Paranathala Menaka P, Yoganathan Katie T, Mitchell Patrick, Williams Isobel A, Gourley Lois, Coulter Ian C
Department of Neurosurgery (MPP, PM, LG, ICC), Royal Victoria Infirmary, Newcastle; Transitional and Clinical Research Institute (MPP, IAW), Newcastle University, Newcastle; Department of Neurology (KTY), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (KTY), John Radcliffe Hospital, Oxford; and Department of Clinical Neuropsychology (IAW), Royal Victoria Infirmary, Newcastle, United Kingdom.
Neurol Clin Pract. 2024 Dec;14(6):e200348. doi: 10.1212/CPJ.0000000000200348. Epub 2024 Aug 16.
Idiopathic intracranial hypertension (IIH) is a chronic headache disorder with increasing prevalence. Although characterized by raised intracranial pressure causing papilledema with a risk of visual impairment, psychological symptoms such as depression, anxiety, and cognitive impairment are frequently seen but are understudied and under-reported. Together, these can negatively affect quality of life. These were explored through a systematic PRISMA scoping review. OVID, EMBASE, Cochrane, and PubMed databases were searched in April 2023, limited to those in English and published during January 2000-March 2023. PROSPERO ID CRD42023399410.
From 454 identified studies, 24 relevant articles were identified from a range of countries including the United Kingdom, the United States, Israel, Egypt, Canada, Germany, and Brazil. Data on study design, participants, tests performed, and outcomes were collated. There is a considerable burden of psychiatric, affective, and cognitive conditions, as well as impaired quality of life, in adult patients with IIH. Notably, these were independently correlated with the presence of headache in a number of studies and with obesity in others.
Aside from optimizing symptom control, including reducing the severity of headaches and protecting visual function, clinicians should be mindful of the biopsychosocial difficulties and potential cognitive impairments patients with IIH face. Assistance may be required with managing concurrent depression and anxiety, as well as optimizing cognitive function. Incorporating neuropsychological assessment and individualized management strategies may be beneficial at the point of diagnosis and throughout the illness.
特发性颅内高压（IIH）是一种患病率不断上升的慢性头痛疾病。尽管其特征为颅内压升高导致视乳头水肿并伴有视力损害风险，但抑郁、焦虑和认知障碍等心理症状也很常见，却未得到充分研究和报告。这些症状会对生活质量产生负面影响。通过一项系统的PRISMA范围综述对这些问题进行了探讨。于2023年4月检索了OVID、EMBASE、Cochrane和PubMed数据库，仅限于英文文献且发表于2000年1月至2023年3月期间。PROSPERO注册号为CRD42023399410。
从454项已识别的研究中，从包括英国、美国、以色列、埃及、加拿大、德国和巴西等一系列国家中识别出24篇相关文章。整理了关于研究设计、参与者、所进行的测试和结果的数据。成年IIH患者存在相当大的精神、情感和认知问题负担，以及生活质量受损。值得注意的是，在一些研究中这些问题与头痛的存在独立相关，在另一些研究中与肥胖相关。
除了优化症状控制，包括减轻头痛严重程度和保护视觉功能外，临床医生应注意IIH患者面临的生物心理社会困难和潜在认知障碍。在管理并发的抑郁和焦虑以及优化认知功能方面可能需要提供帮助。在诊断时及整个病程中纳入神经心理学评估和个体化管理策略可能有益。
