Logo image
Back
Safety and Feasibility of Serial Lumbar Punctures: Long-term Results from the Parkinson’s Progression Markers Initiative
Journal article   Open access   Peer reviewed

Safety and Feasibility of Serial Lumbar Punctures: Long-term Results from the Parkinson’s Progression Markers Initiative

William Barbosa, Ruth B Schneider, Seung Ho Choi, Micah J Marshall, David-Erick Lafontant, Chelsea Caspell-Garcia, Christopher S Coffey, Jason Ross, Andrew Siderowf, Kenneth Marek, …
Clinical parkinsonism & related disorders, Vol.13, 100385
2025
DOI: 10.1016/j.prdoa.2025.100385
PMCID: PMC12391599
PMID: 40895170
url
https://doi.org/10.1016/j.prdoa.2025.100385View
Published (Version of record) Open Access

Abstract

•Clinical studies are incorporating cerebrospinal fluid biomarker metrics into trial design.•Longitudinal analysis of lumbar puncture safety and feasibility is limited.•In a large cohort study, serial lumbar punctures were safe over a 13-year period.•Compliance is high over the first three years but further investigation is warranted to improve long term success. Cerebrospinal fluid (CSF) serves an essential role in biomarker research. New Parkinson’s disease (PD) classifications incorporate CSF α-synuclein status into trial design. This study evaluated the safety and feasibility of serial CSF collection in participants enrolled in the Parkinson’s Progression Markers Initiative (PPMI). PPMI participants were evaluated over 13-years with lumbar punctures (LPs) occurring annually from baseline through year five and biennially thereafter. Adverse events and compliance, defined as percentage of LPs with CSF collection, were assessed at baseline and upon follow up. Logistic regression and generalized linear mixed effects models were used to calculate odds ratios and 95% confidence intervals for predictors of baseline and longitudinal LP success. 3479 participants (PD: n = 1412, prodromal: n = 1768, healthy control: n = 299) were analyzed. 3360 attempted at least one LP with 29.5 % experiencing an adverse event (1.3 % severe). Baseline compliance was 90 %. From baseline to year five, percent change in compliance decreased by 39.4 % in the PD cohort, 41.4 % in the prodromal cohort, and 27.8 % in the healthy control cohort. Predictive variables of baseline LP success included fewer years since diagnosis (PD: OR 0.82, 0.76–0.89), lower BMI (prodromal: OR 0.92, 0.89–0.94), and site location U.S. vs. non-U.S. (PD: OR 1.5, 1.03–2.18, healthy control: OR 3.6, 1.22–10.64). Baseline LP success was the best predictor of longitudinal success (OR 7.82, 5.74–10.65). Lumbar punctures were safe in PD research participants over a 13-year period. Compliance was high over the first three years, but further investigation is warranted to improve long term success.
 Cerebrospinal fluid Feasibility Lumbar puncture Parkinson’s disease α-synuclein

Details

Metrics

3 Record Views
Logo image