Emerging themes in Idiopathic Intracranial Hypertension

Olivia Grech; Susan Mollan; Benjamin Wakerley; Zerin Alimajstorovic; Gareth Lavery; Alex Sinclair

doi:10.1007/s00415-020-10090-4

Emerging themes in Idiopathic Intracranial Hypertension

Olivia Grech, Susan Mollan, Benjamin Wakerley, Zerin Alimajstorovic, Gareth Lavery, Alex Sinclair

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

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Abstract

Purpose
Idiopathic intracranial hypertension (IIH) is a rare disorder characterised by raised intracranial pressure. The underlying pathophysiology is mostly unknown and effective treatment is an unmet clinical need in this disease. This review evaluates key emerging themes regarding disease characteristics, mechanisms contributing to raised intracranial pressure and advances in potential therapeutic targets.

Findings
IIH is becoming more common, with the incidence rising in parallel with the global obesity epidemic. Current medical management remains centred around weight management, which is challenging. Metabolic investigations of patients have identified specific androgen profiles in cerebrospinal fluid (CSF), which suggest an endocrine dysfunction impacting CSF secretion in IIH. Glucagon-like peptide-1 (GLP-1) and 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) have been found to play a role in CSF dynamics in IIH and have formed the basis of the first clinical trials looking at new treatments.

Conclusions
Identification of novel molecular targets thought to underlie IIH pathology is now being translated to clinical trials.

Original language	English
Pages (from-to)	3776-3784
Number of pages	9
Journal	Journal of Neurology
Volume	267
Issue number	12
Early online date	22 Jul 2020
DOIs	https://doi.org/10.1007/s00415-020-10090-4
Publication status	Published - Dec 2020

Bibliographical note

Publisher Copyright:
© 2020, The Author(s).

Keywords

Glucagon-like peptide-1 (GLP-1)
Headache
Idiopathic intracranial hypertension
Intracranial pressure
Obesity
Papilloedema

ASJC Scopus subject areas

Neurology
Clinical Neurology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00415-020-10090-4Licence: Creative Commons: Attribution (CC BY)

Grech_et_al_2020_Emerging_themes_in_idiopathic_intracranial_hypertension_Journal_of_NeurologyFinal published version, 772 KBLicence: Creative Commons: Attribution (CC BY)

Regulation of NAD+ metabolism in skeletal muscle during ageing and disease
Lavery, G. (Principal Investigator)
The Wellcome Trust
1/11/14 → 30/04/21
Project: Research

Cite this

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title = "Emerging themes in Idiopathic Intracranial Hypertension",

abstract = "PurposeIdiopathic intracranial hypertension (IIH) is a rare disorder characterised by raised intracranial pressure. The underlying pathophysiology is mostly unknown and effective treatment is an unmet clinical need in this disease. This review evaluates key emerging themes regarding disease characteristics, mechanisms contributing to raised intracranial pressure and advances in potential therapeutic targets.FindingsIIH is becoming more common, with the incidence rising in parallel with the global obesity epidemic. Current medical management remains centred around weight management, which is challenging. Metabolic investigations of patients have identified specific androgen profiles in cerebrospinal fluid (CSF), which suggest an endocrine dysfunction impacting CSF secretion in IIH. Glucagon-like peptide-1 (GLP-1) and 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) have been found to play a role in CSF dynamics in IIH and have formed the basis of the first clinical trials looking at new treatments.ConclusionsIdentification of novel molecular targets thought to underlie IIH pathology is now being translated to clinical trials.",

keywords = "Glucagon-like peptide-1 (GLP-1), Headache, Idiopathic intracranial hypertension, Intracranial pressure, Obesity, Papilloedema",

author = "Olivia Grech and Susan Mollan and Benjamin Wakerley and Zerin Alimajstorovic and Gareth Lavery and Alex Sinclair",

note = "Publisher Copyright: {\textcopyright} 2020, The Author(s).",

year = "2020",

month = dec,

doi = "10.1007/s00415-020-10090-4",

language = "English",

volume = "267",

pages = "3776--3784",

journal = "Journal of Neurology",

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AU - Grech, Olivia

AU - Mollan, Susan

AU - Wakerley, Benjamin

AU - Alimajstorovic, Zerin

AU - Lavery, Gareth

AU - Sinclair, Alex

PY - 2020/12

Y1 - 2020/12

N2 - PurposeIdiopathic intracranial hypertension (IIH) is a rare disorder characterised by raised intracranial pressure. The underlying pathophysiology is mostly unknown and effective treatment is an unmet clinical need in this disease. This review evaluates key emerging themes regarding disease characteristics, mechanisms contributing to raised intracranial pressure and advances in potential therapeutic targets.FindingsIIH is becoming more common, with the incidence rising in parallel with the global obesity epidemic. Current medical management remains centred around weight management, which is challenging. Metabolic investigations of patients have identified specific androgen profiles in cerebrospinal fluid (CSF), which suggest an endocrine dysfunction impacting CSF secretion in IIH. Glucagon-like peptide-1 (GLP-1) and 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) have been found to play a role in CSF dynamics in IIH and have formed the basis of the first clinical trials looking at new treatments.ConclusionsIdentification of novel molecular targets thought to underlie IIH pathology is now being translated to clinical trials.

AB - PurposeIdiopathic intracranial hypertension (IIH) is a rare disorder characterised by raised intracranial pressure. The underlying pathophysiology is mostly unknown and effective treatment is an unmet clinical need in this disease. This review evaluates key emerging themes regarding disease characteristics, mechanisms contributing to raised intracranial pressure and advances in potential therapeutic targets.FindingsIIH is becoming more common, with the incidence rising in parallel with the global obesity epidemic. Current medical management remains centred around weight management, which is challenging. Metabolic investigations of patients have identified specific androgen profiles in cerebrospinal fluid (CSF), which suggest an endocrine dysfunction impacting CSF secretion in IIH. Glucagon-like peptide-1 (GLP-1) and 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) have been found to play a role in CSF dynamics in IIH and have formed the basis of the first clinical trials looking at new treatments.ConclusionsIdentification of novel molecular targets thought to underlie IIH pathology is now being translated to clinical trials.

KW - Glucagon-like peptide-1 (GLP-1)

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JF - Journal of Neurology

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Emerging themes in Idiopathic Intracranial Hypertension

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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Projects

Regulation of NAD+ metabolism in skeletal muscle during ageing and disease

Cite this