Flow of Fluids in the Brain Reveals New Treatment of Intracranial Pressure – University of Copenhagen

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24 August 2017

Flow of Fluids in the Brain Reveals New Treatment of Intracranial Pressure

Skull pressure

Brain conditions involving high pressure in the skull have always been very difficult to treat. Now a new study by researchers from the University of Copenhagen, among others, has studied the flow of fluids in the brain using rat models and shown that diabetes medicine is able to reduce intracranial pressure. According to the researchers, the results should lead to more tests on both animal and human subjects.

High pressure in the skull and thus on the brain is a serious condition. It can emerge as a result of acute problems such as a concussion or cerebral haemorrhage. But high pressure in the brain can also emerge gradually over a longer period of time, for example in connection with the condition hydrocephalus, also known as water on the brain. Today the only treatment for this condition is mechanical, which can include inserting a drainage tube to remove fluid from the cranial cavity.

However, in a new study published in the scientific journal Science Translational Medicine researchers from the University of Copenhagen and the University of Birmingham have now discovered an easier way of easing intracranial pressure. In isolated trials with rat tissue samples the researchers were able to map the mechanism behind fluid exchange in the brain. This knowledge has led to the discovery that a new diabetes medicine can reduce intracranial pressure among live rats suffering from hydrocephalus.

‘We learned that the diabetes medicine exedin-4 could reduces the flow of sodium, which is strongly connected to the flow of fluids into the cranial cavity. And being able to reduce the inflow of fluids, we were also able to lower the intracranial pressure’, says one of the authors of the study, Clinical Professor at the Department of Clinical Medicine at the University of Copenhagen Rigmor H. Jensen.

About the Condition

In Denmark around 650 new-borns are affected by the condition hydrocephalus each year. It is rarer among adults. The brain fluid of individuals suffering from hydrocephalus is not regulated optimally and is thus prevented from exiting the cranial cavity. The skulls of new-borns are still flexible, and in some cases their heads can therefore become swollen due to the large amount of fluid. Untreated hydrocephalus can cause severe headaches, nausea, dizziness, paralyses, visual disorder and, at worst, death.

Source: Professor Rigmor H. Jensen



Result After 30 Minutes
The fluid balance in the brain is regulated by the cobweb-like tissue plexus choroideus. The researchers examined such tissue samples from rats in isolated trials focussing on the flow of fluids through the cells, as they knew that brain fluids flow from the blood through plexus choroideus to the cranial cavity, where it is called cerebrospinal fluid. In these isolated trials the researchers showed that the transport of sodium is vital to the flow of fluids.

Subsequently, the researchers were able to show, using live rats, that the diabetes medicine exedin-4 can be used to lower the pressure in the skull by reducing the transport of sodium – first in healthy rats and then in rats with hydrocephalus. In both cases the medicine worked, reducing the pressure significantly after just 30 minutes.

The Medicine Is Already in Use
According to the researchers, this suggests that the same type of medicine may in the future be used to treat hydrocephalus if it turns out to have the same effect on humans as on rats.

‘This type of medicine is already used to treat diabetes, which means that tests have shown that it is safe to use. On that basis we should use this medicine in tests on humans suffering from too high pressure in the skull. We expect to get similar results, but of course this requires more research’, says Rigmor H. Jensen who also works at The Danish Headache Center at Rigshospitalet - Glostrup.

She stresses that the researchers need more knowledge of this type of brain condition in general. But she hopes they will be able to find similar results and thus safe forms of treatment for conditions like hydrocephalus. At present the same team of researchers is in the process of testing whether the same applies to idiopathic intracranial hypertension, a serious condition often seen among young, overweight individuals.

Read the entire study: ”A glucagon-like peptide-1 receptor agonist reduces intracranial pressure in a rat model of hydrocephalus”

Contact information
Professor Rigmor H. Jensen
Email: rigmor.jensen@regionh.dk
Phone: +45 38 63 30 59