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Hayasaki G, Chibaatar E, Watanabe K, Okamoto N, Quinn PM, Ikenouchi A, Shinkai T, Kakeda S, Yoshimura R. Volume enlargement of the choroid plexus and brain ventricles in drug-naïve, first-episode major depressive disorder. J Affect Disord 2024; 354:719-724. [PMID: 38521134 DOI: 10.1016/j.jad.2024.03.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND We investigated volumetric alterations in the bilateral choroid plexus (ChP) and brain ventricles of patients during their first episode of major depressive disorder (MDD) prior to antidepressant treatment. METHODS Seventy-one first-episode drug-naïve patients with MDD and seventy-four healthy control (HC) subjects were recruited. MRI data were obtained, and bilateral ChP and brain ventricle volumes were evaluated using segmentation, based on the adaptive multiscale and expectation maximization method. One-way multivariate analysis of covariance was used to calculate volumetric differences in the bilateral ChP and brain ventricles between the groups, and partial Pearson correlation analyses were used to investigate the relationship between the volumes of the bilateral ChP and brain ventricles. RESULTS First-episode drug-naïve patients with MDD showed enlarged volumes of the bilateral ChP, bilateral lateral ventricle (LV), and third ventricle compared with HCs. The ChP volume positively correlated with the LV and third ventricle, but not with the fourth ventricle in patients with MDD, whereas it correlated with all four brain ventricles in HCs. We did not observe significant correlations between bilateral ChP volume and brain ventricles, HAMD scores, or symptom severity. LIMITATIONS Our study populations differed in age and sex and we did not extensively measure the amount of neuroinflammation in the brain or blood, include a functional assessment, nor evaluate other neural comorbidities or neuropsychiatric conditions. CONCLUSIONS Our study extends the existing research to suggest that illness-related alterations in ChP volume enlargement in first-episode antidepressant-naïve patients with MDD may serve as a trait measure.
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Affiliation(s)
- Gaku Hayasaki
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Enkmurun Chibaatar
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Keita Watanabe
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Naomichi Okamoto
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Patrick M Quinn
- Wakamatsu Hospital, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Atsuko Ikenouchi
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takahiro Shinkai
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shingo Kakeda
- Department of Radiology, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan.
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Sadhukhan R, Verma SP, Mondal S, Das A, Banerjee R, Mandal A, Banerjee M, Goswami DK. Humidity-Induced Protein-Based Artificial Synaptic Devices for Neuroprosthetic Applications. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2307439. [PMID: 38213007 DOI: 10.1002/smll.202307439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 11/24/2023] [Indexed: 01/13/2024]
Abstract
Neuroprosthetics and brain-machine interfaces are immensely beneficial for people with neurological disabilities, and the future generation of neural repair systems will utilize neuromorphic devices for the advantages of energy efficiency and real-time performance abilities. Conventional synaptic devices are not compatible to work in such conditions. The cerebrospinal fluid (CSF) in the central part of the nervous system is composed of 99% water. Therefore, artificial synaptic devices, which are the fundamental component of neuromorphic devices, should resemble biological nerves while being biocompatible, and functional in high-humidity environments with higher functional stability for real-time applications in the human body. In this work, artificial synaptic devices are fabricated based on gelatin-PEDOT: PSS composite as an active material to work more effectively in a highly humid environment (≈90% relative humidity). These devices successfully mimic various synaptic properties by the continuous variation of conductance, like, excitatory/inhibitory post-synaptic current(EPSC/IPSC), paired-pulse facilitation/depression(PPF/PPD), spike-voltage dependent plasticity (SVDP), spike-duration dependent plasticity (SDDP), and spike-rate dependent plasticity (SRDP) in environments at a relative humidity levels of ≈90%.
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Affiliation(s)
- Riya Sadhukhan
- Organic Electronics Laboratory, Department of Physics, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India
| | - Shiv Prakash Verma
- School of Nano Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India
| | - Sovanlal Mondal
- School of Nano Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India
| | - Abhirup Das
- Organic Electronics Laboratory, Department of Physics, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India
| | - Rajdeep Banerjee
- Organic Electronics Laboratory, Department of Physics, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India
| | - Ajoy Mandal
- Organic Electronics Laboratory, Department of Physics, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India
| | | | - Dipak K Goswami
- Organic Electronics Laboratory, Department of Physics, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India
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Rycman A, Bustamante M, Cronin DS. Brain Material Properties and Integration of Arachnoid Complex for Biofidelic Impact Response for Human Head Finite Element Model. Ann Biomed Eng 2024; 52:908-919. [PMID: 38218736 DOI: 10.1007/s10439-023-03428-2] [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: 04/03/2023] [Accepted: 12/19/2023] [Indexed: 01/15/2024]
Abstract
Finite element head models offer great potential to study brain-related injuries; however, at present may be limited by geometric and material property simplifications required for continuum-level human body models. Specifically, the mechanical properties of the brain tissues are often represented with simplified linear viscoelastic models, or the material properties have been optimized to specific impact cases. In addition, anatomical structures such as the arachnoid complex have been omitted or implemented in a simple lumped manner. Recent material test data for four brain regions at three strain rates in three modes of loading (tension, compression, and shear) was used to fit material parameters for a hyper-viscoelastic constitutive model. The material model was implemented in a contemporary detailed head finite element model. A detailed representation of the arachnoid trabeculae was implemented with mechanical properties based on experimental data. The enhanced head model was assessed by re-creating 11 ex vivo head impact scenarios and comparing the simulation results with experimental data. The hyper-viscoelastic model faithfully captured mechanical properties of the brain tissue in three modes of loading and multiple strain rates. The enhanced head model showed a high level of biofidelity in all re-created impacts in part due to the improved brain-skull interface associated with implementation of the arachnoid trabeculae. The enhanced head model provides an improved predictive capability with material properties based on tissue level data and is positioned to investigate head injury and tissue damage in the future.
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Affiliation(s)
- Aleksander Rycman
- Department of Mechanical & Mechatronics Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Michael Bustamante
- Department of Mechanical & Mechatronics Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Duane S Cronin
- Department of Mechanical & Mechatronics Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
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4
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Hale AT, Boudreau H, Devulapalli R, Duy PQ, Atchley TJ, Dewan MC, Goolam M, Fieggen G, Spader HL, Smith AA, Blount JP, Johnston JM, Rocque BG, Rozzelle CJ, Chong Z, Strahle JM, Schiff SJ, Kahle KT. The genetic basis of hydrocephalus: genes, pathways, mechanisms, and global impact. Fluids Barriers CNS 2024; 21:24. [PMID: 38439105 PMCID: PMC10913327 DOI: 10.1186/s12987-024-00513-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/25/2024] [Indexed: 03/06/2024] Open
Abstract
Hydrocephalus (HC) is a heterogenous disease characterized by alterations in cerebrospinal fluid (CSF) dynamics that may cause increased intracranial pressure. HC is a component of a wide array of genetic syndromes as well as a secondary consequence of brain injury (intraventricular hemorrhage (IVH), infection, etc.) that can present across the age spectrum, highlighting the phenotypic heterogeneity of the disease. Surgical treatments include ventricular shunting and endoscopic third ventriculostomy with or without choroid plexus cauterization, both of which are prone to failure, and no effective pharmacologic treatments for HC have been developed. Thus, there is an urgent need to understand the genetic architecture and molecular pathogenesis of HC. Without this knowledge, the development of preventive, diagnostic, and therapeutic measures is impeded. However, the genetics of HC is extraordinarily complex, based on studies of varying size, scope, and rigor. This review serves to provide a comprehensive overview of genes, pathways, mechanisms, and global impact of genetics contributing to all etiologies of HC in humans.
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Affiliation(s)
- Andrew T Hale
- Department of Neurosurgery, University of Alabama at Birmingham, FOT Suite 1060, 1720 2ndAve, Birmingham, AL, 35294, UK.
| | - Hunter Boudreau
- Department of Neurosurgery, University of Alabama at Birmingham, FOT Suite 1060, 1720 2ndAve, Birmingham, AL, 35294, UK
| | - Rishi Devulapalli
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, UK
| | - Phan Q Duy
- Department of Neurosurgery, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Travis J Atchley
- Department of Neurosurgery, University of Alabama at Birmingham, FOT Suite 1060, 1720 2ndAve, Birmingham, AL, 35294, UK
| | - Michael C Dewan
- Division of Pediatric Neurosurgery, Monroe Carell Jr. Children's Hospital, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Mubeen Goolam
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Graham Fieggen
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Division of Pediatric Neurosurgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Heather L Spader
- Department of Neurosurgery, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Anastasia A Smith
- Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, UK
| | - Jeffrey P Blount
- Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, UK
| | - James M Johnston
- Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, UK
| | - Brandon G Rocque
- Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, UK
| | - Curtis J Rozzelle
- Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, UK
| | - Zechen Chong
- Heflin Center for Genomics, University of Alabama at Birmingham, Birmingham, AL, UK
| | - Jennifer M Strahle
- Division of Pediatric Neurosurgery, St. Louis Children's Hospital, Washington University in St. Louis, St. Louis, MO, USA
| | - Steven J Schiff
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Kristopher T Kahle
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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5
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Eisma JJ, McKnight CD, Hett K, Elenberger J, Han CJ, Song AK, Considine C, Claassen DO, Donahue MJ. Deep learning segmentation of the choroid plexus from structural magnetic resonance imaging (MRI): validation and normative ranges across the adult lifespan. Fluids Barriers CNS 2024; 21:21. [PMID: 38424598 PMCID: PMC10903155 DOI: 10.1186/s12987-024-00525-9] [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: 09/08/2023] [Accepted: 02/21/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The choroid plexus functions as the blood-cerebrospinal fluid (CSF) barrier, plays an important role in CSF production and circulation, and has gained increased attention in light of the recent elucidation of CSF circulation dysfunction in neurodegenerative conditions. However, methods for routinely quantifying choroid plexus volume are suboptimal and require technical improvements and validation. Here, we propose three deep learning models that can segment the choroid plexus from commonly-acquired anatomical MRI data and report performance metrics and changes across the adult lifespan. METHODS Fully convolutional neural networks were trained from 3D T1-weighted, 3D T2-weighted, and 2D T2-weighted FLAIR MRI using gold-standard manual segmentations in control and neurodegenerative participants across the lifespan (n = 50; age = 21-85 years). Dice coefficients, 95% Hausdorff distances, and area-under-curve (AUCs) were calculated for each model and compared to segmentations from FreeSurfer using two-tailed Wilcoxon tests (significance criteria: p < 0.05 after false discovery rate multiple comparisons correction). Metrics were regressed against lateral ventricular volume using generalized linear models to assess model performance for varying levels of atrophy. Finally, models were applied to an expanded cohort of adult controls (n = 98; age = 21-89 years) to provide an exemplar of choroid plexus volumetry values across the lifespan. RESULTS Deep learning results yielded Dice coefficient = 0.72, Hausdorff distance = 1.97 mm, AUC = 0.87 for T1-weighted MRI, Dice coefficient = 0.72, Hausdorff distance = 2.22 mm, AUC = 0.87 for T2-weighted MRI, and Dice coefficient = 0.74, Hausdorff distance = 1.69 mm, AUC = 0.87 for T2-weighted FLAIR MRI; values did not differ significantly between MRI sequences and were statistically improved compared to current commercially-available algorithms (p < 0.001). The intraclass coefficients were 0.95, 0.95, and 0.96 between T1-weighted and T2-weighted FLAIR, T1-weighted and T2-weighted, and T2-weighted and T2-weighted FLAIR models, respectively. Mean lateral ventricle choroid plexus volume across all participants was 3.20 ± 1.4 cm3; a significant, positive relationship (R2 = 0.54-0.60) was observed between participant age and choroid plexus volume for all MRI sequences (p < 0.001). CONCLUSIONS Findings support comparable performance in choroid plexus delineation between standard, clinically available, non-contrasted anatomical MRI sequences. The software embedding the evaluated models is freely available online and should provide a useful tool for the growing number of studies that desire to quantitatively evaluate choroid plexus structure and function ( https://github.com/hettk/chp_seg ).
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Affiliation(s)
- Jarrod J Eisma
- Department of Neurology, Behavioral and Cognitive Neurology, Vanderbilt University Medical Center, 1500 21 stAve South, Village at Vanderbilt, Suite 2600, Nashville, TN, 37212, USA
| | - Colin D McKnight
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kilian Hett
- Department of Neurology, Behavioral and Cognitive Neurology, Vanderbilt University Medical Center, 1500 21 stAve South, Village at Vanderbilt, Suite 2600, Nashville, TN, 37212, USA
| | - Jason Elenberger
- Department of Neurology, Behavioral and Cognitive Neurology, Vanderbilt University Medical Center, 1500 21 stAve South, Village at Vanderbilt, Suite 2600, Nashville, TN, 37212, USA
| | - Caleb J Han
- Department of Neurology, Behavioral and Cognitive Neurology, Vanderbilt University Medical Center, 1500 21 stAve South, Village at Vanderbilt, Suite 2600, Nashville, TN, 37212, USA
| | - Alexander K Song
- Department of Neurology, Behavioral and Cognitive Neurology, Vanderbilt University Medical Center, 1500 21 stAve South, Village at Vanderbilt, Suite 2600, Nashville, TN, 37212, USA
| | - Ciaran Considine
- Department of Neurology, Behavioral and Cognitive Neurology, Vanderbilt University Medical Center, 1500 21 stAve South, Village at Vanderbilt, Suite 2600, Nashville, TN, 37212, USA
| | - Daniel O Claassen
- Department of Neurology, Behavioral and Cognitive Neurology, Vanderbilt University Medical Center, 1500 21 stAve South, Village at Vanderbilt, Suite 2600, Nashville, TN, 37212, USA
| | - Manus J Donahue
- Department of Neurology, Behavioral and Cognitive Neurology, Vanderbilt University Medical Center, 1500 21 stAve South, Village at Vanderbilt, Suite 2600, Nashville, TN, 37212, USA.
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA.
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Han G, Wan S, Dandu C, Zhou D, Ding Y, Ji X, Meng R. Intensive mannitol slow infusion post-stenting may attenuate stenting-related early adverse effects in patients with cerebral venous sinus stenosis. CNS Neurosci Ther 2024; 30:e14350. [PMID: 37424178 PMCID: PMC10848041 DOI: 10.1111/cns.14350] [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: 02/17/2023] [Revised: 06/18/2023] [Accepted: 06/26/2023] [Indexed: 07/11/2023] Open
Abstract
AIMS To analyze intensive slow mannitol poststenting on attenuating stenting-related early adverse effects in cerebral venous sinus stenosis (CVSS). METHODS This real-world study enrolled subacute or chronic CVSS patients from January 2017 through March 2022 and divided them into DSA only and stenting post-DSA groups. The later group was subdivided into control (without extra mannitol use) and intensive slow mannitol subgroup (immediate extra mannitol 250-500 mL, 2 mL/min infusion post-stenting) after signed informed consent. All data were compared. RESULTS A total of 95 eligible patients entered into final analysis, in which 37 cases underwent DSA only and 58 cases underwent stenting post-DSA. Finally, 28 patients were entered into intensive slow mannitol subgroup and 30 in control. Stenting group vs. DSA group, HIT-6 scores and WBC counts were higher in the former (both p < 0.001). Intensive slow mannitol subgroup vs. control on the third day post-stenting, a statistically significant reductions were noticed in the former on WBC counts (6.19 ± 1.86 × 109 /L vs. 9.59 ± 2.05 × 109 /L); HIT-6 scores (degree of headache) (40.00 (38.00-40.00) vs. 49.00 (41.75-55.25)) and brain edema surrounding the stent on CT maps (17.86% vs.96.67%), all p < 0.001. CONCLUSIONS Stenting-related severe headache, inflammatory biomarkers elevation, and brain edema aggravation can be attenuated by intensive slow mannitol infusion.
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Affiliation(s)
- Guangyu Han
- Department of Neurology, Xuanwu HospitalCapital Medical UniversityBeijingChina
- Advanced Center of StrokeBeijing Institute for Brain DisordersBeijingChina
- National Center for Neurological Disorders, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Shuling Wan
- Department of Neurology, Xuanwu HospitalCapital Medical UniversityBeijingChina
- Advanced Center of StrokeBeijing Institute for Brain DisordersBeijingChina
- National Center for Neurological Disorders, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Chaitu Dandu
- Department of NeurosurgeryWayne State University School of MedicineDetroitMichiganUSA
| | - Da Zhou
- Department of Neurology, Xuanwu HospitalCapital Medical UniversityBeijingChina
- Advanced Center of StrokeBeijing Institute for Brain DisordersBeijingChina
- National Center for Neurological Disorders, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Yuchuan Ding
- Department of NeurosurgeryWayne State University School of MedicineDetroitMichiganUSA
| | - Xunming Ji
- National Center for Neurological Disorders, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Ran Meng
- Department of Neurology, Xuanwu HospitalCapital Medical UniversityBeijingChina
- Advanced Center of StrokeBeijing Institute for Brain DisordersBeijingChina
- National Center for Neurological Disorders, Xuanwu HospitalCapital Medical UniversityBeijingChina
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7
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Aragón C, Robinson D, Kocher M, Barrick K, Chen L, Zierhut H. Genetic etiologies and diagnostic methods for congenital ventriculomegaly and hydrocephalus: A scoping review. Birth Defects Res 2024; 116:e2287. [PMID: 38116905 DOI: 10.1002/bdr2.2287] [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: 08/30/2023] [Accepted: 11/26/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Congenital hydrocephalus (CH) is a life-threatening neurological condition that results from an imbalance in production, flow, or absorption of cerebrospinal fluid. Predicted outcomes from in utero diagnosis are frequently unclear. Moreover, conventional treatments consisting primarily of antenatal and postnatal surgeries are often unsuccessful, leading to high mortality rates. Causes of CH can range from secondary insults to germline pathogenic variants, complicating diagnostic processes and treatment outcomes. Currently, an updated summary of CH genetic etiologies in conjunction with clinical testing methodologies is lacking. This review addresses this need by generating a centralized survey of known genetic causes and available molecular tests for CH. METHODS The scoping review protocol was registered with the Open Science Framework and followed the Arksey and O'Malley framework and the Joanna Briggs Institute methodology. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was utilized to define search guidelines and screening criteria. RESULTS Our survey revealed a high number of genetic etiologies associated with CH, ranging from single gene variants to multifactorial birth defects, and additionally uncovered diagnostic challenges that are further complicated by changes in testing approaches over the years. Furthermore, we discovered that most of the existing literature consists of case reports, underscoring the need for studies that utilize CH patient research cohorts as well as more mechanistic studies. CONCLUSIONS The pursuit of such studies will facilitate novel gene discovery while recognizing phenotypic complexity. Addressing these research gaps could ultimately inform evidence-based diagnostic guidelines to improve patient care.
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Affiliation(s)
- Caroline Aragón
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, Minnesota, USA
| | - D'aviyan Robinson
- Department of Biology Teaching and Learning, University of Minnesota, Minneapolis, Minnesota, USA
| | - Megan Kocher
- University of Minnesota Libraries, Minneapolis, Minnesota, USA
| | - Katie Barrick
- University of Minnesota Libraries, Minneapolis, Minnesota, USA
| | - Lihsia Chen
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, Minnesota, USA
- Developmental Biology Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Heather Zierhut
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, Minnesota, USA
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8
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Sandau US, Magaña SM, Costa J, Nolan JP, Ikezu T, Vella LJ, Jackson HK, Moreira LR, Palacio PL, Hill AF, Quinn JF, Van Keuren‐Jensen KR, McFarland TJ, Palade J, Sribnick EA, Su H, Vekrellis K, Coyle B, Yang Y, Falcón‐Perez JM, Nieuwland R, Saugstad JA. Recommendations for reproducibility of cerebrospinal fluid extracellular vesicle studies. J Extracell Vesicles 2024; 13:e12397. [PMID: 38158550 PMCID: PMC10756860 DOI: 10.1002/jev2.12397] [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: 06/30/2023] [Revised: 11/09/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024] Open
Abstract
Cerebrospinal fluid (CSF) is a clear, transparent fluid derived from blood plasma that protects the brain and spinal cord against mechanical shock, provides buoyancy, clears metabolic waste and transports extracellular components to remote sites in the brain. Given its contact with the brain and the spinal cord, CSF is the most informative biofluid for studies of the central nervous system (CNS). In addition to other components, CSF contains extracellular vesicles (EVs) that carry bioactive cargoes (e.g., lipids, nucleic acids, proteins), and that can have biological functions within and beyond the CNS. Thus, CSF EVs likely serve as both mediators of and contributors to communication in the CNS. Accordingly, their potential as biomarkers for CNS diseases has stimulated much excitement for and attention to CSF EV research. However, studies on CSF EVs present unique challenges relative to EV studies in other biofluids, including the invasive nature of CSF collection, limited CSF volumes and the low numbers of EVs in CSF as compared to plasma. Here, the objectives of the International Society for Extracellular Vesicles CSF Task Force are to promote the reproducibility of CSF EV studies by providing current reporting and best practices, and recommendations and reporting guidelines, for CSF EV studies. To accomplish this, we created and distributed a world-wide survey to ISEV members to assess methods considered 'best practices' for CSF EVs, then performed a detailed literature review for CSF EV publications that was used to curate methods and resources. Based on responses to the survey and curated information from publications, the CSF Task Force herein provides recommendations and reporting guidelines to promote the reproducibility of CSF EV studies in seven domains: (i) CSF Collection, Processing, and Storage; (ii) CSF EV Separation/Concentration; (iii) CSF EV Size and Number Measurements; (iv) CSF EV Protein Studies; (v) CSF EV RNA Studies; (vi) CSF EV Omics Studies and (vii) CSF EV Functional Studies.
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Affiliation(s)
- Ursula S. Sandau
- Department of Anesthesiology & Perioperative MedicineOregon Health & Science UniversityPortlandOregonUSA
| | - Setty M. Magaña
- Center for Clinical and Translational Research, Abigail Wexner Research InstituteNationwide Children's HospitalColumbusOhioUSA
| | - Júlia Costa
- Instituto de Tecnologia Química e Biológica António XavierUniversidade Nova de Lisboa, Avenida da RepúblicaOeirasPortugal
| | - John P. Nolan
- Scintillon Institute for Biomedical and Bioenergy ResearchSan DiegoCaliforniaUSA
| | - Tsuneya Ikezu
- Department of NeuroscienceMayo Clinic FloridaJacksonvilleFloridaUSA
| | - Laura J. Vella
- Department of Surgery, The Royal Melbourne HospitalThe University of MelbourneParkvilleVictoriaAustralia
- The Florey Institute of Neuroscience and Mental HealthUniversity of MelbourneParkville, MelbourneVictoriaAustralia
| | - Hannah K. Jackson
- Department of PathologyUniversity of CambridgeCambridgeUK
- Exosis, Inc.Palm BeachFloridaUSA
| | - Lissette Retana Moreira
- Department of Parasitology, Faculty of MicrobiologyUniversity of Costa RicaSan JoséCosta Rica, Central America
- Centro de Investigación en Enfermedades TropicalesUniversity of Costa RicaSan JoséCosta Rica, Central America
| | - Paola Loreto Palacio
- Center for Clinical and Translational Research, Abigail Wexner Research InstituteNationwide Children's HospitalColumbusOhioUSA
| | - Andrew F. Hill
- Institute for Health and SportVictoria UniversityMelbourneVictoriaAustralia
- Department of Biochemistry and Chemistry, La Trobe Institute for Molecular ScienceLa Trobe UniversityBundooraVictoriaAustralia
| | - Joseph F. Quinn
- Department of NeurologyOregon Health & Science UniversityPortlandOregonUSA
- Portland VA Medical CenterPortlandOregonUSA
| | | | - Trevor J. McFarland
- Department of Anesthesiology & Perioperative MedicineOregon Health & Science UniversityPortlandOregonUSA
| | - Joanna Palade
- Neurogenomics DivisionTranslational Genomics Research InstitutePhoenixArizonaUSA
| | - Eric A. Sribnick
- Department of NeurosurgeryNationwide Children's Hospital, The Ohio State UniversityColumbusOhioUSA
| | - Huaqi Su
- The Florey Institute of Neuroscience and Mental HealthUniversity of MelbourneParkville, MelbourneVictoriaAustralia
| | | | - Beth Coyle
- Children's Brain Tumour Research Centre, School of MedicineUniversity of Nottingham Biodiscovery Institute, University of NottinghamNottinghamNottinghamshireUK
| | - You Yang
- Scintillon Institute for Biomedical and Bioenergy ResearchSan DiegoCaliforniaUSA
| | - Juan M. Falcón‐Perez
- Exosomes Laboratory, Center for Cooperative Research in BiosciencesBasque Research and Technology AllianceDerioSpain
- Metabolomics Platform, Center for Cooperative Research in BiosciencesBasque Research and Technology AllianceDerioSpain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasMadridSpain
- Ikerbasque, Basque Foundation for ScienceBilbaoSpain
| | - Rienk Nieuwland
- Laboratory of Experimental Clinical Chemistry, Amsterdam University Medical Centers, Location AMCUniversity of AmsterdamAmsterdamThe Netherlands
- Amsterdam Vesicle Center, Amsterdam University Medical Centers, Location AMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Julie A. Saugstad
- Department of Anesthesiology & Perioperative MedicineOregon Health & Science UniversityPortlandOregonUSA
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Pietilä R, Del Gaudio F, He L, Vázquez-Liébanas E, Vanlandewijck M, Muhl L, Mocci G, Bjørnholm KD, Lindblad C, Fletcher-Sandersjöö A, Svensson M, Thelin EP, Liu J, van Voorden AJ, Torres M, Antila S, Xin L, Karlström H, Storm-Mathisen J, Bergersen LH, Moggio A, Hansson EM, Ulvmar MH, Nilsson P, Mäkinen T, Andaloussi Mäe M, Alitalo K, Proulx ST, Engelhardt B, McDonald DM, Lendahl U, Andrae J, Betsholtz C. Molecular anatomy of adult mouse leptomeninges. Neuron 2023; 111:3745-3764.e7. [PMID: 37776854 DOI: 10.1016/j.neuron.2023.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 07/07/2023] [Accepted: 09/05/2023] [Indexed: 10/02/2023]
Abstract
Leptomeninges, consisting of the pia mater and arachnoid, form a connective tissue investment and barrier enclosure of the brain. The exact nature of leptomeningeal cells has long been debated. In this study, we identify five molecularly distinct fibroblast-like transcriptomes in cerebral leptomeninges; link them to anatomically distinct cell types of the pia, inner arachnoid, outer arachnoid barrier, and dural border layer; and contrast them to a sixth fibroblast-like transcriptome present in the choroid plexus and median eminence. Newly identified transcriptional markers enabled molecular characterization of cell types responsible for adherence of arachnoid layers to one another and for the arachnoid barrier. These markers also proved useful in identifying the molecular features of leptomeningeal development, injury, and repair that were preserved or changed after traumatic brain injury. Together, the findings highlight the value of identifying fibroblast transcriptional subsets and their cellular locations toward advancing the understanding of leptomeningeal physiology and pathology.
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Affiliation(s)
- Riikka Pietilä
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, 75185 Uppsala, Sweden
| | - Francesca Del Gaudio
- Department of Medicine Huddinge, Karolinska Institutet, 14157 Huddinge, Sweden; Department of Cell and Molecular Biology, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Liqun He
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, 75185 Uppsala, Sweden
| | - Elisa Vázquez-Liébanas
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, 75185 Uppsala, Sweden
| | - Michael Vanlandewijck
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, 75185 Uppsala, Sweden; Department of Medicine Huddinge, Karolinska Institutet, 14157 Huddinge, Sweden
| | - Lars Muhl
- Department of Medicine Huddinge, Karolinska Institutet, 14157 Huddinge, Sweden
| | - Giuseppe Mocci
- Department of Medicine Huddinge, Karolinska Institutet, 14157 Huddinge, Sweden
| | - Katrine D Bjørnholm
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Center for Alzheimer Research, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Caroline Lindblad
- Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden; Department of Neurosurgery, Uppsala University Hospital, 75185 Uppsala, Sweden; Department of Medical Sciences, Uppsala University, 75185 Uppsala, Sweden
| | - Alexander Fletcher-Sandersjöö
- Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden; Department of Neurosurgery, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Mikael Svensson
- Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden; Department of Neurology, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Eric P Thelin
- Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden; Department of Neurology, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Jianping Liu
- Department of Medicine Huddinge, Karolinska Institutet, 14157 Huddinge, Sweden
| | - A Jantine van Voorden
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, 75185 Uppsala, Sweden
| | - Monica Torres
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, 75185 Uppsala, Sweden
| | - Salli Antila
- Wihuri Research Institute and Translational Cancer Medicine Program, University of Helsinki, 00014 Helsinki, Finland
| | - Li Xin
- Theodor Kocher Institute, University of Bern, 3012 Bern, Switzerland
| | - Helena Karlström
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Center for Alzheimer Research, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Jon Storm-Mathisen
- Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, 0317 Oslo, Norway
| | - Linda Hildegard Bergersen
- Brain and Muscle Energy Group, Institute of Oral Biology, University of Oslo, 0316 Oslo, Norway; Center for Healthy Aging, Copenhagen University, 2200 Copenhagen, Denmark
| | - Aldo Moggio
- Department of Cell and Molecular Biology, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Emil M Hansson
- Department of Cell and Molecular Biology, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Maria H Ulvmar
- Department of Medical Biochemistry and Microbiology, Uppsala University, 75123 Uppsala, Sweden
| | - Per Nilsson
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Center for Alzheimer Research, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Taija Mäkinen
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, 75185 Uppsala, Sweden
| | - Maarja Andaloussi Mäe
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, 75185 Uppsala, Sweden
| | - Kari Alitalo
- Wihuri Research Institute and Translational Cancer Medicine Program, University of Helsinki, 00014 Helsinki, Finland
| | - Steven T Proulx
- Theodor Kocher Institute, University of Bern, 3012 Bern, Switzerland
| | - Britta Engelhardt
- Theodor Kocher Institute, University of Bern, 3012 Bern, Switzerland
| | - Donald M McDonald
- Cardiovascular Research Institute, UCSF Helen Diller Family Comprehensive Cancer Center, and Department of Anatomy, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Urban Lendahl
- Department of Cell and Molecular Biology, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Johanna Andrae
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, 75185 Uppsala, Sweden
| | - Christer Betsholtz
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, 75185 Uppsala, Sweden; Department of Medicine Huddinge, Karolinska Institutet, 14157 Huddinge, Sweden.
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10
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Hashimoto H, Takemoto O, Chiba Y. Growth patterns and ratios of posterior cranial fossa structures in the Japanese pediatric population: a study utilizing CT scans. Neuroradiology 2023; 65:1835-1844. [PMID: 37798333 DOI: 10.1007/s00234-023-03229-3] [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: 07/10/2023] [Accepted: 09/26/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE The changes in the proportion of posterior cranial fossa structures during pediatric development remain unclear. This retrospective study aimed to investigate the growth patterns and ratios of these structures using CT scans. METHODS Head CT scans of pediatric patients with minor head trauma from Osaka Women's and Children's Hospital between March 2006 and May 2023 were analyzed. The study segmented the intracranial volume (ICV), posterior cranial fossa volume (PCFV), cerebellum volume (CBMV), and brainstem volume (BSV). Correlation coefficients were calculated among the parameters. Patients aged 0 to 10 years were divided into 15 age-related clusters, and mean and standard deviation values were measured. Growth curves were created by plotting mean values sequentially. Ratios such as PCFV/ICV and (CBMV + BSV)/PCFV were examined. Statistical analyses, including unpaired t tests and logarithmic curve fitting, were performed. RESULTS A total of 234 CT scans (97 from females, 115 from infants under 1 year of age) were analyzed. Positive correlations were observed among the parameters, with the strongest between PCFV and CBMV. The growth curves for ICV, PCFV, CBMV, and BSV exhibited a two-phase process, with rapid growth until approximately 4 years of age, followed by stabilization. The ratios PCFV/ICV and (CBMV + BSV)/PCFV showed increasing trends from birth onwards, stabilizing by 4 and 1 years of age, respectively. CONCLUSION This study provides insights into the growth patterns and ratios of posterior cranial fossa structures in the pediatric population. The findings demonstrate a two-phase growth process and increasing trends in the examined ratios.
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Affiliation(s)
- Hiroaki Hashimoto
- Department of Neurosurgery, Osaka Women's and Children's Hospital, Osaka, Izumi, 594-1101, Japan.
- Department of Neurological Diagnosis and Restoration, Graduate School of Medicine, Osaka University, Osaka, Suita, 565-0871, Japan.
| | - Osamu Takemoto
- Department of Neurosurgery, Osaka Women's and Children's Hospital, Osaka, Izumi, 594-1101, Japan
| | - Yasuyoshi Chiba
- Department of Neurosurgery, Osaka Women's and Children's Hospital, Osaka, Izumi, 594-1101, Japan
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11
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Sanker V, Kundu M, El Kassem S, El Nouiri A, Emara M, Maaz ZA, Nazir A, Bekele BK, Uwishema O. Posttraumatic hydrocephalus: Recent advances and new therapeutic strategies. Health Sci Rep 2023; 6:e1713. [PMID: 38028696 PMCID: PMC10652704 DOI: 10.1002/hsr2.1713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/28/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
Background Hydrocephalus or ventriculomegaly is a condition brought on by an overabundance of cerebrospinal fluid (CSF) in the ventricular system. The major contributor to posttraumatic hydrocephalus (PTH) is traumatic brain injuries (TBIs), especially in individuals with occupations set in industrial settings. A variety of criteria have been employed for the diagnosis of PTH, including the combination of neurological symptoms like nerve deficits and headache, as well as an initial improvement followed by a worsened relapse of altered consciousness and neurological deterioration, which is detected by computed tomography-brain imaging that reveals gradual ventriculomegaly. Aim In this article, we discuss and summarize briefly the current understandings and advancements in the management of PTH. Methods The available literature for this review was searched on various bibliographic databases using an individually verified, prespecified approach. The level of evidence of the included studies was considered as per the Centre for Evidence-Based Medicine recommendations. Results The commonly practiced current treatment modality involves shunting CSF but is often associated with complications and recurrence. The lack of a definitive management strategy for PTH warrants the utilization of novel and innovative modalities such as stem cell transplantations and antioxidative stress therapies. Conclusion One of the worst complications of a TBI is PTH, which has a high morbidity and mortality rate. Even though there hasn't been a successful method in stopping PTH from happening, hemorrhage-derived blood, and its metabolic by-products, like iron, hemoglobin, free radicals, thrombin, and red blood cells, may be potential targets for PTH hindrance and management. Also, using stem cell transplantations in animal models and antioxidative stress therapies in future studies can lower PTH occurrence and improve its outcome. Moreover, the integration of clinical trials and theoretical knowledge should be encouraged in future research projects to establish effective and updated management guidelines for PTH.
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Affiliation(s)
- Vivek Sanker
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Society of Brain Mapping and TherapeuticsLos AngelesCaliforniaUSA
| | - Mrinmoy Kundu
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Institute of Medical Sciences and SUM HospitalBhubaneswarIndia
| | - Sarah El Kassem
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Faculty of MedicineBeirut Arab UniversityBeirutLebanon
| | - Ahmad El Nouiri
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Faculty of MedicineBeirut Arab UniversityBeirutLebanon
| | - Mohamed Emara
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- College of MedicineUniversity of SharjahSharjahUnited Arab Emirates
| | - Zeina Al Maaz
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Faculty of MedicineBeirut Arab UniversityBeirutLebanon
| | - Abubakar Nazir
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
| | - Bezawit Kassahun Bekele
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- School of MedicineAddis Ababa UniversityAddis AbabaEthiopia
- Milken Institute of Public HealthGeorge Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Olivier Uwishema
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Department of medicineClinton Global Initiative UniversityNew YorkNew YorkUSA
- Faculty of MedicineKaradeniz Technical UniversityTrabzonTurkey
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12
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Wang DJJ, Hua J, Cao D, Ho ML. Neurofluids and the glymphatic system: anatomy, physiology, and imaging. Br J Radiol 2023; 96:20230016. [PMID: 37191063 PMCID: PMC10607419 DOI: 10.1259/bjr.20230016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/05/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023] Open
Abstract
First described in 2012, the glymphatic system is responsible for maintaining homeostasis within the central nervous system, including nutrient delivery, waste clearance, and consistency of the ionic microenvironment. It is comprised of glial cells and barrier systems that modulate neurofluid production, circulation, and exchange. Experimental interrogation of neurofluid dynamics is restricted to ex vivo and in vitro studies in animals and humans, therefore diagnostic imaging plays an important role in minimally invasive evaluation. This review article will synthesize current knowledge and theories regarding neurofluid circulation and implications for neuroimaging. First, we will discuss the anatomy of the neurogliovascular unit, including paravascular and perivascular pathways of fluid exchange. In addition, we will summarize the structure and function of barrier systems including the blood-brain, blood-cerebrospinal fluid, and brain-cerebrospinal fluid barriers. Next, we will mention physiologic factors that yield normal variations in neurofluid circulation, and how various disease pathologies can disrupt glymphatic drainage pathways. Lastly, we will cover the spectrum of diagnostic imaging and interventional techniques with relevance to glymphatic structure, flow, and function. We conclude by highlighting current barriers and future directions for translational imaging and applications to neurologic disorders.
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Affiliation(s)
- Danny JJ Wang
- Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, United States
| | | | | | - Mai-Lan Ho
- Nationwide Children’s Hospital and The Ohio State University, Columbus, Ohio, United States
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13
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Diaz PM, Leehans A, Ravishankar P, Daily A. Multiomic Approaches for Cancer Biomarker Discovery in Liquid Biopsies: Advances and Challenges. Biomark Insights 2023; 18:11772719231204508. [PMID: 37846373 PMCID: PMC10576933 DOI: 10.1177/11772719231204508] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/12/2023] [Indexed: 10/18/2023] Open
Abstract
Cancer is a complex and heterogeneous disease that poses a significant threat to global health. Early diagnosis and treatment are critical for improving patient outcomes, and the use of liquid biopsies has emerged as a promising approach for cancer detection and monitoring. Traditionally, cancer diagnosis has relied on invasive tissue biopsies, the collection of which can prove challenging for patients and the results of which may not always provide accurate results due to tumor heterogeneity. Liquid biopsies have gained increasing attention as they provide a non-invasive and accessible source of cancer biomarkers, which can be used to diagnose cancer, monitor treatment response, and detect relapse. The integration of -omics technologies, such as proteomics, genomics, and metabolomics, has further enhanced the capabilities of liquid biopsies by introducing precision oncology and enabling the tailoring of treatment for individual patients based on their unique tumor biology. In this review, we will discuss the challenges and advances in the field of cancer liquid biopsies and the integration of -omics technologies for different types of liquid biopsies, including blood, tear, urine, sweat, saliva, and cerebrospinal fluid.
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Affiliation(s)
- Paola Monterroso Diaz
- Namida Lab Inc., Fayetteville, AR, USA
- University of Arkansas, Department of Biomedical Engineering, Fayetteville, AR, USA
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14
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Eisma JJ, McKnight CD, Hett K, Elenberger J, Song AK, Considine C, Claassen DO, Donahue MJ. Deep learning segmentation of the choroid plexus from structural magnetic resonance imaging (MRI): validation and normative ranges across the adult lifespan. RESEARCH SQUARE 2023:rs.3.rs-3338860. [PMID: 37790534 PMCID: PMC10543490 DOI: 10.21203/rs.3.rs-3338860/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Background The choroid plexus functions as the blood-cerebrospinal fluid barrier, plays an important role in neurofluid production and circulation, and has gained increased attention in light of the recent elucidation of neurofluid circulation dysfunction in neurodegenerative conditions. However, methods for routinely quantifying choroid plexus volume are suboptimal and require technical improvements and validation. Here, we propose three deep learning models that can segment the choroid plexus from commonly-acquired anatomical MRI data and report performance metrics and changes across the adult lifespan. Methods Fully convolutional neural networks were trained from 3-D T1-weighted, 3-D T2-weighted, and 2-D T2-weighted FLAIR MRI and gold-standard manual segmentations in healthy and neurodegenerative participants across the lifespan (n=50; age=21-85 years). Dice coefficients, 95% Hausdorff distances, and area-under-curve (AUCs) were calculated for each model and compared to segmentations from FreeSurfer using two-tailed Wilcoxon tests (significance criteria: p<0.05 after false discovery rate multiple comparisons correction). Metrics were regressed against lateral ventricular volume using generalized linear models to assess model performance for varying levels of atrophy. Finally, models were applied to an expanded cohort of healthy adults (n=98; age=21-89 years) to provide an exemplar of choroid plexus volumetry values across the lifespan. Results Deep learning results yielded Dice coefficient=0.72, Hausdorff distance=1.97 mm, AUC=0.87 for T1-weighted MRI, Dice coefficient=0.72, Hausdorff distance=2.22 mm, AUC=0.87 for T2-weighted MRI, and Dice coefficient=0.74, Hausdorff distance=1.69 mm, AUC=0.87 for T2-weighted FLAIR MRI; values did not differ significantly between2 MRI sequences and were statistically improved compared to current commercially-available algorithms (p<0.001). The intraclass coefficients were 0.95, 0.95, and 0.96 between T1-weighted and T2-FLAIR, T1-weighted and T2-weighted, and T2-weighted and T2-FLAIR models, respectively. Mean lateral ventricle choroid plexus volume across all participants was 3.20±1.4 cm3; a significant, positive relationship (R2=0.54; slope=0.047) was observed between participant age and choroid plexus volume for all MRI sequences (p<0.001). Conclusions Findings support comparable performance in choroid plexus delineation between standard, clinically available, non-contrasted anatomical MRI sequences. The software embedding the evaluated models is freely available online and should provide a useful tool for the growing number of studies that desire to quantitatively evaluate choroid plexus structure and function (https://github.com/hettk/chp_seg).
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15
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Tidwell JB, Taylor JA, Collins HR, Chamberlin JH, Barisano G, Sepehrband F, Turner MD, Gauthier G, Mulder ER, Gerlach DA, Roberts DR. Longitudinal Changes in Cerebral Perfusion, Perivascular Space Volume, and Ventricular Volume in a Healthy Cohort Undergoing a Spaceflight Analog. AJNR Am J Neuroradiol 2023; 44:1026-1031. [PMID: 37562828 PMCID: PMC10494950 DOI: 10.3174/ajnr.a7949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 06/25/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND AND PURPOSE A global decrease in brain perfusion has recently been reported during exposure to a ground-based spaceflight analog. Considering that CSF and glymphatic flow are hypothesized to be propelled by arterial pulsations, it is unknown whether a change in perfusion would impact these CSF compartments. The aim of the current study was to evaluate the relationship among changes in cerebral perfusion, ventricular volume, and perivascular space volume before, during, and after a spaceflight analog. MATERIALS AND METHODS Eleven healthy participants underwent 30 days of bed rest at 6° head-down tilt with 0.5% atmospheric CO2 as a spaceflight analog. For each participant, 6 MR imaging brain scans, including perfusion and anatomic-weighted T1 sequences, were obtained before, during, and after the analog period. Global perfusion, ventricular volume, and perivascular space volume time courses were constructed and evaluated with repeated measures ANOVAs. RESULTS Global perfusion followed a divergent time trajectory from ventricular and perivascular space volume, with perfusion decreasing during the analog, whereas ventricular and perivascular space volume increased (P < .001). These patterns subsequently reversed during the 2-week recovery period. CONCLUSIONS The patterns of change in brain physiology observed in healthy participants suggest a relationship between cerebral perfusion and CSF homeostasis. Further study is warranted to determine whether a causal relationship exists and whether similar neurophysiologic responses occur during spaceflight.
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Affiliation(s)
- J B Tidwell
- From the Department of Radiology and Radiological Science (J.B.T., J.A.T., H.R.C., J.H.C., M.D.T., G.G., D.R.R.), Medical University of South Carolina; Charleston, South Carolina
| | - J A Taylor
- From the Department of Radiology and Radiological Science (J.B.T., J.A.T., H.R.C., J.H.C., M.D.T., G.G., D.R.R.), Medical University of South Carolina; Charleston, South Carolina
| | - H R Collins
- From the Department of Radiology and Radiological Science (J.B.T., J.A.T., H.R.C., J.H.C., M.D.T., G.G., D.R.R.), Medical University of South Carolina; Charleston, South Carolina
| | - J H Chamberlin
- From the Department of Radiology and Radiological Science (J.B.T., J.A.T., H.R.C., J.H.C., M.D.T., G.G., D.R.R.), Medical University of South Carolina; Charleston, South Carolina
| | - G Barisano
- Laboratory of Neuroimaging (F.S.), University of Southern California, Los Angeles, California
| | - F Sepehrband
- Department of Neurosurgery (G.B.), Stanford University, Stanford, California
| | - M D Turner
- From the Department of Radiology and Radiological Science (J.B.T., J.A.T., H.R.C., J.H.C., M.D.T., G.G., D.R.R.), Medical University of South Carolina; Charleston, South Carolina
| | - G Gauthier
- From the Department of Radiology and Radiological Science (J.B.T., J.A.T., H.R.C., J.H.C., M.D.T., G.G., D.R.R.), Medical University of South Carolina; Charleston, South Carolina
| | - E R Mulder
- Department of Neurosurgery (G.B.), Stanford University, Stanford, California
| | - D A Gerlach
- Department of Neurosurgery (G.B.), Stanford University, Stanford, California
| | - D R Roberts
- From the Department of Radiology and Radiological Science (J.B.T., J.A.T., H.R.C., J.H.C., M.D.T., G.G., D.R.R.), Medical University of South Carolina; Charleston, South Carolina
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16
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Marants R, Tattenberg S, Scholey J, Kaza E, Miao X, Benkert T, Magneson O, Fischer J, Vinas L, Niepel K, Bortfeld T, Landry G, Parodi K, Verburg J, Sudhyadhom A. Validation of an MR-based multimodal method for molecular composition and proton stopping power ratio determination using ex vivo animal tissues and tissue-mimicking phantoms. Phys Med Biol 2023; 68:10.1088/1361-6560/ace876. [PMID: 37463589 PMCID: PMC10645122 DOI: 10.1088/1361-6560/ace876] [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: 04/23/2023] [Accepted: 07/18/2023] [Indexed: 07/20/2023]
Abstract
Objective. Range uncertainty in proton therapy is an important factor limiting clinical effectiveness. Magnetic resonance imaging (MRI) can measure voxel-wise molecular composition and, when combined with kilovoltage CT (kVCT), accurately determine mean ionization potential (Im), electron density, and stopping power ratio (SPR). We aimed to develop a novel MR-based multimodal method to accurately determine SPR and molecular compositions. This method was evaluated in tissue-mimicking andex vivoporcine phantoms, and in a brain radiotherapy patient.Approach. Four tissue-mimicking phantoms with known compositions, two porcine tissue phantoms, and a brain cancer patient were imaged with kVCT and MRI. Three imaging-based values were determined: SPRCM(CT-based Multimodal), SPRMM(MR-based Multimodal), and SPRstoich(stoichiometric calibration). MRI was used to determine two tissue-specific quantities of the Bethe Bloch equation (Im, electron density) to compute SPRCMand SPRMM. Imaging-based SPRs were compared to measurements for phantoms in a proton beam using a multilayer ionization chamber (SPRMLIC).Main results. Root mean square errors relative to SPRMLICwere 0.0104(0.86%), 0.0046(0.45%), and 0.0142(1.31%) for SPRCM, SPRMM, and SPRstoich, respectively. The largest errors were in bony phantoms, while soft tissue and porcine tissue phantoms had <1% errors across all SPR values. Relative to known physical molecular compositions, imaging-determined compositions differed by approximately ≤10%. In the brain case, the largest differences between SPRstoichand SPRMMwere in bone and high lipids/fat tissue. The magnitudes and trends of these differences matched phantom results.Significance. Our MR-based multimodal method determined molecular compositions and SPR in various tissue-mimicking phantoms with high accuracy, as confirmed with proton beam measurements. This method also revealed significant SPR differences compared to stoichiometric kVCT-only calculation in a clinical case, with the largest differences in bone. These findings support that including MRI in proton therapy treatment planning can improve the accuracy of calculated SPR values and reduce range uncertainties.
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Affiliation(s)
- Raanan Marants
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sebastian Tattenberg
- Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians-Universität München, Garching, Germany
- Division of Radiation Biophysics, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jessica Scholey
- Department of Radiation Oncology, University of California, San Francisco, San Francisco, California, United States of America
| | - Evangelia Kaza
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Xin Miao
- Siemens Medical Solutions USA Inc., Boston, Massachusetts, United States of America
| | | | - Olivia Magneson
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jade Fischer
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Medical Physics, University of Calgary, Calgary, Alberta, Canada
| | - Luciano Vinas
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Statistics, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Katharina Niepel
- Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians-Universität München, Garching, Germany
| | - Thomas Bortfeld
- Division of Radiation Biophysics, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Guillaume Landry
- Department of Radiation Oncology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Katia Parodi
- Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians-Universität München, Garching, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Joost Verburg
- Division of Radiation Biophysics, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Atchar Sudhyadhom
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts, United States of America
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Kopeć K, Szleszkowski S, Koziorowski D, Szlufik S. Glymphatic System and Mitochondrial Dysfunction as Two Crucial Players in Pathophysiology of Neurodegenerative Disorders. Int J Mol Sci 2023; 24:10366. [PMID: 37373513 DOI: 10.3390/ijms241210366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Neurodegenerative diseases are a complex problem affecting millions of people around the world. The pathogenesis is not fully understood, but it is known that both insufficiency of the glymphatic system and mitochondrial disorders affect the development of pathology. It appears that these are not just two independent factors that coexist in the processes of neurodegeneration, but that they often interact and drive each other. Bioenergetics disturbances are potentially associated with the accumulation of protein aggregates and impaired glymphatic clearance. Furthermore, sleep disorders characteristic of neurodegeneration may impair the work of both the glymphatic system and the activity of mitochondria. Melatonin may be one of the elements linking sleep disorders with the function of these systems. Moreover, noteworthy in this context is the process of neuroinflammation inextricably linked to mitochondria and its impact not only on neurons, but also on glia cells involved in glymphatic clearance. This review only presents possible direct and indirect connections between the glymphatic system and mitochondria in the process of neurodegeneration. Clarifying the connection between these two areas in relation to neurodegeneration could lead to the development of new multidirectional therapies, which, due to the complexity of pathogenesis, seems to be worth considering.
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Affiliation(s)
- Kamila Kopeć
- Department of Neurology, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Stanisław Szleszkowski
- Department of Neurology, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Dariusz Koziorowski
- Department of Neurology, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Stanislaw Szlufik
- Department of Neurology, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
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18
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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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19
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Czarniak N, Kamińska J, Matowicka-Karna J, Koper-Lenkiewicz OM. Cerebrospinal Fluid-Basic Concepts Review. Biomedicines 2023; 11:biomedicines11051461. [PMID: 37239132 DOI: 10.3390/biomedicines11051461] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/08/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Cerebrospinal fluid plays a crucial role in protecting the central nervous system (CNS) by providing mechanical support, acting as a shock absorber, and transporting nutrients and waste products. It is produced in the ventricles of the brain and circulates through the brain and spinal cord in a continuous flow. In the current review, we presented basic concepts related to cerebrospinal fluid history, cerebrospinal fluid production, circulation, and its main components, the role of the blood-brain barrier and the blood-cerebrospinal fluid barrier in the maintenance of cerebrospinal fluid homeostasis, and the utility of Albumin Quotient (QAlb) evaluation in the diagnosis of CNS diseases. We also discussed the collection of cerebrospinal fluid (type, number of tubes, and volume), time of transport to the laboratory, and storage conditions. Finally, we briefly presented the role of cerebrospinal fluid examination in CNS disease diagnosis of various etiologies and highlighted that research on identifying cerebrospinal fluid biomarkers indicating disease presence or severity, evaluating treatment effectiveness, and enabling understanding of pathogenesis and disease mechanisms is of great importance. Thus, in our opinion, research on cerebrospinal fluid is still necessary for both the improvement of CNS disease management and the discovery of new treatment options.
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Affiliation(s)
- Natalia Czarniak
- Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Joanna Kamińska
- Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Joanna Matowicka-Karna
- Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
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20
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Svarcbahs R, Blossom SM, Baffoe-Bonnie HS, Trychta KA, Greer LK, Pickel J, Henderson MJ, Harvey BK. Atransgenic mouse line for assaying tissue-specific changes in endoplasmic reticulum proteostasis. Transgenic Res 2023; 32:209-221. [PMID: 37133648 DOI: 10.1007/s11248-023-00349-7] [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: 12/19/2022] [Accepted: 04/17/2023] [Indexed: 05/04/2023]
Abstract
Maintenance of calcium homeostasis is important for proper endoplasmic reticulum (ER) function. When cellular stress conditions deplete the high concentration of calcium in the ER, ER-resident proteins are secreted into the extracellular space in a process called exodosis. Monitoring exodosis provides insight into changes in ER homeostasis and proteostasis resulting from cellular stress associated with ER calcium dysregulation. To monitor cell-type specific exodosis in the intact animal, we created a transgenic mouse line with a Gaussia luciferase (GLuc)-based, secreted ER calcium-modulated protein, SERCaMP, preceded by a LoxP-STOP-LoxP (LSL) sequence. The Cre-dependent LSL-SERCaMP mice were crossed with albumin (Alb)-Cre and dopamine transporter (DAT)-Cre mouse lines. GLuc-SERCaMP expression was characterized in mouse organs and extracellular fluids, and the secretion of GLuc-SERCaMP in response to cellular stress was monitored following pharmacological depletion of ER calcium. In LSL-SERCaMP × Alb-Cre mice, robust GLuc activity was observed only in the liver and blood, whereas in LSL-SERCaMP × DAT-Cre mice, GLuc activity was seen in midbrain dopaminergic neurons and tissue samples innervated by dopaminergic projections. After calcium depletion, we saw increased GLuc signal in the plasma and cerebrospinal fluid collected from the Alb-Cre and DAT-Cre crosses, respectively. This mouse model can be used to investigate the secretion of ER-resident proteins from specific cell and tissue types during disease pathogenesis and may aid in the identification of therapeutics and biomarkers of disease.
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Affiliation(s)
- Reinis Svarcbahs
- Cellular Stress and Inflammation Section, Intramural Research Program, National Institute On Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Sarah M Blossom
- Cellular Stress and Inflammation Section, Intramural Research Program, National Institute On Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Helena S Baffoe-Bonnie
- Cellular Stress and Inflammation Section, Intramural Research Program, National Institute On Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Kathleen A Trychta
- Cellular Stress and Inflammation Section, Intramural Research Program, National Institute On Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Lacey K Greer
- Cellular Stress and Inflammation Section, Intramural Research Program, National Institute On Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
| | - James Pickel
- Transgenic Technology Core, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Mark J Henderson
- Cellular Stress and Inflammation Section, Intramural Research Program, National Institute On Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
- National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD, 20850, USA
| | - Brandon K Harvey
- Cellular Stress and Inflammation Section, Intramural Research Program, National Institute On Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA.
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21
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Eghbal K, Farrokhi MR, Mousavi SR, Shahpari Motlagh MA, Kazeminezhad A, Ghaffarpasand F. Acute supratentorial subdural hematoma after craniocervical junction arachnolysis in a patient with posttraumatic syringomyelia; case report and literature review. Clin Case Rep 2023; 11:e7170. [PMID: 37006844 PMCID: PMC10064022 DOI: 10.1002/ccr3.7170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/28/2023] [Accepted: 03/15/2023] [Indexed: 04/03/2023] Open
Abstract
In patients with SAA rapid CSF drainage while performing durotomy must be avoided by utilizing cotton pads and lowering the head level to avoid catastrophic complications.
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Affiliation(s)
- Keyvan Eghbal
- Department of NeurosurgeryShiraz University of Medical SciencesShirazIran
| | - Majid Reza Farrokhi
- Shiraz Neurosciences Research Center, Department of NeurosurgeryShiraz University of Medical SciencesShirazIran
| | - Seyed Reza Mousavi
- Department of NeurosurgeryShiraz University of Medical SciencesShirazIran
| | | | - Ali Kazeminezhad
- Department of Neurosurgery, Peymanieh Hospital, Trauma Research CenterJahrom University of Medical SciencesJahromIran
| | - Fariborz Ghaffarpasand
- Research Center for Neuromodulation and PainShiraz University of Medical SciencesShirazIran
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22
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Yazdan-Panah A, Schmidt-Mengin M, Ricigliano VAG, Soulier T, Stankoff B, Colliot O. Automatic segmentation of the choroid plexuses: Method and validation in controls and patients with multiple sclerosis. Neuroimage Clin 2023; 38:103368. [PMID: 36913908 PMCID: PMC10011049 DOI: 10.1016/j.nicl.2023.103368] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/10/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023]
Abstract
Choroid Plexuses (ChP) are structures located in the ventricles that produce the cerebrospinal fluid (CSF) in the central nervous system. They are also a key component of the blood-CSF barrier. Recent studies have described clinically relevant ChP volumetric changes in several neurological diseases including Alzheimer's, Parkinson's disease, and multiple sclerosis (MS). Therefore, a reliable and automated tool for ChP segmentation on images derived from magnetic resonance imaging (MRI) is a crucial need for large studies attempting to elucidate their role in neurological disorders. Here, we propose a novel automatic method for ChP segmentation in large imaging datasets. The approach is based on a 2-step 3D U-Net to keep preprocessing steps to a minimum for ease of use and to lower memory requirements. The models are trained and validated on a first research cohort including people with MS and healthy subjects. A second validation is also performed on a cohort of pre-symptomatic MS patients having acquired MRIs in routine clinical practice. Our method reaches an average Dice coefficient of 0.72 ± 0.01 with the ground truth and a volume correlation of 0.86 on the first cohort while outperforming FreeSurfer and FastSurfer-based ChP segmentations. On the dataset originating from clinical practice, the method reaches a Dice coefficient of 0.67 ± 0.01 (being close to the inter-rater agreement of 0.64 ± 0.02) and a volume correlation of 0.84. These results demonstrate that this is a suitable and robust method for the segmentation of the ChP both on research and clinical datasets.
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Affiliation(s)
- Arya Yazdan-Panah
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France
| | - Marius Schmidt-Mengin
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France
| | - Vito A G Ricigliano
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France
| | - Théodore Soulier
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France
| | - Bruno Stankoff
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, AP-HP, Hôpital Saint-Antoine, F-75012 Paris, France
| | - Olivier Colliot
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France.
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23
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Patel S, Ditamo M, Mangal R, Gould M, Ganti L. Normal Pressure Hydrocephalus. Cureus 2023; 15:e35131. [PMID: 36949988 PMCID: PMC10026533 DOI: 10.7759/cureus.35131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2023] [Indexed: 02/20/2023] Open
Abstract
Normal Pressure Hydrocephalus (NPH) occurs when there is an accumulation of cerebrospinal fluid due to impeded flow or excess production, resulting in gait and memory impairment and urinary incontinence. The authors present the case of a 67-year-old male, who had symptoms for a year prior to being diagnosed. His neurological exam was significant for a slow, and unsteady wide-based gait. No underlying cause for his NPH was found. He underwent a shunt procedure following which he made a complete recovery.
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Affiliation(s)
- Shaan Patel
- Biology, John Burroughs School, St. Louis, USA
| | | | - Rohan Mangal
- Medical School, University of Miami Miller School of Medicine, Miami, USA
| | | | - Latha Ganti
- Emergency Medicine, HCA Florida Ocala Hospital, Ocala, USA
- Emergency Medicine, Envision Physician Services, Plantation, USA
- Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA
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24
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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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25
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Chen X, Lim DA, Lawlor MW, Dimmock D, Vite CH, Lester T, Tavakkoli F, Sadhu C, Prasad S, Gray SJ. Biodistribution of Adeno-Associated Virus Gene Therapy Following Cerebrospinal Fluid-Directed Administration. Hum Gene Ther 2023; 34:94-111. [PMID: 36606687 DOI: 10.1089/hum.2022.163] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Adeno-associated virus (AAV)-based gene therapies, exemplified by the approved therapy for spinal muscular atrophy, have the potential to deliver disease-course-altering treatments for central nervous system (CNS) indications. However, several clinical trials have reported severe adverse events, including patient deaths following high-dose systemic administration for muscle-directed gene transfer, highlighting the need to explore approaches utilizing lower doses when targeting the CNS. Animal models of disease provide insight into the response to new AAV therapies. However, translation from small to larger animals and eventually to humans is hampered by anatomical and biological differences across the species and their impact on AAV delivery. We performed a literature review of preclinical studies of AAV gene therapy biodistribution following cerebrospinal fluid (CSF) delivery (intracerebroventricular, intra-cisterna magna, and intrathecal lumbar). The reviewed literature varies greatly in the reported biodistribution of AAV following administration into the CSF. Differences between studies, including animal model, vector serotype used, method used to assess biodistribution, and route of administration, among other variables, contribute to differing outcomes and difficulties in translating these preclinical results. For example, only half of the published AAV-based gene therapy studies report vector copy number, the most direct readout following administration of a vector; none of these studies reported details such as the empty:full capsid ratio and quality of encapsidated genome. Analysis of the last decade's literature focusing on AAV-based gene therapies targeting the CNS underscores limitations of the body of knowledge and room for continued research. In particular, there is a need to understand the biodistribution achieved by different CSF-directed routes of administration and determining if specific cell types/structures of interest will be transduced. Our findings point to a clear need for a more systematic approach across the field to align the assessments and elements reported in preclinical research to enable more reliable translation across animal models and into human studies.
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Affiliation(s)
- Xin Chen
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Daniel A Lim
- Department of Neurological Surgery, Eli and Edythe Broad Center for Regeneration Medicine, and the Weill Institute for Neurosciences, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Michael W Lawlor
- Medical College of Wisconsin and Diverge Translational Science Laboratory, Milwaukee, Wisconsin, USA
| | - David Dimmock
- Rady Children's Institute for Genomic Medicine, San Diego, California, USA
| | - Charles H Vite
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; and
| | | | | | | | | | - Steven J Gray
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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26
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Engel S, Halcour J, Ellwardt E, Uphaus T, Steffen F, Zipp F, Bittner S, Luessi F. Elevated neurofilament light chain CSF/serum ratio indicates impaired CSF outflow in idiopathic intracranial hypertension. Fluids Barriers CNS 2023; 20:3. [PMID: 36631830 PMCID: PMC9832777 DOI: 10.1186/s12987-022-00403-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/17/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Impaired cerebrospinal fluid (CSF) homeostasis is central to the pathogenesis of idiopathic intracranial hypertension (IIH), although the precise mechanisms involved are still not completely understood. The aim of the current study was to assess the CSF/serum ratio of neurofilament light chain levels (QNfL) as a potential indicator of functional CSF outflow obstruction in IIH patients. METHODS NfL levels were measured by single molecule array in CSF and serum samples of 87 IIH patients and in three control groups, consisting of 52 multiple sclerosis (MS) patients with an acute relapse, 21 patients with an axonal polyneuropathy (PNP), and 41 neurologically healthy controls (HC). QNfL was calculated as the ratio of CSF and serum NfL levels. Similarly, we also assessed the CSF/serum ratio of glial fibrillary acidic protein (QGFAP) levels to validate the QNfL data. Routine CSF parameters including the CSF/serum albumin ratio (QAlb) were determined in all groups. Lumbar puncture opening pressure of IIH patients was measured by manometry. RESULTS CSF-NfL levels (r = 0.29, p = 0.008) and QNfL (0.40, p = 0.0009), but not serum NfL (S-NfL) levels, were associated with lumbar puncture opening pressure in IIH patients. CSF-NfL levels were increased in IIH patients, MS patients, and PNP patients, whereas sNfL levels were normal in IIH, but elevated in MS and PNP. Remarkably, QNfL (p < 0.0001) as well as QGFAP (p < 0.01) were only increased in IIH patients. QNfL was positively correlated with CSF-NfL levels (r = 0.51, p = 0.0012) and negatively correlated with S-NfL levels (r = - 0.51, p = 0.0012) in HC, while it was only positively associated with CSF-NfL levels in IIH patients (r = 0.71, p < 0.0001). An increase in blood-CSF barrier permeability assessed by QAlb did not lead to a decrease in QNfL in any cohort. CONCLUSIONS The observed elevation of QNfL in IIH patients, which was associated with lumbar puncture opening pressure, indicates a reduced NfL transition from the CSF to serum compartment. This supports the hypothesis of a pressure-dependent CSF outflow obstruction to be critically involved in IIH pathogenesis.
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Affiliation(s)
- Sinah Engel
- grid.410607.4Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine-Main Neuroscience Network (Rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Johannes Halcour
- grid.410607.4Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine-Main Neuroscience Network (Rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Erik Ellwardt
- grid.410607.4Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine-Main Neuroscience Network (Rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Timo Uphaus
- grid.410607.4Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine-Main Neuroscience Network (Rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Falk Steffen
- grid.410607.4Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine-Main Neuroscience Network (Rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Frauke Zipp
- grid.410607.4Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine-Main Neuroscience Network (Rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Stefan Bittner
- grid.410607.4Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine-Main Neuroscience Network (Rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Felix Luessi
- Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine-Main Neuroscience Network (Rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
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27
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Rethinking the cilia hypothesis of hydrocephalus. Neurobiol Dis 2022; 175:105913. [DOI: 10.1016/j.nbd.2022.105913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/24/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
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28
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Bissenas A, Fleeting C, Patel D, Al-Bahou R, Patel A, Nguyen A, Woolridge M, Angelle C, Lucke-Wold B. CSF Dynamics: Implications for Hydrocephalus and Glymphatic Clearance. CURRENT RESEARCH IN MEDICAL SCIENCES 2022; 1:24-42. [PMID: 36649460 PMCID: PMC9840530 DOI: 10.56397/crms.2022.12.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Beyond its neuroprotective role, CSF functions to rid the brain of toxic waste products through glymphatic clearance. Disturbances in the circulation of CSF and glymphatic exchange are common among those experiencing HCP syndrome, which often results from SAH. Normally, the secretion of CSF follows a two-step process, including filtration of plasma followed by the introduction of ions, bicarbonate, and water. Arachnoid granulations are the main site of CSF absorption, although there are other influencing factors that affect this process. The pathway through which CSF is through to flow is from its site of secretion, at the choroid plexus, to its site of absorption. However, the CSF flow dynamics are influenced by the cardiovascular system and interactions between CSF and CNS anatomy. One, two, and three-dimensional models are currently methods researchers use to predict and describe CSF flow, both under normal and pathological conditions. They are, however, not without their limitations. "Rest-of-body" models, which consider whole-body compartments, may be more effective for understanding the disruption to CSF flow due to hemorrhages and hydrocephalus. Specifically, SAH is thought to prevent CSF flow into the basal cistern and paravascular spaces. It is also more subject to backflow, caused by the presence of coagulation cascade products. In regard to the fluid dynamics of CSF, scar tissue, red blood cells, and protein content resulting from SAH may contribute to increased viscosity, decreased vessel diameter, and increased vessel resistance. Outside of its direct influence on CSF flow, SAH may result in one or both forms of hydrocephalus, including noncommunicating (obstructive) and communicating (nonobstructive) HCP. Imaging modalities such as PC-MRI, Time-SLIP, and CFD model, a mathematical model relying on PC-MRI data, are commonly used to better understand CSF flow. While PC-MRI utilizes phase shift data to ultimately determine CSF speed and flow, Time-SLIP compares signals generated by CSF to background signals to characterizes complex fluid dynamics. Currently, there are gaps in sufficient CSF flow models and imaging modalities. A prospective area of study includes generation of models that consider "rest-of-body" compartments and elements like arterial pulse waves, respiratory waves, posture, and jugular venous posture. Going forward, imaging modalities should work to focus more on patients in nature in order to appropriately assess how CSF flow is disrupted in SAH and HCP.
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Affiliation(s)
- Ashley Bissenas
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Chance Fleeting
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Drashti Patel
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Raja Al-Bahou
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Aashay Patel
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Andrew Nguyen
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Maxwell Woolridge
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Conner Angelle
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
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Phase 1 study of intraventricular 131I-omburtamab targeting B7H3 (CD276)-expressing CNS malignancies. J Hematol Oncol 2022; 15:165. [PMID: 36371226 PMCID: PMC9655863 DOI: 10.1186/s13045-022-01383-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/15/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The prognosis for metastatic and recurrent tumors of the central nervous system (CNS) remains dismal, and the need for newer therapeutic targets and modalities is critical. The cell surface glycoprotein B7H3 is expressed on a range of solid tumors with a restricted expression on normal tissues. We hypothesized that compartmental radioimmunotherapy (cRIT) with the anti-B7H3 murine monoclonal antibody omburtamab injected intraventricularly could safely target CNS malignancies. PATIENTS AND METHODS We conducted a phase I trial of intraventricular 131I-omburtamab using a standard 3 + 3 design. Eligibility criteria included adequate cerebrospinal fluid (CSF) flow, no major organ toxicity, and for patients > dose level 6, availability of autologous stem cells. Patients initially received 74 MBq radioiodinated omburtamab to evaluate dosimetry and biodistribution followed by therapeutic 131I-omburtamab dose-escalated from 370 to 2960 MBq. Patients were monitored clinically and biochemically for toxicity graded using CTCAEv 3.0. Dosimetry was evaluated using serial CSF and blood sampling, and serial PET or gamma-camera scans. Patients could receive a second cycle in the absence of grade 3/4 non-hematologic toxicity or progressive disease. RESULTS Thirty-eight patients received 100 radioiodinated omburtamab injections. Diagnoses included metastatic neuroblastoma (n = 16) and other B7H3-expressing solid tumors (n = 22). Thirty-five patients received at least 1 cycle of treatment with both dosimetry and therapy doses. Acute toxicities included < grade 4 self-limited headache, vomiting or fever, and biochemical abnormalities. Grade 3/4 thrombocytopenia was the most common hematologic toxicity. Recommended phase 2 dose was 1850 MBq/injection. The median radiation dose to the CSF and blood by sampling was 1.01 and 0.04 mGy/MBq, respectively, showing a consistently high therapeutic advantage for CSF. Major organ exposure was well below maximum tolerated levels. In patients developing antidrug antibodies, blood clearance, and therefore therapeutic index, was significantly increased. In patients receiving cRIT for neuroblastoma, survival was markedly increased (median PFS 7.5 years) compared to historical data. CONCLUSIONS cRIT with 131I-omburtamab is safe, has favorable dosimetry and may have a therapeutic benefit as adjuvant therapy for B7-H3-expressing leptomeningeal metastases. TRIAL REGISTRATION clinicaltrials.gov NCT00089245, August 5, 2004.
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Lynch M, Pham W, Sinclair B, O’Brien TJ, Law M, Vivash L. Perivascular spaces as a potential biomarker of Alzheimer's disease. Front Neurosci 2022; 16:1021131. [PMID: 36330347 PMCID: PMC9623161 DOI: 10.3389/fnins.2022.1021131] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/23/2022] [Indexed: 07/20/2023] Open
Abstract
Alzheimer's disease (AD) is a highly damaging disease that affects one's cognition and memory and presents an increasing societal and economic burden globally. Considerable research has gone into understanding AD; however, there is still a lack of effective biomarkers that aid in early diagnosis and intervention. The recent discovery of the glymphatic system and associated Perivascular Spaces (PVS) has led to the theory that enlarged PVS (ePVS) may be an indicator of AD progression and act as an early diagnostic marker. Visible on Magnetic Resonance Imaging (MRI), PVS appear to enlarge when known biomarkers of AD, amyloid-β and tau, accumulate. The central goal of ePVS and AD research is to determine when ePVS occurs in AD progression and if ePVS are causal or epiphenomena. Furthermore, if ePVS are indeed causative, interventions promoting glymphatic clearance are an attractive target for research. However, it is necessary first to ascertain where on the pathological progression of AD ePVS occurs. This review aims to examine the knowledge gap that exists in understanding the contribution of ePVS to AD. It is essential to understand whether ePVS in the brain correlate with increased regional tau distribution and global or regional Amyloid-β distribution and to determine if these spaces increase proportionally over time as individuals experience neurodegeneration. This review demonstrates that ePVS are associated with reduced glymphatic clearance and that this reduced clearance is associated with an increase in amyloid-β. However, it is not yet understood if ePVS are the outcome or driver of protein accumulation. Further, it is not yet clear if ePVS volume and number change longitudinally. Ultimately, it is vital to determine early diagnostic criteria and early interventions for AD to ease the burden it presents to the world; ePVS may be able to fulfill this role and therefore merit further research.
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Affiliation(s)
- Miranda Lynch
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - William Pham
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Terence J. O’Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Meng Law
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Radiology, Alfred Health, Melbourne, VIC, Australia
- Department of Electrical and Computer Systems Engineering, Monash University, Melbourne, VIC, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
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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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Wilting J, Becker J. The lymphatic vascular system: much more than just a sewer. Cell Biosci 2022; 12:157. [PMID: 36109802 PMCID: PMC9476376 DOI: 10.1186/s13578-022-00898-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/06/2022] [Indexed: 11/18/2022] Open
Abstract
Almost 400 years after the (re)discovery of the lymphatic vascular system (LVS) by Gaspare Aselli (Asellius G. De lactibus, sive lacteis venis, quarto vasorum mesaraicorum genere, novo invento Gasparis Asellii Cremo. Dissertatio. (MDCXXIIX), Milan; 1628.), structure, function, development and evolution of this so-called 'second' vascular system are still enigmatic. Interest in the LVS was low because it was (and is) hardly visible, and its diseases are not as life-threatening as those of the blood vascular system. It is not uncommon for patients with lymphedema to be told that yes, they can live with it. Usually, the functions of the LVS are discussed in terms of fluid homeostasis, uptake of chylomicrons from the gut, and immune cell circulation. However, the broad molecular equipment of lymphatic endothelial cells suggests that they possess many more functions, which are also reflected in the pathophysiology of the system. With some specific exceptions, lymphatics develop in all organs. Although basic structure and function are the same regardless their position in the body wall or the internal organs, there are important site-specific characteristics. We discuss common structure and function of lymphatics; and point to important functions for hyaluronan turn-over, salt balance, coagulation, extracellular matrix production, adipose tissue development and potential appetite regulation, and the influence of hypoxia on the regulation of these functions. Differences with respect to the embryonic origin and molecular equipment between somatic and splanchnic lymphatics are discussed with a side-view on the phylogeny of the LVS. The functions of the lymphatic vasculature are much broader than generally thought, and lymphatic research will have many interesting and surprising aspects to offer in the future.
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Affiliation(s)
- Jörg Wilting
- Department of Anatomy and Cell Biology, University Medical School Göttingen, Göttingen, Germany.
| | - Jürgen Becker
- Department of Anatomy and Cell Biology, University Medical School Göttingen, Göttingen, Germany
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Thompson D, Brissette CA, Watt JA. The choroid plexus and its role in the pathogenesis of neurological infections. Fluids Barriers CNS 2022; 19:75. [PMID: 36088417 PMCID: PMC9463972 DOI: 10.1186/s12987-022-00372-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/27/2022] [Indexed: 11/10/2022] Open
Abstract
AbstractThe choroid plexus is situated at an anatomically and functionally important interface within the ventricles of the brain, forming the blood-cerebrospinal fluid barrier that separates the periphery from the central nervous system. In contrast to the blood–brain barrier, the choroid plexus and its epithelial barrier have received considerably less attention. As the main producer of cerebrospinal fluid, the secretory functions of the epithelial cells aid in the maintenance of CNS homeostasis and are capable of relaying inflammatory signals to the brain. The choroid plexus acts as an immunological niche where several types of peripheral immune cells can be found within the stroma including dendritic cells, macrophages, and T cells. Including the epithelia cells, these cells perform immunosurveillance, detecting pathogens and changes in the cytokine milieu. As such, their activation leads to the release of homing molecules to induce chemotaxis of circulating immune cells, driving an immune response at the choroid plexus. Research into the barrier properties have shown how inflammation can alter the structural junctions and promote increased bidirectional transmigration of cells and pathogens. The goal of this review is to highlight our foundational knowledge of the choroid plexus and discuss how recent research has shifted our understanding towards viewing the choroid plexus as a highly dynamic and important contributor to the pathogenesis of neurological infections. With the emergence of several high-profile diseases, including ZIKA and SARS-CoV-2, this review provides a pertinent update on the cellular response of the choroid plexus to these diseases. Historically, pharmacological interventions of CNS disorders have proven difficult to develop, however, a greater focus on the role of the choroid plexus in driving these disorders would provide for novel targets and routes for therapeutics.
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Sheng J, Li Q, Liu T, Wang X. Cerebrospinal fluid dynamics along the optic nerve. Front Neurol 2022; 13:931523. [PMID: 36046631 PMCID: PMC9420993 DOI: 10.3389/fneur.2022.931523] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/21/2022] [Indexed: 11/23/2022] Open
Abstract
The cerebrospinal fluid (CSF) plays an important role in delivering nutrients and eliminating the metabolic wastes of the central nervous system. An interrupted CSF flow could cause disorders of the brain and eyes such as Alzheimer's disease and glaucoma. This review provides an overview of the anatomy and flow pathways of the CSF system with an emphasis on the optic nerve. Imaging technologies used for visualizing the CSF dynamics and the anatomic structures associated with CSF circulation have been highlighted. Recent advances in the use of computational models to predict CSF flow patterns have been introduced. Open questions and potential mechanisms underlying CSF circulation at the optic nerves have also been discussed.
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Affiliation(s)
- Jinqiao Sheng
- Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- School of General Engineering, Beihang University, Beijing, China
| | - Qi Li
- Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Tingting Liu
- Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Xiaofei Wang
- Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- *Correspondence: Xiaofei Wang
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Stigliano C, Frazier A, Horner PJ. Modulation of Neuroinflammation Via Selective Nanoparticle‐Mediated Drug Delivery to Activated Microglia/Macrophages in Spinal Cord Injury. ADVANCED THERAPEUTICS 2022. [DOI: 10.1002/adtp.202200083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Cinzia Stigliano
- Department of Neurosurgery Center for Neuroregeneration Houston Methodist Academic Institute Houston TX 77030 USA
| | - Allison Frazier
- Department of Neurosurgery Center for Neuroregeneration Houston Methodist Academic Institute Houston TX 77030 USA
| | - Philip J Horner
- Department of Neurosurgery Center for Neuroregeneration Houston Methodist Academic Institute Houston TX 77030 USA
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Harkins D, Harvey TJ, Atterton C, Miller I, Currey L, Oishi S, Kasherman M, Davila RA, Harris L, Green K, Piper H, Parton RG, Thor S, Cooper HM, Piper M. Hydrocephalus in Nfix−/− Mice Is Underpinned by Changes in Ependymal Cell Physiology. Cells 2022; 11:cells11152377. [PMID: 35954220 PMCID: PMC9368351 DOI: 10.3390/cells11152377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 02/04/2023] Open
Abstract
Nuclear factor one X (NFIX) is a transcription factor required for normal ependymal development. Constitutive loss of Nfix in mice (Nfix−/−) is associated with hydrocephalus and sloughing of the dorsal ependyma within the lateral ventricles. Previous studies have implicated NFIX in the transcriptional regulation of genes encoding for factors essential to ependymal development. However, the cellular and molecular mechanisms underpinning hydrocephalus in Nfix−/− mice are unknown. To investigate the role of NFIX in hydrocephalus, we examined ependymal cells in brains from postnatal Nfix−/− and control (Nfix+/+) mice using a combination of confocal and electron microscopy. This revealed that the ependymal cells in Nfix−/− mice exhibited abnormal cilia structure and disrupted localisation of adhesion proteins. Furthermore, we modelled ependymal cell adhesion using epithelial cell culture and revealed changes in extracellular matrix and adherens junction gene expression following knockdown of NFIX. Finally, the ablation of Nfix from ependymal cells in the adult brain using a conditional approach culminated in enlarged ventricles, sloughing of ependymal cells from the lateral ventricles and abnormal localisation of adhesion proteins, which are phenotypes observed during development. Collectively, these data demonstrate a pivotal role for NFIX in the regulation of cell adhesion within ependymal cells of the lateral ventricles.
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Affiliation(s)
- Danyon Harkins
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia; (D.H.); (T.J.H.); (C.A.); (I.M.); (L.C.); (S.O.); (M.K.); (R.A.D.); (H.P.); (S.T.)
| | - Tracey J. Harvey
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia; (D.H.); (T.J.H.); (C.A.); (I.M.); (L.C.); (S.O.); (M.K.); (R.A.D.); (H.P.); (S.T.)
| | - Cooper Atterton
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia; (D.H.); (T.J.H.); (C.A.); (I.M.); (L.C.); (S.O.); (M.K.); (R.A.D.); (H.P.); (S.T.)
| | - Ingrid Miller
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia; (D.H.); (T.J.H.); (C.A.); (I.M.); (L.C.); (S.O.); (M.K.); (R.A.D.); (H.P.); (S.T.)
| | - Laura Currey
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia; (D.H.); (T.J.H.); (C.A.); (I.M.); (L.C.); (S.O.); (M.K.); (R.A.D.); (H.P.); (S.T.)
| | - Sabrina Oishi
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia; (D.H.); (T.J.H.); (C.A.); (I.M.); (L.C.); (S.O.); (M.K.); (R.A.D.); (H.P.); (S.T.)
| | - Maria Kasherman
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia; (D.H.); (T.J.H.); (C.A.); (I.M.); (L.C.); (S.O.); (M.K.); (R.A.D.); (H.P.); (S.T.)
| | - Raul Ayala Davila
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia; (D.H.); (T.J.H.); (C.A.); (I.M.); (L.C.); (S.O.); (M.K.); (R.A.D.); (H.P.); (S.T.)
| | - Lucy Harris
- Centre for Microscopy and Microanalysis, The University of Queensland, Brisbane 4072, Australia; (L.H.); (K.G.); (R.G.P.)
| | - Kathryn Green
- Centre for Microscopy and Microanalysis, The University of Queensland, Brisbane 4072, Australia; (L.H.); (K.G.); (R.G.P.)
| | - Hannah Piper
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia; (D.H.); (T.J.H.); (C.A.); (I.M.); (L.C.); (S.O.); (M.K.); (R.A.D.); (H.P.); (S.T.)
| | - Robert G. Parton
- Centre for Microscopy and Microanalysis, The University of Queensland, Brisbane 4072, Australia; (L.H.); (K.G.); (R.G.P.)
- Institute for Molecular Biosciences, The University of Queensland, Brisbane 4072, Australia
| | - Stefan Thor
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia; (D.H.); (T.J.H.); (C.A.); (I.M.); (L.C.); (S.O.); (M.K.); (R.A.D.); (H.P.); (S.T.)
| | - Helen M. Cooper
- Queensland Brain Institute, The University of Queensland, Brisbane 4072, Australia;
| | - Michael Piper
- School of Biomedical Sciences, The University of Queensland, Brisbane 4072, Australia; (D.H.); (T.J.H.); (C.A.); (I.M.); (L.C.); (S.O.); (M.K.); (R.A.D.); (H.P.); (S.T.)
- Queensland Brain Institute, The University of Queensland, Brisbane 4072, Australia;
- Correspondence:
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DenSec: Secreted Protein Prediction in Cerebrospinal Fluid Based on DenseNet and Transformer. MATHEMATICS 2022. [DOI: 10.3390/math10142490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Cerebrospinal fluid (CSF) exists in the surrounding spaces of mammalian central nervous systems (CNS); therefore, there are numerous potential protein biomarkers associated with CNS disease in CSF. Currently, approximately 4300 proteins have been identified in CSF by protein profiling. However, due to the diverse modifications, as well as the existing technical limits, large-scale protein identification in CSF is still considered a challenge. Inspired by computational methods, this paper proposes a deep learning framework, named DenSec, for secreted protein prediction in CSF. In the first phase of DenSec, all input proteins are encoded as a matrix with a fixed size of 1000 × 20 by calculating a position-specific score matrix (PSSM) of protein sequences. In the second phase, a dense convolutional network (DenseNet) is adopted to extract the feature from these PSSMs automatically. After that, Transformer with a fully connected dense layer acts as classifier to perform a binary classification in terms of secretion into CSF or not. According to the experiment results, DenSec achieves a mean accuracy of 86.00% in the test dataset and outperforms the state-of-the-art methods.
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Lubinsky M. Hypothesis: By-products of vascular disruption carried in the CSF affect prenatal brain development. Birth Defects Res 2022; 114:847-854. [PMID: 35775635 DOI: 10.1002/bdr2.2064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/31/2022] [Accepted: 06/12/2022] [Indexed: 01/24/2023]
Abstract
Prenatal CNS disruptions can be associated with physically separate findings. Examples include cognitive issues in septo-optic dysplasia and sporadic and WNT1-related unilateral cerebellar hypoplasia, and physical findings such as thinning of the corpus callosum, ventriculomegaly, hippocampal abnormalities, olfactory tract and bulb hypoplasia, and distant cortical dysplasias with schizencephaly. Similar effects to toxicities with intraventricular hemorrhage in prematurity could occur earlier in development. CSF transportation of disruption by-products would provide access to vulnerable areas through inflammatory effects on blood-brain barrier permeability. Outcomes are influenced by location and volume of byproducts in the CSF, timing, transport, and inflammatory responses. A particular association of vermis disruption with cognitive issues may be related to CSF flow distortions that avoid toxin dilutions in the third ventricle. Symmetrical contralateral cortical dysplasia with schizencephaly may reflect immunovascular field-related vulnerabilities seen in situations such as vitiligo.
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Li W, Cologna SM. Mass spectrometry-based proteomics in neurodegenerative lysosomal storage disorders. Mol Omics 2022; 18:256-278. [PMID: 35343995 PMCID: PMC9098683 DOI: 10.1039/d2mo00004k] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The major function of the lysosome is to degrade unwanted materials such as lipids, proteins, and nucleic acids; therefore, deficits of the lysosomal system can result in improper degradation and trafficking of these biomolecules. Diseases associated with lysosomal failure can be lethal and are termed lysosomal storage disorders (LSDs), which affect 1 in 5000 live births collectively. LSDs are inherited metabolic diseases caused by mutations in single lysosomal and non-lysosomal proteins and resulting in the subsequent accumulation of macromolecules within. Most LSD patients present with neurodegenerative clinical symptoms, as well as damage in other organs. The discovery of new biomarkers is necessary to understand and monitor these diseases and to track therapeutic progress. Over the past ten years, mass spectrometry (MS)-based proteomics has flourished in the biomarker studies in many diseases, including neurodegenerative, and more specifically, LSDs. In this review, biomarkers of disease pathophysiology and monitoring of LSDs revealed by MS-based proteomics are discussed, including examples from Niemann-Pick disease type C, Fabry disease, neuronal ceroid-lipofuscinoses, mucopolysaccharidosis, Krabbe disease, mucolipidosis, and Gaucher disease.
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Affiliation(s)
- Wenping Li
- Department of Chemistry, University of Illinois at Chicago, USA.
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40
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Maloveská M, Humeník F, Vikartovská Z, Hudáková N, Almášiová V, Krešáková L, Čížková D. Brain Fluid Channels for Metabolite Removal. Physiol Res 2022; 71:199-208. [DOI: 10.33549/physiolres.934802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The adult human brain represents only 2 % of the body's total weight, however it is one of the most metabolically active organs in the mammalian body. Its high metabolic activity necessitates an efficacious waste clearance system. Besides the blood, there are two fluids closely linked to the brain and spinal cord drainage system: interstitial fluid (ISF) and cerebrospinal fluid (CSF). The aim of this review is to summarize the latest research clarifying the channels of metabolite removal by fluids from brain tissue, subarachnoid space (SAS) and brain dura (BD). Special attention is focused on lymphatic vascular structures in the brain dura, their localizations within the meninges, morphological properties and topographic anatomy. The review ends with an account of the consequences of brain lymphatic drainage failure. Knowledge of the physiological state of the clearance system is crucial in order to understand the changes related to impaired brain drainage.
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Affiliation(s)
| | | | | | | | | | | | - D Čížková
- Centre of Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy in Kosice, Slovak Republic.
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Extracellular Vesicles from Human Cerebrospinal Fluid Are Effectively Separated by Sepharose CL-6B—Comparison of Four Gravity-Flow Size Exclusion Chromatography Methods. Biomedicines 2022; 10:biomedicines10040785. [PMID: 35453535 PMCID: PMC9032713 DOI: 10.3390/biomedicines10040785] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 02/04/2023] Open
Abstract
Extracellular vesicles (EVs) are a versatile group of cell-secreted membranous nanoparticles present in body fluids. They have an exceptional diagnostic potential due to their molecular content matching the originating cells and accessibility from body fluids. However, methods for EV isolation are still in development, with size exclusion chromatography (SEC) emerging as a preferred method. Here we compared four types of SEC to isolate EVs from the CSF of patients with severe traumatic brain injury. A pool of nine CSF samples was separated by SEC columns packed with Sepharose CL-6B, Sephacryl S-400 or Superose 6PG and a ready-to-use qEV10/70 nm column. A total of 46 fractions were collected and analysed by slot-blot followed by Ponceau staining. Immunodetection was performed for albumin, EV markers CD9, CD81, and lipoprotein markers ApoE and ApoAI. The size and concentration of nanoparticles in fractions were determined by tunable resistive pulse sensing and EVs were visualised by transmission electron microscopy. We show that all four SEC techniques enabled separation of CSF into nanoparticle- and free protein-enriched fractions. Sepharose CL-6B resulted in a significantly higher number of separated EVs while lipoproteins were eluted together with free proteins. Our data indicate that Sepharose CL-6B is suitable for isolation of EVs from CSF and their separation from lipoproteins.
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42
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Flegel TW. Viral Induction of Novel Somatic and Germline DNA Functions in Host Arthropods Opens a New Research Frontier in Biology. Front Mol Biosci 2022; 9:847670. [PMID: 35281280 PMCID: PMC8907731 DOI: 10.3389/fmolb.2022.847670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/02/2022] [Indexed: 11/17/2022] Open
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Wichmann TO, Damkier HH, Pedersen M. A Brief Overview of the Cerebrospinal Fluid System and Its Implications for Brain and Spinal Cord Diseases. Front Hum Neurosci 2022; 15:737217. [PMID: 35126070 PMCID: PMC8813779 DOI: 10.3389/fnhum.2021.737217] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/29/2021] [Indexed: 12/04/2022] Open
Abstract
A comprehensive understanding of the cerebrospinal fluid (CSF) system is essential for our understanding of health and disease within the central nervous system (CNS). The system of CSF refers to all components involved in CSF production, movement, and absorption. In recent years, extensive research has resulted in vastly improved understanding of the CSF system in health and disease. Yet, several aspects remain to be fully clarified, notably along the spinal cord as the preponderance of research has focused on the brain. This review briefly summarizes the CSF system and its implications for CNS diseases and highlights the knowledge gaps that require further research.
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Affiliation(s)
- Thea Overgaard Wichmann
- Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark
- *Correspondence: Thea Overgaard Wichmann
| | | | - Michael Pedersen
- Comparative Medicine Lab, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
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44
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Sadekar SS, Bowen M, Cai H, Jamalian S, Rafidi H, Shatz‐Binder W, Lafrance‐Vanasse J, Chan P, Meilandt WJ, Oldendorp A, Sreedhara A, Daugherty A, Crowell S, Wildsmith KR, Atwal J, Fuji RN, Horvath J. Translational approaches for brain delivery of biologics via cerebrospinal fluid. Clin Pharmacol Ther 2022; 111:826-834. [PMID: 35064573 PMCID: PMC9305158 DOI: 10.1002/cpt.2531] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/04/2022] [Indexed: 11/14/2022]
Abstract
Delivery of biologics via cerebrospinal fluid (CSF) has demonstrated potential to access the tissues of the central nervous system (CNS) by circumventing the blood‐brain barrier and blood‐CSF barrier. Developing an effective CSF drug delivery strategy requires optimization of multiple parameters, including choice of CSF access point, delivery device technology, and delivery kinetics to achieve effective therapeutic concentrations in the target brain region, whereas also considering the biologic modality, mechanism of action, disease indication, and patient population. This review discusses key preclinical and clinical examples of CSF delivery for different biologic modalities (antibodies, nucleic acid‐based therapeutics, and gene therapy) to the brain via CSF or CNS access routes (intracerebroventricular, intrathecal‐cisterna magna, intrathecal‐lumbar, intraparenchymal, and intranasal), including the use of novel device technologies. This review also discusses quantitative models of CSF flow that provide insight into the effect of fluid dynamics in CSF on drug delivery and CNS distribution. Such models can facilitate delivery device design and pharmacokinetic/pharmacodynamic translation from preclinical species to humans in order to optimize CSF drug delivery to brain regions of interest.
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Affiliation(s)
- Shraddha S Sadekar
- Genentech Research and Early Development Genentech, Inc., a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - Mayumi Bowen
- Pharma Technical Development. Genentech, Inc, a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - Hao Cai
- Genentech Research and Early Development Genentech, Inc., a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - Samira Jamalian
- Genentech Research and Early Development Genentech, Inc., a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - Hanine Rafidi
- Genentech Research and Early Development Genentech, Inc., a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - Whitney Shatz‐Binder
- Genentech Research and Early Development Genentech, Inc., a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - Julien Lafrance‐Vanasse
- Genentech Research and Early Development Genentech, Inc., a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - Pamela Chan
- Genentech Research and Early Development Genentech, Inc., a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - William J. Meilandt
- Genentech Research and Early Development Genentech, Inc., a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - Amy Oldendorp
- Genentech Research and Early Development Genentech, Inc., a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - Alavattam Sreedhara
- Pharma Technical Development. Genentech, Inc, a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - Ann Daugherty
- Pharma Technical Development. Genentech, Inc, a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - Susan Crowell
- Genentech Research and Early Development Genentech, Inc., a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - Kristin R. Wildsmith
- Clinical pharmacology and translational medicine Neurology business Eisai, Nutley NJ 07110 USA
| | - Jasvinder Atwal
- Genentech Research and Early Development Genentech, Inc., a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - Reina N. Fuji
- Genentech Research and Early Development Genentech, Inc., a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
| | - Josh Horvath
- Pharma Technical Development. Genentech, Inc, a member of the Roche Group 1 DNA Way South San Francisco CA 94080 USA
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Mehta NH, Sherbansky J, Kamer AR, Carare RO, Butler T, Rusinek H, Chiang GC, Li Y, Strauss S, Saint-Louis LA, Theise ND, Suss RA, Blennow K, Kaplitt M, de Leon MJ. The Brain-Nose Interface: A Potential Cerebrospinal Fluid Clearance Site in Humans. Front Physiol 2022; 12:769948. [PMID: 35058794 PMCID: PMC8764168 DOI: 10.3389/fphys.2021.769948] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/26/2021] [Indexed: 12/17/2022] Open
Abstract
The human brain functions at the center of a network of systems aimed at providing a structural and immunological layer of protection. The cerebrospinal fluid (CSF) maintains a physiological homeostasis that is of paramount importance to proper neurological activity. CSF is largely produced in the choroid plexus where it is continuous with the brain extracellular fluid and circulates through the ventricles. CSF movement through the central nervous system has been extensively explored. Across numerous animal species, the involvement of various drainage pathways in CSF, including arachnoid granulations, cranial nerves, perivascular pathways, and meningeal lymphatics, has been studied. Among these, there is a proposed CSF clearance route spanning the olfactory nerve and exiting the brain at the cribriform plate and entering lymphatics. While this pathway has been demonstrated in multiple animal species, evidence of a similar CSF egress mechanism involving the nasal cavity in humans remains poorly consolidated. This review will synthesize contemporary evidence surrounding CSF clearance at the nose-brain interface, examining across species this anatomical pathway, and its possible significance to human neurodegenerative disease. Our discussion of a bidirectional nasal pathway includes examination of the immune surveillance in the olfactory region protecting the brain. Overall, we expect that an expanded discussion of the brain-nose pathway and interactions with the environment will contribute to an improved understanding of neurodegenerative and infectious diseases, and potentially to novel prevention and treatment considerations.
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Affiliation(s)
- Neel H. Mehta
- Undergraduate Department of Biology, Cornell University, Ithaca, NY, United States
| | | | - Angela R. Kamer
- Department of Periodontology and Implant Dentistry, NYU College of Dentistry, New York, NY, United States
| | - Roxana O. Carare
- Department of Medicine, University of Southampton, Southampton, United Kingdom
| | - Tracy Butler
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY, United States
| | - Henry Rusinek
- Department of Radiology, NYU Langone Health, New York, NY, United States
| | - Gloria C. Chiang
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Yi Li
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY, United States
| | - Sara Strauss
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - L. A. Saint-Louis
- Department of Radiology, NYU Langone Health, New York, NY, United States
| | - Neil D. Theise
- Department of Pathology, NYU Grossman School of Medicine, New York, NY, United States
| | - Richard A. Suss
- Division of Neuroradiology, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Kaj Blennow
- Clinical Neurochemistry Lab, Inst. of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Michael Kaplitt
- Laboratory of Molecular Neurosurgery, Department of Neurological Surgery, Weill Cornell Medical College, New York, NY, United States
| | - Mony J. de Leon
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY, United States
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Gong D, Wang W, Yuan X, Yu H, Zhao M. Long-Term Clinical Efficacy of Human Umbilical Cord Blood Mononuclear Cell Transplantation by Lateral Atlanto-Occipital Space Puncture (Gong’s Puncture) for the Treatment of Multiple System Atrophy. Cell Transplant 2022; 31:9636897221136553. [DOI: 10.1177/09636897221136553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Multiple system atrophy (MSA) is a sporadic, progressive neurodegenerative disease characterized by autonomic nervous dysfunction with parkinsonism or cerebellar ataxia. Mesenchymal stem cell therapy or transplantation of human umbilical cord blood mononuclear cells (hUCB-MCs) may inhibit progression in MSA, but long-term studies are lacking. In addition, injection of stem cells via lateral atlanto-occipital space puncture (LASP, or Gong’s puncture) may efficiently target areas of brain injury and avoid the disadvantages of other methods. This prospective study investigated the long-term clinical efficacy of transplantation of hUCB-MCs via LASP for the treatment of MSA. Seven patients with MSA who received hUCB-MC transplantation via LASP were followed for 3 to 5 years. Neurological function was evaluated before (baseline), at 3, 6, and 12 months, and annually after the first transplantation using the Unified MSA Rating Scale (UMSARS); a lower score indicated improvement. Adverse events were recorded. The best therapeutic effect was observed 3 to 6 months after the first hUCB-MC transplantation. The total UMSARS score at the timepoint of best effect (25.71 ± 11.87) was significantly lower than the score before treatment (42.57 ± 7.96; P = 0.001), but also significantly lower than at the end of follow-up (35.14 ± 18.21; P = 0.038). The UMSARS II score (findings on neurological examination) at the timepoint of best effect was significantly lower than before treatment ( P = 0.001). There were no serious adverse events. In conclusion, transplantation of hUCB-MCs via LASP is a safe and effective treatment for MSA.
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Affiliation(s)
- Dianrong Gong
- Department of Neurology, Liaocheng People’s Hospital, Liaocheng District, China
| | - Weifei Wang
- Department of Neurology, Liaocheng People’s Hospital, Liaocheng District, China
| | - Xiaoling Yuan
- Department of Neurology, Liaocheng People’s Hospital, Liaocheng District, China
| | - Haiyan Yu
- Department of Neurology, Liaocheng People’s Hospital, Liaocheng District, China
| | - Min Zhao
- Department of Neurology, Liaocheng People’s Hospital, Liaocheng District, China
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47
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Dimov AV, Nguyen TD, Spincemaille P, Sweeney EM, Zinger N, Kovanlikaya I, Kopell BH, Gauthier SA, Wang Y. Global cerebrospinal fluid as a zero-reference regularization for brain quantitative susceptibility mapping. J Neuroimaging 2022; 32:141-147. [PMID: 34480496 PMCID: PMC8752493 DOI: 10.1111/jon.12923] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 07/11/2021] [Accepted: 08/09/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND AND PURPOSE The objective ofthis study was to demonstrate a global cerebrospinal fluid (CSF) method for a consistent and automated zero referencing of brain quantitative susceptibility mapping (QSM). METHODS Whole brain CSF mask was automatically segmented by thresholding the gradient echo transverse relaxation ( R2∗) map, and regularization was employed to enforce uniform susceptibility distribution within the CSF volume in the field-to-susceptibility inversion. This global CSF regularization method was compared with a prior ventricular CSF regularization. Both reconstruction methods were compared in a repeatability study of 12 healthy subjects using t-test on susceptibility measurements, and in patient studies of 17 multiple sclerosis (MS) and 10 Parkinson's disease (PD) patients using Wilcoxon rank-sum test on radiological scores. RESULTS In scan-rescan experiments, global CSF regularization provided more consistent CSF volume as well as higher repeatability of QSM measurements than ventricular CSF regularization with a smaller bias: -2.7 parts per billion (ppb) versus -0.13 ppb (t-test p<0.05) and a narrower 95% limits of agreement: [-7.25, 6.99] ppb versus [-16.60, 11.19 ppb] (f-test p<0.05). In PD and MS patients, global CSF regularization reduced smoothly varying shadow artifacts and significantly improved the QSM quality score (p<0.001). CONCLUSIONS The proposed whole brain CSF method for QSM zero referencing improves repeatability and image quality of brain QSM compared to the ventricular CSF method.
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Affiliation(s)
- Alexey V. Dimov
- Department of Radiology, Weill Cornell Medicine, New York, USA
| | - Thanh D. Nguyen
- Department of Radiology, Weill Cornell Medicine, New York, USA
| | | | | | - Nicole Zinger
- Department of Neurology, Weill Cornell Medicine, New York, USA
| | | | - Brian H. Kopell
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Yi Wang
- Department of Radiology, Weill Cornell Medicine, New York, USA
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Althubaity N, Schubert J, Martins D, Yousaf T, Nettis MA, Mondelli V, Pariante C, Harrison NA, Bullmore ET, Dima D, Turkheimer FE, Veronese M. Choroid plexus enlargement is associated with neuroinflammation and reduction of blood brain barrier permeability in depression. Neuroimage Clin 2021; 33:102926. [PMID: 34972034 PMCID: PMC8718974 DOI: 10.1016/j.nicl.2021.102926] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/08/2021] [Accepted: 12/21/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Recent studies have shown that choroid plexuses (CP) may be involved in the neuro-immune axes, playing a role in the interaction between the central and peripheral inflammation. Here we aimed to investigate CP volume alterations in depression and their associations with inflammation. METHODS 51 depressed participants (HDRS score > 13) and 25 age- and sex-matched healthy controls (HCs) from the Wellcome Trust NIMA consortium were re-analysed for the study. All the participants underwent full peripheral cytokine profiling and simultaneous [11C]PK11195 PET/structural MRI imaging for measuring neuroinflammation and CP volume respectively. RESULTS We found a significantly greater CP volume in depressed subjects compared to HCs (t(76) = +2.17) that was positively correlated with [11C]PK11195 PET binding in the anterior cingulate cortex (r = 0.28, p = 0.02), prefrontal cortex (r = 0.24, p = 0.04), and insular cortex (r = 0.24, p = 0.04), but not with the peripheral inflammatory markers: CRP levels (r = 0.07, p = 0.53), IL-6 (r = -0.08, p = 0.61), and TNF-α (r = -0.06, p = 0.70). The CP volume correlated with the [11C]PK11195 PET binding in CP (r = 0.34, p = 0.005). Integration of transcriptomic data from the Allen Human Brain Atlas with the brain map depicting the correlations between CP volume and PET imaging found significant gene enrichment for several pathways involved in neuroinflammatory response. CONCLUSION This result supports the hypothesis that changes in brain barriers may cause reduction in solute exchanges between blood and CSF, disturbing the brain homeostasis and ultimately contributing to inflammation in depression. Given that CP anomalies have been recently detected in other brain disorders, these results may not be specific to depression and might extend to other conditions with a peripheral inflammatory component.
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Affiliation(s)
- Noha Althubaity
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Radiological Sciences, College of Applied Medical Science, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
| | - Julia Schubert
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Martins
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tayyabah Yousaf
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Maria A Nettis
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Carmine Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Neil A Harrison
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK; Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, UK
| | - Edward T Bullmore
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK; Immuno-Psychiatry, Immuno-Inflammation Therapeutic Area Unit, GlaxoSmithKline R&D, Stevenage, UK
| | - Danai Dima
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychology, School of Arts and Social Sciences, City University of London, London, UK
| | - Federico E Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mattia Veronese
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Information Engineering, University of Padua, Padua, Italy
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Multi-Omics Approach to Elucidate Cerebrospinal Fluid Changes in Dogs with Intervertebral Disc Herniation. Int J Mol Sci 2021; 22:ijms222111678. [PMID: 34769107 PMCID: PMC8583948 DOI: 10.3390/ijms222111678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 12/16/2022] Open
Abstract
Herniation of the intervertebral disc (IVDH) is the most common cause of neurological and intervertebral disc degeneration-related diseases. Since the disc starts to degenerate before it can be observed by currently available diagnostic methods, there is an urgent need for novel diagnostic approaches. To identify molecular networks and pathways which may play important roles in intervertebral disc herniation, as well as to reveal the potential features which could be useful for monitoring disease progression and prognosis, multi-omics profiling, including high-resolution liquid chromatography-mass spectrometry (LC-MS)-based metabolomics and tandem mass tag (TMT)-based proteomics was performed. Cerebrospinal fluid of nine dogs with IVDH and six healthy controls were used for the analyses, and an additional five IVDH samples were used for proteomic data validation. Furthermore, multi-omics data were integrated to decipher a complex interaction between individual omics layers, leading to an improved prediction model. Together with metabolic pathways related to amino acids and lipid metabolism and coagulation cascades, our integromics prediction model identified the key features in IVDH, namely the proteins follistatin Like 1 (FSTL1), secretogranin V (SCG5), nucleobindin 1 (NUCB1), calcitonin re-ceptor-stimulating peptide 2 precursor (CRSP2) and the metabolites N-acetyl-D-glucosamine and adenine, involved in neuropathic pain, myelination, and neurotransmission and inflammatory response, respectively. Their clinical application is to be further investigated. The utilization of a novel integrative interdisciplinary approach may provide new opportunities to apply innovative diagnostic and monitoring methods as well as improve treatment strategies and personalized care for patients with degenerative spinal disorders.
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Schiel KA. A beneficial role for elevated extracellular glutamate in Amyotrophic Lateral Sclerosis and cerebral ischemia. Bioessays 2021; 43:e2100127. [PMID: 34585427 DOI: 10.1002/bies.202100127] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/03/2021] [Accepted: 09/08/2021] [Indexed: 11/06/2022]
Abstract
This hypothesis proposes that increased extracellular glutamate in Amyotrophic Lateral Sclerosis (ALS) and cerebral ischemia, currently viewed as a trigger for excitotoxicity, is actually beneficial as it stimulates the utilization of glutamate as metabolic fuel. Renewed appreciation of glutamate oxidation by ischemic neurons has raised questions regarding the role of extracellular glutamate in ischemia. Is it detrimental, as suggested by excitotoxicity in early in vitro studies, or beneficial, as suggested by its oxidation in later in vivo studies? The answer may depend on the activity of N-methyl-D-aspartate (NMDA) glutamate receptors. Early in vitro procedures co-activated NMDA receptors (NMDARs) containing 2A (GluN2A) and 2B (GluN2B) subunits, an event now believed to trigger excitotoxicity; however, during in vivo ischemia D-serine and zinc molecules are released and these ensure only GluN2B receptors are stimulated. This not only prevents excitotoxicity but also initiates signaling cascades that allow ischemic neurons to import and oxidize glutamate.
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