A5043293131- Cerebral Venous Sinus Thrombosis
- Pituitary Gland Disorders and Treatments
- Glaucoma and retinal disorders
- Neurosurgical Procedures and Complications
- Cerebrovascular and Carotid Artery Diseases
- Ophthalmology and Eye Disorders
- Hormonal Regulation and Hypertension
- Aldose Reductase and Taurine
- Retinal Diseases and Treatments
- Retinal and Optic Conditions
- Migraine and Headache Studies
- Systemic Lupus Erythematosus Research
- Estrogen and related hormone effects
- Bariatric Surgery and Outcomes
- Lipid metabolism and disorders
- Venous Thromboembolism Diagnosis and Management
- Cell Adhesion Molecules Research
- Cerebrospinal fluid and hydrocephalus
- Intracerebral and Subarachnoid Hemorrhage Research
- Neurological Complications and Syndromes
- Regulation of Appetite and Obesity
- Cancer, Hypoxia, and Metabolism
- Brain Metastases and Treatment
- Head and Neck Surgical Oncology
- Pharmacogenetics and Drug Metabolism
University of Birmingham
2020-2025
University Hospitals Birmingham NHS Foundation Trust
2021-2022
Nottingham Trent University
2022
Queen Elizabeth Hospital Birmingham
2022
University of Cambridge
2022
HealthPartners
2022
Royal Hallamshire Hospital
2022
Heartlands Hospital
2021-2022
Addenbrooke's Hospital
2022
University College London
2022
<h3>Importance</h3> Idiopathic intracranial hypertension (IIH) causes headaches, vision loss, and reduced quality of life. Sustained weight loss among patients with IIH is necessary to modify the disease prevent relapse. <h3>Objective</h3> To compare effectiveness bariatric surgery that a community management (CWM) intervention for treatment active IIH. <h3>Design, Setting, Participants</h3> This 5-year randomized clinical trial (Idiopathic Intracranial Hypertension Weight Trial) enrolled...
Abstract Therapeutics to reduce intracranial pressure are an unmet need. Preclinical data have demonstrated a novel strategy lower using glucagon-like peptide-1 (GLP-1) receptor signalling. Here, we translate these findings into patients by conducting randomized, placebo-controlled, double-blind trial assess the effect of exenatide, GLP-1 agonist, on in idiopathic hypertension. Telemetric catheters enabled long-term monitoring. The enrolled adult women with active hypertension (intracranial...
BACKGROUND. Idiopathic intracranial hypertension (IIH) is a condition predominantly affecting obese women of reproductive age. Recent evidence suggests that IIH disease metabolic dysregulation, androgen excess, and an increased risk cardiovascular morbidity. Here we evaluate systemic adipose specific determinants the phenotype.
Abstract Objective To gain initial insight into the efficacy to lower intracranial pressure (ICP), side effects, and effects on cognition of five drugs commonly used treat idiopathic hypertension (IIH). Background Limited clinical data exist for treatment IIH. Impaired is recognized in IIH can be exacerbated by medications. Methods This human experimental medicine study was a secondary analysis that focused an unblinded randomized, sequential, cross‐over extension previously completed...
There is an unmet need for noninvasive biomarkers of intracranial pressure (ICP), which manifests as papilledema that can be quantified by optical coherence tomography (OCT) imaging.To determine whether OCT the optic nerve head in could act a surrogate measure ICP.This longitudinal cohort study used data collected from 3 randomized clinical trials were conducted between April 1, 2014, and August 2019. Participants who female had active idiopathic hypertension enrolled 5 National Health...
Treatment options for idiopathic intracranial hypertension are limited. The enzyme 11β-hydroxysteroid dehydrogenase type 1 has been implicated in regulating cerebrospinal fluid secretion, and its activity is associated with alterations pressure hypertension. We assessed therapeutic efficacy, safety tolerability investigated indicators of vivo efficacy the inhibitor AZD4017 compared placebo A multicenter, UK, 16-week phase II randomized, double-blind, placebo-controlled trial 12-week...
Abstract Background The enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) determines prereceptor metabolism and activation of glucocorticoids within peripheral tissues. Its dysregulation has been implicated in a wide array metabolic diseases, leading to the development selective 11β-HSD1 inhibitors. We examined impact reversible competitive inhibitor, AZD4017, on profile an overweight female cohort with idiopathic intracranial hypertension (IIH). Methods conducted UK multicenter...
Cognitive impairments have been reported in idiopathic intracranial hypertension; however, evidence supporting these deficits is scarce and contributing factors not defined. Using a case-control prospective study, we identified multiple domains of deficiency cohort 66 female adult hypertension patients. We significantly impaired attention networks (executive function) sustained compared to body mass index age matched control group 25 healthy participants. aimed investigate how cognitive...
Headache is the predominant disabler in idiopathic intracranial hypertension (IIH). The aim was to characterise headache and investigate association with pressure.IIH:WT a randomised controlled parallel group multicentre trial United Kingdom investigating weight management methods IIH. Participants active IIH (evidenced by papilloedema) body mass index (BMI) ≥35 kg/m2 were recruited. At baseline, 12 months 24 characteristics quality of life outcome measures collected lumbar puncture...
The idiopathic intracranial hypertension randomized controlled weight trial (IIH:WT) established that loss through bariatric surgery significantly reduced pressure when compared with a community management intervention. This substudy aimed to evaluate the amount of required reduce and explore effect different surgical approaches.
Abstract Objective To determine the effectiveness of erenumab in treating headaches idiopathic intracranial hypertension (IIH) whom papilledema had resolved. Background Disability IIH is predominantly driven by debilitating with no evidence for use preventative therapies. Headache therapy an urgent unmet need. Methods A prospective, open‐label study United Kingdom was conducted. Adult females confirmed diagnosis now ocular remission (papilledema resolved) chronic (≥15 days a month) and...
Abstract Objectives Intracranial pressure (ICP) has been thought to vary diurnally. This study evaluates diurnal ICP measurements and quantifies changes in occurring with body posture active idiopathic intracranial hypertension (IIH). Methods prospective observational utilized telemetric monitoring people IIH. Participants had the Raumedic p-Tel intraparenchymal device (Raumedic, Hembrechts, Germany) surgically inserted. Changes supine position were evaluated. Then, was measured standing,...
Abstract Background Idiopathic intracranial hypertension (IIH) is a neurological disorder characterised by raised cerebrospinal fluid (CSF) pressure in the absence of any pathology. IIH mainly affects women with obesity between ages 15 and 45. Two possible mechanisms that could explain increased CSF are excessive production choroid plexus (CP) epithelium or impaired drainage from brain. However, molecular controlling these remain to be determined. Methods In vivo ventriculo-cisternal...
We evaluated the metabolomic profile in CSF, serum, and urine of participants with idiopathic intracranial hypertension (IIH) compared that controls measured changes metabolism associated clinical markers disease activity treatment.
Idiopathic intracranial hypertension, a disease classically occurring in women with obesity, is characterized by raised pressure. Weight loss leads to the reduction Additionally, pharmacological glucagon-like peptide-1 agonism reduces cerebrospinal fluid secretion and The potential mechanisms which weight pressure are unknown were focus of this study. Meal stimulation tests (fasted plasma sample, then samples at 15, 30, 60, 90 120 min following standardized meal) conducted pre-...
Idiopathic intracranial hypertension (IIH) is associated with significant morbidity, predominantly affecting women of childbearing age living obesity. Weight loss has demonstrated successful disease-modifying effects; however, the long-term cost-effectiveness weight interventions for treatment IIH not yet been established.To estimate weight-loss treatments IIH.Single-payer healthcare system (National Health Service, England).A Markov model was developed comparing bariatric surgery a...
Background: Idiopathic intracranial hypertension (IIH) is characterized by increased pressure occurring predominantly in women with obesity. The pathogenesis not understood. We have applied untargeted metabolomic analysis using ultrahigh-performance liquid chromatography–mass spectrometry to characterize the cerebrospinal fluid (CSF) and serum IIH compared control subjects. Methods findings: Samples were collected from patients (n = 66) active disease at baseline again 12 months following...
Background: The Idiopathic Intracranial Hypertension Weight Trial (IIH:WT) established the efficacy of bariatric surgery as compared to a community weight management intervention in reducing intracranial pressure active IIH. aim this cost-effectiveness analysis was evaluate economic impact these loss treatments for Methods: IIH:WT five-year randomised, controlled, parallel group, multicentre trial United Kingdom, where participants with IIH and body mass index ≥35 kg/m2 were randomly...
Inflammation and fibrosis are important components of diseases that contribute to the malfunction epithelia endothelia. The Rho guanine nucleotide exchange factor (GEF) GEF-H1/ARHGEF-2 is induced in disease stimulates inflammatory fibrotic processes, cell migration, metastasis. Here, we have generated peptide inhibitors block function GEF-H1. Inhibitors were designed using a structural silico approach or by isolating an inhibitory sequence from autoregulatory C-terminal domain. Candidate...
Abstract Therapeutics to reduce intracranial pressure are an unmet need. Pre-clinical data has demonstrated a novel strategy lower using glucagon-like peptide-1 receptor signaling. Here, we translate these findings into patients by conducting randomized, placebo controlled, double-blind trial assess the effect of exenatide, agonist, on in idiopathic hypertension. Telemetric catheters enabled long-term monitoring. The enrolled adult women with active hypertension (intracranial >25 cmCSF...
Introduction Raised intracranial pressure (ICP) causes significant morbidity and mortality in a range of conditions including idiopathic hypertension (IIH) traumatic brain injury (TBI). Exenatide is GLP-1 receptor agonist; pre-clinical data demonstrates its ability to reduce ICP. GLP-1R agonists have also been shown neuro-protective properties models TBI. The objectives this study are assess the biological effect Glucagon-like Peptide 1 (GLP-1) agonist on ICP cohort participants with IIH,...
11β-Hydroxysteroid dehydrogenase-1 (11β-HSD1) catalyses the oxoreduction of cortisone to cortisol, amplifying levels active glucocorticoids. It is a pharmaceutical target in metabolic disease and cognitive impairments. 11β-HSD1 also converts some 7oxo-steroids their 7β-hydroxy forms. A recent study mice described ratio tauroursodeoxycholic acid (TUDCA)/tauro-7oxolithocholic (T7oxoLCA) as biomarker for decreased activity. The present evaluates equivalent bile glycoursodeoxycholic...