ArticleFluids and barriers of the CNS2022
Acetazolamide modulates intracranial pressure directly by its action on the cerebrospinal fluid secretion apparatus.
Article in Fluids and barriers of the CNS, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 65 citations in OpenAlex.
- Effectiveness of Topiramate Versus Acetazolamide in the Management of Idiopathic Intracranial Hypertension: ASystematic Review and Meta-Analysis.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Review
- High-Altitude Hypoxia Injury: Systemic Mechanisms and Intervention Strategies on Immune and Inflammatory Responses.Antioxidants (Basel, Switzerland) · 2025Review
- Cerebrospinal fluid proteomic analysis of long-term antihypertensive treatment with amlodipine and atenolol in hypertensive rats.Scientific reports · 2025Article
- Indirect Deuterium Displacement Exchange Imaging for Noninvasive High-Resolution CSF Production Mapping.bioRxiv : the preprint server for biology · 2025Article
- The Role of Choroid Plexus in Hydrocephalus from the Perspective of Structure and Function: a Therapeutic Target.Molecular neurobiology · 2025Review
- Molecular characterization of benign intracranial glioependymal and arachnoid cysts suggest heterogeneous mechanisms of action.Journal of neuropathology and experimental neurology · 2025Article
- The Cerebrospinal Fluid Secretion Rate Increases in Awake and Freely Moving Rats but Differs With Experimental Methodology.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Sodium bicarbonate use in the treatment of idiopathic intracranial hypertension.Eye (London, England) · 2025Article
- The NaAdvanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Covert cerebrospinal fluid dynamics dysfunction: evolution from conventional to innovative therapies.Frontiers in neurology · 2025Review
- Acetazolamide for Idiopathic Intracranial Hypertension: An Up-to-Date Review in 2025.Eye and brain · 2025Review
- Effectiveness of Acetazolamide in Patients With Heart Failure: A Systematic Review and Meta-Analysis.Cureus · 2024Review
- Relaxation-exchange magnetic resonance imaging (REXI): a non-invasive imaging method for evaluating trans-barrier water exchange in the choroid plexus.Fluids and barriers of the CNS · 2024Article
- Role of Acetazolamide in Traumatic CSF Rhinorrhea and Otorrhea: A Randomized Controlled Trial.Asian journal of neurosurgery · 2024Article
- CSF hyperdynamics in rats mimicking the obesity and androgen excess characteristic of patients with idiopathic intracranial hypertension.Fluids and barriers of the CNS · 2024Article
- The Effects of Acetazolamide on Cerebral Hemodynamics in Adult Patients with an Acute Brain Injury: A Systematic Review.Brain sciences · 2023Review
- Cycle-dependent sex differences in expression of membrane proteins involved in cerebrospinal fluid secretion at rat choroid plexus.BMC neuroscience · 2023Article
- Nocturnal increase in cerebrospinal fluid secretion as a circadian regulator of intracranial pressure.Fluids and barriers of the CNS · 2023Article
- Modelling idiopathic intracranial hypertension in rats: contributions of high fat diet and testosterone to intracranial pressure and cerebrospinal fluid production.Fluids and barriers of the CNS · 2023Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundElevated intracranial pressure (ICP) is observed in many neurological pathologies, e.g. hydrocephalus and stroke. This condition is routinely relieved with neurosurgical approaches, since effective and targeted pharmacological tools are still lacking. The carbonic anhydrase inhibitor, acetazolamide (AZE), may be employed to treat elevated ICP. However, its effectiveness is questioned, its location of action unresolved, and its tolerability low. Here, we determined the efficacy and mode of action of AZE in the rat .
methodsWe employed in vivo approaches including ICP and cerebrospinal fluid secretion measurements in anaesthetized rats and telemetric monitoring of ICP and blood pressure in awake rats in combination with ex vivo choroidal radioisotope flux assays and transcriptomic analysis.
resultsAZE effectively reduced the ICP, irrespective of the mode of drug administration and level of anaesthesia. The effect appeared to occur via a direct action on the choroid plexus and an associated decrease in cerebrospinal fluid secretion, and not indirectly via the systemic action of AZE on renal and vascular processes. Upon a single administration, the reduced ICP endured for approximately 10 h post-AZE delivery with no long-term changes of brain water content or choroidal transporter expression. However, a persistent reduction of ICP was secured with repeated AZE administrations throughout the day.
conclusionsAZE lowers ICP directly via its ability to reduce the choroid plexus CSF secretion, irrespective of mode of drug administration.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.