Quality of life at 6 months in the Idiopathic Intracranial Hypertension Treatment Trial

Published on Nov 1, 2016in Neurology9.91
· DOI :10.1212/WNL.0000000000003280
Beau B. Bruce2
Estimated H-index: 2
(Roy J. and Lucille A. Carver College of Medicine),
Kathleen B. Digre55
Estimated H-index: 55
(Roy J. and Lucille A. Carver College of Medicine)
+ 2 AuthorsMichael Wall57
Estimated H-index: 57
(Roy J. and Lucille A. Carver College of Medicine)
Sources
Abstract
Objective: To examine the changes in vision-specific and overall health-related quality of life (QOL) at 6 months in participants with idiopathic intracranial hypertension (IIH) and mild visual loss enrolled in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) and to determine the signs and symptoms of IIH that mediate the effect of acetazolamide on QOL. Methods: We assessed QOL using the National Eye Institute Visual Function Questionnaire–25 (NEI-VFQ-25), the 10-Item NEI-VFQ-25 Neuro-Ophthalmic Supplement, and the 36-Item Short Form Health Survey (SF-36). We examined associations among changes in QOL measures over 6 months, treatment status, and changes in signs and symptoms using linear and structural equation models. Results: Among the 165 participants with IIH (86 randomized to acetazolamide, 79 to placebo), beneficial effects of acetazolamide were seen on all QOL scales evaluated, as well as on the Near Activities (5.60 points, p = 0.03), Social Functioning (3.85 points, p = 0.04), and Mental Health (9.82, p = 0.04) subscales of the NEI-VFQ-25. Positive acetazolamide-related effects on QOL appeared to be primarily mediated by improvements in visual field, neck pain, pulsatile tinnitus, and dizziness/vertigo that outweighed the side effects of acetazolamide. Conclusions: The marked reductions in baseline QOL seen among patients with mild visual loss from IIH are improved by treatment with acetazolamide. When combined with acetazolamide-associated improvements in visual field and other aspects of IIH, our findings with respect to QOL provide further support from the IIHTT in favor of acetazolamide to augment a dietary intervention in the treatment of IIH with mild visual loss (clinicaltrials.gov: NCT01003639).
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#1Martin ten Hove (UTSW: University of Texas Southwestern Medical Center)H-Index: 10
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To examine the tolerability and adverse events reported in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT).Randomized, double-masked, placebo-controlled clinical trial. Trial participants (n = 165) with mild visual loss concurrently receiving low-sodium weight-reduction diet plus the maximally tolerated dosage of acetazolamide (up to 4 g/d) or placebo for 6 months.adverse events (AEs), assessment of clinical and laboratory findings at study visits.Thirty-eight of 86 participants...
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#1Kathleen B. Digre (Roy J. and Lucille A. Carver College of Medicine)H-Index: 55
#2Beau B. Bruce (Emory University)H-Index: 35
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Objective: The study purpose was to examine vision-specific and overall health-related quality of life (QOL) at baseline in Idiopathic Intracranial Hypertension Treatment Trial patients who were newly diagnosed and had mild visual loss. We also sought to determine the associations between vision-specific QOL scores and visual symptoms, visual function, pain, headache-related disability, and obesity. Methods: We assessed QOL using the 36-Item Short Form Health Survey, National Eye Institute Visua...
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#1Steffi Weidt (UZH: University of Zurich)H-Index: 16
Last. Michael Rufer (UZH: University of Zurich)H-Index: 34
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#2Mark J. Kupersmith (Mount Sinai St. Luke's and Mount Sinai Roosevelt)H-Index: 39
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#10Mark J. Kupersmith (Mount Sinai St. Luke's and Mount Sinai Roosevelt)H-Index: 39
Importance Acetazolamide is commonly used to treat idiopathic intracranial hypertension (IIH), but there is insufficient information to establish an evidence base for its use. Objective To determine whether acetazolamide is beneficial in improving vision when added to a low-sodium weight reduction diet in patients with IIH and mild visual loss. Design, Setting, and Participants Multicenter, randomized, double-masked, placebo-controlled study of acetazolamide in 165 participants with IIH and mild...
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#1Colin J. Scott (UI: University of Iowa)H-Index: 1
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#5Mark L. Moster (Albert Einstein Medical Center)H-Index: 10
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#1Carol M. Mangione (UCLA: University of California, Los Angeles)H-Index: 105
#2Paul P. LeeH-Index: 70
Last. Ron D. HaysH-Index: 153
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#2Dilsad Turkdogan (Marmara University)H-Index: 12
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Diagnosis and treatment of pseudotumor cerebri syndrome in children is still a challenge for clinicians. The aim of this study is to reveal the influence of presentation age and CSF opening pressure on long-term prognosis of pseudotumor cerebri and share our clinical data of the very young age (≤ 5-year) group. This retrospective study includes the patients followed by the Marmara University Pediatric Neurology Clinic between years 2012 and 2020 diagnosed with definite, probable, or suggestive p...
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#1Brianna N Brun (Nationwide Children's Hospital)
#2Shawn C. Aylward (Nationwide Children's Hospital)H-Index: 7
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#1Sophia Knodel (Saarland University)H-Index: 2
#2S.N. Roemer (Saarland University)
Last. S. Kalampokini (UCY: University of Cyprus)
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BACKGROUND To assess the validity of neurosonological parameters (transorbital sonography (TOS)) for detection and monitoring of patients with idiopathic intracranial hypertension (IIH). METHODS Prospective, single-center, case-controlled study in 25 patients with IIH and 19 controls. Visual parameters of papilledema, visual acuity, computerized static threshold perimetry, fundus examination, and neurosonological parameters of papilledema/optic disc elevation (ODE), optic nerve sheath diameter (...
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Resume Le traitement chirurgical des fuites spontanees de liquide cerebro-rachidien releve de nos jours d’une prise en charge otorhinolaryngologique car la reparation par voie endoscopique endonasale, moins invasive, est preferee a la craniotomie. Cependant, la fuite spontanee du liquide cerebro-rachidien est souvent le symptome d’une pathologie sous-jacente : l’hypertension intracrânienne idiopathique, qui depasse le champ d’expertise traditionnel de l’otorhinolaryngologiste. La chirurgie est u...
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#1Susan P Mollan (Queen Elizabeth Hospital Birmingham)H-Index: 25
#2Alexandra J Sinclair (Queen Elizabeth Hospital Birmingham)H-Index: 30
IntroductionIdiopathic Intracranial Hypertension is condition characterised by raised intracranial pressure, papilledema, and normal neuroimaging (aside from radiological signs of raised intracranial pressure). Symptoms of idiopathic intracranial hypertension include chronic headaches and for some, visual loss. New treatments are an unmet clinical need.Areas coveredThe aim of this review is to present the evidence base and considered opinion on outcome measures to determine successful management...
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Surgical treatment of spontaneous cerebrospinal fluid (CSF) leak is now performed by ENT surgeons, endonasal endoscopy being preferred to craniotomy as less invasive. However, it is often the symptom of underlying idiopathic intracranial hypertension, which lies outside the traditional sphere of ENT competence. Surgery is a necessary step, but should not obscure the need to treat the underlying pathology. This treatment is complex, and requires multidisciplinary team-work between otorhinolaryngo...
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#2Renata Harumi Gobbato Yamashita (USP: University of São Paulo)
Last. Fernando Campos Gomes Pinto (USP: University of São Paulo)H-Index: 15
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#2Adam J. Kundishora (Yale University)H-Index: 7
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#1Matthew J. ThurtellH-Index: 22
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Idiopathic intracranial hypertension is a syndrome of increased intracranial pressure of unknown cause that most often occurs in women of childbearing age. Most patients are overweight or obese with a history of recent weight gain. Following a brief review of the symptoms and signs, we discuss the approach to assessment and monitoring of this condition. We then present a practical approach to treatment. Because patients frequently struggle with weight loss and can also have refractory headaches ...
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