TY - JOUR
T1 - Factors Influencing Successful Lumbar Puncture in Alzheimer Research
AU - Moulder, Krista L.
AU - Besser, Lilah M.
AU - Beekly, Duane
AU - Blennow, Kaj
AU - Kukull, Walter
AU - Morris, John C.
N1 - Funding Information:
Supported by a grant from the Alzheimer’s Association (W.K., J.C.M.) and by grants from the National Institutes of Health [U01 AG016976 (W.K.) and P50 AG05681 (J.C.M.)].
Publisher Copyright:
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017
Y1 - 2017
N2 - Objective: Lumbar puncture (LP) is increasingly common in Alzheimer disease research; however, agreement to undergo LP varies. We sought to determine factors influencing LP consent at Alzheimer's Disease Centers (ADCs) in the United States. Methods: A 3-part survey was distributed to each ADC: (1) ADC LP Experience; (2) LP Requestor Experience; and (3) Patient LP Experience (both Initial and Follow-up). In all, 64 LP Requestor, 579 Patient/Initial, and 404 Patient/Follow-up surveys were collected. Logistic regression analyses with generalized estimating equations were used to assess factors associated with LP agreement and post-LP complications. Results: Asians and those viewing LP negatively were less likely to agree to LP. Three hundred fifty-two participants had an LP; LP headache occurred in 11.9% (blood patch required in 1.4%) and 9.9% reported other complications. Younger individuals, women, those diagnosed with mild cognitive impairment, use of a Quincke needle, =20mL cerebrospinal fluid drawn, and hemorrhage during LP were associated with LP headache. Use of gravity flow during LP was associated with fewer other complications (nausea, dizziness, vasovagal response, back pain, neck stiffness, and/or nerve root pain). Conclusions: LP in Alzheimer disease research is generally safe and well tolerated. Factors influencing LP agreement potentially could be studied to advance participant acceptance of the procedure.
AB - Objective: Lumbar puncture (LP) is increasingly common in Alzheimer disease research; however, agreement to undergo LP varies. We sought to determine factors influencing LP consent at Alzheimer's Disease Centers (ADCs) in the United States. Methods: A 3-part survey was distributed to each ADC: (1) ADC LP Experience; (2) LP Requestor Experience; and (3) Patient LP Experience (both Initial and Follow-up). In all, 64 LP Requestor, 579 Patient/Initial, and 404 Patient/Follow-up surveys were collected. Logistic regression analyses with generalized estimating equations were used to assess factors associated with LP agreement and post-LP complications. Results: Asians and those viewing LP negatively were less likely to agree to LP. Three hundred fifty-two participants had an LP; LP headache occurred in 11.9% (blood patch required in 1.4%) and 9.9% reported other complications. Younger individuals, women, those diagnosed with mild cognitive impairment, use of a Quincke needle, =20mL cerebrospinal fluid drawn, and hemorrhage during LP were associated with LP headache. Use of gravity flow during LP was associated with fewer other complications (nausea, dizziness, vasovagal response, back pain, neck stiffness, and/or nerve root pain). Conclusions: LP in Alzheimer disease research is generally safe and well tolerated. Factors influencing LP agreement potentially could be studied to advance participant acceptance of the procedure.
KW - Alzheimer disease
KW - biomarkers
KW - cerebrospinal fluid
KW - lumbar puncture
KW - post-LP complications
KW - post-LP headache
UR - http://www.scopus.com/inward/record.url?scp=85036669679&partnerID=8YFLogxK
U2 - 10.1097/WAD.0000000000000209
DO - 10.1097/WAD.0000000000000209
M3 - Article
C2 - 28891819
AN - SCOPUS:85036669679
SN - 0893-0341
VL - 31
SP - 287
EP - 294
JO - Alzheimer disease and associated disorders
JF - Alzheimer disease and associated disorders
IS - 4
ER -