Cerebrospinal fluid sampling for research of Alzheimer’s disease and other neurodegenerative diseases when lumbar punctures are performed by anaesthetists

Objectives An increasing number of people are undergoing lumbar puncture (LP) for the purposes of research. Performing LP for research purposes introduces considerations that differ from LP performed for clinical, diagnostic or therapeutic reasons. The demand for research LP will greatly increase as...

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Main Authors: Lisbeth Evered, David A Scott, Colin L Masters, Kelly J Atkins, Christopher Fowler, Brendan Silbert
Format: Article
Language:English
Published: BMJ Publishing Group 2022-11-01
Series:BMJ Neurology Open
Online Access:https://neurologyopen.bmj.com/content/4/2/e000335.full
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author Lisbeth Evered
David A Scott
Colin L Masters
Kelly J Atkins
Christopher Fowler
Brendan Silbert
author_facet Lisbeth Evered
David A Scott
Colin L Masters
Kelly J Atkins
Christopher Fowler
Brendan Silbert
author_sort Lisbeth Evered
collection DOAJ
description Objectives An increasing number of people are undergoing lumbar puncture (LP) for the purposes of research. Performing LP for research purposes introduces considerations that differ from LP performed for clinical, diagnostic or therapeutic reasons. The demand for research LP will greatly increase as biomarkers are used to both diagnose and monitor disease progression in clinical trials. Minimising adverse events is paramount because research participants receive no clinical benefit and often need repeat procedures. We describe the experience of performing LP for research by anaesthetists.Methods We reviewed the clinical protocol and incidence of adverse events in 326 research LP in an anaesthesia department.Results There was a lower incidence of adverse events compared with previous reports when LP was undertaken for clinical reasons. The incidence of severe post-LP headache was 1.3% when an atraumatic spinal needle with a 27 gauge tip and a 22 gauge shaft was used.Conclusions We describe the practice to sample cerebrospinal fluid (CSF) by LP for research purposes. Specific practices include the sitting position of the participant, aspiration rather than passive CSF withdrawal, attention to the sterility of the procedure, monitoring of vital signs and importantly the use of 22/27 gauge microtip spinal needle.Trial registration numbers ACTRN12612000493842, NCT04623242.
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spelling doaj.art-3d5bfeb474844124bffa50fc0edd620b2023-07-07T00:30:06ZengBMJ Publishing GroupBMJ Neurology Open2632-61402022-11-014210.1136/bmjno-2022-000335Cerebrospinal fluid sampling for research of Alzheimer’s disease and other neurodegenerative diseases when lumbar punctures are performed by anaesthetistsLisbeth Evered0David A Scott1Colin L Masters2Kelly J Atkins3Christopher Fowler4Brendan Silbert5Department of Anaesthesia and Acute Pain Medicine, St Vincent`s Hospital Melbourne, Fitzroy, Victoria, AustraliaDepartment of Anaesthesia and Acute Pain Medicine, St Vincent`s Hospital Melbourne, Fitzroy, Victoria, AustraliaThe Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, AustraliaDepartment of Anaesthesia and Acute Pain Medicine, St Vincent`s Hospital Melbourne, Fitzroy, Victoria, AustraliaThe Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, AustraliaDepartment of Anaesthesia and Acute Pain Medicine, St Vincent`s Hospital Melbourne, Fitzroy, Victoria, AustraliaObjectives An increasing number of people are undergoing lumbar puncture (LP) for the purposes of research. Performing LP for research purposes introduces considerations that differ from LP performed for clinical, diagnostic or therapeutic reasons. The demand for research LP will greatly increase as biomarkers are used to both diagnose and monitor disease progression in clinical trials. Minimising adverse events is paramount because research participants receive no clinical benefit and often need repeat procedures. We describe the experience of performing LP for research by anaesthetists.Methods We reviewed the clinical protocol and incidence of adverse events in 326 research LP in an anaesthesia department.Results There was a lower incidence of adverse events compared with previous reports when LP was undertaken for clinical reasons. The incidence of severe post-LP headache was 1.3% when an atraumatic spinal needle with a 27 gauge tip and a 22 gauge shaft was used.Conclusions We describe the practice to sample cerebrospinal fluid (CSF) by LP for research purposes. Specific practices include the sitting position of the participant, aspiration rather than passive CSF withdrawal, attention to the sterility of the procedure, monitoring of vital signs and importantly the use of 22/27 gauge microtip spinal needle.Trial registration numbers ACTRN12612000493842, NCT04623242.https://neurologyopen.bmj.com/content/4/2/e000335.full
spellingShingle Lisbeth Evered
David A Scott
Colin L Masters
Kelly J Atkins
Christopher Fowler
Brendan Silbert
Cerebrospinal fluid sampling for research of Alzheimer’s disease and other neurodegenerative diseases when lumbar punctures are performed by anaesthetists
BMJ Neurology Open
title Cerebrospinal fluid sampling for research of Alzheimer’s disease and other neurodegenerative diseases when lumbar punctures are performed by anaesthetists
title_full Cerebrospinal fluid sampling for research of Alzheimer’s disease and other neurodegenerative diseases when lumbar punctures are performed by anaesthetists
title_fullStr Cerebrospinal fluid sampling for research of Alzheimer’s disease and other neurodegenerative diseases when lumbar punctures are performed by anaesthetists
title_full_unstemmed Cerebrospinal fluid sampling for research of Alzheimer’s disease and other neurodegenerative diseases when lumbar punctures are performed by anaesthetists
title_short Cerebrospinal fluid sampling for research of Alzheimer’s disease and other neurodegenerative diseases when lumbar punctures are performed by anaesthetists
title_sort cerebrospinal fluid sampling for research of alzheimer s disease and other neurodegenerative diseases when lumbar punctures are performed by anaesthetists
url https://neurologyopen.bmj.com/content/4/2/e000335.full
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