Cognitive function in idiopathic intracranial hypertension: a prospective case-control study.
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.


METHODS
Prospective case-control study.


METHODS
Neurological department, ophthalmological department and a tertiary headache referral clinic at a Danish university hospital.


METHODS
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.


METHODS
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.
Danish Headache Center, Department of Neurology, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark.
Hanne Maria
HM
Yri
Birgitte
B
Fagerlund
Hysse Birgitte
HB
Forchhammer
Rigmor Højland
RH
Jensen
D000328:Adult; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000209:etiology*; D056344:Executive Function; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications*; D008297:Male; D008570:Memory, Short-Term; D009483:Neuropsychological Tests; D011446:Prospective Studies; D065852:Spatial Memory
case-control studies; cognition disorders; pseudotumor cerebri