Evaluating the Fat Distribution in Idiopathic Intracranial Hypertension Using Dual-Energy X-ray Absorptiometry Scanning

Hornby, Catherine; Botfield, Hannah; O’Reilly, Michael; Westgate, Connar; Mitchell, James; Mollan, Susan P; Manolopoulos, K.; Tomlinson, Jeremy W.; Sinclair, Alexandra J

doi:10.1080/01658107.2017.1334218

Cited by 50 publications

(52 citation statements)

References 26 publications

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“… 28 , 29 , 30 Centripetal fat predominance has been identified in IIH and correlates with intracranial pressure. 31 Whether obesity is causal in IIH, or if it represents a comorbidity driven by the underlying metabolic disease state, is unclear. However, weight loss is associated with resolution of IIH.…”

Section: Discussionmentioning

confidence: 99%

Association Between Idiopathic Intracranial Hypertension and Risk of Cardiovascular Diseases in Women in the United Kingdom

et al. 2019

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Key PointsQuestionIs the risk of cardiovascular disease greater in women with idiopathic intracranial hypertension than in women of the same age and body mass index but without idiopathic intracranial hypertension?FindingsIn this population-based matched controlled cohort study of 2760 female patients with idiopathic intracranial hypertension and 27 125 control patients, women with this condition had twice the risk for cardiovascular disease compared with their counterparts with similar body mass index and age. Between 2005 and 2017, the incidence and prevalence of idiopathic intracranial hypertension have tripled.MeaningIdiopathic intracranial hypertension appeared to be a risk factor for cardiovascular disease in women; changing patient management to address the risk factors for cardiovascular disease may reduce long-term morbidity.

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Section: Discussionmentioning

confidence: 99%

Association Between Idiopathic Intracranial Hypertension and Risk of Cardiovascular Diseases in Women in the United Kingdom

et al. 2019

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“…In particular, truncal fat mass and higher BMI has been associated with more severe visual These authors contributed equally: B.B. Bruce, A. Sinclair loss [4,5]. Obesity affects 30.4% of British women and 38.2% of American women [6] (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Differing presenting features of idiopathic intracranial hypertension in the UK and US

Vasseneix

Liczkowski

Yiangou

et al. 2019

Eye

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Aim Demographic factors potentially influencing the presentation and severity of idiopathic intracranial hypertension (IIH) in the US vs. UK populations include obesity and ethnicity. We aimed to compare the presenting features of IIH between populations in the UK and US tertiary referral centres, to assess what population differences exist and whether these cause different presentations and impact on visual function. Methods Clinical data were collected on 243 consecutive UK IIH patients and 469 consecutive US IIH patients seen after 2012 in two tertiary centres. Visual function was defined as severe visual loss when Humphrey visual field mean deviation was <−15 dB, when Goldmann visual fields showed constriction or when visual acuity was <20/200. Results US patients were more commonly of self-reported black race (58.9% vs. 7.1%) than UK patients, but had a similar mean body mass index (38.3 ± 0.63kg/m 2 UK vs. 37.7 ± 0.42kg/m 2 US; p = 0.626). The UK cohort had lower presenting Frisén grade (median 1 vs. 2; p < 0.001) and severe visual loss less frequently (15.4% vs. 5%; p = 0.014), but there was no difference in mean cerebrospinal fluid-opening pressure (CSF-OP) (35.8 ± 0.88cmH 2 O UK vs. 36.3 ± 0.52cmH 2 O US; p = 0.582). African Americans had poorer visual outcomes compared with US whites (19.4% vs. 10% severe visual loss; p = 0.011). Visual function was weakly associated with CSF-OP (R 2 = 0.059; p = 0.001), which was similar between UK and US patients. Conclusions The UK and the US cohorts had a similar average presenting BMI. However, the worse presenting visual function in the US IIH cohort was partially attributable to differences in the black populations in the two countries.

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“…In a more recent study the gold standard dual-energy X-ray absorptiometry (DEXA) scanning technique was used to evaluate fat mass and distribution in IIH patients. In this study the authors found instead that IIH patients have a similar centripetal distribution of fat mass to patients with simple obesity [68]. These results raise the question whether it is the type of adipose tissue or its location that is of relevance for IIH.…”

Section: Iih Pathophysiologymentioning

confidence: 65%

Preclinical update on regulation of intracranial pressure in relation to idiopathic intracranial hypertension

Eftekhari

Westgate

Uldall

et al. 2019

Fluids Barriers CNS

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BackgroundElevated intracranial pressure (ICP) is observed in association with a range of brain disorders. One of these challenging disorders is idiopathic intracranial hypertension (IIH), characterized by raised ICP of unknown cause with significant morbidity and limited therapeutic options. In this review, special focus is put on the preclinical research performed in order to understand the pathophysiology behind ICP regulation and IIH. This includes cerebrospinal fluid dynamics, molecular mechanisms underlying disturbances in brain fluids leading to elevated ICP, role of obesity in IIH, development of an IIH model and ICP measurements in rodents. The review also discusses existing and new drug targets for IIH that have been evaluated in vivo.ConclusionsICP monitoring in rodents is challenging and different methods have been applied. Some of these methods are invasive, depend on use of anesthesia and only allow short-term monitoring. Long-term ICP recordings are needed to study IIH but existing methods are hampered by several limitations. As obesity is one of the most common risk factors for IIH, a rodent obese model has been developed that mimics some key aspects of IIH. The most commonly used drugs for IIH have been evaluated in vivo for their efficacy at lowering ICP in the existing animal models. These studies suggest these drugs, including acetazolamide, might have limited or no reducing effect on ICP. Two drug targets that can impact ICP in healthy rodents are topiramate and a glucagon-like peptide-1 receptor (GLP-1R) agonist. However, it remains to evaluate their effect in an IIH model with more precise and valid ICP monitoring system. Therefore, continued evaluation in the preclinical research with refined tools is of great importance to further understand the pathophysiology behind disorders with raised ICP and to explore new drug targets.

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Evaluating the Fat Distribution in Idiopathic Intracranial Hypertension Using Dual-Energy X-ray Absorptiometry Scanning

Cited by 50 publications

References 26 publications

Association Between Idiopathic Intracranial Hypertension and Risk of Cardiovascular Diseases in Women in the United Kingdom

Association Between Idiopathic Intracranial Hypertension and Risk of Cardiovascular Diseases in Women in the United Kingdom

Differing presenting features of idiopathic intracranial hypertension in the UK and US

Preclinical update on regulation of intracranial pressure in relation to idiopathic intracranial hypertension

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