Therapeutic Cerebral Fluid Puncture in Patients with Idiopathic Intracranial Hypertension: No Short-Term Effect on Neurocognitive Function
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Procedure
2.3. Neuropsychological Assessment
2.3.1. Verbal Learning and Narrative Memory: Logical Memory of WMS-R
2.3.2. Verbal Learning and Memory: CVLT Short Version
2.3.3. Alertness
2.3.4. Word Fluency
2.3.5. Depression and Anxiety
2.4. Statistical Analysis
3. Results
3.1. Demographic Data
3.2. Clinical Characteristics
3.3. Neuropsychological Assessment in the Total Sample
3.3.1. Comparison between IIH Patients and Healthy Controls at Baseline (T1)
3.3.2. Comparison in IIH Patients before (T1) and after Lumbar Puncture (T2)
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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IIH Patients (n =15) | Healthy Controls (n = 15) | |
---|---|---|
Female (%) | 12 (80) | 12 (80) |
Male (%) | 3 (20) | 3 (20) |
Age (years) | 38.6 ± 12.9 | 38.5 ± 12.5 |
BMI (kg/m2) | 36.0 ± 6.2 | 24.8 ± 5.3 |
Education | ||
Lower secondary school certificate (%) | 4 (26.7) | 4 (26.7) |
Intermediate school-leaving certificate (O level) (%) | 7 (46.7) | 7 (46.7) |
Higher education entrance qualification (A levels) (%) | 4 (26.7) | 4 (26.7) |
Clinical Data | IIH Patients (n = 15) |
---|---|
Lumbar opening pressure (cmH2O) | 33 ± 7.2 |
Lumbar opening pressure 25 cmH2O (n) (%) | 13 (86.6%) |
Lumbar opening pressure 30 cmH2O (n) (%) | 11 (73.3%) |
Subjective impairment (NRS) | 6.3 ± 3.2 |
Headache at time of testing (n) (%) | 9 (60.0%) |
Headache intensity (NRS) | 3.5 ± 3.6 |
Cognitive impairment (n) (%) | 11 (73.3%) |
Subjective improvement in cognitive impairment after lumbar puncture (n) (%) | 11 (73.3%) |
Visual disturbances (n) (%) | 11 (73.3%) |
Tinnitus (n) (%) | 10 (66.6%) |
Medication for IIH (n) (%) | 13 (86.6%) |
Acetazolamide (n) (%) | 12 (80.0%) |
Topiramate (n) (%) | 1 (6.6%) |
Employed at time of testing (n) (%) | 15 (100.0%) |
IIH Patients (n = 15) (Mean ± SD) | Healthy Controls (n = 15) (Mean ± SD) | p-Value | Wilcoxon z | Effect Size Pearson’s r | |
---|---|---|---|---|---|
WMS-R | |||||
Logical Memory I | 12.5 ± 4.4 | 15.1 ± 2.8 | 0.13 | ||
Logical Memory II | 10.7 ± 5.0 | 14.5 ± 2.5 | 0.029 | 2.19 | 0.57 |
CVLT | |||||
Trial 1 | 5.2 ± 1.5 | 5.6 ± 1.4 | 0.51 | ||
Learning Sum | 27.4 ± 5.4 | 29.9 ± 4.1 | 0.20 | ||
Long-Delay Free Recall | 6.8 ± 2.1 | 7.8 ± 1.5 | 0.21 | ||
TAP: Alertness | |||||
Median reaction time without warning tone | 268.3 ± 36.2 | 245.9 ± 36.6 | 0.12 | ||
Median reaction time with warning tone | 266.9 ± 39.7 | 250.53 ± 37.8 | 0.29 | ||
Phasic alertness | −0.01 ± 0.2 | −0.01 ± 0.1 | 0.42 | ||
TAP: Go/NoGo | |||||
Incorrect responses | 1.1 ± 1.7 | 0.9 ± 1.2 | 0.95 | ||
Median reaction time | 423.8 ± 63.1 | 426.8 ± 82.8 | 0.91 | ||
RWT | 54.1 ± 14.0 | 71.9 ± 14.4 | 0.002 | 3.03 | 0.78 |
HADS-D | 5.6 ± 4.3 | 1.9 ± 2.2 | 0.007 | 2.69 | 0.69 |
HADS-A | 7.2 ± 4.5 | 4.4 ± 3.2 | 0.08 | ||
HADS-G | 12.8 ± 8.5 | 6.3 ± 4.7 | 0.033 |
IIH-Patients (n = 15) | T1 (Mean ± SD) | T2 (Mean ± SD) | p-Value | Wilcoxon z | Effect Size Pearson’s r |
---|---|---|---|---|---|
WMS-R | |||||
Logical Memory I | 12.5 ± 4.4 | 12.3 ± 4.4 | 0.83 | ||
Logical Memory II | 10.7 ± 5.0 | 11.6 ± 4.8 | 0.42 | ||
CVLT | |||||
Trial 1 | 5.2 ± 1.5 | 5.3 ± 1.7 | 0.87 | ||
Learning Sum | 27.4 ± 5.4 | 27.9 ± 5.8 | 0.67 | ||
Long-Delay Free Recall | 6.8 ± 2.1 | 6.7 ± 3.0 | 0.79 | ||
TAP: Alertness | |||||
Median reaction time without warning tone | 268.3 ± 36.2 | 277.6 ± 36.6 | 0.13 | ||
Median reaction time with warning tone | 266.9 ± 39.7 | 268.5 ± 38.5 | 0.48 | ||
Phasic alertness | −0.01 ± 0.2 | 0.01 ± 0.1 | 0.17 | ||
TAP: Go/NoGo | |||||
Incorrect responses | 1.1 ± 1.7 | 1.9 ± 2.3 | 0.08 | ||
Median reaction time | 423.8 ± 63.1 | 436.0 ± 80.9 | 0.33 | ||
RWT | 54.1 ± 14.0 | 62.6 ± 14.9 | 0.031 | −2.16 | 0.56 |
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Thunstedt, C.; Aydemir, D.; Conrad, J.; Wlasich, E.; Loosli, S.V.; Schöberl, F.; Straube, A.; Eren, O.E. Therapeutic Cerebral Fluid Puncture in Patients with Idiopathic Intracranial Hypertension: No Short-Term Effect on Neurocognitive Function. Brain Sci. 2024, 14, 877. https://doi.org/10.3390/brainsci14090877
Thunstedt C, Aydemir D, Conrad J, Wlasich E, Loosli SV, Schöberl F, Straube A, Eren OE. Therapeutic Cerebral Fluid Puncture in Patients with Idiopathic Intracranial Hypertension: No Short-Term Effect on Neurocognitive Function. Brain Sciences. 2024; 14(9):877. https://doi.org/10.3390/brainsci14090877
Chicago/Turabian StyleThunstedt, Cem, Dilan Aydemir, Julian Conrad, Elisabeth Wlasich, Sandra V. Loosli, Florian Schöberl, Andreas Straube, and Ozan E. Eren. 2024. "Therapeutic Cerebral Fluid Puncture in Patients with Idiopathic Intracranial Hypertension: No Short-Term Effect on Neurocognitive Function" Brain Sciences 14, no. 9: 877. https://doi.org/10.3390/brainsci14090877