Phase contrast MRI measurements of net cerebrospinal fluid flow through the cerebral aqueduct are confounded by respiration

Spijkerman, J.M.; Geurts, Lennart J.; Siero, Jeroen C.W.; Hendrikse, Jeroen; Luijten, Peter R.; Zwanenburg, Jaco J.M.

doi:10.1002/jmri.26181

Cited by 55 publications

(61 citation statements)

References 38 publications

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“…Also, future studies should include multiple PC sequences with different velocity encodings which would allow simultaneous examination of the changes within CSF fluid dynamics together with hemodynamic measures of the arterial and venous counterparts. Changes in AoS velocity, pressure gradients, and flow measures due to heart cycle changes, respiration or exercise should be monitored in future studies [36]. As such, a recent study demonstrated that respiratory-induced pressure gradients-the force driving the net CSF flow through the AoS-dominate over the cardiac component which is responsible for more frequent and pulsatile peak flow rates [37].…”

Section: Discussionmentioning

confidence: 99%

Longitudinal analysis of cerebral aqueduct flow measures: multiple sclerosis flow changes driven by brain atrophy

Jakimovski

Zivadinov

Weinstock‐Guttman

et al. 2020

Fluids Barriers CNS

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Background: Several small cross-sectional studies have investigated cerebrospinal fluid (CSF) flow dynamics in multiple sclerosis (MS) patients and have reported mixed results. Currently, there are no longitudinal studies that investigate CSF dynamics in MS patients. Objective: To determine longitudinal changes in CSF dynamics measured at the level of aqueduct of Sylvius (AoS) in MS patients and matched healthy controls (HCs). Materials and methods: Forty (40) MS patients and 20 HCs underwent 3T MRI cine phase contrast imaging with velocity-encoded pulse-gated sequence at baseline and 5-year follow-up. For atrophy determination, MS patients underwent additional high-resolution 3D T1-weighted imaging. Measures of AoS cross-sectional area (CSA), average systolic and diastolic velocity peaks, maximal systolic and diastolic velocity peaks and average CSF flow rates were determined. Brain atrophy and ventricular CSF (vCSF) expansion rates were determined. Cross-sectional and longitudinal changes were derived by analysis of covariance (ANCOVA) and paired repeated tests. Confirmatory general linear models were also performed. False discovery rate (FDR)-corrected p-values lower than 0.05 were considered significant. Results: The MS population demonstrated significant increase in maximal diastolic peak (from 7.23 to 7.86 cm/s, non-adjusted p = 0.037), diastolic peak flow rate (7.76 ml/min to 9.33 ml/min, non-adjusted p = 0.023) and AoS CSA (from 3.12 to 3.69 mm 2 , adjusted p = 0.001). The only differentiator between MS patients and HCs was the greater AoS CSA (3.58 mm 2 vs. 2.57 mm 2 , age-and sex-adjusted ANCOVA, p = 0.045). The AoS CSA change was associated with vCSF expansion rate (age-and sex-adjusted Spearman's correlation r = 0.496, p = 0.019) and not with baseline nor change in maximal velocity. The expansion rate of the vCSF space explained an additional 23.8% of variance in change of AoS CSA variance when compared to age and sex alone (R 2 = 0.273, t = 2.557, standardized β = 0.51, and p = 0.019). Conclusion: MS patients present with significant longitudinal AoS enlargement, potentially due to regional atrophy changes and ex-vacuo expansion of the aqueduct.

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Section: Discussionmentioning

confidence: 99%

Longitudinal analysis of cerebral aqueduct flow measures: multiple sclerosis flow changes driven by brain atrophy

Jakimovski

Zivadinov

Weinstock‐Guttman

et al. 2020

Fluids Barriers CNS

View full text Add to dashboard Cite

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“…Yildiz et al found that respiratory effects are averaged out at conventional, cardiac-gated PC-MRI compared to real-time PC-MRI ( Yildiz et al, 2017 ). Furthermore, in a recent study, Spijkerman et al used respiratory gated PC-MRI and found that net CSF flow quantity at the aqueductal level was affected by breathing in healthy subjects, but did not affect conclusion about net flow direction ( Spijkerman et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Cerebrospinal fluid volumetric net flow rate and direction in idiopathic normal pressure hydrocephalus

Lindstrøm

Ringstad

Mardal

et al. 2018

NeuroImage: Clinical

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The aim of the present study was to examine cerebrospinal fluid (CSF) volumetric net flow rate and direction at the cranio-cervical junction (CCJ) and cerebral aqueduct in individuals with idiopathic normal pressure hydrocephalus (iNPH) using cardiac-gated phase-contrast magnetic resonance imaging (PC-MRI). An in-depth, pixel-by-pixel analysis of regions of interest from the CCJ and cerebral aqueduct, respectively, was done in 26 iNPH individuals, and in 4 healthy subjects for validation purposes. Results from patients were compared with over-night measurements of static and pulsatile intracranial pressure (ICP). In iNPH, CSF net flow at CCJ was cranially directed in 17/22 as well as in 4/4 healthy subjects. Estimated daily CSF volumetric net flow rate at CCJ was 6.9 ± 9.9 L/24 h in iNPH patients and 4.5 ± 5.0 L/24 h in healthy individuals. Within the cerebral aqueduct, the CSF net flow was antegrade in 7/21 iNPH patients and in 4/4 healthy subjects, while it was retrograde (i.e. towards ventricles) in 14/21 iNPH patients. Estimated daily CSF volumetric net flow rate in cerebral aqueduct was 1.1 ± 2.2 L/24 h in iNPH while 295 ± 53 mL/24 h in healthy individuals. Magnitude of cranially directed CSF net flow in cerebral aqueduct was highest in iNPH individuals with signs of impaired intracranial compliance. The study results indicate CSF flow volumes and direction that are profoundly different from previously assumed. We hypothesize that spinal CSF formation may serve to buffer increased demand for CSF flow through the glymphatic system during sleep and during deep inspiration to compensate for venous outflow.

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“…It represents a recent acquisition intended to modify the theories on the pathogenesis of hydrocephalus (dilation of the ventricular system) the fact that the cerebrospinal fluid is reabsorbed partly through the lymphatic system of the nasal mucosa (in fact the cerebral parenchyma does not contain lymphatic vessels) to which it reaches following the subarachnoid spaces that line the olfactory bulbs. The cerebro-spinal liquid flow analysis with Phase Contrast Magnetic Resonance Imaging (PCMRI) [149] [150], shows that the CSF circulation at the level of the ventricular system and of the subarachnoid spaces is a dynamic oscillatory process synchronized with cardiac contractions. To better define this process we can imagine that the brain "pulsates" continuously, driven by cardiac contractions.…”

Section: The Proton Motive Force and Protons Role In Biological Liquimentioning

confidence: 99%

Deep into the Water: Exploring the Hydro-Electromagnetic and Quantum-Electrodynamic Properties of Interfacial Water in Living Systems

Messori¹

2019

OALib

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Normal water structures are maintained largely by interactions with biomacromolecular surfaces and weak electromagnetic fields, which enable extended networks for electron and proton conductivity. All standard chemistry is totally reliant on electrostatics and avoids all mention of electrodynamics and the consequent radiation field, which is supporting the notion of water as a primary mediator of biological effects induced via electromagnetic means into living systems. Quantum Electrodynamic (QED) field theory have produced a vision of water in a liquid state as a medium, which for a peculiarity of its molecular electronic spectrum reveals itself as an essential tool for long-range communications, being able to change its supra-molecular organization in function of the interaction with the environment. This paper draws attention to the fact that interfacial water (nanoscale confined water) has been shown, independently by Emilio Del Giudice et al. and by Gerald Pollack et al., to contain respectively Coherence Domains (CDs) and Exclusion Zones (EZs), which may be regarded as long-range ensembles of CDs, dynamic aqueous structures, which uses the special properties of water, such as its electron/proton dynamics and organized response to electromagnetic fields, to receive electromagnetically encoded signals endowed with coherence (negentropy) at a low frequency, and sum the resultant excitations, so as to foster the redistribution of that coherence at frequencies which may affect biological systems. The phase transition of water from the ordinary coherence of its liquid state (bulk water) to the semi-crystalline or glassy and super-coherent How to cite this paper: Messori, C. (2019) Deep into the Water: Exploring the Hydro-Electromagnetic and Quantum-Electrodynamic Properties of Interfacial

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Phase contrast MRI measurements of net cerebrospinal fluid flow through the cerebral aqueduct are confounded by respiration

Abstract: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.

Cited by 55 publications

References 38 publications

Longitudinal analysis of cerebral aqueduct flow measures: multiple sclerosis flow changes driven by brain atrophy

Longitudinal analysis of cerebral aqueduct flow measures: multiple sclerosis flow changes driven by brain atrophy

Cerebrospinal fluid volumetric net flow rate and direction in idiopathic normal pressure hydrocephalus

Deep into the Water: Exploring the Hydro-Electromagnetic and Quantum-Electrodynamic Properties of Interfacial Water in Living Systems

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