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  • Bariatric Surgery...

Bariatric Surgery Reduces intracranial pressure in IIH, says JAMA study

Written By : Josepha James |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-06-14T09:15:47+05:30  |  Updated On 14 Jun 2021 11:02 AM IST
Bariatric Surgery Reduces intracranial pressure in IIH, says JAMA study
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The incidence of idiopathic intracranial hypertension (IIH) is increasing and has been associated with increasing obesity rates worldwide. The condition predominately affects women aged 25 to 36 years, with weight gain being a major risk factor. A study suggests that among women with idiopathic intracranial hypertension and a body mass index of 35 or higher, bariatric surgery is an effective treatment to reduce intracranial pressure and for sustained disease remission. The study findings were published in the JAMA Neurology on April 26, 2021.

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 and prevent relapse. Community weight management interventions (excluding very low-energy diets) have been associated with modest weight loss (approximately 5%). Bariatric surgery has been associated with sustained long-term weight loss (25%-30%) as well as positive cardiovascular and metabolic outcomes. Dr Alexandra J. Sinclair and his team conducted a study to compare the effectiveness of bariatric surgery with that of a community weight management (CWM) intervention for the treatment of patients with active IIH.

It was a 5-year randomized clinical trial (Idiopathic Intracranial Hypertension Weight Trial) of 66 women with active IIH and a body mass index of 35 or higher at 5 National Health Service hospitals in the UK between March 1, 2014, and May 25, 2017. The researchers randomized the women to either bariatric surgery (n = 33) or CWM intervention (Weight Watchers) (n = 33). The major outcome assessed was a change in intracranial pressure measured by lumbar puncture opening pressure at 12 months, as evaluated in an intention-to-treat analysis. The researchers also assessed the lumbar puncture opening pressure at 24 months as well as visual acuity, contrast sensitivity, perimetric mean deviation, and quality of life at 12 and 24 months.

Key findings of the study were:

  • Upon analysis, the researchers found that intracranial pressure was significantly lower in the bariatric surgery arm at 12 months (adjusted mean [SE] difference, −6.0 [1.8] cm cerebrospinal fluid [CSF) and at 24 months (adjusted mean [SE] difference, −8.2 [2.0] cm CSF).
  • In the per-protocol analysis, they found that intracranial pressure was significantly lower in the bariatric surgery arm at 12 months (adjusted mean [SE] difference, −7.2 [1.8] cm CSF) and at 24 months (adjusted mean [SE] difference, −8.7 [2.0] cm CSF).
  • They noted that the weight was significantly lower in the bariatric surgery arm at 12 months (adjusted mean [SE] difference, −21.4 [5.4] kg) and at 24 months (adjusted mean [SE] difference, −26.6 [5.6] kg).
  • They also noted significant improvement in the quality of life at 12 months (adjusted mean [SE] difference, 7.3 [3.6) and 24 months (adjusted mean [SE] difference, 10.4 [3.8) in the bariatric surgery arm.

The authors concluded, "In this randomized clinical trial, bariatric surgery was superior to a CWM intervention in lowering intracranial pressure. The continued improvement over the course of 2 years shows the impact of this intervention with regard to sustained disease remission."

For further information:

https://jamanetwork.com/journals/jamaneurology/fullarticle/2778650


JAMA NeurologyBariatric SurgeryCommunity Weight Management InterventionIdiopathic Intracranial Hypertensionintracranial pressureobesitySusan P. Mollan
Article Source :  JAMA Neurology
Josepha James
Josepha James

    Josepha James (Msc Cinical Research) joined Medical Dialogues as a writer in Medical News Section in 2020 . She covers news in several medical specialties from both national and international journals and associations. She has completed Bachelors in Physician Assistant and then pursued Masters in Clinical Research. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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