2021 ABN Andreas Yiangou

Dr Andreas Yiangou

2021 ABN Fellowship

Mechanisms and therapeutics for headache in Idiopathic Intracranial Hypertension

What is Idiopathic Intracranial Hypertension (IIH)?

IIH is a chronic condition of raised brain pressure occurring in young and often overweight women. Increasing numbers of women are diagnosed with IIH, along with the growing obesity epidemic. Patients can suffer blindness but the much more frequent debilitating issue are long-term, disabling headaches that chronically diminish the quality of life in affected women.

The Issue

There are currently no specific treatments for IIH headache, and we don’t understand the underlying causes.

The Plan

Use detailed physiological assessments in patients to gain understanding of IIH headaches and potential drug targets. Our clinical work suggests that blocking calcitonin gene-related peptide (pain chemical) in IIH can improve headaches. We will explore in detail the role of calcitonin gene-related peptide by administering this chemical to patients (well-known procedure) and assessing if it will cause typical IIH headache. Importantly, we will gain unique understanding by monitoring brain pressure changes and brain blood flow during headaches. Our previous work has shown that a novel drug approach (glucagon-like peptide-1 receptor agonists) can reduce brain pressure. We will evaluate if this drug can reduce brain pressure and headache in IIH.

The Solution?

This work provides novel insights into fundamental headache mechanisms in raised brain pressure to guide future treatment approaches. Evaluation of the role of calcitonin gene-related peptide in IIH headache would have direct relevance on future patient care as drugs that block calcitonin gene-related peptide are currently used. We will also evaluate the therapeutic potential of reducing brain pressure.


Idiopathic intracranial hypertension: a step change in understanding the disease mechanisms

Yiangou A, Mollan SP, Sinclair AJ

Nature Reviews Neurology 2023 Dec;19(12):769-785. doi: 10.1038/s41582-023-00893-0. Epub 2023 Nov 13. PMID: 37957260


The Impact of Valsalva Manoeuvres and Exercise on Intracranial Pressure and Cerebrovascular Dynamics in Idiopathic Intracranial Hypertension

Yiangou A, Weaver SRC, Thaller M, Mitchell JL , Lyons HS, Tsermoulas G, Mollan SP, Lucas SJE, Sinclair AJ

Neuro-Ophthalmology, DOI: 10.1080/01658107.2023.2281433