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

Flora H. Duits; Pablo Martinez-Lage; Claire Paquet; Sebastiaan Engelborghs; Alberto Lleo; Lucrezia Hausner; Jose L. Molinuevo; Erik Stomrud; Lucia Farotti; Inez H. G. B. Ramakers; Magda Tsolaki; Constance Skarsgard; Ragnar Astrand; Anders Wallin; Martin Vyhnalek; Marie Holmber-Clausen; Orestes V. Forlenza; Laura Ghezzi; Martin Ingelsson; Erik I. Hoff; C.M.A.A. Roks; Alexandre de Mendonca; Janne M. Papma; Andrea Izagirre; Mariko Taga; Hanne Struyfs; Daniel A. Alcolea; Lutz Froelich; Mircea Balasa; Lennart Minthon; Jos W. R. Twisk; Staffan Persson; Henrik Zetterberg; Wiesje M. van der Flier; Charlotte E. Teunissen; Philip Scheltens; Kaj Blennow

doi:10.1016/j.jalz.2015.08.003

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

Flora H. Duits, Pablo Martinez-Lage, Claire Paquet, Sebastiaan Engelborghs, Alberto Lleo, Lucrezia Hausner, Jose L. Molinuevo, Erik Stomrud, Lucia Farotti, Inez H. G. B. Ramakers, Magda Tsolaki, Constance Skarsgard, Ragnar Astrand, Anders Wallin, Martin Vyhnalek, Marie Holmber-Clausen, Orestes V. Forlenza, Laura Ghezzi, Martin Ingelsson, Erik I. HoffC.M.A.A. Roks, Alexandre de Mendonca, Janne M. Papma, Andrea Izagirre, Mariko Taga, Hanne Struyfs, Daniel A. Alcolea, Lutz Froelich, Mircea Balasa, Lennart Minthon, Jos W. R. Twisk, Staffan Persson, Henrik Zetterberg, Wiesje M. van der Flier, Charlotte E. Teunissen, Philip Scheltens, Kaj Blennow

Medical and Clinical Psychology

Research output: Contribution to journal › Article › Scientific › peer-review

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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.

Original language	English
Pages (from-to)	154-163
Journal	Alzheimers & Dementia
Volume	12
Issue number	2
DOIs	https://doi.org/10.1016/j.jalz.2015.08.003
Publication status	Published - 2016

Keywords

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

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10.1016/j.jalz.2015.08.003

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Duits, F. H., Martinez-Lage, P., Paquet, C., Engelborghs, S., Lleo, A., Hausner, L., Molinuevo, J. L., Stomrud, E., Farotti, L., Ramakers, I. H. G. B., Tsolaki, M., Skarsgard, C., Astrand, R., Wallin, A., Vyhnalek, M., Holmber-Clausen, M., Forlenza, O. V., Ghezzi, L., Ingelsson, M., ... Blennow, K. (2016). Performance and complications of lumbar puncture in memory clinics: Results of the multicenter lumbar puncture feasibility study. Alzheimers & Dementia, 12(2), 154-163. https://doi.org/10.1016/j.jalz.2015.08.003

@article{924d52eeb7104f73ab2c251b32ce8877,

title = "Performance and complications of lumbar puncture in memory clinics: Results of the multicenter lumbar puncture feasibility study",

abstract = "IntroductionLumbar 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.MethodsWe 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.ResultsA 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.DiscussionsThe 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 = "Lumbar puncture, Cognitive disorders, Alzheimer's disease, Memory clinic, Post-LP complications, Post-LP headache, Multicenter study on LP feasibility",

author = "Duits, {Flora H.} and Pablo Martinez-Lage and Claire Paquet and Sebastiaan Engelborghs and Alberto Lleo and Lucrezia Hausner and Molinuevo, {Jose L.} and Erik Stomrud and Lucia Farotti and Ramakers, {Inez H. G. B.} and Magda Tsolaki and Constance Skarsgard and Ragnar Astrand and Anders Wallin and Martin Vyhnalek and Marie Holmber-Clausen and Forlenza, {Orestes V.} and Laura Ghezzi and Martin Ingelsson and Hoff, {Erik I.} and C.M.A.A. Roks and {de Mendonca}, Alexandre and Papma, {Janne M.} and Andrea Izagirre and Mariko Taga and Hanne Struyfs and Alcolea, {Daniel A.} and Lutz Froelich and Mircea Balasa and Lennart Minthon and Twisk, {Jos W. R.} and Staffan Persson and Henrik Zetterberg and {van der Flier}, {Wiesje M.} and Teunissen, {Charlotte E.} and Philip Scheltens and Kaj Blennow",

year = "2016",

doi = "10.1016/j.jalz.2015.08.003",

language = "English",

volume = "12",

pages = "154--163",

journal = "Alzheimers & Dementia",

issn = "1552-5260",

publisher = "Elsevier Inc.",

number = "2",

}

Duits, FH, Martinez-Lage, P, Paquet, C, Engelborghs, S, Lleo, A, Hausner, L, Molinuevo, JL, Stomrud, E, Farotti, L, Ramakers, IHGB, Tsolaki, M, Skarsgard, C, Astrand, R, Wallin, A, Vyhnalek, M, Holmber-Clausen, M, Forlenza, OV, Ghezzi, L, Ingelsson, M, Hoff, EI, Roks, CMAA, de Mendonca, A, Papma, JM, Izagirre, A, Taga, M, Struyfs, H, Alcolea, DA, Froelich, L, Balasa, M, Minthon, L, Twisk, JWR, Persson, S, Zetterberg, H, van der Flier, WM, Teunissen, CE, Scheltens, P & Blennow, K 2016, 'Performance and complications of lumbar puncture in memory clinics: Results of the multicenter lumbar puncture feasibility study', Alzheimers & Dementia, vol. 12, no. 2, pp. 154-163. https://doi.org/10.1016/j.jalz.2015.08.003

TY - JOUR

T1 - Performance and complications of lumbar puncture in memory clinics

T2 - Results of the multicenter lumbar puncture feasibility study

AU - Duits, Flora H.

AU - Martinez-Lage, Pablo

AU - Paquet, Claire

AU - Engelborghs, Sebastiaan

AU - Lleo, Alberto

AU - Hausner, Lucrezia

AU - Molinuevo, Jose L.

AU - Stomrud, Erik

AU - Farotti, Lucia

AU - Ramakers, Inez H. G. B.

AU - Tsolaki, Magda

AU - Skarsgard, Constance

AU - Astrand, Ragnar

AU - Wallin, Anders

AU - Vyhnalek, Martin

AU - Holmber-Clausen, Marie

AU - Forlenza, Orestes V.

AU - Ghezzi, Laura

AU - Ingelsson, Martin

AU - Hoff, Erik I.

AU - Roks, C.M.A.A.

AU - de Mendonca, Alexandre

AU - Papma, Janne M.

AU - Izagirre, Andrea

AU - Taga, Mariko

AU - Struyfs, Hanne

AU - Alcolea, Daniel A.

AU - Froelich, Lutz

AU - Balasa, Mircea

AU - Minthon, Lennart

AU - Twisk, Jos W. R.

AU - Persson, Staffan

AU - Zetterberg, Henrik

AU - van der Flier, Wiesje M.

AU - Teunissen, Charlotte E.

AU - Scheltens, Philip

AU - Blennow, Kaj

PY - 2016

Y1 - 2016

N2 - IntroductionLumbar 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.MethodsWe 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.ResultsA 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.DiscussionsThe 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.

AB - IntroductionLumbar 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.MethodsWe 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.ResultsA 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.DiscussionsThe 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.

KW - Lumbar puncture

KW - Cognitive disorders

KW - Alzheimer's disease

KW - Memory clinic

KW - Post-LP complications

KW - Post-LP headache

KW - Multicenter study on LP feasibility

U2 - 10.1016/j.jalz.2015.08.003

DO - 10.1016/j.jalz.2015.08.003

M3 - Article

SN - 1552-5260

VL - 12

SP - 154

EP - 163

JO - Alzheimers & Dementia

JF - Alzheimers & Dementia

IS - 2

ER -

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

Abstract

Keywords

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