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  Identification of the upward movement of human CSF in vivo and its relation to the brain venous system.

Dreha-Kulaczewski, S., Joseph, A. A., Merboldt, K. D., Ludwig, H. C., Gärtner, J., & Frahm, J. (2017). Identification of the upward movement of human CSF in vivo and its relation to the brain venous system. Journal of Neuroscience, 37(9), 2395-2402. doi:10.1523/JNEUROSCI.2754-16.2017.

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Item Permalink: http://hdl.handle.net/11858/00-001M-0000-002D-09FE-5 Version Permalink: http://hdl.handle.net/21.11116/0000-0001-1EA2-7
Genre: Journal Article

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Dreha-Kulaczewski, S., Author
Joseph, A. A.1, Author              
Merboldt, K. D.1, Author              
Ludwig, H. C., Author
Gärtner, J., Author
Frahm, J.1, Author              
Affiliations:
1Biomedical NMR Research GmbH, MPI for biophysical chemistry, Max Planck Society, ou_578634              

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Free keywords: CSF; human; in vivo flow; phase-contrast real-time MRI; respiration
 Abstract: CSF flux is involved in the pathophysiology of neurodegenerative diseases and cognitive impairment after traumatic brain injury, all hallmarked by the accumulation of cellular metabolic waste. Its effective disposal via various CSF routes has been demonstrated in animal models. In contrast, the CSF dynamics in humans are still poorly understood. Using novel real-time MRI, forced inspiration has been identified recently as a main driving force of CSF flow in the human brain. Exploiting technical advances toward real-time phase-contrast MRI, the current work analyzed directions, velocities, and volumes of human CSF flow within the brain aqueduct as part of the internal ventricular system and in the spinal canal during respiratory cycles. A consistent upward CSF movement toward the brain in response to forced inspiration was seen in all subjects at the aqueduct, in 11/12 subjects at thoracic level 2, and in 4/12 subjects at thoracic level 5. Concomitant analyses of CSF dynamics and cerebral venous blood flow, that is, in epidural veins at cervical level 3, uniquely demonstrated CSF and venous flow to be closely communicating cerebral fluid systems in which inspiration-induced downward flow of venous blood due to reduced intrathoracic pressure is counterbalanced by an upward movement of CSF. The results extend our understanding of human CSF flux and open important clinical implications, including concepts for drug delivery and new classifications and therapeutic options for various forms of hydrocephalus and idiopathic intracranial hypertension.

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Language(s): eng - English
 Dates: 2017-01-302017-03-01
 Publication Status: Published in print
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 Table of Contents: -
 Rev. Method: Peer
 Identifiers: DOI: 10.1523/JNEUROSCI.2754-16.2017
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Title: Journal of Neuroscience
Source Genre: Journal
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Pages: - Volume / Issue: 37 (9) Sequence Number: - Start / End Page: 2395 - 2402 Identifier: -