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    Predictors of cognitive impairment in pseudotumor cerebri

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    Author
    Fermo, Olga P
    Rao, Aruna
    Schwartzbaum, Amy
    Sengupta, Samhita
    Zhang, Yifan
    Wang, Jiangxia
    Moghekar, Abhay
    Date
    2021-08-11
    Journal
    Neurologia i Neurochirurgia Polska (Polish Journal of Neurology and Neuroscience)
    Publisher
    Polish Neurological Society
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://journals.viamedica.pl/neurologia_neurochirurgia_polska/article/view/75902
    Abstract
    Aims of the study: We aimed to define the cognitive burden of the largest pseudotumor cerebri syndrome (PTCS) population to date, compare objective to subjective cognitive dysfunction, and determine clinical predictors of cognitive dysfunction amongst an array of previously unstudied factors. Clinical rationale: Patients with PTCS commonly report cognitive dysfunction, a factor associated with poor quality of life. It is not definitively known whether cognitive impairment is present in these patients, and what features of the syndrome predict impairment. Materials and methods: We administered a cognitive battery consisting of the National Adult Reading Test, Mini-Mental Status Exam, Digit Span, Boston Naming Test, Rey Auditory Verbal Learning Test, Clock Drawing, Trail Making Test, Controlled Oral Word Association, and Category Fluency. Cognitive impairment was defined as mild-single domain with one test score, and mild-multiple domain with two scores, more than two standard deviations below the mean for age-, gender-, and education-adjusted norms. Results: One-hundred and one prospectively recruited PTCS patients were enrolled. The objective testing showed 30 patients had mild-single domain impairment, and 25 had mild-multi domain impairment. More patients without objective cognitive impairment had transverse venous sinus stenosis, but otherwise the groups did not differ. Two measures of headache severity, the Headache Impact Test and pain on the Numeric Rating Scale, were negatively associated with the composite cognitive score, as was ocular pain, vision-related disability, and mental health. Opening pressure and visual function were not associated with objective cognitive impairment. We found no association between subjective and objective cognitive impairment. Conclusions and clinical implications: Patients with PTCS may be cognitively impaired, and this correlates with measures of headache burden. Studies evaluating cognitive impairment before and after remission of the headache disorder would have to be performed to investigate this relationship further. Patients with self-perception of cognitive burden are no more likely to be cognitively impaired. Copyright © 2021 Polish Neurological Society.
    Keyword
    cognition
    headache
    impairment
    pseudotumor cerebri syndrome
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/16723
    ae974a485f413a2113503eed53cd6c53
    10.5603/PJNNS.a2021.0057
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