Guidelines Presented for Lumbar Puncture in Alzheimer's Dx
TUESDAY, Oct. 30, 2018 -- The Alzheimer's Association has released appropriate-use criteria for lumbar puncture and cerebrospinal fluid (CSF) testing in Alzheimer's disease diagnosis, according to a review article published online Oct. 10 in Alzheimer's & Dementia.
Leslie M. Shaw, Ph.D., from the University of Pennsylvania in Philadelphia, and colleagues report on the Alzheimer's Association's convening of a multidisciplinary workgroup to develop appropriate-use criteria to guide the safe and optimal use of the lumbar puncture procedure and CSF testing for Alzheimer's disease pathology detection in the diagnostic process. The workgroup developed key research questions to guide the systematic review of the evidence and developed clinical indications commonly encountered by clinicians based on key patient groups in whom lumbar puncture and CSF may be considered in the diagnostic process.
The workgroup finalized 14 indications, rating six appropriate and eight inappropriate. The appropriate indications include: subjective cognitive decline and an increased risk for Alzheimer's disease; persistent, progressive, and unexplained mild cognitive impairment; symptoms suggestive of possible Alzheimer's disease; mild cognitive impairment or dementia with onset at an early age (<65 years); meeting core clinical criteria for probable Alzheimer's disease with typical age of onset; and having a dominant symptom of unexplained change in behavior with an Alzheimer's disease diagnosis being considered.
"In anticipation of the emergence of more reliable CSF analysis platforms, the manuscript offers important guidance to health care practitioners and suggestions for implementation and future research," write the authors.
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Posted: October 2018
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