Feasibility of Lumbar Puncture in the Study of Cerebrospinal Fluid Biomarkers for Alzheimer’s Disease in Subjects with Down Syndrome

Article type: Research Article

Authors: Carmona-Iragui, María^{a; b; c} | Santos, Telma^d | Videla, Sebastián^{b; e} | Fernández, Susana^b | Benejam, Bessy^b | Videla, Laura^b | Alcolea, Daniel^{a; c} | Blennow, Kaj^f | Blesa, Rafael^{a; c} | Lleó, Alberto^{a; c} | Fortea, Juan^{a; b; c; *}

Affiliations: [a] Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain | [b] Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain | [c] Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain | [d] Neurology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Porto, Portugal | [e] Department of Experimental and Health Sciences, Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain | [f] Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, University of Göteborg, Göteborg, Sweden

Correspondence: [*] Correspondence to: Juan Fortea Ormaechea, Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Down Medical Center, Fundació Catalana Sindrome de Down, Sant Antoni María Claret, 167, 08025 Barcelona, Spain. Tel.: +34 935565986; Fax: +34 935565602; E-mail: jfortea@santpau.cat.

Abstract: Background: Alzheimer’s disease (AD) is the main medical problem in older adults with Down syndrome (DS). Studies of cerebrospinal fluid (CSF) AD biomarkers are limited and the feasibility of lumbar puncture (LP) is controversial in this population. Objective: To analyze the frequency of complications after a LP in DS. Methods: We collected data from 80 adults with DS that underwent a LP within the Down Alzheimer Barcelona Neuroimaging Initiative. Demographics, cognitive status, headache history, and presence of complications after the LP were recorded in every subject. In 53 of them (active group), this information was collected following a semi-structured and validated protocol that actively looks for complications. Other variables related to the LP procedure were also recorded. A telephone interview to the caregiver was performed 5–7 days after the procedure to ask about complications. Data from 27 subjects (clinical practice group), from whom the presence of complications was obtained in a medical follow-up visit within the three months after the LP, were also included. Results: There were no adverse events in 90% of our participants. The most frequent complication was headache (6.25%); only one subject reported a typical post-lumbar puncture headache with moderate severity that required analgesic treatment. Dizziness (3.75%) and back pain (1.25%) were also reported. All the participants that reported complications belonged to the active group. Conclusion: LP can be safely performed to study CSF biomarkers in DS. The reported complications are qualitatively similar to the general population, but are less frequently reported, even when actively searched for.

Keywords: Alzheimer’s disease, biomarkers, cerebrospinal fluid, Down syndrome, complications, lumbar puncture

DOI: 10.3233/JAD-160827

Journal: Journal of Alzheimer's Disease, vol. 55, no. 4, pp. 1489-1496, 2017