Department of Neurology, Inst. Investigacions Biomèdiques-Hospital Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED, Spain.
Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED, Spain Department of Neurology, Center for Research and Advanced Therapies, Fundación CITA-Alzheimer Fundazioa, San Sebastián, Spain.
J Alzheimers Dis. 2014;39(4):719-26. doi: 10.3233/JAD-131334.
Lumbar puncture (LP) is increasingly performed in memory units due to the usefulness of cerebrospinal fluid (CSF) biomarkers in the diagnosis of Alzheimer's disease. The feasibility of this procedure in this context, however, is controversial.
Our aim was to analyze the incidence of complications and their associated factors so as to determine the impact of LP in the study of CSF biomarkers of Alzheimer's disease.
In the context of a larger international initiative, we prospectively collected data from 689 participants who underwent LP in three memory units in Spain. Data included demographic factors, headache history, subjective attitude toward the procedure, patient positioning, needle characteristics, volume of CSF extracted, attempts needed, and resting time after CSF acquisition. Five to seven days after the procedure, we asked participants about complications through a semi-structured telephone interview.
No adverse events were reported in 441 (64.0%) participants. The most frequent complication was headache, reported by 171 (24.8%) subjects. It was severe in only 17 (2.5%). Headache was more frequent in younger participants and when a cutting-edge needle was used. Back pain was present in 111 (16.1%) cases, and it was associated with female gender, cutting-edge needles, increased number of attempts, and longer resting time after LP. No major complications were reported. The use of pen-point needles showed a trend toward a higher frequency of hematic CSF.
LP can be safely performed to study CSF biomarkers. The main complication is headache, associated with younger age and use of cutting-edge needles.
腰椎穿刺（LP）在记忆单元中越来越多地进行，因为脑脊液（CSF）生物标志物在阿尔茨海默病的诊断中很有用。然而，这种方法在这种情况下的可行性存在争议。
我们的目的是分析并发症的发生率及其相关因素，以确定 LP 对阿尔茨海默病 CSF 生物标志物研究的影响。
在一项更大的国际倡议的背景下，我们前瞻性地收集了 689 名参与者在西班牙三个记忆单元接受 LP 的数据。数据包括人口统计学因素、头痛史、对该程序的主观态度、患者体位、针的特征、提取的 CSF 量、所需的尝试次数以及 CSF 采集后的休息时间。在程序后 5-7 天，我们通过半结构化电话访谈询问参与者有关并发症的情况。
441 名（64.0%）参与者未报告不良事件。最常见的并发症是头痛，171 名（24.8%）受试者报告了头痛。只有 17 名（2.5%）患者的头痛严重。头痛在年轻参与者和使用先进的针头时更为常见。111 名（16.1%）患者出现背痛，与女性性别、先进的针头、尝试次数增加和 LP 后休息时间延长有关。未报告重大并发症。使用笔尖针显示出更高频率的血性 CSF 的趋势。
LP 可安全用于研究 CSF 生物标志物。主要并发症是头痛，与年龄较小和使用先进的针头有关。
