Emerging themes in Idiopathic Intracranial Hypertension

Research output: Contribution to journalArticlepeer-review

Authors

  • Olivia Grech
  • Susan Mollan
  • Benjamin Wakerley
  • Zerin Alimajstorovic

Colleges, School and Institutes

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.

Details

Original languageEnglish
JournalJournal of Neurology
Early online date22 Jul 2020
Publication statusE-pub ahead of print - 22 Jul 2020

Keywords

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