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Mental Health Assessment and Suitability for Cognitive-Behavioral Therapy Among Patients With Idiopathic Intracranial Hypertension. 特发性颅内高压患者的心理健康评估及认知行为治疗的适宜性。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2026-01-22 DOI: 10.1097/WNO.0000000000002449
Fannie Nadeau, Mathieu Fradet, Heather E Moss

Background: High rates of mental health conditions have been reported among patients with idiopathic intracranial hypertension (IIH). Cognitive-behavioral therapy (CBT) has been suggested as a complementary treatment to help manage anxiety and headache pain in IIH. This study aims to assess the mental health of IIH patients through a psychiatric interview and to evaluate their suitability and interest in CBT.

Methods: Participants with IIH were recruited from Stanford Byers Eye Institute. Demographic and clinical characteristics were collected, and participants completed self-rated scales for depression (PHQ-9), anxiety (GAD-7), headaches (HIT-6), and disability (WHODAS-12). Diagnostic and Statistical Manual of Mental Disorders, 5th edition diagnoses, patient's suitability for CBT (SSCT scale), and preferred therapy focus were identified through a formal psychiatric interview.

Results: Fifty-three participants were enrolled and completed surveys, and 43 participants went on to have the psychiatric interview (mean age 38 years, 91% female). Among them, 76.7% had a GAD-7 score ≥5, indicating at least mild anxiety, and 76.7% of participants had a PHQ-9 score ≥5, indicating at least mild depression. In total, 81.4% of participants suffered from a mood, anxiety, or trauma- and stressor-related disorder. Participants who had received a venous stent or VP shunt had higher anxiety levels (average GAD-7 11.75 vs 6.52; P = 0.007); 81.4% were interested in CBT, and 83.7% were deemed good candidates for CBT (SSCT ≥ 30). Anxiety management most often emerged as their favored therapeutic focus.

Conclusions: Our results confirm the high prevalence of mental health conditions and symptoms among patients with IIH. A majority of patients are interested in CBT, and many would likely benefit from this approach. CBT should therefore be considered in the therapeutic management of IIH. Further research is warranted to validate the efficacy of this intervention in this specific clinical population.

背景:据报道,特发性颅内高压(IIH)患者的精神健康状况发生率很高。认知行为疗法(CBT)已被建议作为辅助治疗来帮助控制IIH患者的焦虑和头痛。本研究旨在通过精神病学访谈评估IIH患者的心理健康状况,并评估他们对CBT的适合性和兴趣。方法:从斯坦福拜尔斯眼科研究所招募IIH患者。收集了人口统计学和临床特征,参与者完成了抑郁(PHQ-9)、焦虑(GAD-7)、头痛(HIT-6)和残疾(WHODAS-12)的自评量表。通过正式的精神病学访谈确定《精神障碍诊断与统计手册》第5版诊断、患者对CBT的适宜性(SSCT量表)和首选治疗重点。结果:53名参与者被招募并完成了调查,43名参与者继续进行了精神病学访谈(平均年龄38岁,91%为女性)。其中,76.7%的受试者GAD-7评分≥5分,至少有轻度焦虑;76.7%的受试者PHQ-9评分≥5分,至少有轻度抑郁。总的来说,81.4%的参与者患有情绪、焦虑或创伤和压力相关的疾病。接受静脉支架或VP分流术的参与者焦虑水平更高(平均GAD-7为11.75 vs 6.52; P = 0.007);81.4%的人对CBT感兴趣,83.7%的人被认为是CBT的良好候选者(SSCT≥30)。焦虑管理通常是他们最喜欢的治疗重点。结论:我们的研究结果证实了IIH患者中精神健康状况和症状的高患病率。大多数患者对CBT感兴趣,许多人可能会从这种方法中受益。因此,在IIH的治疗管理中应考虑CBT。需要进一步的研究来验证这种干预在这一特定临床人群中的有效性。
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引用次数: 0
Ocular Motor Control and Cognitive Function in Military Veterans With Chronic Mild Traumatic Brain Injury. 慢性轻度创伤性脑损伤退伍军人的眼运动控制和认知功能。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2026-01-21 DOI: 10.1097/WNO.0000000000002435
Jeffrey R Hebert, Brandie D Wagner, Christopher M Filley, Kayla L Crowder, David Rubinstein, Stephen M McNamara, Catharine H Johnston-Brooks, Ramesh Karki, Ashley V McCann, Prem S Subramanian
<p><strong>Background: </strong>Ocular motor control (OMC) and cognitive dysfunction are common persistent sequelae in persons with mild traumatic brain injury (mTBI). Combat and training operations frequently expose military Service Members to biomechanical and blast events that render them susceptible to mTBI, and problems such as OMC disturbances and cognitive dysfunction are frequent long after injury. However, these problems can be difficult to detect, often only becoming clinically evident with physical or psychological stress. Knowledge of the relationship between OMC and cognitive dysfunction in chronic mTBI, and of clinical tools to assess this issue, is limited.</p><p><strong>Methods: </strong>Setting: Academic laboratory; Marcus Institute for Brain Health, University of Colorado; Design: 2-arm, examiner-blinded cross-sectional observational study. Participants: Military Veterans with chronic mTBI (experimental; n = 38) whose most recent mTBI was more than 3 months before enrolment, and Veterans without a history of TBI (control; n = 40); Measures: The computerized King-Devick (K-D) test assessed rapid number naming tasks; the Right Eye computerized eye tracker system measured antisaccade tasks; the Conners' Continuous Performance Test (CPT) tested aspects of selective and sustained attention and impulsivity; the FAS test measured the ability to name as many common nouns that start with "F," "A," and "S" as a method to assess phonemic verbal fluency, attention, and initiation; and the Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) was used as a self-report of posttraumatic stress-related symptoms.</p><p><strong>Results: </strong>Veterans in the experimental group had a median of 2 mTBIs, and these occurred approximately 11 years before the study. On the K-D Test, the experimental group had significantly more errors and took significantly more time (51.32 seconds) compared with the control group (43.00 seconds). Significantly greater antisaccade latencies were found in the experimental group for target only, on target distractor, and ipsilateral proximal distractor paradigms, and antisaccade error rates were significantly greater in the experimental group for the contralateral proximal distractor paradigm. Significantly greater PCL-5, and worse FAS test scores and CPT commissions and omissions scores were found in the experimental group. For the experimental group, time since most recent TBI correlated with antisaccade on target distractor error rates. Regression modeling showed that FAS test scores were a significant determinant of K-D test performance. Separate regression modeling for each of the antisaccade task paradigms indicated that group status was significantly associated with antisaccade latency scores for the ipsilateral proximal distractor paradigm. PCL-5 was a significant factor for the on target distractor paradigm, and age and cognitive function denoted by FAS test and CPT scores were significant factors
背景:眼运动控制(OMC)和认知功能障碍是轻度创伤性脑损伤(mTBI)患者常见的持续性后遗症。战斗和训练行动经常使军人暴露在生物力学和爆炸事件中,使他们容易发生mTBI,并且在受伤后很长一段时间内经常出现OMC紊乱和认知功能障碍等问题。然而,这些问题很难发现,通常只有在身体或心理压力的情况下才会出现临床症状。对于慢性mTBI中OMC与认知功能障碍之间的关系以及评估这一问题的临床工具的了解是有限的。设置:学术实验室;科罗拉多大学马库斯脑健康研究所;设计:两组、检查者盲法横断面观察研究。参与者:慢性mTBI退伍军人(实验,n = 38),其最近一次mTBI在入组前超过3个月,以及没有TBI病史的退伍军人(对照组,n = 40);测量方法:计算机化King-Devick (K-D)测试评估快速数字命名任务;右眼计算机眼动仪系统测量抗扫视任务;Conners’s Continuous Performance Test (CPT)测试选择性、持续性注意力和冲动性;FAS测试测试了尽可能多的以“F”、“A”和“S”开头的普通名词的命名能力,以此来评估语音的流畅性、注意力和入门性;使用DSM-5的创伤后应激障碍(PTSD)检查表(PCL-5)作为创伤后应激相关症状的自我报告。结果:实验组的退伍军人中位数为2 mtbi,这些发生在研究前大约11年。在K-D测试中,实验组的错误率明显高于对照组(51.32秒),所用时间明显高于对照组(43.00秒)。实验组的反扫视潜伏期显著高于单纯目标、非目标牵张器和同侧近端牵张器模式,而对侧近端牵张器模式的反扫视错误率显著高于对侧近端牵张器模式。实验组PCL-5显著增高,FAS评分和CPT委托与遗漏评分显著降低。对于实验组来说,距离最近一次脑外伤的时间与目标分心物误差率的反扫视相关。回归模型显示,FAS测试成绩是K-D测试成绩的显著决定因素。每个反扫视任务范式的独立回归模型表明,在同侧近端分心物范式中,组状态与反扫视潜伏期得分显著相关。PCL-5是非目标干扰物范式的显著影响因素,年龄、FAS测验和CPT分数表征的认知功能是多指定反扫视范式任务表现错误率的显著影响因素。结论:研究结果支持OMC和认知表现是慢性mTBI退伍军人持续共存的问题。值得注意的是,即使在11年前发生的2次mTBI后,也可以检测到这些缺陷,这表明慢性mTBI可能存在omc -认知轴。结果还确定了OMC任务范式的认知相关性,有助于这些测试在慢性mTBI中的临床应用和解释。
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引用次数: 0
Perivascular Diffusivity Suggests Dynamic and Modifiable Glymphatic Transit in Idiopathic Intracranial Hypertension. 特发性颅内高压患者血管周围弥漫性提示动态和可改变的淋巴转运。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2026-01-07 DOI: 10.1097/WNO.0000000000002434
Marc A Bouffard, Donnella S Comeau, Mahsa A Avanaki, Narjes Jaafar, Alexander Brook, Bardia Abbasi, David C Alsop, Yu-Ming Chang, Joseph F Rizzo, Robert M Mallery, Bart K Chwalisz, Katherine L Reinshagen, Olivia Grech, Jeremy N Ford

Background: Preliminary work suggests that glymphatic transit is abnormal and dynamic in idiopathic intracranial hypertension (IIH), although its incomplete characterization across the disease course has led to debate as to its pathophysiologic relevance. We seek to clarify whether glymphatic transit varies across IIH's disease course, correlates with intracranial pressure, and might be measured radiographically to aid diagnosis.

Methods: Diffusion tensor imaging along the perivascular space (ALPS) was used to measure perivascular diffusivity and generate indices of glymphatic transit (ALPS-indices). We studied healthy controls and participants with IIH cross-sectionally, the latter stratified into untreated, treated, or cured IIH. Participants with untreated IIH were substratified as "acute" if imaged <6 months from onset or "chronic" if imaged ≥6 months from onset.

Results: Forty participants were studied. We identified a positive, nonlinear correlation between ALPS-indices and disease duration in patients with untreated IIH. ALPS-indices differed between participants with chronic, treated, and acute IIH, in descending order. Healthy controls exhibited lower ALPS-indices than participants with chronic IIH and higher ALPS-indices than participants with acute IIH. ALPS-indices correlated positively with lumbar puncture opening pressures in participants with chronic IIH. Receiver-operating-characteristic curves demonstrated high areas-under-the curve in distinguishing between participants with untreated IIH and controls.

Conclusions: These data support the hypothesis that changes in glymphatic transit are likely a result rather than a cause of IIH, that radiographic indices of glymphatic transit may be leveraged diagnostically, and that ALPS-indices measuring perivascular diffusivity are likely a physiologically valid reflection of glymphatic transit in humans.

背景:初步研究表明,在特发性颅内高压(IIH)中,淋巴转运是异常和动态的,尽管其在整个病程中的不完整特征导致了关于其病理生理相关性的争论。我们试图澄清淋巴转运是否在IIH的病程中有所不同,是否与颅内压相关,是否可以通过影像学测量来辅助诊断。方法:采用沿血管周围间隙弥散张量成像(ALPS)测量血管周围弥散度,生成淋巴转运指数(ALPS指数)。我们对健康对照和IIH患者进行了横断面研究,后者分为未治疗、治疗或治愈的IIH。未经治疗的IIH参与者被分层为“急性”,如果成像结果:40名参与者进行了研究。我们发现未经治疗的IIH患者的alps指数与病程呈正非线性相关。慢性、治疗和急性IIH患者的alps指数按降序排列。健康对照组的alps指数低于慢性IIH患者,而高于急性IIH患者。慢性IIH患者的alps指数与腰椎穿刺开口压力呈正相关。接受者工作特征曲线显示,在区分未经治疗的IIH参与者和对照组时,曲线下面积较高。结论:这些数据支持以下假设:类淋巴转运的改变可能是IIH的结果而不是原因,类淋巴转运的影像学指标可以用于诊断,测量血管周围弥漫性的alps指数可能是人类类淋巴转运的生理有效反映。
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引用次数: 0
Hemi-Prosopometamorphopsia From Ipsilateral Splenial Infarction-A Case Report and Literature Review. 同侧脾梗死致半人面畸形1例并文献复习。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-12-24 DOI: 10.1097/WNO.0000000000002427
Wenjun Song, Shaun Previn Appaduray, Wai-Yung Yu, Chee Fang Chin
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引用次数: 0
Should Patients Who Develop Nonarteritic Anterior Ischemic Optic Neuropathy While Using PDE-5 Inhibitors Continue Using These Medications? 在使用PDE-5抑制剂时发生非动脉性前缺血性视神经病变的患者是否应继续使用这些药物?
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-12-23 DOI: 10.1097/WNO.0000000000002421
Howard D Pomeranz, Ore-Ofe O Adesina, Andrew G Lee, Gregory P Van Stavern
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引用次数: 0
Another One: A Novel Variant Associated With Leber Hereditary Optic Neuropathy. 另一个:一种与Leber遗传性视神经病变相关的新变异。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-12-23 DOI: 10.1097/WNO.0000000000002430
Nicholas G Janigian, Tatiana V Bakaeva
{"title":"Another One: A Novel Variant Associated With Leber Hereditary Optic Neuropathy.","authors":"Nicholas G Janigian, Tatiana V Bakaeva","doi":"10.1097/WNO.0000000000002430","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002430","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spontaneous Unilateral Superior Ophthalmic Vein Thrombosis Associated With Hereditary Hemorrhagic Telangiectasia. 自发性单侧眼上静脉血栓形成与遗传性出血性毛细血管扩张有关。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-12-22 DOI: 10.1097/WNO.0000000000002425
Nicole Hamagami, Steven Obiefuna, Sara Krachmalnick, Matthew S Elitt, Darshan Shastri, Gregory P Van Stavern, Leanne Stunkel
{"title":"Spontaneous Unilateral Superior Ophthalmic Vein Thrombosis Associated With Hereditary Hemorrhagic Telangiectasia.","authors":"Nicole Hamagami, Steven Obiefuna, Sara Krachmalnick, Matthew S Elitt, Darshan Shastri, Gregory P Van Stavern, Leanne Stunkel","doi":"10.1097/WNO.0000000000002425","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002425","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comment: Clinical Characteristics and Treatment Effects of Chronic Immunotherapy in Idiopathic Recurrent Neuroretinitis and Idiopathic Recurrent Papillitis: Describing a Potential New Phenotype. 评论:慢性免疫治疗特发性复发性神经视网膜炎和特发性复发性乳头炎的临床特点和治疗效果:描述一种潜在的新表型。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-12-22 DOI: 10.1097/WNO.0000000000002423
Gordon T Plant
{"title":"Comment: Clinical Characteristics and Treatment Effects of Chronic Immunotherapy in Idiopathic Recurrent Neuroretinitis and Idiopathic Recurrent Papillitis: Describing a Potential New Phenotype.","authors":"Gordon T Plant","doi":"10.1097/WNO.0000000000002423","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002423","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bilateral Occipital Lobe Infarcts, A Rare Cause of Vision Loss in Giant Cell Arteritis. 双侧枕叶梗死,巨细胞动脉炎中视力丧失的罕见原因。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-12-22 DOI: 10.1097/WNO.0000000000002419
Joshua A Read
{"title":"Bilateral Occipital Lobe Infarcts, A Rare Cause of Vision Loss in Giant Cell Arteritis.","authors":"Joshua A Read","doi":"10.1097/WNO.0000000000002419","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002419","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Screening Eye Examination in a 9-Year-Old Girl With Congenital Renal Dysplasia. 9岁女童先天性肾发育不良的筛检。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-12-19 DOI: 10.1097/WNO.0000000000002420
Jebgy V Vargas, Dhruva Drew Gupta, Catherine S Choi, Eric D Gaier
{"title":"Screening Eye Examination in a 9-Year-Old Girl With Congenital Renal Dysplasia.","authors":"Jebgy V Vargas, Dhruva Drew Gupta, Catherine S Choi, Eric D Gaier","doi":"10.1097/WNO.0000000000002420","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002420","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Neuro-Ophthalmology
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