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Abstract Details

Identifying Factors that Predict Complications and Influence Participation in Longitudinal Cerebrospinal Fluid Biomarker Studies
Aging, Dementia, and Behavioral Neurology
S9 - Aging and Dementia: Clinical Trials and Novel Therapies (4:58 PM-5:09 PM)
009
Biomarkers are increasingly used to determine the cause of dementia, define the biological processes that influence dementia progression, and identify cognitively normal research participants at higher risk of developing dementia. There is a need to understand the factors that influence participation in observational studies incorporating serial CSF measures. 
To determine the participant- and procedure-specific factors that predict lumbar puncture complications and influence participation in longitudinal research studies incorporating cerebrospinal fluid (CSF) measures.
Participant- and procedure-specific factors associated with lumbar puncture complications and participation in biomarker studies were determined in participants engaged in longitudinal studies of memory and aging at the Knight Alzheimer Disease Research Center (Washington University School of Medicine; Saint Louis, Missouri) from 2004 to 2018.

929 participants completed 1484 lumbar punctures. Complications were reported following 331 (23.1%) lumbar punctures—most commonly headache (11.3%) or self-resolving back pain (9.5%). Thirty-eight (2.8%) participants developed a severe headache, requiring blood patch. Complications were more likely in younger (65.8±8.9 vs 69.2±8.9 years, p<0.001), female (RR 1.5, 95%CI: 1.2-1.9), cognitively normal (RR 2.1, 95%CI: 1.4, 2.5] participants, and those with a prior history of complications (RR 1.7, 95%CI: 1.3-2.2). Lower body mass index (23.5±3.3 vs 27.9±5.5 kg/m2; p<0.001) and fewer years of operator experience (3.4±3.7 vs 6.3±6.9; p=0.01) were additionally associated with severe headaches. 126 participants completed ≥3 serial lumbar punctures. Serial completers were younger (61.7±8.6 vs 69.0±9.3 years; p<0.001), more often female (RR 1.4, 95%CI: 1.0-1.9) and less likely to have known heart disease (RR 2.1, 95%CI 1.3-3.3) than non-completers, followed for similar lengths of time.
Lumbar puncture complications requiring medical intervention were rare in our cohort. Knowledge of the factors that predict complications and influence participation may be leveraged to provide personalized risk assessments and improve recruitment and retention within longitudinal studies incorporating CSF measures.
Authors/Disclosures
Gregory S. Day, MD, MSc, FAAN (Mayo Clinic)
PRESENTER 		Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Parabon Nanolabs. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys Therapeutics. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for DynaMed (EBSCO Health). Dr. Day has stock in ANI Pharmaceuticals. The institution of Dr. Day has received research support from National Institutes of Health / NIA. The institution of Dr. Day has received research support from Chan Zuckerberg Initiative. The institution of Dr. Day has received research support from Alzheimer's Association. The institution of Dr. Day has received research support from National Institutes of Health / NINDS. The institution of Dr. Day has received research support from Amgen Pharmaceuticals. The institution of Dr. Day has received research support from AVID Radiopharmaceuticals. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Presenter at Annual Meeting (CME) with 好色先生. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Content Development (CME) with PeerView, Inc. Dr. Day has received personal compensation in the range of $5,000-$9,999 for serving as a Content Development (CME) with Continuing 好色先生, Inc. Dr. Day has received personal compensation in the range of $5,000-$9,999 for serving as a Content Development (CME) with Ionis Pharmaceuticals. Dr. Day has a non-compensated relationship as a Clinical Director with Anti-NMDA Receptor Encephalitis Foundation that is relevant to AAN interests or activities.
No disclosure on file
No disclosure on file