title: Feasibility of lumbar puncture in the study of cerebrospinal fluid biomarkers for Alzheimer's disease: a multicenter study in Spain.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  LP can be safely performed to study CSF biomarkers. The main complication is headache, associated with younger age and use of cutting-edge needles.
authors.affiliation: 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.
authors.forename: Daniel
authors.initials: D
authors.lastname: Alcolea
authors.affiliation: 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.
authors.forename: Pablo
authors.initials: P
authors.lastname: Martínez-Lage
authors.affiliation: Department of Neurology, Center for Research and Advanced Therapies, Fundación CITA-Alzheimer Fundazioa, San Sebastián, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: Izagirre
authors.affiliation: Department of Neurology, Center for Research and Advanced Therapies, Fundación CITA-Alzheimer Fundazioa, San Sebastián, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Clerigué
authors.affiliation: 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.
authors.forename: María
authors.initials: M
authors.lastname: Carmona-Iragui
authors.affiliation: Department of Neurology, Alzheimer's Disease and other Cognitive Disorders Unit, Hospital Clínic, Barcelona, Spain.
authors.forename: Rosa María
authors.initials: RM
authors.lastname: Alvarez
authors.affiliation: 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.
authors.forename: Juan
authors.initials: J
authors.lastname: Fortea
authors.affiliation: Department of Neurology, Alzheimer's Disease and other Cognitive Disorders Unit, Hospital Clínic, Barcelona, Spain.
authors.forename: Mircea
authors.initials: M
authors.lastname: Balasa
authors.affiliation: 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.
authors.forename: Estrella
authors.initials: E
authors.lastname: Morenas-Rodríguez
authors.affiliation: Department of Neurology, Alzheimer's Disease and other Cognitive Disorders Unit, Hospital Clínic, Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Lladó
authors.affiliation: Department of Neurology, Alzheimer's Disease and other Cognitive Disorders Unit, Hospital Clínic, Barcelona, Spain.
authors.forename: Oriol
authors.initials: O
authors.lastname: Grau
authors.affiliation: Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, University of Göteborg, Göteborg, Sweden.
authors.forename: Kaj
authors.initials: K
authors.lastname: Blennow
authors.affiliation: 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.
authors.forename: Alberto
authors.initials: A
authors.lastname: Lleó
authors.affiliation: Department of Neurology, Alzheimer's Disease and other Cognitive Disorders Unit, Hospital Clínic, Barcelona, Spain.
authors.forename: José L
authors.initials: JL
authors.lastname: Molinuevo
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000453:epidemiology*; D015415:Biomarkers / Q000134:cerebrospinal fluid; D005240:Feasibility Studies; D005260:Female; D006261:Headache / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D013129:Spinal Puncture / Q000009:adverse effects / Q000379:methods*
chemical_list: D015415:Biomarkers
keywords: Alzheimer's disease; biomarkers; cerebrospinal fluid; dementia; lumbar puncture; post-lumbar puncture headache