Wang Wendy, Clough Meaghan, White Owen, Shuey Neil, Van Der Walt Anneke, Fielding Joanne
Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia.
Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia.
Front Neurol. 2021 Nov 16;12:772513. doi: 10.3389/fneur.2021.772513. eCollection 2021.
To determine whether cognitive impairments in patients with Idiopathic Intracranial Hypertension (IIH) are correlated with changes in visual processing, weight, waist circumference, mood or headache, and whether they change over time. Twenty-two newly diagnosed IIH patients participated, with a subset assessed longitudinally at 3 and 6 months. Both conventional and novel ocular motor tests of cognition were included: Symbol Digit Modalities Test (SDMT), Stroop Colour and Word Test (SCWT), Digit Span, California Verbal Learning Test (CVLT), prosaccade (PS) task, antisaccade (AS) task, interleaved antisaccade-prosaccade (AS-PS) task. Patients also completed headache, mood, and visual functioning questionnaires. IIH patients performed more poorly than controls on the SDMT (< ), SCWT ( = ), Digit Span test (< ) and CVLT ( = ) at baseline, and generated a higher proportion of AS errors in both the AS (< ) and AS-PS tasks ( = ). Further, IIH patients exhibited prolonged latencies on the cognitively complex AS-PS task ( = ). While weight, waist circumference, headache and mood did not predict performance on any experimental measure, increased retinal nerve fibre layer (RNFL) was associated with AS error rate on both the block = = = and AS-PS task = = = . Unlike ocular motor changes, impairments revealed on conventional tests of cognition persisted up to 6 months. We found multi-domain cognitive impairments in IIH patients that were unrelated to clinical characteristics. Marked ocular motor inhibitory control deficits were predicted by RNFL thickness but remained distinct from other cognitive changes, underscoring the significance of visual processing changes in IIH.
为了确定特发性颅内高压（IIH）患者的认知障碍是否与视觉处理、体重、腰围、情绪或头痛的变化相关，以及这些障碍是否随时间变化。22名新诊断的IIH患者参与研究，其中一部分在3个月和6个月时进行纵向评估。研究纳入了传统和新型的认知眼动测试：符号数字模态测试（SDMT）、斯特鲁普颜色和文字测试（SCWT）、数字广度测试、加利福尼亚言语学习测试（CVLT）、前扫视（PS）任务、反扫视（AS）任务、交错反扫视 - 前扫视（AS - PS）任务。患者还完成了头痛、情绪和视觉功能问卷。在基线时，IIH患者在SDMT（< ）、SCWT（ = ）、数字广度测试（< ）和CVLT（ = ）上的表现比对照组差，并且在AS（< ）和AS - PS任务（ = ）中产生的AS错误比例更高。此外，IIH患者在认知复杂的AS - PS任务上表现出更长的潜伏期（ = ）。虽然体重、腰围、头痛和情绪不能预测任何实验测量的表现，但视网膜神经纤维层（RNFL）增厚与AS任务（ = = = ）和AS - PS任务（ = = = ）中的AS错误率相关。与眼动变化不同，传统认知测试中发现的损伤持续长达6个月。我们发现IIH患者存在多领域认知障碍，且与临床特征无关。RNFL厚度可预测明显的眼动抑制控制缺陷，但这些缺陷与其他认知变化不同，这突出了IIH中视觉处理变化的重要性。
