Lumbar drains can affect CSF biomarker levels.
Author(s): Craven CL, Chapman MD, D'Antona L, Thompson SD, Lakdawala N, Zetterberg H, Watkins LD, Toma AK
Publication: J Clin Pathol, 2019, Vol. 72, Page 91-92
PubMed ID: 29997233 PubMed Review Paper? No
Purpose of Paper
The purpose of this paper was to determine if the amount of time cerebrospinal fluid (CSF) dwells within a catheter during a lumbar drain affects the concentration of tau (Tau) and β-amyloid (1-42) (Aβ1-42). Two different catheters, (barium-impregnated and silver-lined) were compared to case-matched control CSF specimens collected via lumbar puncture.
Conclusion of Paper
Aβ1-42 but not Tau concentration was significantly affected by the length of time CSF dwelled in the catheter during a lumbar drain when compared to case-matched specimens collected via lumbar puncture into a Sarstedt tube. The largest reduction in Aβ1-42 concentration in CSF specimens occurred after a catheter dwell time of 1 min, with similar results observed among barium-impregnated (21.8% reduction) and silver-lined (21.5% reduction) catheters (p=0.003 for both). Shorter and longer catheter dwell times also resulted in significant reductions in CSF Aβ1-42 concentration compared to CSF collected via lumbar puncture, although the extent of the reduction was catheter-specific. The authors advised that when collected by lumbar drain, the CSF specimen should be transferred from the catheter immediately.
Studies
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Study Purpose
The purpose of this study was to determine if the amount of time CSF dwells within a catheter during a lumbar drain affects the concentration of Tau and Aβ1-42. CSF was collected from three donors via lumbar puncture, frozen, and stored at an unspecified temperature. For the experiment, CSF specimens were thawed at 21°C and centrifuged for 5 min before 800 µl aliquots were injected into a Sarstedt tube (control), a barium-impregnated catheter, or a silver-lined catheter. CSF aliquots injected into a catheter were subjected to dwell times of 30 sec, 1 min, or 5 min before the catheters were drained and the CSF samples were analyzed by ELISA for tau and Aβ1-42. CSF aliquots that passes through a catheter were compared to case-matched controls collected via lumbar puncture and stored in Sarstedt tubes. Protein concentrations are represented as pg/ml and all experiments were run in triplicate.
Summary of Findings:
Aβ1-42 but not Tau concentration was significantly affected by the length of time a CSF dwelled in the catheter during a lumbar drain when compared to case-matched specimens collected via lumbar puncture and into a Sarstedt tube. The largest reduction in Aβ1-42 concentration in CSF specimens occurred after a catheter dwell time of 1 min, with similar results observed among barium-impregnated (21.8% reduction) and silver-lined (21.5% reduction) catheters (p=0.003 for both). Catheter dwell times of 30 sec and 5 min also resulted in significant reductions in Aβ1-42 although differences between catheter types were more pronounced. A catheter dwell time of 30 sec resulted in a significant decline in Aβ1-42 concentration in CSF specimens collected using a barium-impregnated catheter (12.4% reduction) or a silver-lined catheter (5.0% reduction) (p=0.04 for both). Conversely, a catheter dwell time of 5 min resulted in a more robust reduction in Aβ1-42 concentration when the CSF specimen was collected in a silver-lined catheter (20.5% reduction) than a barium-impregnated catheter (9.3% reduction) (p=0.003 for both).
Biospecimens
Preservative Types
- Frozen
Diagnoses:
- Not specified
Platform:
Analyte Technology Platform Protein ELISA Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Acquisition Type of collection container/solution Silver-lined catheter
Barium-impregnated catheter
Sarstedt tube
ELISA Specific Targeted peptide/protein Aβ1-42
Tau
Biospecimen Acquisition Method of fluid acquisition Lumbar drain (Multiple dwell times examined)
Lumbar puncture
Lumbar drain