Intra‐ and post‐procedural lumbar puncture symptoms in a sample of Black/African American, American Indian/Alaska Native, and White middle age older adults

Abstract

AbstractBackgroundCerebral spinal fluid (CSF) as a biomarker of Alzheimer’s disease (AD) is a helpful tool in diagnosing preclinical disease. While blood‐based biomarkers are becoming increasingly used for early detection, CSF collection is still necessary for validation of AD blood‐based biomarkers and for identification of biomarkers for other types of dementias, including those that commonly co‐occur with AD. Attitudes and beliefs surrounding lumbar punctures (LPs) vary, and differing techniques as well as side effect rates might dissuade both clinicians and participants from considering LPs as a viable biomarker option. The aim of this analysis was to examine intra‐ and post‐procedural symptoms of a specific technique for collecting CSF from adult volunteers enrolled in the Wisconsin Alzheimer’s Disease Research Center.MethodLPs were performed on 587 volunteers using a standardized LP technique with atraumatic needle. Up to 22 milliliters of cerebral spinal fluid was obtained using gentle syringe aspiration of fluid. Clinician notes documenting the procedure were used to assess intra‐procedural symptoms. A follow‐up phone call the next day was used to evaluate any post‐procedural symptoms. The association between participant characteristics and LP intra‐procedural symptoms, post‐procedural symptoms, and LP success were tested using linear regression.ResultThe majority of participants did not report any intra‐procedural (59%) or post‐procedural (77%) symptoms. Being female was associated with experiencing increased intra‐procedural symptoms among Black / African American and White participants; younger age and lower waist‐to‐hip ratio were associated with higher rates of intra‐procedural symptoms among White participants. Participant characteristics were not associated with post‐procedural symptoms. LP success was high for all groups (67% to 90%). Among White participants, pain and vasovagal responses were associated with terminating the LP before sufficient fluid was collected. Among Black / African American participants, pain was associated with terminating the LP procedure before sufficient fluid was collected. Among American Indian / Alaska Native participants, no intra‐procedural symptoms were associated with early LP termination.ConclusionWe provide rates of LP intra‐procedural and post‐procedural symptoms in a diverse sample of middle‐aged and older adults. These data suggest that LPs are safe and well tolerated across a diverse group of participants.