Evaluation of relationship between androgen levels and cerebrospinal fluid opening pressure in women diagnosed with idiopathic intracranial hypertension

Abstract

Objective: In this study, we evaluated the relationship of plasma and cerebrospinal fluid (CSF) testosterone and dehydroepiandrosterone sulfate (DHEA-S) levels with CSF opening pressure in women diagnosed with idiopathic intracranial hypertension (IIH).

Method: We prospectively evaluated 52 female patients (aged 15-45 years) diagnosed with IIH according to modified Dandy criteria. In the plasma and CSF samples collected simultaneously, testosterone and DHEA-S levels were measured using chemiluminescence microparticle immunoassay (CMIA). The patients were assigned into two groups based on CSF opening pressure. The hormone levels were compared and correlation and ROC analyses were performed.

Results: In the group with high CSF pressure (≥ 40 cmH₂O), the plasma testosterone, plasma DHEA-S and CSF testosterone levels were found to be significantly higher (p<0.05). In addition, strong positive correlations were observed with CSF opening pressure and plasma testosterone (r=0.856), CSF testosterone (r=0.870) and plasma DHEA-S (r=0.915) levels. In the ROC analysis, the cut-off value was determined as ≥ 3.45 nmol/L for plasma testosterone, ≥ 295 µg/dL for plasma DHEA-S and ≥ 0.08 nmol/L for CSF testosterone.

Conclusion: Plasma testosterone and DHEA-S levels showed a significant relationship with CSF opening pressure. These findings suggest that plasma androgen levels can be used as a potential biomarker to predict intracranial pressure in a non-invasive manner.