Connar Stanley James Westgate

IIH is a disorder in which increased fluid pressure in the brain causes a number of distressing symptoms and complications:

‘IIH typically causes severe headache that does not respond to ordinary pain relievers, as well as vision problems in the form of visual disturbances. It typically affects young, overweight women around the age of 30, who then have problems coping with a full-time job and family life,’ says Connar Stanley James Westgate, postdoc at the Danish Headache Center, Rigshospitalet.

He has just been awarded the Lundbeck Foundation's Talent Prize 2023 for his research investigating changes in metabolism associated with this disorder, which is rare, but over-represented in women of fertile age.

The problem is that little is known about the disorder (see Fact Box).

‘In seeking answers, I conducted purely biochemical investigations of women affected by IIH and clinical obesity – meaning a BMI of 30 or more – and compared the results with data from women affected by obesity but not IIH. I did this by investigating the content of hormones and proteins in samples of blood, urine and lipids,’ says Westgate, who originally worked in Birmingham before moving to Denmark.

He explains that he is driven by the thrill of making new discoveries, and by a belief that what he does is meaningful for patients. So far, he has achieved both, in that his findings show that obesity in women is caused by an abnormal metabolism, and consequently not something they have control over:

‘We demonstrated that patients with IIH are predisposed to excess weight gain, and this is of value because the patients in this category are told to lose weight. But if your body is programmed to store fat instead of burn it, which is the case here, then dieting is doomed to failure. That matters to the patients, who can now say they are doing nothing wrong, and that their overweight is caused by their disorder,’ says Westgate.

An underlying cause

Another line of his research is about understanding the biology behind IIH and the main cause of the increased fluid pressure in the brain.

‘My theory is that the increased fluid pressure in the brain is a symptom of something else like an underlying disorder that we aren’t currently able to detect. In addition, I’m trying to find the biological cause of swelling of the retina of the eye, which can cause vision loss, and in extreme cases blindness. In our study, we’ve demonstrated that obesity in female rats increases fluid pressure in the brain and causes retinal degeneration in the eye,’ Westgate explains. 

Aside from the hope that his research within IIH will result in improved diagnostics and treatment, there is also a bigger perspective in that IIH is ideal for modelling what happens when the fluid pressure increases due to various factors in the brain.

‘Increased fluid pressure in the brain is a disorder that can be caused by countless medical conditions, such as stroke or brain tumour, that are difficult to simulate in experimental animals. In our case, the IIH model can be used to understand what happens when the fluid pressure in the brain increases, which can also occur when young, active individuals like myself sustain a blow to the head, for example. Unfortunately, we’re many years behind compared with other disorders,’ he says.