Lumber Puncture Shortfalls in Dementia Workup

Objectives: To extract from germane literature methodological shortfalls in obtaining cerebrospinal fluid specimens by lumbar puncture. Methods: 20 peer reviewed articles were analyzed in which cerebrospinal fluid (CSF) obtained biomarkers were used to assess Alzheimer’s Disease. Binary assessment of eight variables was performed: albumin, total protein, CSF pressure, cephalad CSF obstruction, obtained but unreported data, inclusion of erythrocyte contaminated samples, exclusion of erythrocyte contaminated samples, exclusion of white blood cell contaminated samples, and failed lumbar puncture attempts. Results: An apparent shortfall exists in the assessment of contravening variables, which could alter CSF results. Conclusions: We suggest that more attention be placed on lumbar puncture methodological difficulties in obtained CSF specimens, and that all practical obtainable data be routinely reported.