Population-based evaluation of lumbar puncture opening pressures

Feng Wang, Elizabeth R. Lesser, Jeremy K. Cutsforth-Gregory, M. Tariq Bhatti, Khin P. Kilgore, David O. Hodge, Jonathan Graff-Radford, Ronald Carl Petersen, David S Knopman, Michelle M Mielke, Giuseppe Lanzino, Jaqueline A. Leavitt, John Chen

Research output: Contribution to journalArticle

Abstract

Importance: Prior studies evaluating opening pressure (OP) have mostly involved lumbar puncture (LP) for diagnosis of neurologic disease or small cohorts of healthy volunteers and therefore the normal OP is not well-defined. Objective: The goal of this study was to establish the normal range of OP in a community-based population using the Mayo Clinic Study of Aging (MCSA) and to evaluate factors that contribute to OP variability. Design: LP OP were obtained from participants aged 32–95 years between 11/1/07 and 10/1/17, as part of routine data collection for the MCSA, a longitudinal, population-based study of residents of Olmsted County, Minnesota. Setting: A longitudinal, population-based study of residents of Olmsted County, Minnesota. Participants: There were 639 participants (56.8% male; 98.5% white) who underwent LP with recorded OP as part of the MCSA. Intervention: LP. Main Outcome(s) and Measure(s): LP OP was recorded along with variables that could possibly influence its variability, including age, body mass index (BMI), and obstructive sleep apnea (OSA). Results: Six hundred thirty-nine participants (56.8% men) underwent LP with recorded OP; average age was 71.0 years (SD 10.9) with a mean BMI of 28.0 (SD 4.6). Mean OP was 155.4 mmH2 O (SD 41.9) with a 95% reference interval of 82–242 mmH2 O (range 60–314; Q1, Q3: 124, 182). Increasing age was associated with lower OP (p < 0.001), while increasing BMI was associated with higher OP (p < 0.001). Twelve (2%) participants had OP ≥ 250 mmH2 O; they were younger [58.5 (SD 8.2), p < 0.001], had higher BMI [33.6 (SD 4.6), p < 0.001], and were more likely to have OSA (75%, p < 0.001). Among the 79 participants with repeat LPs within 2.5 years, the coefficient of repeatability (CR) was 64.9. Ten (12.7%) had an OP difference ≥50 mmH2 O between serial LPs. Conclusions and Relevance: This large population-based study showed that LP OP can vary significantly among individuals. Higher OPs were associated with higher BMI and younger age.

Original languageEnglish (US)
Article number899
JournalFrontiers in Neurology
Volume10
Issue numberAUG
DOIs
StatePublished - Jan 1 2019

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Spinal Puncture
Pressure
Population
Body Mass Index
Obstructive Sleep Apnea
Nervous System Diseases

Keywords

  • Age
  • Idiopathic intracranial hypertension (IIH)
  • Lumbar puncture (LP)
  • Mayo clinic study of aging
  • Obesity
  • Obstructive sleep apnea
  • Opening pressure

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Wang, F., Lesser, E. R., Cutsforth-Gregory, J. K., Bhatti, M. T., Kilgore, K. P., Hodge, D. O., ... Chen, J. (2019). Population-based evaluation of lumbar puncture opening pressures. Frontiers in Neurology, 10(AUG), [899]. https://doi.org/10.3389/fneur.2019.00899

Population-based evaluation of lumbar puncture opening pressures. / Wang, Feng; Lesser, Elizabeth R.; Cutsforth-Gregory, Jeremy K.; Bhatti, M. Tariq; Kilgore, Khin P.; Hodge, David O.; Graff-Radford, Jonathan; Petersen, Ronald Carl; Knopman, David S; Mielke, Michelle M; Lanzino, Giuseppe; Leavitt, Jaqueline A.; Chen, John.

In: Frontiers in Neurology, Vol. 10, No. AUG, 899, 01.01.2019.

Research output: Contribution to journalArticle

Wang, F, Lesser, ER, Cutsforth-Gregory, JK, Bhatti, MT, Kilgore, KP, Hodge, DO, Graff-Radford, J, Petersen, RC, Knopman, DS, Mielke, MM, Lanzino, G, Leavitt, JA & Chen, J 2019, 'Population-based evaluation of lumbar puncture opening pressures', Frontiers in Neurology, vol. 10, no. AUG, 899. https://doi.org/10.3389/fneur.2019.00899
Wang F, Lesser ER, Cutsforth-Gregory JK, Bhatti MT, Kilgore KP, Hodge DO et al. Population-based evaluation of lumbar puncture opening pressures. Frontiers in Neurology. 2019 Jan 1;10(AUG). 899. https://doi.org/10.3389/fneur.2019.00899
Wang, Feng ; Lesser, Elizabeth R. ; Cutsforth-Gregory, Jeremy K. ; Bhatti, M. Tariq ; Kilgore, Khin P. ; Hodge, David O. ; Graff-Radford, Jonathan ; Petersen, Ronald Carl ; Knopman, David S ; Mielke, Michelle M ; Lanzino, Giuseppe ; Leavitt, Jaqueline A. ; Chen, John. / Population-based evaluation of lumbar puncture opening pressures. In: Frontiers in Neurology. 2019 ; Vol. 10, No. AUG.
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abstract = "Importance: Prior studies evaluating opening pressure (OP) have mostly involved lumbar puncture (LP) for diagnosis of neurologic disease or small cohorts of healthy volunteers and therefore the normal OP is not well-defined. Objective: The goal of this study was to establish the normal range of OP in a community-based population using the Mayo Clinic Study of Aging (MCSA) and to evaluate factors that contribute to OP variability. Design: LP OP were obtained from participants aged 32–95 years between 11/1/07 and 10/1/17, as part of routine data collection for the MCSA, a longitudinal, population-based study of residents of Olmsted County, Minnesota. Setting: A longitudinal, population-based study of residents of Olmsted County, Minnesota. Participants: There were 639 participants (56.8{\%} male; 98.5{\%} white) who underwent LP with recorded OP as part of the MCSA. Intervention: LP. Main Outcome(s) and Measure(s): LP OP was recorded along with variables that could possibly influence its variability, including age, body mass index (BMI), and obstructive sleep apnea (OSA). Results: Six hundred thirty-nine participants (56.8{\%} men) underwent LP with recorded OP; average age was 71.0 years (SD 10.9) with a mean BMI of 28.0 (SD 4.6). Mean OP was 155.4 mmH2 O (SD 41.9) with a 95{\%} reference interval of 82–242 mmH2 O (range 60–314; Q1, Q3: 124, 182). Increasing age was associated with lower OP (p < 0.001), while increasing BMI was associated with higher OP (p < 0.001). Twelve (2{\%}) participants had OP ≥ 250 mmH2 O; they were younger [58.5 (SD 8.2), p < 0.001], had higher BMI [33.6 (SD 4.6), p < 0.001], and were more likely to have OSA (75{\%}, p < 0.001). Among the 79 participants with repeat LPs within 2.5 years, the coefficient of repeatability (CR) was 64.9. Ten (12.7{\%}) had an OP difference ≥50 mmH2 O between serial LPs. Conclusions and Relevance: This large population-based study showed that LP OP can vary significantly among individuals. Higher OPs were associated with higher BMI and younger age.",
keywords = "Age, Idiopathic intracranial hypertension (IIH), Lumbar puncture (LP), Mayo clinic study of aging, Obesity, Obstructive sleep apnea, Opening pressure",
author = "Feng Wang and Lesser, {Elizabeth R.} and Cutsforth-Gregory, {Jeremy K.} and Bhatti, {M. Tariq} and Kilgore, {Khin P.} and Hodge, {David O.} and Jonathan Graff-Radford and Petersen, {Ronald Carl} and Knopman, {David S} and Mielke, {Michelle M} and Giuseppe Lanzino and Leavitt, {Jaqueline A.} and John Chen",
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AU - Wang, Feng

AU - Lesser, Elizabeth R.

AU - Cutsforth-Gregory, Jeremy K.

AU - Bhatti, M. Tariq

AU - Kilgore, Khin P.

AU - Hodge, David O.

AU - Graff-Radford, Jonathan

AU - Petersen, Ronald Carl

AU - Knopman, David S

AU - Mielke, Michelle M

AU - Lanzino, Giuseppe

AU - Leavitt, Jaqueline A.

AU - Chen, John

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Importance: Prior studies evaluating opening pressure (OP) have mostly involved lumbar puncture (LP) for diagnosis of neurologic disease or small cohorts of healthy volunteers and therefore the normal OP is not well-defined. Objective: The goal of this study was to establish the normal range of OP in a community-based population using the Mayo Clinic Study of Aging (MCSA) and to evaluate factors that contribute to OP variability. Design: LP OP were obtained from participants aged 32–95 years between 11/1/07 and 10/1/17, as part of routine data collection for the MCSA, a longitudinal, population-based study of residents of Olmsted County, Minnesota. Setting: A longitudinal, population-based study of residents of Olmsted County, Minnesota. Participants: There were 639 participants (56.8% male; 98.5% white) who underwent LP with recorded OP as part of the MCSA. Intervention: LP. Main Outcome(s) and Measure(s): LP OP was recorded along with variables that could possibly influence its variability, including age, body mass index (BMI), and obstructive sleep apnea (OSA). Results: Six hundred thirty-nine participants (56.8% men) underwent LP with recorded OP; average age was 71.0 years (SD 10.9) with a mean BMI of 28.0 (SD 4.6). Mean OP was 155.4 mmH2 O (SD 41.9) with a 95% reference interval of 82–242 mmH2 O (range 60–314; Q1, Q3: 124, 182). Increasing age was associated with lower OP (p < 0.001), while increasing BMI was associated with higher OP (p < 0.001). Twelve (2%) participants had OP ≥ 250 mmH2 O; they were younger [58.5 (SD 8.2), p < 0.001], had higher BMI [33.6 (SD 4.6), p < 0.001], and were more likely to have OSA (75%, p < 0.001). Among the 79 participants with repeat LPs within 2.5 years, the coefficient of repeatability (CR) was 64.9. Ten (12.7%) had an OP difference ≥50 mmH2 O between serial LPs. Conclusions and Relevance: This large population-based study showed that LP OP can vary significantly among individuals. Higher OPs were associated with higher BMI and younger age.

AB - Importance: Prior studies evaluating opening pressure (OP) have mostly involved lumbar puncture (LP) for diagnosis of neurologic disease or small cohorts of healthy volunteers and therefore the normal OP is not well-defined. Objective: The goal of this study was to establish the normal range of OP in a community-based population using the Mayo Clinic Study of Aging (MCSA) and to evaluate factors that contribute to OP variability. Design: LP OP were obtained from participants aged 32–95 years between 11/1/07 and 10/1/17, as part of routine data collection for the MCSA, a longitudinal, population-based study of residents of Olmsted County, Minnesota. Setting: A longitudinal, population-based study of residents of Olmsted County, Minnesota. Participants: There were 639 participants (56.8% male; 98.5% white) who underwent LP with recorded OP as part of the MCSA. Intervention: LP. Main Outcome(s) and Measure(s): LP OP was recorded along with variables that could possibly influence its variability, including age, body mass index (BMI), and obstructive sleep apnea (OSA). Results: Six hundred thirty-nine participants (56.8% men) underwent LP with recorded OP; average age was 71.0 years (SD 10.9) with a mean BMI of 28.0 (SD 4.6). Mean OP was 155.4 mmH2 O (SD 41.9) with a 95% reference interval of 82–242 mmH2 O (range 60–314; Q1, Q3: 124, 182). Increasing age was associated with lower OP (p < 0.001), while increasing BMI was associated with higher OP (p < 0.001). Twelve (2%) participants had OP ≥ 250 mmH2 O; they were younger [58.5 (SD 8.2), p < 0.001], had higher BMI [33.6 (SD 4.6), p < 0.001], and were more likely to have OSA (75%, p < 0.001). Among the 79 participants with repeat LPs within 2.5 years, the coefficient of repeatability (CR) was 64.9. Ten (12.7%) had an OP difference ≥50 mmH2 O between serial LPs. Conclusions and Relevance: This large population-based study showed that LP OP can vary significantly among individuals. Higher OPs were associated with higher BMI and younger age.

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KW - Idiopathic intracranial hypertension (IIH)

KW - Lumbar puncture (LP)

KW - Mayo clinic study of aging

KW - Obesity

KW - Obstructive sleep apnea

KW - Opening pressure

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