State-of-the-art of lumbar puncture and its place in the journey of patients with Alzheimer's disease

Recent advances in developing disease-modifying therapies (DMT) for Alzheimer's disease (AD), and the recognition that AD pathophysiology emerges decades before clinical symptoms, necessitate a paradigm shift of health-care systems toward biomarker-guided early detection, diagnosis, and therape...

Descripción completa

Detalles Bibliográficos
Autores: Hampel, Harald, Shaw, Leslie M., Aisen, Paul, Chen, Christopher, Lleó, Alberto|||0000-0002-2568-5478, Iwatsubo, Takeshi, Iwata, Atsushi, Yamada, Masahito, Ikeuchi, Takeshi|||0000-0001-8828-8085, Jia, Jianping, Wang, Huali, Teunissen, Charlotte E.|||0000-0002-4061-0837, Peskind, Elaine, Blennow, Kaj|||0000-0002-1890-4193, Cummings, Jeffrey, Vergallo, Andrea
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:282283
Acceso en línea:https://ddd.uab.cat/record/282283
https://dx.doi.org/urn:doi:10.1002/alz.12372
Access Level:acceso abierto
Palabra clave:Alzheimer's disease
Biomarker
Cerebrospinal fluid
Diagnosis
Evidence-based guidelines
Lumbar puncture
System readiness
Descripción
Sumario:Recent advances in developing disease-modifying therapies (DMT) for Alzheimer's disease (AD), and the recognition that AD pathophysiology emerges decades before clinical symptoms, necessitate a paradigm shift of health-care systems toward biomarker-guided early detection, diagnosis, and therapeutic decision-making. Appropriate incorporation of cerebrospinal fluid biomarker analysis in clinical practice is an essential step toward system readiness for accommodating the demand of AD diagnosis and proper use of DMTs-once they become available. However, the use of lumbar puncture (LP) in individuals with suspected neurodegenerative diseases such as AD is inconsistent, and the perception of its utility and safety differs considerably among medical specialties as well as among regions and countries. This review describes the state-of-the-art evidence concerning the safety profile of LP in older adults, discusses the risk factors for LP-associated adverse events, and provides recommendations and an outlook for optimized use and global implementation of LP in individuals with suspected AD.