minnesmottagningen, Eskilstuna, Sweden.
17
Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
18
Neurology Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Grandam IRCCS Ospedale Policlinico, Milan, Italy.
19
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
20
Department of Neurology, Atrium Medical Center Parkstad, Heerlen, The Netherlands.
21
Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands.
22
Department of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
23
Department of Neurology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.
24
Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.
25
Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
26
Department of Clinical Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal Sweden.
27
Department of Clinical Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal Sweden; UCL Institute of Neurology, Department of Molecular Neuroscience, London, UK.
28
Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
29
Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
30
Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: p.scheltens@vumc.nl.

Abstract

INTRODUCTION:

Lumbar puncture (LP) is increasingly performed in memory clinics. We investigated patient-acceptance of LP, incidence of and risk factors for post-LP complications in memory clinic populations.

METHODS:

We prospectively enrolled 3868 patients (50% women, age 66 ± 11 years, mini mental state examination 25 ± 5) at 23 memory clinics. We used logistic regression analysis using generalized estimated equations to investigate risk factors for post-LP complications, such as typical postlumbar puncture headache (PLPH) and back pain.

RESULTS:

A total of 1065 patients (31%) reported post-LP complaints; 589 patients (17%) reported back pain, 649 (19%) headache, of which 296 (9%) reported typical PLPH. Only few patients needed medical intervention: 11 (0.3%) received a blood patch, 23 (0.7%) were hospitalized. The most important risk factor for PLPH was medical history of headache. An atraumatic needle and age >65 years were preventive. Gender, rest after LP, or volume of cerebrospinal fluid had no effect.

DISCUSSIONS:

The overall risk of complications is relatively low. If risk factors shown in this study are taken into account, LPs can be safely performed in memory clinics.

KEYWORDS:

Alzheimer's disease; Cognitive disorders; Lumbar puncture; Memory clinic; Multicenter study on LP feasibility; Post-LP complications; Post-LP headache

PMID:
26368321
DOI:
10.1016/j.jalz.2015.08.003
[Indexed for MEDLINE]

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