Tero Puustinen1, Joona Tervonen1, Cecilia Avellan2, Henna-Kaisa Jyrkkänen1, Jussi J Paterno3, Päivi Hartikainen4, Ulla Vanhanen1, Ville Leinonen5, Soili M Lehto6, Antti-Pekka Elomaa1, Terhi J Huttunen7. 1. Neurosurgery KUH NeuroCenter, Kuopio University Hospital, and Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. 2. Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital, Turku, Finland. 3. Opthalmology KUH, Kuopio University Hospital and Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. 4. Neurology KUH NeuroCenter, Kuopio University Hospital and Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. 5. Department of Neurosurgery, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland; Unit of Clinical Neuroscience, Neurosurgery, University of Oulu and Medical Research Center, Oulu University Hospital, Oulu, Finland. 6. Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Department of Psychiatry, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland. 7. Neurosurgery KUH NeuroCenter, Kuopio University Hospital, and Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. Electronic address: terhi.j.huttunen@kuh.fi.
Abstract
OBJECTIVE: Idiopathic intracranial hypertension (IIH) is aetiologically unknown disorder that associates with endocrinological disturbances, including dysfunction of hypothalamic-pituitary-adrenal-axis. Neuroendocrinological dysfunctions have also been characterized in psychiatric disorders, and therefore we investigated the presence of psychiatric disorders of patients with IIH in a well-defined cohort. PATIENTS AND METHODS: A total of 51 patients with IIH were included. Patient demographics, symptoms, imaging data, ophthalmological and clinical findings were collected. RESULTS: At the time of diagnosis the mean age was 32.5years (SD 10.7), the body mass index was 37.1 kg/m2 (SD 7.4), and the opening pressure 29.1 mmHg (SD 6.2). A total of 88.2% of patients were female and 45.1% were diagnosed with a psychiatric co-morbidity prior to IIH diagnosis. The mean follow-up time was 4.4 years (SD 5.4). The overall treatment outcome was significantly poorer on a group of patients with psychiatric diagnosis when compared to individuals without such history (p = 0.001), but there were no differences in the resolution of papilledema (p = 0.405). Patients with IIH and psychiatric disorders had more often empty sella on their imaging at diagnosis when compared to patients without psychiatric co-morbidity (p = 0.044). CONCLUSION: Psychiatric disorders are highly prevalent in patients with IIH and associate with worse subjective outcomes. These findings advocate for monitoring the mental health of patients with IIH and warrant further multidisciplinary research to understand the potentially underlying psychosocial and neuroendocrinological mechanisms.
OBJECTIVE:Idiopathic intracranial hypertension (IIH) is aetiologically unknown disorder that associates with endocrinological disturbances, including dysfunction of hypothalamic-pituitary-adrenal-axis. Neuroendocrinological dysfunctions have also been characterized in psychiatric disorders, and therefore we investigated the presence of psychiatric disorders of patients with IIH in a well-defined cohort. PATIENTS AND METHODS: A total of 51 patients with IIH were included. Patient demographics, symptoms, imaging data, ophthalmological and clinical findings were collected. RESULTS: At the time of diagnosis the mean age was 32.5years (SD 10.7), the body mass index was 37.1 kg/m2 (SD 7.4), and the opening pressure 29.1 mmHg (SD 6.2). A total of 88.2% of patients were female and 45.1% were diagnosed with a psychiatric co-morbidity prior to IIH diagnosis. The mean follow-up time was 4.4 years (SD 5.4). The overall treatment outcome was significantly poorer on a group of patients with psychiatric diagnosis when compared to individuals without such history (p = 0.001), but there were no differences in the resolution of papilledema (p = 0.405). Patients with IIH and psychiatric disorders had more often empty sella on their imaging at diagnosis when compared to patients without psychiatric co-morbidity (p = 0.044). CONCLUSION:Psychiatric disorders are highly prevalent in patients with IIH and associate with worse subjective outcomes. These findings advocate for monitoring the mental health of patients with IIH and warrant further multidisciplinary research to understand the potentially underlying psychosocial and neuroendocrinological mechanisms.
Authors: Aku L Kaipainen; Erik Martoma; Tero Puustinen; Joona Tervonen; Henna-Kaisa Jyrkkänen; Jussi J Paterno; Anna Kotkansalo; Susanna Rantala; Ulla Vanhanen; Ville Leinonen; Soili M Lehto; Matti Iso-Mustajärvi; Antti-Pekka Elomaa; Sara Qvarlander; Terhi J Huuskonen Journal: Acta Neurochir (Wien) Date: 2021-08-27 Impact factor: 2.216
Authors: Olivia Grech; Andrew Clouter; James L Mitchell; Zerin Alimajstorovic; Ryan S Ottridge; Andreas Yiangou; Marianne Roque; Abd A Tahrani; Matthew Nicholls; Angela E Taylor; Fozia Shaheen; Wiebke Arlt; Gareth G Lavery; Kimron Shapiro; Susan P Mollan; Alexandra J Sinclair Journal: Brain Commun Date: 2021-09-02