Quality of life in idiopathic intracranial hypertension at diagnosis

Digre, Kathleen B.; Bruce, Bonnie; McDermott, Michael P.; Galetta, Kristin; Balcer, Laura J.; Wall, Michael

doi:10.1212/wnl.0000000000001687

Cited by 90 publications

(64 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The HIT-6 score was also associated with worse quality of life on the SF-36 physical (r = −0.57, p < 0.0001) and mental (r = −0.34, p < 0.0001) component summaries as well as all SF-36 subscale scores (Table 2). Additionally, there was a significant difference in the mean NEI-VFQ-25 total score between those with and without neck pain (group difference = −9.39, p=0.001) 7 .…”

Section: Resultsmentioning

confidence: 90%

“…Mean HIT-6 scores were significantly different for those with (62.1 ± 7.0, n = 96) and without photophobia (56.3 ± 10.4, n = 68, p < 0.0001) and with (62.0 ± 7.6, n = 72) and without phonophobia (57.9 ± 9.6, n = 92, p = 0.003). There were highly significant correlations between the HIT-6 score and NEI-VFQ-25 total score (r = −0.47, p < 0.0001) and NEI-VFQ-25 neuro-ophthalmic supplement total score (r = −0.41, p < 0.0001) at baseline 7 . The HIT-6 score was also associated with worse quality of life on the SF-36 physical (r = −0.57, p < 0.0001) and mental (r = −0.34, p < 0.0001) component summaries as well as all SF-36 subscale scores (Table 2).…”

Section: Resultsmentioning

confidence: 93%

See 1 more Smart Citation

Headache in Idiopathic Intracranial Hypertension: Findings From the Idiopathic Intracranial Hypertension Treatment Trial

et al. 2017

View full text Add to dashboard Cite

Objective To characterize the phenotype, headache-related disability, medical co-morbidities, use of symptomatic headache medications, and headache response to study interventions in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT). Methods Patients with untreated IIH and mild vision loss enrolled in the IIHTT and randomized to acetazolamide (ACZ) and weight loss or placebo (PLB) and weight loss had prospective assessment of headache disability using the Headache Impact Test 6 (HIT-6) questionnaire. Subjects with headache at the baseline visit were assigned a headache phenotype using the International Classification for Headache Disorders version 3 beta (ICHD-3b). Medication overuse was determined using the participants’ reported medication use for the preceding month and ICHD-3b thresholds for diagnosing medication overuse headache. We investigated relationships between headache disability and various other clinical characteristics at baseline and at six months. Results Headache was present in 139 (84%) of the 165 enrollees at baseline. The most common headache phenotypes were migraine (52%), tension type headache (22%), probable migraine (16%), and probable tension type headache (4%). Fifty-one (37%) participants overused symptomatic medications at baseline, most frequently simple analgesics. A similar amount of improvement in the adjusted mean (± standard error) HIT-6 score occurred in the ACZ (−9.56 ± 1.05) and PLB groups (−9.11 ± 1.14) at six months (group difference −0.45, 95% CI −3.50 to 2.60, p=0.77). Headache disability did not correlate with any of the studies headache parameters, which included: the lumbar puncture opening pressure at baseline or at six months, body mass index, the amount of weight lost, papilledema grade, perimetric mean deviation, or the use of hormonal contraception. Headache disability was significantly associated with patient-reported quality of life in the physical, mental, and visual domains. Conclusions Headache was common, of varied character, disabling, and associated with poorer quality of life in our cohort of patients with mild visual impairment. The lack of correlation between headache disability and cerebrospinal fluid (CSF) pressure at baseline and at the end of the randomized phase of the study implies that headache in IIH may be related to factors other than intracranial hypertension, and that specific headache treatment is needed in addition to therapies directed at lowering CSF pressure.

show abstract

Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 93%

Headache in Idiopathic Intracranial Hypertension: Findings From the Idiopathic Intracranial Hypertension Treatment Trial

et al. 2017

View full text Add to dashboard Cite

show abstract

“…12 This included vision-specific QoL measures. 12 In addition, we found at six months, the acetazolamide-treated participants experienced significant improvement in quality of life measures, including the VFQ-25 total score and its 10- item neuro-ophthalmic supplement as well as the SF-36 Physical Component Summary and Mental Component Summary scores. 2 In the LIIHT subjects at 12 months we found significant improvement in QoL only in the placebo group that started open-label acetazolamide.…”

Section: Discussionmentioning

confidence: 99%

The Longitudinal Idiopathic Intracranial Hypertension Trial: Outcomes From Months 6–12

Wall

Kupersmith

Thurtell

et al. 2017

American Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose To determine whether the beneficial effects of acetazolamide (ACZ) in improving vision at 6 months continues to month 12 in participants of the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT). Design non-randomized clinical study Methods In the IIHTT, subjects were randomly assigned to placebo-plus-diet or maximally tolerated dosage of acetazolamide-plus-diet. At 6 months subjects transitioned from study drug to ACZ. This resulted in the following groups 1) ACZ to ACZ; n = 34; 2) placebo to ACZ; n = 35; 3) ACZ to no treatment; n = 16; and 4) placebo to no treatment; n = 11. 96 IIHTT subjects had evaluations at 6 and 12 months. Our main outcome measure was change from month 6 to month 12 in visual field mean deviation with secondary measures being change in papilledema grade, ETDRS scores and quality of life (QoL) measures. Results The ACZ to ACZ group improved 0.35 dB , p=0.05; placebo subjects with no ACZ improved 0.81 dB MD, p = 0.07 at 12 mos. The other groups improved 0.35 to 0.46 dB MD. Mean improvements in papilledema grade occurred most markedly in the group that exchanged placebo for ACZ (0.91 units, p < 0.001). QoL and headache disability scores showed significant improvements in the placebo group added ACZ. Conclusion Improvements in MD continued from month 6 to month 12 of the IIHTT in all treatment groups –most marked in the placebo group tapered off study drug. Adding ACZ to the placebo group significantly improved papilledema grade, headache and QoL measures.

show abstract

“…Studies verify that IIH has a significant effect on health-related quality of life (QOL)69 73 patients with IIH have also been found to have higher levels of anxiety, depression and fatigue than controls 74. In the IIHTT QOL scores were measured and found to be reduced at the time of the IIH diagnosis 75.…”

Section: Assessment and Investigationsmentioning

confidence: 99%

Evolving evidence in adult idiopathic intracranial hypertension: pathophysiology and management

Mollan

Ali

Hassan-Smith

et al. 2016

J Neurol Neurosurg Psychiatry

189

162

View full text Add to dashboard Cite

Idiopathic intracranial hypertension (IIH) is a rare but important disease associated with significant morbidity. There is an expected rise in prevalence in line with the escalating global burden of obesity. Modern revisions in the terminology and diagnostic criteria for IIH help guide clinicians in investigations and researchers in standardising recruitment criteria for clinical trials. The pathophysiology of IIH is incompletely characterised; suggested underpinning mechanisms include the role of cerebrospinal fluid regulation as well as metabolic and endocrinological perspectives. Recent treatment trials are providing insights into the management but debate still surrounds key areas in treatment. This review will provide an up-to-date discussion on the potential pathogenic mechanisms and management of IIH.

show abstract

Quality of life in idiopathic intracranial hypertension at diagnosis

Cited by 90 publications

References 27 publications

Headache in Idiopathic Intracranial Hypertension: Findings From the Idiopathic Intracranial Hypertension Treatment Trial

Headache in Idiopathic Intracranial Hypertension: Findings From the Idiopathic Intracranial Hypertension Treatment Trial

The Longitudinal Idiopathic Intracranial Hypertension Trial: Outcomes From Months 6–12

Evolving evidence in adult idiopathic intracranial hypertension: pathophysiology and management

Contact Info

Product

Resources

About