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Effect of glucagon like peptide-1 receptor agonist exenatide, used as an intracranial pressure lowering agent, on cognition in Idiopathic Intracranial Hypertension
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Effect of glucagon like peptide-1 receptor agonist exenatide, used as an intracranial pressure lowering agent, on cognition in Idiopathic Intracranial Hypertension
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Effect of glucagon like peptide-1 receptor agonist exenatide, used as an intracranial pressure lowering agent, on cognition in Idiopathic Intracranial Hypertension
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Journal Article
Effect of glucagon like peptide-1 receptor agonist exenatide, used as an intracranial pressure lowering agent, on cognition in Idiopathic Intracranial Hypertension
2024
Overview
Background
Cognitive function can be affected in conditions with raised intracranial pressure (ICP) such as idiopathic intracranial hypertension (IIH). Drugs used off label to treat raised ICP also have cognitive side effects, underscoring the unmet need for effective therapeutics which reduce ICP without worsening cognition. The Glucagon Like Peptide-1 (GLP-1) receptor agonist, exenatide, has been shown to significantly reduce ICP in IIH, therefore this study aimed to determine the effects of exenatide on cognition in IIH.
Methods
This was an exploratory study of the IIH:Pressure trial (ISTCRN 12678718). Women with IIH and telemetric ICP monitors (n = 15) were treated with exenatide (n = 7) or placebo (n = 8) for 12 weeks. Cognitive function was tested using the National Institute of Health Toolbox Cognitive Battery at baseline and 12 weeks.
Results
Cognitive performance was impaired in fluid intelligence ((T-score of 50 = population mean), mean (SD) 37.20 (9.87)), attention (33.93 (7.15)) and executive function (38.07 (14.61)). After 12-weeks there was no evidence that exenatide compromised cognition (no differences between exenatide and placebo). Cognition improved in exenatide treated patients in fluid intelligence (baseline 38.4 (8.2), 12 weeks 52.9 (6.6),
p
= 0.0005), processing speed (baseline 43.7 (9.4), 12 weeks 58.4 (10.4),
p
= 0.0058) and episodic memory (baseline 49.4 (5.3), 12 weeks 62.1 (13.2),
p
= 0.0315).
Conclusions
In patients with raised ICP due to IIH, exenatide, a drug emerging as an ICP lowering agent, does not adversely impact cognition. This is encouraging and has potential to be relevant when considering prescribing choices to lower ICP.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Adult
/ Agonists
/ Female
/ Glucagon
/ Glucagon-Like Peptide-1 Receptor Agonists
/ Humans
/ Hypoglycemic Agents - therapeutic use
/ Intracranial Pressure - drug effects
/ Medicine
/ Peptides
/ Pharmaceutical Sciences/Technology
/ Placebos
/ Pseudotumor Cerebri - drug therapy
/ Pseudotumor Cerebri - physiopathology
/ Surgery
