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Pierobon Mays G, Hett K, Eisma J, McKnight CD, Elenberger J, Song AK, Considine C, Richerson WT, Han C, Stark A, Claassen DO, Donahue MJ. Reduced cerebrospinal fluid motion in patients with Parkinson's disease revealed by magnetic resonance imaging with low b-value diffusion weighted imaging. Fluids Barriers CNS 2024; 21:40. [PMID: 38725029 PMCID: PMC11080257 DOI: 10.1186/s12987-024-00542-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Parkinson's disease is characterized by dopamine-responsive symptoms as well as aggregation of α-synuclein protofibrils. New diagnostic methods assess α-synuclein aggregation characteristics from cerebrospinal fluid (CSF) and recent pathophysiologic mechanisms suggest that CSF circulation disruptions may precipitate α-synuclein retention. Here, diffusion-weighted MRI with low-to-intermediate diffusion-weightings was applied to test the hypothesis that CSF motion is reduced in Parkinson's disease relative to healthy participants. METHODS Multi-shell diffusion weighted MRI (spatial resolution = 1.8 × 1.8 × 4.0 mm) with low-to-intermediate diffusion weightings (b-values = 0, 50, 100, 200, 300, 700, and 1000 s/mm2) was applied over the approximate kinetic range of suprasellar cistern fluid motion at 3 Tesla in Parkinson's disease (n = 27; age = 66 ± 6.7 years) and non-Parkinson's control (n = 32; age = 68 ± 8.9 years) participants. Wilcoxon rank-sum tests were applied to test the primary hypothesis that the noise floor-corrected decay rate of CSF signal as a function of b-value, which reflects increasing fluid motion, is reduced within the suprasellar cistern of persons with versus without Parkinson's disease and inversely relates to choroid plexus activity assessed from perfusion-weighted MRI (significance-criteria: p < 0.05). RESULTS Consistent with the primary hypothesis, CSF decay rates were higher in healthy (D = 0.00673 ± 0.00213 mm2/s) relative to Parkinson's disease (D = 0.00517 ± 0.00110 mm2/s) participants. This finding was preserved after controlling for age and sex and was observed in the posterior region of the suprasellar cistern (p < 0.001). An inverse correlation between choroid plexus perfusion and decay rate in the voxels within the suprasellar cistern (Spearman's-r=-0.312; p = 0.019) was observed. CONCLUSIONS Multi-shell diffusion MRI was applied to identify reduced CSF motion at the level of the suprasellar cistern in adults with versus without Parkinson's disease; the strengths and limitations of this methodology are discussed in the context of the growing literature on CSF flow.
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Affiliation(s)
| | - Kilian Hett
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jarrod Eisma
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Colin D McKnight
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jason Elenberger
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alexander K Song
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ciaran Considine
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Wesley T Richerson
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Caleb Han
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Adam Stark
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manus J Donahue
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
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2
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Shao X. Editorial for "Vascular Aging in the Choroid Plexus: A 7T Ultrasmall Superparamagnetic Iron Oxide (USPIO)-MRI Study". J Magn Reson Imaging 2024. [PMID: 38595191 DOI: 10.1002/jmri.29382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/11/2024] Open
Affiliation(s)
- Xingfeng Shao
- Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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3
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Sun Z, Li C, Muccio M, Jiang L, Masurkar A, Buch S, Chen Y, Zhang J, Haacke EM, Wisniewski T, Ge Y. Vascular Aging in the Choroid Plexus: A 7T Ultrasmall Superparamagnetic Iron Oxide (USPIO)-MRI Study. J Magn Reson Imaging 2024. [PMID: 38587279 DOI: 10.1002/jmri.29381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND The choroid plexus (ChP), a densely vascularized structure, has drawn increasing attention for its involvement in brain homeostasis and waste clearance. While the volumetric changes have been explored in many imaging studies, few studies have investigated the vascular degeneration associated with aging in the ChP. PURPOSE To investigate the sub-structural characteristics of the ChP, particularly the vascular compartment using high-resolution 7T imaging enhanced with Ferumoxytol, an ultrasmall super-paramagnetic iron oxide, which greatly increase the susceptibility contrast for vessels. STUDY TYPE Prospective. SUBJECTS Forty-nine subjects without neurological disorders (age: 21-80 years; 42 ± 17 years; 20 females). FIELD STRENGTH/SEQUENCE 7-T with 2D and 3D T2* GRE, 3D MPRAGE T1, 2D TSE T2, and 2D FLAIR. ASSESSMENT The vascular and stromal compartments of the ChP were segmented using K-means clustering on post-contrast 2D GRE images. Visual and qualitative assessment of ChP vascular characteristics were conducted independently by three observers. Vascular density (Volvessel/VolChP ratio) and susceptibility change (Δχ) induced by Ferumoxytol were analyzed on 3D GRE-derived susceptibility-weighted imaging and quantitative susceptibility mapping, respectively. STATISTICAL TESTS Independent t-test, Mann-Whitney U test, and Chi-square test were utilized for group comparisons. The relationship between age and ChP's vascular alterations was examined using Pearson's correlation. Intra-class coefficient was calculated for inter-observer agreement. A P value <0.05 was considered statistically significant. RESULTS 2D GRE images demonstrated superior contrast and accurate delineation of ChP substructures (ICC = 0.86). Older subjects exhibited a significantly smaller vascular density (16.5 ± 4.34%) and lower Δχ (22.10 ± 12.82 ppb) compared to younger subjects (24.85 ± 6.84% and 34.64 ± 12.69 ppb). Vascular density and mean Δχ within the ChP negatively correlated with age (r = -0.48, and r = -0.45). DATA CONCLUSION Ferumoxytol-enhanced 7T images can demonstrate ChP alterations in elderly with decreased vascular density and expansion of nonvascular compartment. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Zhe Sun
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
- Vilcek Institute of Graduate Medical Sciences, NYU Grossman School of Medicine, New York, New York, USA
| | - Chenyang Li
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
- Vilcek Institute of Graduate Medical Sciences, NYU Grossman School of Medicine, New York, New York, USA
| | - Marco Muccio
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
| | - Li Jiang
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
| | - Arjun Masurkar
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Sagar Buch
- Department of Neurology, Wayne State University, Detroit, Michigan, USA
| | - Yongsheng Chen
- Department of Neurology, Wayne State University, Detroit, Michigan, USA
| | - Jiangyang Zhang
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, Michigan, USA
| | - Thomas Wisniewski
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
- Departments of Pathology and Psychiatry, NYU Grossman School of Medicine, New York, New York, USA
| | - Yulin Ge
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
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Visani V, Pizzini FB, Natale V, Tamanti A, Anglani M, Bertoldo A, Calabrese M, Castellaro M. Choroid plexus volume in multiple sclerosis can be estimated on structural MRI avoiding contrast injection. Eur Radiol Exp 2024; 8:33. [PMID: 38409562 PMCID: PMC10897123 DOI: 10.1186/s41747-024-00421-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/11/2023] [Indexed: 02/28/2024] Open
Abstract
We compared choroid plexus (ChP) manual segmentation on non-contrast-enhanced (non-CE) sequences and reference standard CE T1- weighted (T1w) sequences in 61 multiple sclerosis patients prospectively included. ChP was separately segmented on T1w, T2-weighted (T2w) fluid-attenuated inversion-recovery (FLAIR), and CE-T1w sequences. Inter-rater variability assessed on 10 subjects showed high reproducibility between sequences measured by intraclass correlation coefficient (T1w 0.93, FLAIR 0.93, CE-T1w 0.99). CE-T1w showed higher signal-to-noise ratio and contrast-to-noise ratio (CE-T1w 23.77 and 18.49, T1w 13.73 and 7.44, FLAIR 13.09 and 10.77, respectively). Manual segmentation of ChP resulted 3.073 ± 0.563 mL (mean ± standard deviation) on T1w, 3.787 ± 0.679 mL on FLAIR, and 2.984 ± 0.506 mL on CE-T1w images, with an error of 28.02 ± 19.02% for FLAIR and 3.52 ± 12.61% for T1w. FLAIR overestimated ChP volume compared to CE-T1w (p < 0.001). The Dice similarity coefficient of CE-T1w versus T1w and FLAIR was 0.67 ± 0.05 and 0.68 ± 0.05, respectively. Spatial error distribution per slice was calculated after nonlinear coregistration to the standard MNI152 space and showed a heterogeneous profile along the ChP especially near the fornix and the hippocampus. Quantitative analyses suggest T1w as a surrogate of CE-T1w to estimate ChP volume.Relevance statement To estimate the ChP volume, CE-T1w can be replaced by non-CE T1w sequences because the error is acceptable, while FLAIR overestimates the ChP volume. This encourages the development of automatic tools for ChP segmentation, also improving the understanding of the role of the ChP volume in multiple sclerosis, promoting longitudinal studies.Key points • CE-T1w sequences are considered the reference standard for ChP manual segmentation.• FLAIR sequences showed a higher CNR than T1w sequences but overestimated the ChP volume.• Non-CE T1w sequences can be a surrogate of CE-T1w sequences for manual segmentation of ChP.
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Affiliation(s)
- Valentina Visani
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Francesca B Pizzini
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - Valerio Natale
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Agnese Tamanti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Alessandra Bertoldo
- Department of Information Engineering, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Massimiliano Calabrese
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Marco Castellaro
- Department of Information Engineering, University of Padova, Padova, Italy.
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Parobková V, Kompaníková P, Lázňovský J, Kavková M, Hampl M, Buchtová M, Zikmund T, Kaiser J, Bryja V. Ch OP-CT: quantitative morphometrical analysis of the Hindbrain Choroid Plexus by X-ray micro-computed tomography. Fluids Barriers CNS 2024; 21:9. [PMID: 38268040 DOI: 10.1186/s12987-023-00502-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/11/2023] [Indexed: 01/26/2024] Open
Abstract
The Hindbrain Choroid Plexus is a complex, cerebrospinal fluid-secreting tissue that projects into the 4th vertebrate brain ventricle. Despite its irreplaceability in the development and homeostasis of the entire central nervous system, the research of Hindbrain Choroid Plexus and other Choroid Plexuses has been neglected by neuroscientists for decades. One of the obstacles is the lack of tools that describe the complex shape of the Hindbrain Choroid Plexus in the context of brain ventricles. Here we introduce an effective tool, termed ChOP-CT, for the noninvasive, X-ray micro-computed tomography-based, three-dimensional visualization and subsequent quantitative spatial morphological analysis of developing mouse Hindbrain Choroid Plexus. ChOP-CT can reliably quantify Hindbrain Choroid Plexus volume, surface area, length, outgrowth angle, the proportion of the ventricular space occupied, asymmetries and general shape alterations in mouse embryos from embryonic day 13.5 onwards. We provide evidence that ChOP-CT is suitable for the unbiased evaluation and detection of the Hindbrain Choroid Plexus alterations within various mutant embryos. We believe, that thanks to its versatility, quantitative nature and the possibility of automation, ChOP-CT will facilitate the analysis of the Hindbrain Choroid Plexus in the mouse models. This will ultimately accelerate the screening of the candidate genes and mechanisms involved in the onset of various Hindbrain Choroid Plexus-related diseases.
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Affiliation(s)
- Viktória Parobková
- Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic
| | - Petra Kompaníková
- Department of Experimental Biology, Faculty of Science, Masaryk University, 625 00, Brno, Czech Republic
| | - Jakub Lázňovský
- Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic
| | - Michaela Kavková
- Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic
| | - Marek Hampl
- Department of Experimental Biology, Faculty of Science, Masaryk University, 625 00, Brno, Czech Republic
- Laboratory of Molecular Morphogenesis, Institute of Animal Physiology and Genetics, Czech Academy of Sciences, 602 00, Brno, Czech Republic
| | - Marcela Buchtová
- Department of Experimental Biology, Faculty of Science, Masaryk University, 625 00, Brno, Czech Republic
- Laboratory of Molecular Morphogenesis, Institute of Animal Physiology and Genetics, Czech Academy of Sciences, 602 00, Brno, Czech Republic
| | - Tomáš Zikmund
- Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic.
| | - Jozef Kaiser
- Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic
| | - Vítězslav Bryja
- Department of Experimental Biology, Faculty of Science, Masaryk University, 625 00, Brno, Czech Republic.
- Department of Cytokinetics, Institute of Biophysics, Academy of Sciences of the Czech Republic, Brno, Czech Republic.
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6
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Jiang D, Gou Y, Wei Z, Hou X, Yedavalli V, Lu H. Quantification of T 1 and T 2 of subarachnoid CSF: Implications for water exchange between CSF and brain tissues. Magn Reson Med 2023; 90:2411-2419. [PMID: 37582262 PMCID: PMC10696635 DOI: 10.1002/mrm.29829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE To quantify the T1 and T2 values of CSF in the subarachnoid space (SAS) at 3 T and interpret them in the context of water exchange between CSF and brain tissues. METHODS CSF T1 was measured using inversion recovery, and CSF T2 was assessed using T2 -preparation. T1 and T2 values in the SAS were compared with those in the frontal horns of lateral ventricles, which have less brain-CSF exchange. Phantom experiments were performed to examine whether there were spatial variations in T1 and T2 that were unrelated to brain-CSF exchange. Simulations were conducted to investigate the relationship between the brain-CSF exchange rate and the apparent T1 and T2 values of SAS CSF. RESULTS The CSF T1 and T2 values were 4308.7 ± 146.9 ms and 1885.5 ± 67.9 ms, respectively, in the SAS and were 4454.0 ± 187.9 ms and 2372.9 ± 72.0 ms in the frontal horns. The SAS CSF had shorter T1 (p = 0.006) and T2 (p < 0.0001) than CSF in the frontal horns. Phantom experiments showed negligible (< 6 ms for T1 ; < 1 ms for T2 ) spatial variations in T1 and T2 , suggesting that the T1 and T2 differences between SAS and frontal horns were largely attributed to physiological reasons. Simulations revealed that faster brain-CSF exchange rates lead to shorter apparent T1 and T2 of SAS CSF. However, the experimentally observed T2 difference between SAS and frontal horns was greater than that attributable to typical exchange effect, suggesting that the T2 shortening in SAS may reflect a combined effect of exchange and deoxyhemoglobin susceptibility. CONCLUSION Quantification of SAS CSF relaxation times may be useful to assess the brain-CSF exchange.
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Affiliation(s)
- Dengrong Jiang
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yifan Gou
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Zhiliang Wei
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Xirui Hou
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vivek Yedavalli
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hanzhang Lu
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, Maryland, USA
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Ricigliano VAG, Stankoff B. Choroid plexuses at the interface of peripheral immunity and tissue repair in multiple sclerosis. Curr Opin Neurol 2023; 36:214-221. [PMID: 37078651 DOI: 10.1097/wco.0000000000001160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
PURPOSE OF REVIEW Choroid plexuses (ChPs) are key actors of the blood-to-cerebrospinal-fluid barrier and serve as brain immune checkpoint. The past years have seen a regain of interest about their potential involvement in the physiopathology of neuroinflammatory disorders like multiple sclerosis (MS). This article offers an overview of the recent findings on ChP alterations in MS, with a focus on the imaging tools able to detect these abnormalities and on their involvement in inflammation, tissue damage and repair. RECENT FINDINGS On MRI, ChPs are enlarged in people with MS (PwMS) versus healthy individuals. This size increase is an early event, already detected in presymptomatic and pediatric MS. Enlargement of ChPs is linked to local inflammatory infiltrates, and their dysfunction selectively impacts periventricular damage, larger ChPs predicting the expansion of chronic active lesions, smoldering inflammation and remyelination failure in tissues surrounding the ventricles. ChP volumetry may add value for the prediction of disease activity and disability worsening. SUMMARY ChP imaging metrics are emerging as possible biomarkers of neuroinflammation and repair failure in MS. Future works combining multimodal imaging techniques should provide a more refined characterization of ChP functional changes, their link with tissue damage, blood to cerebrospinal-fluid barrier dysfunction and fluid trafficking in MS.
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Affiliation(s)
- Vito A G Ricigliano
- Sorbonne Université, Paris Brain Institute, ICM, CNRS, Inserm
- Neurology Department, Pitié-Salpêtrière Hospital
| | - Bruno Stankoff
- Sorbonne Université, Paris Brain Institute, ICM, CNRS, Inserm
- Neurology Department, St Antoine Hospital, APHP-Sorbonne, Paris, France
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Petitclerc L, Hirschler L, Örzsik B, Asllani I, van Osch MJP. Arterial spin labeling signal in the CSF: Implications for partial volume correction and blood-CSF barrier characterization. NMR IN BIOMEDICINE 2023; 36:e4852. [PMID: 36269104 PMCID: PMC10078195 DOI: 10.1002/nbm.4852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/21/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
For better quantification of perfusion with arterial spin labeling (ASL), partial volume correction (PVC) is used to disentangle the signals from gray matter (GM) and white matter within any voxel. Based on physiological considerations, PVC algorithms typically assume zero signal in the cerebrospinal fluid (CSF). Recent measurements, however, have shown that CSF-ASL signal can exceed 10% of GM signal, even when using recommended ASL labeling parameters. CSF signal is expected to particularly affect PVC results in the choroid plexus. This study aims to measure the impact of CSF signal on PVC perfusion measurements, and to investigate the potential use of PVC to retrieve pure CSF-ASL signal for blood-CSF barrier characterization. In vivo imaging included six pCASL sequences with variable label duration and post-labeling delay (PLD), and an eight-echo 3D-GRASE readout. A dataset was simulated to estimate the effect of CSF-PVC with known ground-truth parameters. Differences between the results of CSF-PVC and non-CSF-PVC were estimated for regions of interest (ROIs) based on GM probability, and a separate ROI isolating the choroid plexus. In vivo, the suitability of PVC-CSF signal as an estimate of pure CSF was investigated by comparing its time course with the long-TE CSF signal. Results from both simulation and in vivo data indicated that including the CSF signal in PVC improves quantification of GM CBF by approximately 10%. In simulated data, this improvement was greater for multi-PLD (model fitting) quantification than for single PLD (~1-5% difference). In the choroid plexus, the difference between CSF-PVC and non-CSF-PVC was much larger, averaging around 30%. Long-TE (pure) CSF signal could not be estimated from PVC CSF signal as it followed a different time course, indicating the presence of residual macrovascular signal in the PVC. The inclusion of CSF adds value to PVC for more accurate measurements of GM perfusion, and especially for quantification of perfusion in the choroid plexus and study of the glymphatic system.
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Affiliation(s)
- Léonie Petitclerc
- C.J. Gorter MRI Center, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
- Leiden Institute for Brain and Cognition (LIBC)LeidenThe Netherlands
- Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Lydiane Hirschler
- C.J. Gorter MRI Center, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
- Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Balázs Örzsik
- Clinical Imaging Science Center, Department of NeuroscienceUniversity of SussexBrightonUK
| | - Iris Asllani
- Clinical Imaging Science Center, Department of NeuroscienceUniversity of SussexBrightonUK
- Department of Biomedical EngineeringRochester Institute of TechnologyRochesterNYUSA
| | - Matthias J. P. van Osch
- C.J. Gorter MRI Center, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
- Leiden Institute for Brain and Cognition (LIBC)LeidenThe Netherlands
- Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
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Eisma JJ, McKnight CD, Hett K, Elenberger J, Song AK, Stark AJ, Claassen DO, Donahue MJ. Choroid plexus perfusion and bulk cerebrospinal fluid flow across the adult lifespan. J Cereb Blood Flow Metab 2023; 43:269-280. [PMID: 36200473 PMCID: PMC9903224 DOI: 10.1177/0271678x221129101] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/28/2022] [Accepted: 09/04/2022] [Indexed: 01/24/2023]
Abstract
The choroid plexus (ChP) comprises a collection of modified ependymal cells that play an important role in the production of brain cerebrospinal fluid (CSF), and ChP perfusion aberrations have been implicated in a range of cerebrovascular and neurodegenerative disorders. To provide an exemplar for the growing interest in ChP activity, we evaluated ChP perfusion and bulk CSF flow cross-sectionally across the healthy adult lifespan. Participants (n = 77; age range = 21-86 years) were scanned at 3T using T1-weighted, T2-weighted-FLAIR, perfusion-weighted pCASL, and phase contrast MRI to calculate ChP anatomy, perfusion, and aqueductal CSF flow, respectively. Regression models were applied to evaluate aging effects on ChP volume and ChP perfusion in the lateral ventricles, as well as CSF flow. ChP volume (mean ± std = 2.81 ± 1.1 cm3) increased (p < 0.001), ChP perfusion (36.3 ± 8.6 mL/100 g/min) decreased (p = 0.0078), and ChP total blood flow (1.13 ± 0.34 mL/min) increased (p < 0.001) with age. Cranial-to-caudal net CSF flow (0.245 ± 0.20 mL/min) decreased, absolute CSF flow (4.86 ± 2.96 mL/min) increased, and CSF regurgitant fraction (0.87 ± 0.126) increased with age (all: p < 0.001). ChP perfusion was directly related to net cranial-to-caudal CSF flow through the aqueduct (p = 0.033). The implications of these findings are discussed in the context of the growing literature on CSF circulatory dysfunction in neurodegeneration and cerebrovascular disease.
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Affiliation(s)
- Jarrod J Eisma
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Colin D McKnight
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kilian Hett
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jason Elenberger
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alexander K Song
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Adam J Stark
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manus J Donahue
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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10
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Liu G, Ladrón-de-Guevara A, Izhiman Y, Nedergaard M, Du T. Measurements of cerebrospinal fluid production: a review of the limitations and advantages of current methodologies. Fluids Barriers CNS 2022; 19:101. [PMID: 36522656 PMCID: PMC9753305 DOI: 10.1186/s12987-022-00382-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/13/2022] [Indexed: 12/23/2022] Open
Abstract
Cerebrospinal fluid (CSF) is an essential and critical component of the central nervous system (CNS). According to the concept of the "third circulation" originally proposed by Cushing, CSF is mainly produced by the choroid plexus and subsequently leaves the cerebral ventricles via the foramen of Magendie and Luschka. CSF then fills the subarachnoid space from whence it disperses to all parts of the CNS, including the forebrain and spinal cord. CSF provides buoyancy to the submerged brain, thus protecting it against mechanical injury. CSF is also transported via the glymphatic pathway to reach deep interstitial brain regions along perivascular channels; this CSF clearance pathway promotes transport of energy metabolites and signaling molecules, and the clearance of metabolic waste. In particular, CSF is now intensively studied as a carrier for the removal of proteins implicated in neurodegeneration, such as amyloid-β and tau. Despite this key function of CSF, there is little information about its production rate, the factors controlling CSF production, and the impact of diseases on CSF flux. Therefore, we consider it to be a matter of paramount importance to quantify better the rate of CSF production, thereby obtaining a better understanding of CSF dynamics. To this end, we now review the existing methods developed to measure CSF production, including invasive, noninvasive, direct, and indirect methods, and MRI-based techniques. Depending on the methodology, estimates of CSF production rates in a given species can extend over a ten-fold range. Throughout this review, we interrogate the technical details of CSF measurement methods and discuss the consequences of minor experimental modifications on estimates of production rate. Our aim is to highlight the gaps in our knowledge and inspire the development of more accurate, reproducible, and less invasive techniques for quantitation of CSF production.
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Affiliation(s)
- Guojun Liu
- Department of Neurosurgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, China
- School of Pharmacy, China Medical University, Shenyang, 110122, China
- Center for Translational Neuromedicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Antonio Ladrón-de-Guevara
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Yara Izhiman
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Maiken Nedergaard
- Center for Translational Neuromedicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark.
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, 14642, USA.
| | - Ting Du
- School of Pharmacy, China Medical University, Shenyang, 110122, China.
- Center for Translational Neuromedicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark.
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, 14642, USA.
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11
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Lee H, Ozturk B, Stringer MS, Koundal S, MacIntosh BJ, Rothman D, Benveniste H. Choroid plexus tissue perfusion and blood to CSF barrier function in rats measured with continuous arterial spin labeling. Neuroimage 2022; 261:119512. [PMID: 35882269 PMCID: PMC9969358 DOI: 10.1016/j.neuroimage.2022.119512] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/18/2022] [Accepted: 07/22/2022] [Indexed: 02/08/2023] Open
Abstract
The choroid plexus (ChP) of the cerebral ventricles is a source of cerebrospinal fluid (CSF) production and also plays a key role in immune surveillance at the level of blood-to-CSF-barrier (BCSFB). In this study, we quantify ChP blood perfusion and BCSFB mediated water exchange from arterial blood into ventricular CSF using non-invasive continuous arterial spin labelling magnetic resonance imaging (CASL-MRI). Systemic administration of anti-diuretic hormone (vasopressin) was used to validate BCSFB water flow as a metric of choroidal CSF secretory function. To further investigate the coupling between ChP blood perfusion and BCSFB water flow, we characterized the effects of two anesthetic regimens known to have large-scale differential effects on cerebral blood flow. For quantification of ChP blood perfusion a multi-compartment perfusion model was employed, and we discovered that partial volume correction improved measurement accuracy. Vasopressin significantly reduced both ChP blood perfusion and BCSFB water flow. ChP blood perfusion was significantly higher with pure isoflurane anesthesia (2-2.5%) when compared to a balanced anesthesia with dexmedetomidine and low-dose isoflurane (1.0 %), and significant correlation between ChP blood perfusion and BCSFB water flow was observed, however there was no significant difference in BCSFB water flow. In summary, here we introduce a non-invasive, robust, and spatially resolved in vivo imaging platform to quantify ChP blood perfusion as well as BCSFB water flow which can be applied to study coupling of these two key parameters in future clinical translational studies.
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Affiliation(s)
- Hedok Lee
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA.
| | - Burhan Ozturk
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA
| | - Michael S Stringer
- Brain Research Imaging Centre and UK Dementia Research Institute, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Sunil Koundal
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA
| | - Bradley J MacIntosh
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Douglas Rothman
- Departments of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Helene Benveniste
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA
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12
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Ricigliano VAG, Louapre C, Poirion E, Colombi A, Yazdan Panah A, Lazzarotto A, Morena E, Martin E, Bottlaender M, Bodini B, Seilhean D, Stankoff B. Imaging Characteristics of Choroid Plexuses in Presymptomatic Multiple Sclerosis: A Retrospective Study. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2022; 9:9/6/e200026. [PMID: 36229188 PMCID: PMC9562043 DOI: 10.1212/nxi.0000000000200026] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 07/18/2022] [Indexed: 11/06/2022]
Abstract
Background and Objectives Recent imaging studies have suggested a possible involvement of the choroid plexus (CP) in multiple sclerosis (MS). Here, we investigated whether CP changes are already detectable at the earliest stage of MS, preceding symptom onset. Methods This study is a retrospective analysis of 27 patients with presymptomatic MS, 97 patients with clinically definite MS (CDMS), and 53 healthy controls (HCs) who underwent a cross-sectional 3T-MRI acquisition; of which, 22 MS, 19 HCs, and 1 presymptomatic MS (evaluated 8 months before conversion to CDMS) also underwent translocator protein (TSPO) 18F-DPA-714 PET and were included in the analysis. CPs were manually segmented on 3D T1-weighted images for volumetric analysis. CP 18F-DPA-714 uptake, reflecting inflammation, was calculated as the average standardized uptake value (SUV). Multivariable regressions adjusted for age, sex, and ventricular and brain volume were fitted to test CP volume differences between presymptomatic patients and MS or HCs. For the presymptomatic case who also had 18F-DPA-714 PET, CP SUV differences with MS and HCs were assessed through Crawford-Howell tests. To provide further insight into the interpretation of 18F-DPA-714-PET uptake at the CP level, a postmortem analysis of CPs in MS vs HCs was performed to characterize the cellular localization of TSPO expression. Results Compared with HCs, patients with presymptomatic MS had 32% larger CPs (β = 0.38, p = 0.001), which were not dissimilar to MS CPs (p = 0.69). Moreover, in the baseline scan of the presymptomatic case who later on developed MS, TSPO PET showed 33% greater CP inflammation vs HCs (p = 0.04), although no differences in 18F-DPA-714 uptake were found in parenchymal regions vs controls. CP postmortem analysis identified a population of CD163+ mononuclear phagocytes expressing TSPO in MS, possibly contributing to the increased 18F-DPA-714 uptake. Discussion We identified an imaging signature in CPs at the presymptomatic MS stage using MRI; in addition, we found an increased CP inflammation with PET in a single presymptomatic patient. These findings suggest a role of CP imaging as an early biomarker and argue for the involvement of the blood-CSF barrier dysfunction in disease development. Trial Registration Information APHP-20210727144630, EudraCT-Number: 2008-004174-40; ClinicalTrials.gov: NCT02305264, NCT01651520, and NCT02319382.
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Affiliation(s)
- Vito A G Ricigliano
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Céline Louapre
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Emilie Poirion
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Annalisa Colombi
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Arya Yazdan Panah
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Andrea Lazzarotto
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Emanuele Morena
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Elodie Martin
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Michel Bottlaender
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Benedetta Bodini
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Danielle Seilhean
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France
| | - Bruno Stankoff
- From the Sorbonne Université (V.A.G.R., C.L., E.P., A.C., A.Y.P., A.L., Emanuele Morena, Elodie Martin, B.B., D.S., B.S.), Paris Brain Institute, ICM, CNRS, Inserm; Neurology Department (V.A.G.R., A.L., B.B., B.S.), St Antoine Hospital, APHP-Sorbonne, Paris; Neurology Department (C.L.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris; Service D'Imagerie Médicale (E.P.), Hôpital Fondation Adolphe de Rothschild, Paris; Université Paris-Saclay (M.B.), CEA, CNRS, Inserm, BioMaps, Service Hospitalier Frédéric Joliot, Orsay; and Neuropathology Department (D.S.), Pitié-Salpêtrière Hospital, APHP-Sorbonne, Paris, France.
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13
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Perera C, Tolomeo D, Baker RR, Ohene Y, Korsak A, Lythgoe MF, Thomas DL, Wells JA. Investigating changes in blood-cerebrospinal fluid barrier function in a rat model of chronic hypertension using non-invasive magnetic resonance imaging. Front Mol Neurosci 2022; 15:964632. [PMID: 36117909 PMCID: PMC9478509 DOI: 10.3389/fnmol.2022.964632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/02/2022] [Indexed: 12/03/2022] Open
Abstract
Chronic hypertension is a major risk factor for the development of neurodegenerative disease, yet the etiology of hypertension-driven neurodegeneration remains poorly understood. Forming a unique interface between the systemic circulation and the brain, the blood-cerebrospinal fluid barrier (BCSFB) at the choroid plexus (CP) has been proposed as a key site of vulnerability to hypertension that may initiate downstream neurodegenerative processes. However, our ability to understand BCSFB's role in pathological processes has, to date, been restricted by a lack of non-invasive functional measurement techniques. In this work, we apply a novel Blood-Cerebrospinal Fluid Barrier Arterial Spin Labeling (BCSFB-ASL) Magnetic resonance imaging (MRI) approach with the aim of detecting possible derangement of BCSFB function in the Spontaneous Hypertensive Rat (SHR) model using a non-invasive, translational technique. SHRs displayed a 36% reduction in BCSFB-mediated labeled arterial water delivery into ventricular cerebrospinal fluid (CSF), relative to normotensive controls, indicative of down-regulated choroid plexus function. This was concomitant with additional changes in brain fluid biomarkers, namely ventriculomegaly and changes in CSF composition, as measured by T1 lengthening. However, cortical cerebral blood flow (CBF) measurements, an imaging biomarker of cerebrovascular health, revealed no measurable change between the groups. Here, we provide the first demonstration of BCSFB-ASL in the rat brain, enabling non-invasive assessment of BCSFB function in healthy and hypertensive rats. Our data highlights the potential for BCSFB-ASL to serve as a sensitive early biomarker for hypertension-driven neurodegeneration, in addition to investigating the mechanisms relating hypertension to neurodegenerative outcomes.
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Affiliation(s)
- Charith Perera
- Division of Medicine, UCL Centre for Advanced Biomedical Imaging, University College London, London, United Kingdom
| | - Daniele Tolomeo
- Division of Medicine, UCL Centre for Advanced Biomedical Imaging, University College London, London, United Kingdom
| | - Rebecca R. Baker
- Division of Medicine, UCL Centre for Advanced Biomedical Imaging, University College London, London, United Kingdom
| | - Yolanda Ohene
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
- Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester, United Kingdom
| | - Alla Korsak
- Centre for Cardiovascular and Metabolic Neuroscience, Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
| | - Mark F. Lythgoe
- Division of Medicine, UCL Centre for Advanced Biomedical Imaging, University College London, London, United Kingdom
| | - David L. Thomas
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Jack A. Wells
- Division of Medicine, UCL Centre for Advanced Biomedical Imaging, University College London, London, United Kingdom
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14
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Mehta NH, Suss RA, Dyke JP, Theise ND, Chiang GC, Strauss S, Saint-Louis L, Li Y, Pahlajani S, Babaria V, Glodzik L, Carare RO, de Leon MJ. Quantifying cerebrospinal fluid dynamics: A review of human neuroimaging contributions to CSF physiology and neurodegenerative disease. Neurobiol Dis 2022; 170:105776. [PMID: 35643187 PMCID: PMC9987579 DOI: 10.1016/j.nbd.2022.105776] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/21/2022] [Indexed: 01/13/2023] Open
Abstract
Cerebrospinal fluid (CSF), predominantly produced in the ventricles and circulating throughout the brain and spinal cord, is a key protective mechanism of the central nervous system (CNS). Physical cushioning, nutrient delivery, metabolic waste, including protein clearance, are key functions of the CSF in humans. CSF volume and flow dynamics regulate intracranial pressure and are fundamental to diagnosing disorders including normal pressure hydrocephalus, intracranial hypotension, CSF leaks, and possibly Alzheimer's disease (AD). The ability of CSF to clear normal and pathological proteins, such as amyloid-beta (Aβ), tau, alpha synuclein and others, implicates it production, circulation, and composition, in many neuropathologies. Several neuroimaging modalities have been developed to probe CSF fluid dynamics and better relate CSF volume and flow to anatomy and clinical conditions. Approaches include 2-photon microscopic techniques, MRI (tracer-based, gadolinium contrast, endogenous phase-contrast), and dynamic positron emission tomography (PET) using existing approved radiotracers. Here, we discuss CSF flow neuroimaging, from animal models to recent clinical-research advances, summarizing current endeavors to quantify and map CSF flow with implications towards pathophysiology, new biomarkers, and treatments of neurological diseases.
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Affiliation(s)
- Neel H Mehta
- Department of Biology, Cornell University, Ithaca, NY, USA
| | - Richard A Suss
- Division of Neuroradiology, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jonathan P Dyke
- Citigroup Biomedical Imaging Center, Weill Cornell Medicine, New York, NY, USA
| | - Neil D Theise
- Department of Pathology, NYU Grossman School of Medicine, New York, NY, USA
| | - Gloria C Chiang
- Division of Neuroradiology, Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Sara Strauss
- Division of Neuroradiology, Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | | | - Yi Li
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Silky Pahlajani
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Vivek Babaria
- Orange County Spine and Sports, Interventional Physiatry, Newport Beach, CA, USA
| | - Lidia Glodzik
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Roxana O Carare
- Department of Medicine, University of Southampton, Southampton, UK
| | - Mony J de Leon
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, NY, USA.
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15
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Ultra-long-TE arterial spin labeling reveals rapid and brain-wide blood-to-CSF water transport in humans. Neuroimage 2021; 245:118755. [PMID: 34826596 PMCID: PMC7612938 DOI: 10.1016/j.neuroimage.2021.118755] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/20/2022] Open
Abstract
The study of brain clearance mechanisms is an active area of research. While we know that the cerebrospinal fluid (CSF) plays a central role in one of the main existing clearance pathways, the exact processes for the secretion of CSF and the removal of waste products from tissue are under debate. CSF is thought to be created by the exchange of water and ions from the blood, which is believed to mainly occur in the choroid plexus. This exchange has not been thoroughly studied in vivo. We propose a modified arterial spin labeling (ASL) MRI sequence and image analysis to track blood water as it is transported to the CSF, and to characterize its exchange from blood to CSF. We acquired six pseudo-continuous ASL sequences with varying labeling duration (LD) and post-labeling delay (PLD) and a segmented 3D-GRASE readout with a long echo train (8 echo times (TE)) which allowed separation of the very long-T2 CSF signal. ASL signal was observed at long TEs (793 ms and higher), indicating presence of labeled water transported from blood to CSF. This signal appeared both in the CSF proximal to the choroid plexus and in the subarachnoid space surrounding the cortex. ASL signal was separated into its blood, gray matter and CSF components by fitting a triexponential function with T2s taken from literature. A two-compartment dynamic model was introduced to describe the exchange of water through time and TE. From this, a water exchange time from the blood to the CSF (Tbl->CSF) was mapped, with an order of magnitude of approximately 60 s.
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Johnson SE, McKnight CD, Jordan LC, Claassen DO, Waddle S, Lee C, Garza M, Patel NJ, Davis LT, Pruthi S, Trujillo P, Chitale R, Fusco M, Donahue MJ. Choroid plexus perfusion in sickle cell disease and moyamoya vasculopathy: Implications for glymphatic flow. J Cereb Blood Flow Metab 2021; 41:2699-2711. [PMID: 33906512 PMCID: PMC8504961 DOI: 10.1177/0271678x211010731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Cerebrospinal fluid (CSF) and interstitial fluid exchange have been shown to increase following pharmacologically-manipulated increases in cerebral arterial pulsatility, consistent with arterial pulsatility improving CSF circulation along perivascular glymphatic pathways. The choroid plexus (CP) complexes produce CSF, and CP activity may provide a centralized indicator of perivascular flow. We tested the primary hypothesis that elevated cortical cerebral blood volume and flow, present in sickle cell disease (SCD), is associated with fractionally-reduced CP perfusion relative to healthy adults, and the supplementary hypothesis that reduced arterial patency, present in moyamoya vasculopathy, is associated with elevated fractional CP perfusion relative to healthy adults. Participants (n = 75) provided informed consent and were scanned using a 3-Tesla arterial-spin-labeling MRI sequence for CP and cerebral gray matter (GM) perfusion quantification. ANOVA was used to calculate differences in CP-to-GM perfusion ratios between groups, and regression analyses applied to evaluate the dependence of the CP-to-GM perfusion ratio on group after co-varying for age and sex. ANOVA yielded significant (p < 0.001) group differences, with CP-to-GM perfusion ratios increasing between SCD (ratio = 0.93 ± 0.28), healthy (ratio = 1.04 ± 0.32), and moyamoya (ratio = 1.29 ± 0.32) participants, which was also consistent with regression analyses. Findings are consistent with CP perfusion being inversely associated with cortical perfusion.
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Affiliation(s)
- Skylar E Johnson
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Colin D McKnight
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lori C Jordan
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Spencer Waddle
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Chelsea Lee
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Maria Garza
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Niral J Patel
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - L Taylor Davis
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sumit Pruthi
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rohan Chitale
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Matthew Fusco
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manus J Donahue
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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17
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Alisch JSR, Kiely M, Triebswetter C, Alsameen MH, Gong Z, Khattar N, Egan JM, Bouhrara M. Characterization of Age-Related Differences in the Human Choroid Plexus Volume, Microstructural Integrity, and Blood Perfusion Using Multiparameter Magnetic Resonance Imaging. Front Aging Neurosci 2021; 13:734992. [PMID: 34603011 PMCID: PMC8485051 DOI: 10.3389/fnagi.2021.734992] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/30/2021] [Indexed: 11/13/2022] Open
Abstract
The choroid plexus (CP) is an important cerebral structure involved in cerebrospinal fluid production and transport of solutes into the brain. Recent studies have uncovered the involvement of the CP in neurological disorders such as Alzheimer's disease and multiple sclerosis. However, our understanding of human age-related microstructural and functional changes in the CP with aging and neuropathology is limited. In this cross-sectional study, we investigated age and sex differences in the CP structure and function using advanced quantitative magnetic resonance imaging methodology in a large cohort (n = 155) of cognitively unimpaired individuals over a wide age range between 21 and 94 years. Our analysis included volumetric measurements, relaxometry measures (T 1 and T 2), diffusion tensor imaging (DTI) measures of fractional anisotropy (FA) and mean diffusivity (MD), as well as measures of cerebral blood flow (CBF). Our results revealed that CP volume was increasing with advancing age. We conjecture that this novel observation is likely attributed to alterations in the CP microstructure or function as well as to ventriculomegaly. Indeed, we also found that CBF was lower with advanced age, while, consistent with previous studies, T 1, T 2 and MD were higher, and FA was lower with advanced age. We attribute these functional and microstructural differences to a deteriorated CP structural integrity with aging. Furthermore, our relaxometry and DTI measures were found to be associated with differences in blood perfusion revealing lower microstructural integrity with lower CBF. Finally, in agreement with literature, sex-related differences in MD and CBF were statistically significant. This work lays the foundation for ongoing investigation of the involvement of CP in neurodegeneration.
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Affiliation(s)
| | | | | | | | | | | | | | - Mustapha Bouhrara
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
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18
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Perera C, Harrison IF, Lythgoe MF, Thomas DL, Wells JA. Pharmacological MRI with Simultaneous Measurement of Cerebral Perfusion and Blood-Cerebrospinal Fluid Barrier Function using Interleaved Echo-Time Arterial Spin Labelling. Neuroimage 2021; 238:118270. [PMID: 34144160 PMCID: PMC8543042 DOI: 10.1016/j.neuroimage.2021.118270] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/28/2021] [Accepted: 06/14/2021] [Indexed: 11/22/2022] Open
Abstract
Pharmacological MRI (phMRI) studies seek to capture changes in brain haemodynamics in response to a drug. This provides a methodological platform for the evaluation of novel therapeutics, and when applied to disease states, may provide diagnostic or mechanistic information pertaining to common brain disorders such as dementia. Changes to brain perfusion and blood-cerebrospinal fluid barrier (BCSFB) function can be probed, non-invasively, by arterial spin labelling (ASL) and blood-cerebrospinal fluid barrier arterial spin labelling (BCSFB-ASL) MRI respectively. Here, we introduce a method for simultaneous recording of pharmacological perturbation of brain perfusion and BCSFB function using interleaved echo-time ASL, applied to the anesthetized mouse brain. Using this approach, we capture an exclusive decrease in BCSFB-mediated delivery of arterial blood water to ventricular CSF, following anti-diuretic hormone, vasopressin, administration. The commonly used vasodilatory agent, CO2, induced similar increases (~21%) in both cortical perfusion and the BCSFB-ASL signal. Furthermore, we present evidence that caffeine administration triggers a marked decrease in BCSFB-mediated labelled water delivery (41%), with no significant changes in cortical perfusion. Finally, we demonstrate a marked decrease in the functional response of the BCSFB to, vasopressin, in the aged vs adult brain. Together these data, the first of such kind, highlight the value of this translational approach to capture simultaneous and differential pharmacological modulation of vessel tone at the blood brain barrier and BCSFB and how this relationship may be modified in the ageing brain.
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Affiliation(s)
- Charith Perera
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, United Kingdom
| | - Ian F Harrison
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, United Kingdom
| | - Mark F Lythgoe
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, United Kingdom
| | - David L Thomas
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom; Leonard Wolfson Experimental Neurology Centre, UCL Queen Square Institute of Neurology, London, United Kingdom; Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Jack A Wells
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, United Kingdom.
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19
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Keep RF, Jones HC, Drewes LR. Brain Barriers and brain fluids research in 2020 and the fluids and barriers of the CNS thematic series on advances in in vitro modeling of the blood-brain barrier and neurovascular unit. Fluids Barriers CNS 2021; 18:24. [PMID: 34020685 PMCID: PMC8138848 DOI: 10.1186/s12987-021-00258-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This editorial discusses advances in brain barrier and brain fluid research in 2020. Topics include: the cerebral endothelium and the neurovascular unit; the choroid plexus; the meninges; cerebrospinal fluid and the glymphatic system; disease states impacting the brain barriers and brain fluids; drug delivery to the brain. This editorial also highlights the recently completed Fluids Barriers CNS thematic series entitled, Advances in in vitro modeling of the bloodbrain barrier and neurovascular unit. Such in vitro modeling is progressing rapidly.
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Affiliation(s)
- Richard F Keep
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI, 48105, USA. .,Department of Neurosurgery, University of Michigan, 109 Zina Pitcher Place, Ann Arbor, R5018 BSRB, MI, 48109-2200, USA.
| | - Hazel C Jones
- Gagle Brook House, Chesterton, Bicester, OX26 1UF, UK
| | - Lester R Drewes
- Department of Biomedical Sciences, University of Minnesota Medical School Duluth, Duluth, MN, 55812, USA
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