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Emerging themes in idiopathic intracranial hypertension

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 charac...

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Autores principales: Grech, Olivia, Mollan, Susan P., Wakerley, Benjamin R., Alimajstorovic, Zerin, Lavery, Gareth G., Sinclair, Alexandra J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7674362/
https://www.ncbi.nlm.nih.gov/pubmed/32700012
http://dx.doi.org/10.1007/s00415-020-10090-4
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author Grech, Olivia
Mollan, Susan P.
Wakerley, Benjamin R.
Alimajstorovic, Zerin
Lavery, Gareth G.
Sinclair, Alexandra J.
author_facet Grech, Olivia
Mollan, Susan P.
Wakerley, Benjamin R.
Alimajstorovic, Zerin
Lavery, Gareth G.
Sinclair, Alexandra J.
author_sort Grech, Olivia
collection PubMed
description 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.
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spelling pubmed-76743622020-11-30 Emerging themes in idiopathic intracranial hypertension Grech, Olivia Mollan, Susan P. Wakerley, Benjamin R. Alimajstorovic, Zerin Lavery, Gareth G. Sinclair, Alexandra J. J Neurol Neurological Update 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. Springer Berlin Heidelberg 2020-07-22 2020 /pmc/articles/PMC7674362/ /pubmed/32700012 http://dx.doi.org/10.1007/s00415-020-10090-4 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Neurological Update
Grech, Olivia
Mollan, Susan P.
Wakerley, Benjamin R.
Alimajstorovic, Zerin
Lavery, Gareth G.
Sinclair, Alexandra J.
Emerging themes in idiopathic intracranial hypertension
title Emerging themes in idiopathic intracranial hypertension
title_full Emerging themes in idiopathic intracranial hypertension
title_fullStr Emerging themes in idiopathic intracranial hypertension
title_full_unstemmed Emerging themes in idiopathic intracranial hypertension
title_short Emerging themes in idiopathic intracranial hypertension
title_sort emerging themes in idiopathic intracranial hypertension
topic Neurological Update
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7674362/
https://www.ncbi.nlm.nih.gov/pubmed/32700012
http://dx.doi.org/10.1007/s00415-020-10090-4
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