Ouabain-Pseudotumor Project

Idiopathic intracranial hypertension (IIH, also known as pseudotumor cerebri) is a chronic headache condition caused by increased pressure within the brain (i.e., elevated intracranial pressure). Our previous study [Borsody M, Semenov I, Carroll K, et al. Headache 46: 2006; 1255-60] discovered that the elevated intracranial pressure of IIH may be related to abnormal brain levels of the steroid ouabain, as measured in cerebrospinal fluid samples. However, that study was not large enough to adequately test such a relationship. Thus, it is the specific aim of this research proposal to determine if there is any correlation between ouabain levels in cerebrospinal fluid and intracranial pressure in IIH patients.

Lumbar puncture will be performed in IIH patients as a routine part of their diagnostic and therapeutic healthcare. Using an enzyme-linked immunosorbant assay (ELISA), ouabain concentration will be measured in cerebrospinal fluid samples taken from the IIH patients during lumbar puncture. Intracranial pressure will also be measured by manometry. Correlation between ouabain concentration in the cerebrospinal fluid and intracranial pressure will then be determined by regression analysis. We plan to enroll 30 IIH patients.

The long-term objective of our research program is to identify the pathophysiological mechanism by which intracranial pressure becomes elevated in IIH. Knowing this mechanism may then allow for development of an effective, target-directed treatment for IIH.