Evidence map›Paper›PMID 40781762›Full record

SynthesisHeadache2025

Cerebrospinal fluid and serum biomarkers in idiopathic intracranial hypertension: A systematic review.

Marina Romozzi, Fabio Zeoli, Renata Martinelli, Federico Tosto, Antonio Funcis, Giuseppe Garignano, Sabrina Chiloiro, Lucia Di Nardo, Catello Vollono, Alessandro Olivi and 2 more

Abstract readSystematic Review
In one paragraph

Synthesis in Headache, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Marina RomozziDepartment of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy.ORCID 0000-0001-6016-3141
Fabio ZeoliDepartment of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Renata MartinelliDepartment of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Federico TostoDepartment of Neuroscience, "Giovanni Paolo II" Hospital, Catanzaro, Italy.
Antonio FuncisDepartment of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy.
Giuseppe GarignanoRadiology and Neuroradiology Unit, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Sabrina ChiloiroDipartimento Di Medicina Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.
Lucia Di NardoDermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.
Catello VollonoDepartment of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy.
Alessandro OliviDepartment of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Paolo CalabresiDepartment of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy.
Francesco SignorelliDepartment of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aimed to systematically review the literature on soluble biomarkers in adults with idiopathic intracranial hypertension (IIH).

backgroundIdiopathic intracranial hypertension is a multifactorial disorder marked by elevated intracranial pressure without a clear cause. Although it primarily affects overweight women of reproductive age, its pathogenesis remains incompletely understood. Symptoms include headache and visual disturbances due to papilledema. Increasing attention has focused on soluble biomarkers in serum and to understand disease mechanisms and aid diagnosis and management.

methodsThis systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered in PROSPERO (CRD420250630653). The systematic literature search was conducted across PubMed, Web of Science, and Scopus for studies published in English between January 1995 and December 2024. Articles investigating cerebrospinal fluid (CSF) and/or blood biomarkers in adult patients with IIH were included. Multiple reviewers independently conducted screening, data extraction, and quality assessment. The risk of bias was evaluated using the ROBINS-I tool.

resultsA total of 38 studies on serum/plasma, urine, and CSF biomarkers met the inclusion criteria. The identified biomarkers were categorized into five main groups: (1) metabolic/endocrine, (2) systemic and neurogenic inflammation, (3) neurodegeneration, (4) neural antibodies and CSF dynamics, and (5) miscellaneous. Consistently elevated leptin levels were reported across studies, alongside evidence of cortisol dysregulation, altered androgen profiles, and insulin resistance. Inflammatory markers were frequently elevated, indicating a state of low-grade systemic inflammation; however, findings regarding specific inflammatory markers were variable and lacked consistency. Two studies evaluated calcitonin gene-related peptide (CGRP) in plasma, finding elevated levels in IIH, especially in those with migraine-like headache. Neuronal markers like neurofilament light chain (NfL) were increased and correlated with disease severity. Emerging candidates included microRNAs, metabolites identified through metabolomic approaches, and novel proteins discovered via proteomic analyses.

conclusionsIIH appears to involve interplay of inflammatory, metabolic, and neurodegenerative processes. Although androgen dysregulation, leptin, and NfL show the most consistent association, substantial heterogeneity in study methods and populations limits generalizability. CGRP may emerge as a promising biomarker reflecting the predominant clinical symptom-headache-potentially guiding future therapeutic strategies.

Indexed as

BiomarkersPseudotumor CerebriHumansBiomarkerscalcitonin gene‐related peptideheadacheidiopathic intracranial hypertensionpapilledemapseudotumor cerebri

Identifiers

PMID40781762
PMCPMC12455426

What OpenQuestion holds

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Registered trials

None linked

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.