title: Performance and complications of lumbar puncture in memory clinics: Results of the multicenter lumbar puncture feasibility study.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Flora H
authors.initials: FH
authors.lastname: Duits
authors.affiliation: Department of Neurology, Fundacion CITA-Alzheimer Fundazioa, San Sebastián, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Martinez-Lage
authors.affiliation: 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.
authors.forename: Claire
authors.initials: C
authors.lastname: Paquet
authors.affiliation: 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.
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Engelborghs
authors.affiliation: 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.
authors.forename: Alberto
authors.initials: A
authors.lastname: Lleó
authors.affiliation: Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany.
authors.forename: Lucrezia
authors.initials: L
authors.lastname: Hausner
authors.affiliation: Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, ICN Hospital Clinic i Universitari and Pasqual Maragall Foundation, Barcelona, Spain.
authors.forename: José L
authors.initials: JL
authors.lastname: Molinuevo
authors.affiliation: Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Stomrud
authors.affiliation: Centro Disturbi della Memoria, Clinica Neurologica, Università degli Studi di Perugia, Perugia, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Farotti
authors.affiliation: Alzheimer Center Limburg, Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
authors.forename: Inez H G B
authors.initials: IHGB
authors.lastname: Ramakers
authors.affiliation: 3rd Department of Neurology, Aristotle University of Thessaloniki, Macedonia, Greece.
authors.forename: Magda
authors.initials: M
authors.lastname: Tsolaki
authors.affiliation: The Department of Geriatrics, Kalmar County Hospital, Kalmar, Sweden.
authors.forename: Constance
authors.initials: C
authors.lastname: Skarsgård
authors.affiliation: Department of Cognitive Medicine, Karlstad Central Hospital, Karlstad, Sweden.
authors.forename: Ragnar
authors.initials: R
authors.lastname: Åstrand
authors.affiliation: Memory Clinic at Department of Neuropsychiatry, Sahlgrenska University Hospital, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Wallin
authors.affiliation: 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.
authors.forename: Martin
authors.initials: M
authors.lastname: Vyhnalek
authors.affiliation: Department of Geriatrics, Minnesmottagningen, Eskilstuna, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Holmber-Clausen
authors.affiliation: Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
authors.forename: Orestes V
authors.initials: OV
authors.lastname: Forlenza
authors.affiliation: Neurology Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Grandam IRCCS Ospedale Policlinico, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Ghezzi
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Ingelsson
authors.affiliation: Department of Neurology, Atrium Medical Center Parkstad, Heerlen, The Netherlands.
authors.forename: Erik I
authors.initials: EI
authors.lastname: Hoff
authors.affiliation: Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands.
authors.forename: Gerwin
authors.initials: G
authors.lastname: Roks
authors.affiliation: Department of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
authors.forename: Alexandre
authors.initials: A
authors.lastname: de Mendonça
authors.affiliation: Department of Neurology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.
authors.forename: Janne M
authors.initials: JM
authors.lastname: Papma
authors.affiliation: Department of Neurology, Fundacion CITA-Alzheimer Fundazioa, San Sebastián, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: Izagirre
authors.affiliation: 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.
authors.forename: Mariko
authors.initials: M
authors.lastname: Taga
authors.affiliation: Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.
authors.forename: Hanne
authors.initials: H
authors.lastname: Struyfs
authors.affiliation: 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.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Alcolea
authors.affiliation: Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany.
authors.forename: Lutz
authors.initials: L
authors.lastname: Frölich
authors.affiliation: Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, ICN Hospital Clinic i Universitari and Pasqual Maragall Foundation, Barcelona, Spain.
authors.forename: Mircea
authors.initials: M
authors.lastname: Balasa
authors.affiliation: Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
authors.forename: Lennart
authors.initials: L
authors.lastname: Minthon
authors.affiliation: Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Jos W R
authors.initials: JWR
authors.lastname: Twisk
authors.affiliation: Department of Clinical Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Persson
authors.affiliation: 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.
authors.forename: Henrik
authors.initials: H
authors.lastname: Zetterberg
authors.affiliation: 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.
authors.forename: Wiesje M
authors.initials: WM
authors.lastname: van der Flier
authors.affiliation: Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Charlotte E
authors.initials: CE
authors.lastname: Teunissen
authors.affiliation: Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: p.scheltens@vumc.nl.
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.affiliation: Department of Clinical Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal Sweden.
authors.forename: Kaj
authors.initials: K
authors.lastname: Blennow
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities; D003072:Cognition Disorders / Q000134:cerebrospinal fluid; D003704:Dementia / Q000134:cerebrospinal fluid; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008568:Memory / Q000502:physiology*; D008875:Middle Aged; D051299:Post-Dural Puncture Headache / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D013129:Spinal Puncture / Q000009:adverse effects* / Q000379:methods
keywords: Alzheimer's disease; Cognitive disorders; Lumbar puncture; Memory clinic; Multicenter study on LP feasibility; Post-LP complications; Post-LP headache