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Feasibility and safety of lumbar puncture in the Parkinson's disease research participants: Parkinson's Progression Marker Initiative (PPMI)
Journal article   Peer reviewed

Feasibility and safety of lumbar puncture in the Parkinson's disease research participants: Parkinson's Progression Marker Initiative (PPMI)

Neha Prakash, Chelsea Caspell-Garcia, Christopher Coffey, Andrew Siderowf, Karl Kieburtz, Brit Mollenhauer, Douglas Galasko, Kalpana Merchant, Tatiana Foroud, Lana M Chahine, …
Parkinsonism & related disorders, Vol.62, pp.201-209
05/2019
DOI: 10.1016/j.parkreldis.2018.12.025
PMCID: PMC8978879
PMID: 30738748
url
https://www.ncbi.nlm.nih.gov/pmc/articles/8978879View
Open Access

Abstract

To determine the feasibility, safety and tolerability of lumbar punctures (LPs) in research participants with early Parkinson disease (PD), subjects without evidence of dopaminergic deficiency (SWEDDs) and healthy volunteers (HC). Cerebrospinal fluid (CSF) analysis is becoming an essential part of the biomarkers discovery effort in PD with still limited data on safety and feasibility of serial LPs in PD participants. Parkinson's Progression Marker Initiative (PPMI) is a longitudinal observation study designed to identify PD progression biomarkers. All PPMI participants undergo LP at baseline, 6, 12 months and yearly thereafter. CSF collection is performed by a trained investigator using predominantly atraumatic needles. Adverse events (AEs) are monitored by phone one week after LP completion. We analyzed safety data from baseline LPs. PPMI enrolled 683 participants (423 PD/196 HC/64 SWEDDs) from 23 study sites. CSF was collected at baseline in 97.5% of participants, of whom 5.4% underwent collection under fluoroscopy. 23% participants reported any related AEs, 68% of all AE were mild while 5.6% were severe. The most common AEs were headaches (13%) and low back pain (6.5%) and both occurred more commonly in HC and SWEDDs compared to PD participants. Factors associated with higher incidence of AEs across the cohorts included female gender, younger age and use of traumatic needles with larger diameter. AEs largely did not impact compliance with the future LPs. LPs are safe and feasible in PD research participants. Specific LP techniques (needle type and gauge) may reduce the overall incidence of AEs.
Feasibility Studies Aged Biomarkers - cerebrospinal fluid Cohort Studies Disease Progression Female Humans Longitudinal Studies Male Middle Aged Parkinson Disease - cerebrospinal fluid Parkinson Disease - diagnosis Post-Dural Puncture Headache - diagnosis Post-Dural Puncture Headache - etiology Spinal Puncture - adverse effects Spinal Puncture - methods Tinnitus - diagnosis Tinnitus - etiology

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