Cognitive function in idiopathic intracranial hypertension: a prospective case–control study. Issue 4 (8th April 2014)

• Record Type: Journal Article
• Authors: Yri, Hanne Maria; Fagerlund, Birgitte; Forchhammer, Hysse Birgitte; Jensen, Rigmor Højland
• Is Part Of: BMJ open. Volume 4:Issue 4(2014)
• Publication Date: 2014-04-08
• Subjects: pseudotumor cerebri -- cognition disorders -- case-control studies; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2013-004376
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: To explore the extent and nature of cognitive deficits in patients with idiopathic intracranial hypertension (IIH) at the time of diagnosis and after 3 months of treatment. Design: Prospective case–control study. Setting: Neurological department, ophthalmological department and a tertiary headache referral clinic at a Danish university hospital. Participants: 31 patients with definite IIH referred from June 2011 to February 2013 and included within 1 week of diagnostic intracranial pressure (ICP) measurement. 29 patients completed re-examination at the 3-month follow-up. At the time of testing, none of the patients took medication potentially affecting cognitive function. Controls were 31 healthy age-matched and sex-matched volunteers from the local community. Outcome measures: Executive function, working memory, visuospatial memory, processing speed, attention and reaction time assessed by a comprehensive neuropsychological test battery consisting of validated computerised (Cambridge neuropsychological test automated battery) and paper-and-pencil tests. Results: Patients with IIH performed significantly worse than controls in four of six cognitive domains (p≤0.02). Deficits were most pronounced in reaction time (1.45 SD below controls 95% CI 2.10 to 0.85) and processing speed (1.48 SD below controls 95% CI 2.08 to 0.81). Despite marked improvement in ICP and headache, re-examination showed persistent cognitive dysfunction 3 months after diagnosis and start of treatment. Conclusions: We demonstrate for the first time in a well-defined cohort of patients that IIH may be associated with cognitive dysfunction. This could explain the functional disability of patients with IIH. A focused multidisciplinary approach including neuropsychological rehabilitation, therefore, might be relevant in the treatment of patients with IIH.