Wang Xinhui, Qiao Yuchen, Liang Yuchen, Han Jinming, Duan Hongyan, Tang Yi, Qin Qi
Department of Geriatrics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China.
Brain Behav. 2025 Jun;15(6):e70597. doi: 10.1002/brb3.70597.
Cognitive impairment is prevalent among the elderly population. Cerebrospinal fluid (CSF) biomarker tests are employed to facilitate timely and differential diagnosis of cognitive dysfunction.
To investigate incidence and risk factors of post-lumbar puncture headache (PLPH) in Chinese geriatric patients with cognitive impairment.
A total of 254 consecutive patients with cognitive impairment were recruited between March and September 2023 and categorized into two groups: mild cognitive impairment (MCI) and dementia. Different scales, such as the short-form of the McGill pain questionnaire (SF-MPQ), facial visual analogue scale (F-VAS), revised Wong-Baker Assessment of Facial Expression Pain (FPS-R), and Chinese version of Pain Assessment Scale for Advanced Dementia (C-PAINAD), were used to evaluate the incidence of headache after lumbar puncture. Univariate and multivariate factor analyses were conducted to identify potential risk factors, with the most influential predictors included in regression models.
Among patients with cognitive disorders, the incidence of PLPH was 24.8%. The incidence and duration of headache did not differ significantly between the MCI and dementia groups. The average time of post-lumbar puncture headache (PLPH) was 22.9 h. There was no significant difference in headache scale scores between MCI patients. The incidence of PLPH in women with cognitive impairment was higher than that in men. The incidence of PLPH in cognitive impairment patients with a history of headache was significantly higher than that in cognitive impairment patients without a history of headache. However, no significant differences were observed in years of education, number of lumbar punctures, length of bed rest, and oral rehydration volume.
PLPH is more commonly observed in women, individuals with a history of headache, younger age, or lower body mass index (BMI). C-PAINAD and SF-MPQ are the preferred assessment tools for evaluating PLPH in patients with cognitive impairment.
认知障碍在老年人群中普遍存在。脑脊液（CSF）生物标志物检测用于促进认知功能障碍的及时和鉴别诊断。
探讨中国老年认知障碍患者腰椎穿刺后头痛（PLPH）的发生率及危险因素。
2023年3月至9月共纳入254例连续的认知障碍患者，分为两组：轻度认知障碍（MCI）组和痴呆组。采用不同量表，如麦吉尔疼痛问卷简表（SF-MPQ）、面部视觉模拟量表（F-VAS）、修订的面部表情疼痛评估法（FPS-R）和中文版晚期痴呆疼痛评估量表（C-PAINAD），评估腰椎穿刺后头痛的发生率。进行单因素和多因素分析以确定潜在危险因素，并将最有影响的预测因素纳入回归模型。
在认知障碍患者中，PLPH的发生率为24.8%。MCI组和痴呆组头痛的发生率和持续时间无显著差异。腰椎穿刺后头痛（PLPH）的平均时间为22.9小时。MCI患者头痛量表评分无显著差异。认知障碍女性患者PLPH的发生率高于男性。有头痛病史的认知障碍患者PLPH的发生率显著高于无头痛病史的认知障碍患者。然而，在受教育年限、腰椎穿刺次数、卧床休息时间和口服补液量方面未观察到显著差异。
PLPH在女性、有头痛病史者、年龄较小或体重指数（BMI）较低者中更常见。C-PAINAD和SF-MPQ是评估认知障碍患者PLPH的首选评估工具。
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