Idiopathic intracranial hypertension, hormones, and 11β-hydroxysteroid dehydrogenases

Idiopathic intracranial hypertension (IIH) results in raised intracranial pressure (ICP) leading to papilledema, visual dysfunction, and headaches. Obese females of reproductive age are predominantly affected, but the underlying pathological mechanisms behind IIH remain unknown. This review provides an overview of pathogenic factors that could result in IIH with particular focus on hormones and the impact of obesity, including its role in neuroendocrine signaling and driving inflammation. Despite occurring almost exclusively in obese women, there have been a few studies evaluating the mechanisms by which hormones and adipokines exert their effects on ICP regulation in IIH. Research involving 11β-hydroxysteroid dehydrogenase type 1, a modulator of glucocorticoids, suggests a potential role in IIH. Improved understanding of the complex interplay between adipose signaling factors such as adipokines, steroid hormones, and ICP regulation may be key to the understanding and future management of IIH.

• Publication year

  2016

• Venue

  Journal of Pain Research

• Publication date

  2016-04-19

• Fields of study

  Biology, Medicine

• Identifiers
  DOI 10.2147/JPR.S80824PMID 27186074PMCID 4847593
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions.

  2016cited by this paper
• Oligoclonal bands and increased cytokine levels in idiopathic intracranial hypertension

  2015cited by this paper
• The incidence of idiopathic intracranial hypertension in Israel from 2005 to 2007: results of a nationwide survey

  2014cited by this paper
• University of Birmingham Hyperandrogenemia predicts metabolic phenotype in polycystic ovary syndrome : the utility of serum androstenedione

  2014cited by this paper
• Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology. 2013;81: 1159-1165

  2014cited by this paper
• Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children

  2014cited by this paper
• Hyperandrogenemia Predicts Metabolic Phenotype in Polycystic Ovary Syndrome: The Utility of Serum Androstenedione

  2014cited by this paper
• Cerebrospinal Fluid Pressure in Adults

  2014cited by this paper
• Hyperandrogenism is Associated with Earlier Age of Onset of Idiopathic Intracranial Hypertension in Women

  2013cited by this paper
• Idiopathic Intracranial Hypertension and Pregnancy

  2013cited by this paper
• Increased levels of interleukins 2 and 17 in the cerebrospinal fluid of patients with idiopathic intracranial hypertension.

  2013cited by this paper
• Metabolic control of puberty: roles of leptin and kisspeptins.

  2013cited by this paper
• 11β-hydroxysteroid dehydrogenases: intracellular gate-keepers of tissue glucocorticoid action.

  2013cited by this paper
• Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children

  2013cited by this paper
• Cerebrospinal fluid secretion by the choroid plexus.

  2013cited by this paper
• Greater than expected prevalence of pseudotumor cerebri: a prospective study.

  2013cited by this paper
• Idiopathic intracranial hypertension: a unifying neuroendocrine hypothesis through the adrenal-brain axis.

  2012cited by this paper
• Body mass index has a linear relationship with cerebrospinal fluid pressure.

  2012influential reference
• Bariatric surgery for the treatment of idiopathic intracranial hypertension.

  2011cited by this paper
• 11-hydroxysteroid dehydrogenases and the brain

  2011cited by this paper
• Disease activity in idiopathic intracranial hypertension: a 3-month follow-up study

  2011cited by this paper
• The incidence and prevalence of idiopathic intracranial hypertension in Sheffield, UK

  2011cited by this paper
• Thrombophilic factors in idiopathic intracranial hypertension: a report of 51 patients and a meta-analysis

  2010cited by this paper
• Cushing's disease and idiopathic intracranial hypertension: case report and review of underlying pathophysiological mechanisms.

  2010cited by this paper
• Addison's disease presenting with idiopathic intracranial hypertension in 24-year-old woman: a case report

  2010cited by this paper
• Original Papers

  2010cited by this paper
• Low energy diet and intracranial pressure in women with idiopathic intracranial hypertension: prospective cohort study

  2010influential reference
• Risk factors for idiopathic intracranial hypertension in men: a case-control study.

  2010cited by this paper
• Idiopathic intracranial hypertension is associated with lower body adiposity.

  2010cited by this paper
• Cerebrospinal fluid corticosteroid levels and cortisol metabolism in patients with idiopathic intracranial hypertension: a link between 11beta-HSD1 and intracranial pressure regulation?

  2010cited by this paper
• Is cerebrospinal fluid leptin altered in idiopathic intracranial hypertension?

  2009cited by this paper
• Leptin and the Regulation of Renal Sodium Handling and Renal Na+-Transporting ATPases: Role in the Pathogenesis of Arterial Hypertension

  2009cited by this paper
• Cytokines and Chemokines in Idiopathic Intracranial Hypertension

  2009cited by this paper
• Elevated cerebrospinal fluid (CSF) leptin in idiopathic intracranial hypertension (IIH): evidence for hypothalamic leptin resistance?

  2009influential reference
• Idiopathic intracranial hypertension in men

  2009cited by this paper
• Recent advances in the discovery of 11beta-HSD1 inhibitors.

  2008cited by this paper
• Cerebrospinal Fluid Concentration of Interleukin-6 and Interleukin-10 in Idiopathic Intracranial Hypertension

  2008cited by this paper
• Idiopathic intracranial hypertension (Pseudotumor cerebri)

  2008cited by this paper
• The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review

  2007cited by this paper
• Profiles of obesity, weight gain, and quality of life in idiopathic intracranial hypertension (pseudotumor cerebri).

  2007cited by this paper
• Carbenoxolone treatment attenuates symptoms of metabolic syndrome and atherogenesis in obese, hyperlipidemic mice.

  2007cited by this paper
• Corticosteroids, 11β‐Hydroxysteroid Dehydrogenase Isozymes and the Rabbit Choroid Plexus

  2007cited by this paper
• CSF opening pressure: Reference interval and the effect of body mass index

  2006influential reference
• Idiopathic intracranial hypertension associated with depot medroxyprogesterone

  2006cited by this paper
• Changes in weight, papilledema, headache, visual field, and life status in response to diet and metformin in women with idiopathic intracranial hypertension with and without concurrent polycystic ovary syndrome or hyperinsulinemia.

  2006cited by this paper
• Pseudotumour cerebri in a young obese woman on oral contraceptives

  2006cited by this paper
• Idiopathic intracranial hypertension, polycystic-ovary syndrome, and thrombophilia.

  2005cited by this paper
• Increased in vivo regeneration of cortisol in adipose tissue in human obesity and effects of the 11beta-hydroxysteroid dehydrogenase type 1 inhibitor carbenoxolone.

  2005cited by this paper
• Plasma ghrelin levels are normal in obese patients with idiopathic intracranial hypertension (pseudotumor cerebri).

  2004cited by this paper
• Cooperativity between 11beta-hydroxysteroid dehydrogenase type 1 and hexose-6-phosphate dehydrogenase in the lumen of the endoplasmic reticulum.

  2004cited by this paper
• Weight loss increases 11beta-hydroxysteroid dehydrogenase type 1 expression in human adipose tissue.

  2004cited by this paper
• Corticosteroid action on choroid plexus: Reduction in Na+—K+-ATPase activity, choline transport capacity, and rate of CSF formation

  2004cited by this paper
• 11 beta-hydroxysteroid dehydrogenase type 1 in obesity and the metabolic syndrome.

  2004cited by this paper
• 11beta-hydroxysteroid dehydrogenase type 1: a tissue-specific regulator of glucocorticoid response.

  2004cited by this paper
• Clinical characterization of idiopathic intracranial hypertension at the Detroit Medical Center.

  2004cited by this paper
• Metabolic syndrome without obesity: Hepatic overexpression of 11beta-hydroxysteroid dehydrogenase type 1 in transgenic mice.

  2004cited by this paper
• Inhibition of 11beta-hydroxysteroid dehydrogenase type 1 lowers intraocular pressure in patients with ocular hypertension.

  2003cited by this paper
• Effects of the 11 beta-hydroxysteroid dehydrogenase inhibitor carbenoxolone on insulin sensitivity in men with type 2 diabetes.

  2003cited by this paper
• Effects of the 11β-Hydroxysteroid Dehydrogenase Inhibitor Carbenoxolone on Insulin Sensitivity in Men with Type 2 Diabetes

  2003cited by this paper
• Leptin Signaling, Adiposity, and Energy Balance

  2002cited by this paper
• Serum leptin level in women with idiopathic intracranial hypertension

  2002cited by this paper
• Characterizaton of short isoforms of the leptin receptor in rat cerebral microvessels and of brain uptake of leptin in mouse models of obesity.

  2002cited by this paper
• Cerebrospinal Fluid and Plasma Concentrations of Leptin, NPY, andα -MSH in Obese Women and Their Relationship to Negative Energy Balance

  2001cited by this paper
• A Transgenic Model of Visceral Obesity and the Metabolic Syndrome

  2001cited by this paper
• Improved Lipid and Lipoprotein Profile, Hepatic Insulin Sensitivity, and Glucose Tolerance in 11β-Hydroxysteroid Dehydrogenase Type 1 Null Mice*

  2001cited by this paper
• Idiopathic intracranial hypertension; incidence, presenting features and outcome in Northern Ireland (1991-1995).

  2001cited by this paper
• Cerebrospinal fluid and plasma concentrations of leptin, NPY, and alpha-MSH in obese women and their relationship to negative energy balance.

  2001cited by this paper
• Leptin inhibits bone formation through a hypothalamic relay: a central control of bone mass.

  2000cited by this paper
• Chemical characterization of leptin‐activated neurons in the rat brain

  2000cited by this paper
• The role of the 11beta-hydroxysteroid dehydrogenase type 2 in human hypertension.

  2000cited by this paper
• The role of the 11β‐hydroxysteroid dehydrogenase type 2 in human hypertension

  2000cited by this paper
• How do glucocorticoids influence stress responses? Integrating permissive, suppressive, stimulatory, and preparative actions.

  2000cited by this paper
• Gastric surgery for pseudotumor cerebri associated with severe obesity.

  1999cited by this paper
• Parabiosis between db/db and ob/ob or db/+ mice.

  1999cited by this paper
• Leptin modulates the T-cell immune response and reverses starvation-induced immunosuppression

  1998cited by this paper
• The role of weight loss and acetazolamide in the treatment of idiopathic intracranial hypertension (pseudotumor cerebri)

  1998cited by this paper
• Expression of Leptin Receptor Isoforms in Rat Brain Microvessels.

  1998cited by this paper
• Expression of leptin receptor isoforms in rat brain microvessels.

  1998cited by this paper
• Increased intra-abdominal pressure and cardiac filling pressures in obesity-associated pseudotumor cerebri

  1997cited by this paper
• Relation between plasma leptin concentration and body fat, gender, diet, age, and metabolic covariates.

  1996cited by this paper
• Cerebrospinal fluid leptin levels: Relationship to plasma levels and to adiposity in humans

  1996cited by this paper
• Benign intracranial hypertension during prednisolone treatment for inflammatory bowel disease.

  1994cited by this paper
• Idiopathic intracranial hypertension (pseudotumor cerebri). Descriptive epidemiology in Rochester, Minn, 1976 to 1990.

  1993cited by this paper
• Cerebrospinal fluid estrone in pseudotumor cerebri: A change in cerebral steroid hormone metabolism?

  1991cited by this paper
• Regional distribution of 11 beta-hydroxysteroid dehydrogenase in rat brain.

  1991cited by this paper
• Regional Distribution of 1 β-Hydroxysteroid Dehydrogenase in Rat Brain

  1991cited by this paper
• Changes in transport functions of isolated rabbit choroid plexus under the influence of oestrogen and progesterone.

  1989cited by this paper
• Intracranial pressure and obstructive sleep apnea.

  1989cited by this paper
• The incidence of pseudotumor cerebri. Population studies in Iowa and Louisiana.

  1988cited by this paper
• Cerebrospinal fluid oestrone in pseudotumour cerebri

  1982cited by this paper
• The effect of dexamethasone on the rate of formation of cerebrospinal fluid in the monkey.

  1974cited by this paper
• Pseudotumor cerebri treated by rice reduction diet.

  1974cited by this paper
• The effect of dexamethasone phosphate on the production rate of cerebrospinal fluid in the spinal subarachnoid space of dogs.

  1973cited by this paper
• Journal of Pain Research

  year unknowncited by this paper

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  2026cites this paper
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  2026cites this paper
• Structural MRI Biomarkers of Intracranial Pressure in IIH: Linking Optic Nerve Sheath, Pituitary Morphology, and Hormonal Changes.

  2026cites this paper
• A unifying disease model of idiopathic intracranial hypertension: A narrative review.

  2025cites this paper
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  2025cites this paper
• Contraceptive Counseling Prior to Neuro-Ophthalmology Referral in Idiopathic Intracranial Hypertension.

  2025cites this paper
• Headache and Other Factors Modifying Cerebrospinal Fluid Opening Pressure in Pediatric Patients

  2024cites this paper
• Pseudotumor cerebri in the paediatric population: clinical features, treatment and prognosis.

  2024cites this paper
• CSF hyperdynamics in rats mimicking the obesity and androgen excess characteristic of patients with idiopathic intracranial hypertension

  2024cites this paper
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  2024cites this paper
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  2024cites this paper
• Metabolic Dysfunction in Idiopathic Intracranial Hypertension: Current Theories and Updates

  2024influential citation
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  2024cites this paper
• Intermittent spontaneous CSF rhinorrhea exacerbated by hormonal fluctuations associated with menstrual cycles

  2024cites this paper
• Current and emerging diagnostic and management approaches for idiopathic intracranial hypertension

  2023cites this paper
• Understanding the pathophysiology of idiopathic intracranial hypertension (IIH): a review of recent developments

  2023cites this paper
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  2023cites this paper
• Modelling idiopathic intracranial hypertension in rats: contributions of high fat diet and testosterone to intracranial pressure and cerebrospinal fluid production

  2023cites this paper
• Oculodigital Sign: A Clinical Clue for Diagnosis

  2022cites this paper
• Intracranial hypertension and empty Sella from adrenal adenoma and excessive and prolonged steroid usage: a case report

  2022cites this paper
• Why don't ventricles dilate in pseudotumor cerebri? A circuit model of the cerebral windkessel.

  2022cites this paper
• Management of Raised Intracranial Pressure—When Three is Better than Two

  2022cites this paper
• Discovery of a novel 2-spiro-proline steroid mimetic scaffold for the potent inhibition of 11β-HSD1.

  2022cites this paper
• Sex hormones, CSF and serum leptin in patients with idiopathic intracranial hypertension

  2022cites this paper
• Idiopathic Intracranial Hypertension: Implications for the Otolaryngologist.

  2022cites this paper
• Long-Term Outcomes of Bariatric Surgery in Idiopathic Intracranial Hypertension Patients

  2022cites this paper
• Micronutrient Deficiencies Presenting with Optic Disc Swelling Associated with or without Intracranial Hypertension: A Systematic Review

  2022cites this paper
• Update in the Management of Idiopathic Intracranial Hypertension.

  2021cites this paper
• Diagnosis of idiopathic intracranial hypertension - the importance of excluding secondary causes: A systematic review

  2021cites this paper
• Pseudotumor cerebri in the paediatric population: clinical features, treatment and prognosis.

  2021cites this paper
• Benign intracranial hypertension associated with inhaled corticosteroids in a child with asthma

  2021cites this paper
• Commentary: The role of inflammation in idiopathic intracranial hypertension

  2021cites this paper
• Dural Venous Sinus Stenting in the Treatment of Idiopathic Intracranial Hypertension: A Systematic Review and Critique of Literature.

  2021cites this paper
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  2020cites this paper
• Inflammation in Obesity-Related Complications in Children: The Protective Effect of Diet and Its Potential Role as a Therapeutic Agent

  2020cites this paper
• An update on idiopathic intracranial hypertension in adults: a look at pathophysiology, diagnostic approach and management

  2020cites this paper
• Infectious and inflammatory disorders might increase the risk of developing idiopathic intracranial hypertension – a national case-control study

  2020cites this paper
• Guide to preclinical models used to study the pathophysiology of idiopathic intracranial hypertension

  2020cites this paper
• Preclinical update on regulation of intracranial pressure in relation to idiopathic intracranial hypertension

  2019cites this paper
• Cerebrospinal fluid diversion versus bariatric surgery in the management of idiopathic intracranial hypertension

  2019cites this paper
• Cerebrospinal fluid opening pressure: The effect of body mass index and body composition.

  2019cites this paper
• Hormonal Fertility Therapy as a Potential Risk Factor for Cerebrospinal Fluid Leak After Endoscopic Endonasal Surgery: A Case Study and Literature Review.

  2019cites this paper
• IIH: Optic Nerve Sheath Fenestration Versus Shunt Placement

  2019cites this paper
• Idiopathic intracranial hypertension in a transgender female.

  2019cites this paper
• European Headache Federation guideline on idiopathic intracranial hypertension

  2018cites this paper
• Adult outcome in pediatric hydrocephalus

  2018cites this paper
• An Up to Date Review of Pseudotumor Cerebri Syndrome

  2018cites this paper
• Altered brain microstructure in association with repetitive subconcussive head impacts and the potential protective effect of jugular vein compression: a longitudinal study of female soccer athletes

  2018cites this paper
• Update on Idiopathic Intracranial Hypertension

  2018cites this paper
• Learning pharmacokinetic models for in vivo glucocorticoid activation.

  2018cites this paper
• Pediatric Pseudotumor Cerebri Syndrome: Diagnosis, Classification, and Underlying Pathophysiology.

  2017cites this paper
• Idiopathic Intracranial Hypertension: Prognostic Factors and Multidisciplinary Management

  2017cites this paper
• Current concepts and strategies in the diagnosis and management of idiopathic intracranial hypertension in adults

  2017cites this paper
• Factors affecting cerebrospinal fluid opening pressure in patients with spontaneous intracranial hypotension

  2017cites this paper