Procedure at the Clínic

Although lumbar punctures have traditionally been used to make diagnoses in neurology (e.g. for infectious and demyelinating diseases), in 2006 the Hospital Clínic Barcelona began to perform lumbar punctures in patients with neurodegenerative diseases, such as Parkinson's disease, with the aim of doing biomarker research. This practice was extended to Alzheimer's disease in 2008 and was routinely incorporated into its diagnosis in 2011. This was done by determining the cerebrospinal fluid levels of three proteins involved in its pathophysiology: beta-amyloid, total tau and phosphorylated tau. This test has been shown to have a high diagnostic yield, over 90%, even in early symptomatic phases such as mild cognitive impairment.

In addition, since the end of 2021, the seed amplification assay known as RT-QuIC has been added to detect the aggregating capacity of pathological alpha-synuclein in cerebrospinal fluid samples. This was done after demonstrating that the laboratory could diagnose Parkinson's disease with a yield of 90% or more. This technique can detect this protein in patients with synuclein-related disorders and, in addition to Parkinson's disease, can diagnose isolated REM sleep behaviour disorder and dementia with Lewy bodies with a yield also over 90%.

Additionally, a lumbar puncture is used at the Clínic in the diagnosis of narcolepsy to detect any deficiency of the orexin protein, which is the cause of this disease.

Each year, around 300 lumbar punctures are performed to diagnose these diseases; thus improving the precision and effectiveness of treatment for patients at the Clínic.