Indications, réalisation et faisabilité de la ponction lombaire dans 18 centres mémoires de ressources et de recherche

Paquet, Claire; Latour, F.; Saulnier, Isabelle; Hanon, Olivier

doi:10.1016/j.neurol.2011.08.012

Cited by 14 publications

(6 citation statements)

References 17 publications

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“…CSF biomarker tests were performed in local laboratories for all subjects. All biochemical teams were involved in two national cohorts and shared the same standards for CSF analysis and interpretation [ 24 – 28 ]. In addition, the laboratories performed two external quality controls: one run by a working group of the Société Française de Biologie Clinique (French Society of Clinical Biology) and the other by the Alzheimer’s Association [ 29 ].…”

Section: Methodsmentioning

confidence: 99%

Utility of CSF biomarkers in psychiatric disorders: a national multicentre prospective study

Paquet¹,

Magnin

Wallon

et al. 2016

Alz Res Therapy

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BackgroundAffective and psychotic disorders are mental or behavioural patterns resulting in an inability to cope with life’s ordinary demands and routines. These conditions can be a prodromal event of Alzheimer’s disease (AD). The prevalence of underlying AD lesions in psychiatric diseases is unknown, and it would be helpful to determine them in patients. AD cerebrospinal fluid (CSF) biomarkers (amyloid β, tau and phosphorylated tau) have high diagnostic accuracy, both for AD with dementia and to predict incipient AD (mild cognitive impairment due to AD), and they are sometimes used to discriminate psychiatric diseases from AD. Our objective in the present study was to evaluate the clinical utility of CSF biomarkers in a group of patients with psychiatric disease as the main diagnosis.MethodsIn a multicentre prospective study, clinicians filled out an anonymous questionnaire about all of their patients who had undergone CSF biomarker evaluation. Before and after CSF biomarker results were obtained, clinicians provided a diagnosis with their level of confidence and information about the treatment. We included patients with a psychiatric disorder as the initial diagnosis. In a second part of the study conducted retrospectively in a followed subgroup, clinicians detailed the psychiatric history and we classified patients into three categories: (1) psychiatric symptoms associated with AD, (2) dual diagnosis and (3) cognitive decline not linked to a neurodegenerative disorder.ResultsOf 957 patients, 69 had an initial diagnosis of a psychiatric disorder. Among these 69 patients, 14 (20.2 %) had a CSF AD profile, 5 (7.2 %) presented with an intermediate CSF profile and 50 (72.4 %) had a non-AD CSF profile. Ultimately, 13 (18.8 %) patients were diagnosed with AD. We show that in the AD group psychiatric symptoms occurred later and the delay between the first psychiatric symptoms and the cognitive decline was shorter.ConclusionsThis study revealed that about 20 % of patients with a primary psychiatric disorder diagnosis before undergoing a CSF exploration for cognitive disorder displayed a CSF biomarker AD profile. In memory clinics, it seems important to consider AD as a possible diagnosis before finalizing a diagnosis of a psychiatric disorder.

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Section: Methodsmentioning

confidence: 99%

Utility of CSF biomarkers in psychiatric disorders: a national multicentre prospective study

Paquet¹,

Magnin

Wallon

et al. 2016

Alz Res Therapy

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“…Five samples were divided into polypropylene or polystyrene tubes and stored for 24 hours at −80°C. The h-sAPPα values of samples stored in polystyrene tubes were not significantly different from those of samples stored in polypropylene tubes (mean recovery: 93 ± 2%; Table 3), which is a real concern in a clinical practice [28-30]. …”

Section: Resultsmentioning

confidence: 99%

New highly sensitive rodent and human tests for soluble amyloid precursor protein alpha quantification: preclinical and clinical applications in Alzheimer’s disease

et al. 2012

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BackgroundAmyloid precursor protein (APP), a key molecule in Alzheimer’s disease (AD), is metabolized in two alternative cleavages, generating either the amyloidogenic peptides involved in AD pathology or the soluble form of APP (sAPPα). The level of amyloidogenic peptides in human cerebrospinal fluid (CSF) is considered to be a biomarker of AD, whereas the level of sAPPα in CSF as a biomarker has not been clearly established. sAPPα has neurotrophic and neuroprotective properties. Stimulating its formation and secretion is a promising therapeutic target in AD research. To this end, very sensitive tests for preclinical and clinical research are required.MethodsThe tests are based on homogenous time-resolved fluorescence and require no washing steps.ResultsWe describe two new rapid and sensitive tests for quantifying mouse and human sAPPα. These 20 μl-volume tests quantify the levels of: i) endogenous mouse sAPPα in the conditioned medium of mouse neuron primary cultures, as well as in the CSF of wild-type mice, ii) human sAPPα in the CSF of AD mouse models, and iii) human sAPPα in the CSF of AD and non-AD patients. These tests require only 5 μl of conditioned medium from 5 × 104 mouse primary neurons, 1 μl of CSF from wild-type and transgenic mice, and 0.5 μl of human CSF.ConclusionsThe high sensitivity of the mouse sAPPα test will allow high-throughput investigations of molecules capable of increasing the secretion of endogenous sAPPα in primary neurons, as well as the in vivo validation of molecules of interest through the quantification of sAPPα in the CSF of treated wild-type mice. Active molecules could then be tested in the AD mouse models by quantifying human sAPPα in the CSF through the progression of the disease. Finally, the human sAPPα test could strengthen the biological diagnosis of AD in large clinical investigations. Taken together, these new tests have a wide field of applications in preclinical and clinical studies.

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“…Complications are rare, mostly minor (postdural puncture headache), and significantly reduced by the use of atraumatic needles [3,4]. Nevertheless, the general picture of LP and associated side effects remains negative, although generally safe and well-tolerated [3,[5][6][7]. The use of non-pharmacological techniques, before or during the procedure, must be considered to reduce LP-related anxiety and pain, so that its acceptance in routine clinical practice would be improved.…”

Section: Introductionmentioning

confidence: 99%

Hypnosis for pain and anxiety management in cognitively impaired older adults undergoing scheduled lumbar punctures: a randomized controlled pilot study

et al. 2022

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Background Core cerebrospinal fluid (CSF) amyloid and tau biomarker assessment has been recommended to refine the diagnostic accuracy of Alzheimer’s disease. Lumbar punctures (LP) are invasive procedures that might induce anxiety and pain. The use of non-pharmacological techniques must be considered to reduce the patient’s discomfort, in this setting. The objective of this study was to examine the efficacy of hypnosis on anxiety and pain associated with LP. Methods A monocentric interventional randomized-controlled pilot study is conducted in a university geriatric day hospital. Cognitively impaired patients aged over 70 were referred for scheduled LP for the diagnostic purpose (CSF biomarkers). The participants were randomly assigned either to a hypnosis intervention group or usual care. Pain and anxiety were both self-assessed by the patient and hetero-evaluated by the operator. Results We included 50 cognitively impaired elderly outpatients (women 54%, mean age 77.2 ± 5.0, mean Mini-Mental State Examination score 23.2 ± 3.5). Hypnosis was significantly associated with reduced self-assessed (p < 0.05) and hetero-assessed anxiety (p < 0.01). Hetero-evaluated pain was significantly lower in the hypnosis group (p < 0.05). The overall perception of hypnosis was safe, well-accepted, and feasible in all the participants of the intervention group with 68% perceiving the procedure as better or much better than expected. Conclusions This pilot study suggested that hypnosis was feasible and may be used to reduce the symptoms of discomfort due to invasive procedures in older cognitively impaired patients. Our results also confirmed the overall good acceptance of LP in this population, despite the usual negative perception. Trial registration ClinicalTrials.gov NCT04368572. Registered on April 30, 2020.

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Indications, réalisation et faisabilité de la ponction lombaire dans 18 centres mémoires de ressources et de recherche

Cited by 14 publications

References 17 publications

Utility of CSF biomarkers in psychiatric disorders: a national multicentre prospective study

Utility of CSF biomarkers in psychiatric disorders: a national multicentre prospective study

New highly sensitive rodent and human tests for soluble amyloid precursor protein alpha quantification: preclinical and clinical applications in Alzheimer’s disease

Hypnosis for pain and anxiety management in cognitively impaired older adults undergoing scheduled lumbar punctures: a randomized controlled pilot study

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