Volume 12, Issue 2 p. 154-163
Featured Article

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

Flora H. Duits

Flora H. Duits

Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands

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Pablo Martinez-Lage

Pablo Martinez-Lage

Department of Neurology, Fundacion CITA-Alzheimer Fundazioa, San Sebastián, Spain

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Claire Paquet

Claire Paquet

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

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Sebastiaan Engelborghs

Sebastiaan Engelborghs

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

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Alberto Lleó

Alberto Lleó

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

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Lucrezia Hausner

Lucrezia Hausner

Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany

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José L. Molinuevo

José L. Molinuevo

Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, ICN Hospital Clinic i Universitari and Pasqual Maragall Foundation, Barcelona, Spain

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Erik Stomrud

Erik Stomrud

Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden

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Lucia Farotti

Lucia Farotti

Centro Disturbi della Memoria, Clinica Neurologica, Università degli Studi di Perugia, Perugia, Italy

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Inez H.G.B. Ramakers

Inez H.G.B. Ramakers

Alzheimer Center Limburg, Department of Psychiatry & NeuropsychologySchool for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands

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Magda Tsolaki

Magda Tsolaki

3rd Department of Neurology, Aristotle University of Thessaloniki, Macedonia, Greece

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Constance Skarsgård

Constance Skarsgård

The Department of Geriatrics, Kalmar County Hospital, Kalmar, Sweden

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Ragnar Åstrand

Ragnar Åstrand

Department of Cognitive Medicine, Karlstad Central Hospital, Karlstad, Sweden

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Anders Wallin

Anders Wallin

Memory Clinic at Department of NeuropsychiatrySahlgrenska University Hospital, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden

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Martin Vyhnalek

Martin Vyhnalek

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

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Marie Holmber-Clausen

Marie Holmber-Clausen

Department of Geriatrics, Minnesmottagningen, Eskilstuna, Sweden

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Orestes V. Forlenza

Orestes V. Forlenza

Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil

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Laura Ghezzi

Laura Ghezzi

Neurology Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Grandam IRCCS Ospedale Policlinico, Milan, Italy

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Martin Ingelsson

Martin Ingelsson

Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden

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Erik I. Hoff

Erik I. Hoff

Department of Neurology, Atrium Medical Center Parkstad, Heerlen, The Netherlands

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Gerwin Roks

Gerwin Roks

Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands

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Alexandre de Mendonça

Alexandre de Mendonça

Department of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal

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Janne M. Papma

Janne M. Papma

Department of Neurology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands

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Andrea Izagirre

Andrea Izagirre

Department of Neurology, Fundacion CITA-Alzheimer Fundazioa, San Sebastián, Spain

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Mariko Taga

Mariko Taga

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

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Hanne Struyfs

Hanne Struyfs

Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium

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Daniel A. Alcolea

Daniel A. Alcolea

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

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Lutz Frölich

Lutz Frölich

Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany

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Mircea Balasa

Mircea Balasa

Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, ICN Hospital Clinic i Universitari and Pasqual Maragall Foundation, Barcelona, Spain

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Lennart Minthon

Lennart Minthon

Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden

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Jos W.R. Twisk

Jos W.R. Twisk

Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands

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Staffan Persson

Staffan Persson

Department of Clinical Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden

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Henrik Zetterberg

Henrik Zetterberg

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

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Wiesje M. van der Flier

Wiesje M. van der Flier

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

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Charlotte E. Teunissen

Charlotte E. Teunissen

Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands

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Philip Scheltens

Corresponding Author

Philip Scheltens

Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands

Shared last authors.

Corresponding author. Tel.: +31-20-4440816; Fax: +31-20-4448529.

E-mail address: [email protected]

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Kaj Blennow

Kaj Blennow

Department of Clinical Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden

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First published: 11 September 2015
Citations: 156

C.E.T. is a member of international advisory boards of Fujirebio and Roche and has performed contract research for Probiodrug, IBL, Shire. S.E. is/was consultant for Fujirebio Europe, ADx Neurosciences, and Roche diagnostics. P.S. serves/has served on the advisory boards of: Novartis, Pfizer, Roche, Danone, Jansen AI, Baxter, and Lundbeck. He has been a speaker at symposia organized by Lundbeck, Lilly, Merz, Pfizer, Jansen AI, Danone, and Roche. He is co-editor-in-chief of Alzheimer's Research & Therapy. He is a member of the scientific advisory board of the EU Joint Programme on Neurodegenerative Disease Research (JPND) and the French National Plan Alzheimer. He acts as vice-chair of the Dutch Deltaplan Dementia. He receives no personal compensation for the activities mentioned previously. F.H.D., P.M.-L., C.P., J.L.M., A.L., L.H., E.S., L.F., I.H.G.B.R., M.T., C.S., R.Å., A.W., M.V., M.H.-C., O.V.F., L.G., E.H., G.R., A.D.M., J.M.P., A.I., M.T., H.S., D.A.A., L.F., M.B., L.M., J.W.R.T., S.P., H.Z., W.M.V.D.F., and K.B. report no conflicts of interest.

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.