Population-Based Evaluation of Lumbar Puncture Opening Pressures

Area of Science:

• Neurology
• Clinical Physiology

Background:

• Normal opening pressure (OP) via lumbar puncture (LP) is not well-defined, with prior studies limited to specific patient groups or small healthy cohorts.
• Establishing a population-based normal OP range is crucial for accurate diagnosis and understanding OP variability.

Purpose of the Study:

• To determine the normal range of OP in a community-based population using data from the Mayo Clinic Study of Aging (MCSA).
• To identify factors influencing OP variability, such as age, body mass index (BMI), and obstructive sleep apnea (OSA).

Main Methods:

• Lumbar puncture OP data were collected from 639 participants (aged 32-95) in the MCSA between 2007 and 2017.
• OP was analyzed alongside participant age, BMI, and presence of OSA to assess factors contributing to variability.
• Serial LPs were used to evaluate the repeatability of OP measurements.

Main Results:

• The mean OP was 155.4 mmH2O (95% reference interval: 82-242 mmH2O).
• Increasing age was associated with lower OP (p < 0.001), while increasing BMI correlated with higher OP (p < 0.001).
• Participants with OP ≥ 250 mmH2O were younger, had higher BMI, and were more likely to have OSA.

Conclusions:

• Lumbar puncture OP exhibits significant individual variability within a population.
• Higher OP measurements are associated with increased BMI and younger age.
• These findings provide a more robust reference range for OP in a community setting.