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Park BJ, Choi Y, Lee JS, Ahn YC, Lee EJ, Son CG. Effectiveness of meditation for fatigue management: Insight from a comprehensive systematic review and meta-analysis. Gen Hosp Psychiatry 2024:S0163-8343(24)00170-1. [PMID: 39244428 DOI: 10.1016/j.genhosppsych.2024.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 08/10/2024] [Accepted: 08/10/2024] [Indexed: 09/09/2024]
Abstract
OBJECTIVE This systematic review and meta-analysis revealed the effectiveness of meditation in addressing fatigue, given its widespread use as a remedy for sleep disturbances and fatigue. METHOD We analyzed 29 randomized controlled trials from MEDLINE and the Cochrane Library, spanning from December 31, 2022. We conducted two metaanalyses using mean difference (MD) with normalized data and standardized mean difference (SMD) with original data. RESULTS These trials included various populations, with baseline fatigue severity observed at 52.2 ± 16.0 points among 4104 participants. After an average meditation duration of 9.6 ± 4.7 weeks, fatigue scores decreased significantly by 6.4 points of MD [95% CI, 4.3-8.5] compared to controls. The most significant reduction occurred in the sub-healthy group (MD 8.2 [95% CI, 2.7 to 13.8]), followed by the general group (MD 6.9 [95% CI, 0.4 to 13.4]), and the disease group (MD 5.7 [95% CI, 3.4 to 8.0]). Notably, meditation-based anti-fatigue effects were particularly pronounced for mental fatigue (MD 10.0 [95% CI, 4.3 to 15.6]), especially with expert guidance and supplementary homework. CONCLUSION These findings align with meta-analysis results using standardized mean difference (SMD), providing evidence for meditation as an effective nonpharmacological intervention for fatigue management, while also informing effective meditation approaches. REGISTRATION NUMBER CRD42023395551 in PROSPERO.
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Affiliation(s)
- Byung-Jin Park
- Korean Medical College of Daejeon University, Daehak-ro 62, Dong-gu, Daejeon 345 20, Republic of Korea
| | - Yujin Choi
- Institute of Bioscience & Integrative Medicine, Daejeon University, Daedukdae-ro 176 bun-gil 75, Seo-gu, Daejeon 35235, Republic of Korea
| | - Jin-Seok Lee
- Institute of Bioscience & Integrative Medicine, Daejeon University, Daedukdae-ro 176 bun-gil 75, Seo-gu, Daejeon 35235, Republic of Korea
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, Daehak-ro 62, Dong-gu, Daejeon 34520, Republic of Korea
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea.
| | - Chang-Gue Son
- Institute of Bioscience & Integrative Medicine, Daejeon University, Daedukdae-ro 176 bun-gil 75, Seo-gu, Daejeon 35235, Republic of Korea; Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, 176 Daedeok-daero, Seo-gu, Daejeon 35235, Republic of Korea.
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Raitamaa L, Kautto J, Tuunanen J, Helakari H, Huotari N, Järvelä M, Korhonen V, Kiviniemi V. Association of body-mass index with physiological brain pulsations across adulthood - a fast fMRI study. Int J Obes (Lond) 2024; 48:1011-1018. [PMID: 38553569 PMCID: PMC11216984 DOI: 10.1038/s41366-024-01515-5] [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: 10/27/2023] [Revised: 03/18/2024] [Accepted: 03/22/2024] [Indexed: 07/03/2024]
Abstract
BACKGROUND/OBJECTIVE Obesity is a risk factor for several brain-related health issues, and high body-mass index (BMI) is associated with an increased risk for several neurological conditions, including cognitive decline and dementia. Cardiovascular, respiratory, and vasomotor brain pulsations have each been shown to drive intracranial cerebrovascular fluid (CSF) flow, which is linked to the brain metabolite efflux that sustains homeostasis. While these three physiological pulsations are demonstrably altered in numerous brain diseases, there is no previous investigation of the association between physiological brain pulsations and BMI. SUBJECTS/METHODS We measured the amplitudes of the physiological brain pulsations using amplitude of low frequency fluctation (ALFF) based method with resting-state functional magnetic resonance imaging via high temporal resolution whole-brain magnetic resonance encephalography (MREG) in 115 healthy subjects. We next undertook multiple linear regression to model the BMI effect voxel-wise whole-brain on very low frequency (VLF), respiration, cardiovascular, and respiratory induced modulation of cardiovascular pulsation amplitudes with age, pulse pressure, and gender as nuisance variables. RESULTS In our study population, BMI was positively associated with the amplitudes of vasomotor, respiratory, and respiratory induced modulations of cardiovascular pulsations (p < 0.05), while negatively associated with the amplitudes of cardiovascular pulsations (p < 0.05). CONCLUSIONS The findings suggest that BMI is a significant factor in alterations of cardiovascular pulsation of neurofluids. As physiological pulsations are the drivers of CSF flow and subsequent metabolite clearance, these results emphasize the need for further research into the mechanisms through which obesity affects brain clearance.
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Affiliation(s)
- Lauri Raitamaa
- Oulu Functional NeuroImaging (OFNI), Diagnostic Imaging, Medical Research Center (MRC), Finland Oulu University Hospital, 90029, Oulu, Finland.
- Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, 90220, Oulu, Finland.
| | - Joona Kautto
- Oulu Functional NeuroImaging (OFNI), Diagnostic Imaging, Medical Research Center (MRC), Finland Oulu University Hospital, 90029, Oulu, Finland
- Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, 90220, Oulu, Finland
| | - Johanna Tuunanen
- Oulu Functional NeuroImaging (OFNI), Diagnostic Imaging, Medical Research Center (MRC), Finland Oulu University Hospital, 90029, Oulu, Finland
- Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, 90220, Oulu, Finland
| | - Heta Helakari
- Oulu Functional NeuroImaging (OFNI), Diagnostic Imaging, Medical Research Center (MRC), Finland Oulu University Hospital, 90029, Oulu, Finland
- Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, 90220, Oulu, Finland
| | - Niko Huotari
- Oulu Functional NeuroImaging (OFNI), Diagnostic Imaging, Medical Research Center (MRC), Finland Oulu University Hospital, 90029, Oulu, Finland
- Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, 90220, Oulu, Finland
| | - Matti Järvelä
- Oulu Functional NeuroImaging (OFNI), Diagnostic Imaging, Medical Research Center (MRC), Finland Oulu University Hospital, 90029, Oulu, Finland
- Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, 90220, Oulu, Finland
| | - Vesa Korhonen
- Oulu Functional NeuroImaging (OFNI), Diagnostic Imaging, Medical Research Center (MRC), Finland Oulu University Hospital, 90029, Oulu, Finland
- Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, 90220, Oulu, Finland
| | - Vesa Kiviniemi
- Oulu Functional NeuroImaging (OFNI), Diagnostic Imaging, Medical Research Center (MRC), Finland Oulu University Hospital, 90029, Oulu, Finland
- Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, 90220, Oulu, Finland
- Oulu Center for Cell-Matrix Research, Faculty of Biochemistry and Molecular Medicine, Biocenter Oulu, University of Oulu, Oulu, Finland
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Li X, Zhou Y, Zhang C, Wang H, Wang X. Neural correlates of breath work, mental imagery of yoga postures, and meditation in yoga practitioners: a functional near-infrared spectroscopy study. Front Neurosci 2024; 18:1322071. [PMID: 38576867 PMCID: PMC10991824 DOI: 10.3389/fnins.2024.1322071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 02/26/2024] [Indexed: 04/06/2024] Open
Abstract
Objective Previous research has shown numerous health benefits of yoga, a multicomponent physical and mental activity. The three important aspects of both traditional and modern yoga are breath work, postures, and meditation. However, the neural mechanisms associated with these three aspects of yoga remain largely unknown. The present study investigated the neural underpinnings associated with each of these three yoga components in long- and short-term yoga practitioners to clarify the neural advantages of yoga experience, aiming to provide a more comprehensive understanding of yoga's health-promoting effects. Methods Participants were 40 Chinese women, 20 with a long-term yoga practice and 20 with a short-term yoga practice. Functional near-infrared spectroscopy was conducted while participants performed abdominal breathing, mental imagery of yoga postures, and mindfulness meditation. The oxygenated hemoglobin concentrations activated in the brain during these three tasks were used to assess the neural responses to the different aspects of yoga practice. The self-reported mastery of each yoga posture was used to assess the advantages of practicing yoga postures. Results Blood oxygen levels in the dorsolateral prefrontal cortex during breath work were significantly higher in long-term yoga practitioners than in short-term yoga practitioners. In the mental imagery of yoga postures task, self-reported data showed that long-term yoga practitioners had better mastery than short-term practitioners. Long-term yoga practitioners demonstrated lower activation in the ventrolateral prefrontal cortex, with lower blood oxygen levels associated with performing this task, than short-term yoga practitioners. In the mindfulness meditation task, blood oxygen levels in the orbitofrontal cortex and the ventrolateral prefrontal cortex were significantly higher in long-term yoga practitioners than in short-term yoga practitioners. Conclusion The three core yoga components, namely, yogic breathing, postures, and meditation, showed differences and similarities in the activation levels of the prefrontal cortex. Long-term practice of each component led to the neural benefits of efficient activation in the prefrontal cortex, especially in the dorsolateral prefrontal cortex, orbitofrontal cortex, and ventrolateral prefrontal cortex.
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Affiliation(s)
- Xiawen Li
- Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Yu Zhou
- Shanghai University of Sport, Shanghai, China
| | - Chenping Zhang
- Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Hongbiao Wang
- Shanghai University of Medicine and Health Sciences, Shanghai, China
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Abstract
The brain is a complex organ, fundamentally changing across the day to perform basic functions like sleep, thought, and regulating whole-body physiology. This requires a complex symphony of nutrients, hormones, ions, neurotransmitters and more to be properly distributed across the brain to maintain homeostasis throughout 24 hours. These solutes are distributed both by the blood and by cerebrospinal fluid. Cerebrospinal fluid contents are distinct from the general circulation because of regulation at brain barriers including the choroid plexus, glymphatic system, and blood-brain barrier. In this review, we discuss the overlapping circadian (≈24-hour) rhythms in brain fluid biology and at the brain barriers. Our goal is for the reader to gain both a fundamental understanding of brain barriers alongside an understanding of the interactions between these fluids and the circadian timing system. Ultimately, this review will provide new insight into how alterations in these finely tuned clocks may lead to pathology.
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Affiliation(s)
- Velia S Vizcarra
- Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Ryann M Fame
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Lauren M Hablitz
- Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, NY, 14642, USA
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Plini ERG, Melnychuk MC, Dockree PM. Meditation Experience is Associated with Increased Structural Integrity of the Pineal Gland and greater total Grey Matter maintenance. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.04.24303649. [PMID: 38496551 PMCID: PMC10942509 DOI: 10.1101/2024.03.04.24303649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Growing evidence demonstrates that meditation practice supports cognitive functions including attention and interoceptive processing, and is associated with structural changes across cortical networks including prefrontal regions, and the insula. However, the extent of subcortical morphometric changes linked to meditation practice is less appreciated. A noteworthy candidate is the Pineal Gland, a key producer of melatonin, which regulates circadian rhythms that augment sleep-wake patterns, and may also provide neuroprotective benefits to offset cognitive decline. Increased melatonin levels as well as increased fMRI BOLD signal in the Pineal Gland has been observed in mediators vs. controls. However, it is not known if long-term meditators exhibit structural change in the Pineal Gland linked to lifetime duration of practice. In the current study we performed Voxel-based morphometry (VBM) analysis to investigate: 1) whether long-term meditators (LTMs) (n=14) exhibited greater Pineal Gland integrity compared to a control group (n=969), 2) a potential association between the estimated lifetime hours of meditation (ELHOM) and Pineal Gland integrity, and 3) whether LTMs show greater Grey Matter (GM) maintenance (BrainPAD) that is associated with Pineal Gland integrity. The results revealed greater Pineal Gland integrity and lower BrainPAD scores (younger brain age) in LTMs compared to controls. Exploratory analysis revealed a positive association between ELHOM and greater signal intensity in the Pineal Gland but not with GM maintenance as measured by BrainPAD score. However, greater Pineal integrity and lower BrainPAD scores were correlated in LTMs. The potential mechanisms by which meditation influences Pineal Gland function, hormonal metabolism, and GM maintenance are discussed - in particular melatonin's roles in sleep, immune response, inflammation modulation, and stem cell and neural regeneration.
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Affiliation(s)
- Emanuele RG Plini
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | | | - Paul M Dockree
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
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Burman R, Alperin N. CSF-to-blood toxins clearance is modulated by breathing through cranio-spinal CSF oscillation. J Sleep Res 2024; 33:e14029. [PMID: 37734843 DOI: 10.1111/jsr.14029] [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: 05/18/2023] [Revised: 07/14/2023] [Accepted: 08/16/2023] [Indexed: 09/23/2023]
Abstract
Clearance of brain toxins occurs during sleep, although the mechanism remains unknown. Previous studies implied that the intracranial aqueductal cerebrospinal fluid (CSF) oscillations are involved, but no mechanism was suggested. The rationale for focusing on the aqueductal CSF oscillations is unclear. This study focuses on the cranio-spinal CSF oscillation and the factors that modulate this flow. We propose a mechanism where increased cranio-spinal CSF movements enhance CSF-to-blood metabolic waste clearance through the spinal CSF re-absorption sites. A recent study demonstrating that disturbed sleep impairs CSF-to-blood but not brain-to-CSF clearance, supports the fundamentals of our proposed mechanism. Eight healthy subjects underwent phase-contrast magnetic resonance imaging to quantify the effect of respiration on the cranio-spinal CSF oscillations. Maximal CSF volume displaced from the cranium to the spinal canal during each respiration and cardiac cycle were derived as measures of cranio-spinal CSF mixing level. Transition from normal to slow and abdominal breathing resulted in a 56% increase in the maximal displaced CSF volume. Maximal change in the arterial-venous blood volume, which is the driving force of the CSF oscillations, was increased by 41% during slow abdominal breathing. Cranio-spinal CSF oscillations are driven by the momentary difference between arterial inflow and venous outflow. Breathing modulates the CSF oscillation through changes in the venous outflow. The amount of toxins being transferred to the spinal canal during each respiratory cycle is significantly increased during slow and deeper abdominal breathing, which explains enhanced CSF-to-blood toxins clearance during slow-wave sleep and poor clearance during disrupted sleep.
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Affiliation(s)
- Ritambhar Burman
- Department of Biomedical Engineering, University of Miami, Miami, Florida, USA
| | - Noam Alperin
- Department of Biomedical Engineering, University of Miami, Miami, Florida, USA
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, Florida, USA
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Nozaleda GL, Alaminos-Quesada J, Coenen W, Haughton V, Sánchez AL. An analytic model for the flow induced in syringomyelia cavities. JOURNAL OF FLUID MECHANICS 2024; 978:A22. [PMID: 38746046 PMCID: PMC11089288 DOI: 10.1017/jfm.2023.1018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
A simple two-dimensional fluid-structure-interaction problem, involving viscous oscillatory flow in a channel separated by an elastic membrane from a fluid-filled slender cavity, is analyzed to shed light on the flow dynamics pertaining to syringomyelia, a neurological disorder characterized by the appearance of a large tubular cavity (syrinx) within the spinal cord. The focus is on configurations in which the velocity induced in the cavity, representing the syrinx, is comparable to that found in the channel, representing the subarachnoid space surrounding the spinal cord, both flows being coupled through a linear elastic equation describing the membrane deformation. An asymptotic analysis for small stroke lengths leads to closed-form expressions for the leading-order oscillatory flow, and also for the stationary flow associated with the first-order corrections, the latter involving a steady distribution of transmembrane pressure. The magnitude of the induced flow is found to depend strongly on the frequency, with the result that for channel flow rates of non-sinusoidal waveform, as those found in the spinal canal, higher harmonics can dominate the sloshing motion in the cavity, in agreement with previous in vivo observations. Under some conditions, the cycle-averaged transmembrane pressure, also showing a marked dependence on the frequency, changes sign on increasing the cavity transverse dimension (i.e. orthogonal to the cord axis), underscoring the importance of cavity size in connection with the underlying hydrodynamics. The analytic results presented here can be instrumental in guiding future numerical investigations, needed to clarify the pathogenesis of syringomyelia cavities.
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Affiliation(s)
- G. L. Nozaleda
- Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla, CA 92093-0411, USA
| | - J. Alaminos-Quesada
- Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla, CA 92093-0411, USA
| | - W. Coenen
- Grupo de Mecánica de Fluidos, Universidad Carlos III de Madrid, Leganés, 28911 Spain
| | - V. Haughton
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53706 USA
| | - A. L. Sánchez
- Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla, CA 92093-0411, USA
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Helakari H, Järvelä M, Väyrynen T, Tuunanen J, Piispala J, Kallio M, Ebrahimi SM, Poltojainen V, Kananen J, Elabasy A, Huotari N, Raitamaa L, Tuovinen T, Korhonen V, Nedergaard M, Kiviniemi V. Effect of sleep deprivation and NREM sleep stage on physiological brain pulsations. Front Neurosci 2023; 17:1275184. [PMID: 38105924 PMCID: PMC10722275 DOI: 10.3389/fnins.2023.1275184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/02/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Sleep increases brain fluid transport and the power of pulsations driving the fluids. We investigated how sleep deprivation or electrophysiologically different stages of non-rapid-eye-movement (NREM) sleep affect the human brain pulsations. Methods Fast functional magnetic resonance imaging (fMRI) was performed in healthy subjects (n = 23) with synchronous electroencephalography (EEG), that was used to verify arousal states (awake, N1 and N2 sleep). Cardiorespiratory rates were verified with physiological monitoring. Spectral power analysis assessed the strength, and spectral entropy assessed the stability of the pulsations. Results In N1 sleep, the power of vasomotor (VLF < 0.1 Hz), but not cardiorespiratory pulsations, intensified after sleep deprived vs. non-sleep deprived subjects. The power of all three pulsations increased as a function of arousal state (N2 > N1 > awake) encompassing brain tissue in both sleep stages, but extra-axial CSF spaces only in N2 sleep. Spectral entropy of full band and respiratory pulsations decreased most in N2 sleep stage, while cardiac spectral entropy increased in ventricles. Discussion In summary, the sleep deprivation and sleep depth, both increase the power and harmonize the spectral content of human brain pulsations.
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Affiliation(s)
- Heta Helakari
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Matti Järvelä
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Tommi Väyrynen
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Johanna Tuunanen
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Johanna Piispala
- Clinical Neurophysiology, Oulu University Hospital, Oulu, Finland
| | - Mika Kallio
- Clinical Neurophysiology, Oulu University Hospital, Oulu, Finland
| | - Seyed Mohsen Ebrahimi
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Valter Poltojainen
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Janne Kananen
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Clinical Neurophysiology, Oulu University Hospital, Oulu, Finland
| | - Ahmed Elabasy
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Niko Huotari
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Lauri Raitamaa
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Timo Tuovinen
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Vesa Korhonen
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Maiken Nedergaard
- Center of Translational Neuromedicine, University of Copenhagen, Copenhagen, Denmark
- Center of Translational Neuromedicine, University of Rochester, Rochester, NY, United States
| | - Vesa Kiviniemi
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
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Dredla BK, Del Brutto OH, Castillo PR. Sleep and Perivascular Spaces. Curr Neurol Neurosci Rep 2023; 23:607-615. [PMID: 37572227 DOI: 10.1007/s11910-023-01293-z] [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: 07/31/2023] [Indexed: 08/14/2023]
Abstract
PURPOSE OF REVIEW The glymphatic system is hypothesized to act as the brain's filtration system to remove toxic solutes that accumulate throughout the day. Perivascular spaces (PVSs) play a fundamental role in the ability of the glymphatic system to function, and sleep influences the effectiveness of this system. This article reviews the complexity of the interplay between sleep, the glymphatic system, and PVS. RECENT FINDINGS New imaging techniques have illuminated the structure of PVS and their associations with differing disease states. Research has shown that sleep may play a key role in the function of PVS and the influence of adenosine, astrocyte, and aquaporin-4 channel in the function of the glymphatic system. Emerging data suggest that differing pathological states such as neuroinflammatory conditions, neurodegenerative diseases, and cognitive dysfunction may be associated with underlying glymphatic system dysfunction, and sleep disorders could be a potential intervention target.
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Affiliation(s)
- Brynn K Dredla
- Sleep Disorders Center, Mayo Clinic College of Medicine, Jacksonville, FL, USA
| | - Oscar H Del Brutto
- School of Medicine and Research Center, Universidad Espíritu Santo-Ecuador, Samborondón, Ecuador.
| | - Pablo R Castillo
- Sleep Disorders Center, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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Ozturk B, Koundal S, Al Bizri E, Chen X, Gursky Z, Dai F, Lim A, Heerdt P, Kipnis J, Tannenbaum A, Lee H, Benveniste H. Continuous positive airway pressure increases CSF flow and glymphatic transport. JCI Insight 2023; 8:e170270. [PMID: 37159262 PMCID: PMC10371231 DOI: 10.1172/jci.insight.170270] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/04/2023] [Indexed: 05/10/2023] Open
Abstract
Respiration can positively influence cerebrospinal fluid (CSF) flow in the brain, yet its effects on central nervous system (CNS) fluid homeostasis, including waste clearance function via glymphatic and meningeal lymphatic systems, remain unclear. Here, we investigated the effect of supporting respiratory function via continuous positive airway pressure (CPAP) on glymphatic-lymphatic function in spontaneously breathing anesthetized rodents. To do this, we used a systems approach combining engineering, MRI, computational fluid dynamics analysis, and physiological testing. We first designed a nasal CPAP device for use in the rat and demonstrated that it functioned similarly to clinical devices, as evidenced by its ability to open the upper airway, augment end-expiratory lung volume, and improve arterial oxygenation. We further showed that CPAP increased CSF flow speed at the skull base and augmented glymphatic transport regionally. The CPAP-induced augmented CSF flow speed was associated with an increase in intracranial pressure (ICP), including the ICP waveform pulse amplitude. We suggest that the augmented pulse amplitude with CPAP underlies the increase in CSF bulk flow and glymphatic transport. Our results provide insights into the functional crosstalk at the pulmonary-CSF interface and suggest that CPAP might have therapeutic benefit for sustaining glymphatic-lymphatic function.
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Affiliation(s)
- Burhan Ozturk
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Sunil Koundal
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ehab Al Bizri
- Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Xinan Chen
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Zachary Gursky
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Feng Dai
- Quantitative Data Sciences, Global Product Development Pfizer Inc., Groton, Connecticut, USA
| | - Andrew Lim
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Paul Heerdt
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jonathan Kipnis
- Brain Immunology and Glia (BIG) Center, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Allen Tannenbaum
- Departments of Computer Science and Applied Mathematics & Statistics, College of Engineering and Applied Sciences, Stony Brook University, Stony Brook, New York, USA
| | - Hedok Lee
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Helene Benveniste
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Biomedical Engineering, Yale School of Medicine, New Haven, Connecticut, USA
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11
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Elabasy A, Suhonen M, Rajna Z, Hosni Y, Kananen J, Annunen J, Ansakorpi H, Korhonen V, Seppänen T, Kiviniemi V. Respiratory brain impulse propagation in focal epilepsy. Sci Rep 2023; 13:5222. [PMID: 36997658 PMCID: PMC10063583 DOI: 10.1038/s41598-023-32271-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023] Open
Abstract
Respiratory brain pulsations pertaining to intra-axial hydrodynamic solute transport are markedly altered in focal epilepsy. We used optical flow analysis of ultra-fast functional magnetic resonance imaging (fMRI) data to investigate the velocity characteristics of respiratory brain impulse propagation in patients with focal epilepsy treated with antiseizure medication (ASM) (medicated patients with focal epilepsy; ME, n = 23), drug-naïve patients with at least one seizure (DN, n = 19) and matched healthy control subjects (HC, n = 75). We detected in the two patient groups (ME and DN) several significant alterations in the respiratory brain pulsation propagation velocity, which showed a bidirectional change dominated by a reduction in speed. Furthermore, the respiratory impulses moved more in reversed or incoherent directions in both patient groups vs. the HC group. The speed reductions and directionality changes occurred in specific phases of the respiratory cycle. In conclusion, irrespective of medication status, both patient groups showed incoherent and slower respiratory brain impulses, which may contribute to epileptic brain pathology by hindering brain hydrodynamics.
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Affiliation(s)
- Ahmed Elabasy
- Center for Machine Vision and Signal Analysis, University of Oulu, 90014, Oulu, Finland.
- Oulu Functional NeuroImaging, Diagnostic Radiology, Medical Research Center/HTS, Oulu University Hospital, 90029, Oulu, Finland.
| | - Mia Suhonen
- Medical Imaging, Physics and Technology, University of Oulu, 90029, Oulu, Finland.
- Oulu Functional NeuroImaging, Diagnostic Radiology, Medical Research Center/HTS, Oulu University Hospital, 90029, Oulu, Finland.
| | - Zalan Rajna
- Center for Machine Vision and Signal Analysis, University of Oulu, 90014, Oulu, Finland
| | - Youssef Hosni
- Center for Machine Vision and Signal Analysis, University of Oulu, 90014, Oulu, Finland
- Oulu Functional NeuroImaging, Diagnostic Radiology, Medical Research Center/HTS, Oulu University Hospital, 90029, Oulu, Finland
| | - Janne Kananen
- Medical Imaging, Physics and Technology, University of Oulu, 90029, Oulu, Finland
- Oulu Functional NeuroImaging, Diagnostic Radiology, Medical Research Center/HTS, Oulu University Hospital, 90029, Oulu, Finland
- Clinical Neurophysiology, Oulu University Hospital, 90029 OYS, Oulu, Finland
| | - Johanna Annunen
- Research Unit of Clinical Neuroscience, Neurology, University of Oulu, 90029, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Member of ERN EpiCARE, 90029, Oulu, Finland
- MRC, Oulu University Hospital, 90029, Oulu, Finland
| | - Hanna Ansakorpi
- Research Unit of Clinical Neuroscience, Neurology, University of Oulu, 90029, Oulu, Finland
| | - Vesa Korhonen
- Medical Imaging, Physics and Technology, University of Oulu, 90029, Oulu, Finland
- Oulu Functional NeuroImaging, Diagnostic Radiology, Medical Research Center/HTS, Oulu University Hospital, 90029, Oulu, Finland
| | - Tapio Seppänen
- Center for Machine Vision and Signal Analysis, University of Oulu, 90014, Oulu, Finland
| | - Vesa Kiviniemi
- Medical Imaging, Physics and Technology, University of Oulu, 90029, Oulu, Finland.
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12
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Williams SD, Setzer B, Fultz NE, Valdiviezo Z, Tacugue N, Diamandis Z, Lewis LD. Neural activity induced by sensory stimulation can drive large-scale cerebrospinal fluid flow during wakefulness in humans. PLoS Biol 2023; 21:e3002035. [PMID: 36996009 PMCID: PMC10062585 DOI: 10.1371/journal.pbio.3002035] [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: 08/08/2022] [Accepted: 02/15/2023] [Indexed: 03/31/2023] Open
Abstract
Cerebrospinal fluid (CSF) flow maintains healthy brain homeostasis, facilitating solute transport and the exchange of brain waste products. CSF flow is thus important for brain health, but the mechanisms that control its large-scale movement through the ventricles are not well understood. While it is well established that CSF flow is modulated by respiratory and cardiovascular dynamics, recent work has also demonstrated that neural activity is coupled to large waves of CSF flow in the ventricles during sleep. To test whether the temporal coupling between neural activity and CSF flow is in part due to a causal relationship, we investigated whether CSF flow could be induced by driving neural activity with intense visual stimulation. We manipulated neural activity with a flickering checkerboard visual stimulus and found that we could drive macroscopic CSF flow in the human brain. The timing and amplitude of CSF flow was matched to the visually evoked hemodynamic responses, suggesting neural activity can modulate CSF flow via neurovascular coupling. These results demonstrate that neural activity can contribute to driving CSF flow in the human brain and that the temporal dynamics of neurovascular coupling can explain this effect.
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Affiliation(s)
- Stephanie D. Williams
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, United States of America
| | - Beverly Setzer
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
- Graduate Program in Neuroscience, Boston University, Boston, Massachusetts, United States of America
| | - Nina E. Fultz
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
| | - Zenia Valdiviezo
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
| | - Nicole Tacugue
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
| | - Zachary Diamandis
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
| | - Laura D. Lewis
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
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13
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Olovnikov AM. Planetary Metronome as a Regulator of Lifespan and Aging Rate: The Metronomic Hypothesis. BIOCHEMISTRY. BIOKHIMIIA 2022; 87:1640-1650. [PMID: 36717453 DOI: 10.1134/s0006297922120197] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
A metronomic mechanism for the duration control of ontogenetic cycle periods of an animal is proposed. The components of the proposed metronomic system include the ventricular system of the brain, planet Earth as a generator of metronomic signals, and temporal DNA (tDNA) as a substrate that is epigenetically marked to measure elapsed time of ontogenesis. The metronomic system generates repetitive signals in the form of hydrodynamic disturbances in the cerebrospinal fluid (CSF). The metronomic effect arises due to the superposition of two processes - the near-wall unidirectional flow of CSF and oscillations in the movement of the planet. Hydrodynamic impacts of the metronome are transformed into nerve impulses that initiate epigenetic modification of tDNA in neurons, changing the content of factors expressed by this DNA for innervated targets of the body. The duration of ontogenetic cycle periods, including duration of the adult life, depends on the rate of addition of epigenetic marks to tDNA. This rate depends mainly on the frequency of the metronomic signals used by each particular species. But epigenetic modifications can also be influenced by factors that modulate metabolism and the rate of chromatin modifications, such as a calorie-restricted diet.
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Affiliation(s)
- Alexey M Olovnikov
- Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, 119334, Russia.
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14
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Gutiérrez-Montes C, Coenen W, Vidorreta M, Sincomb S, Martínez-Bazán C, Sánchez AL, Haughton V. Effect of Normal Breathing on the Movement of CSF in the Spinal Subarachnoid Space. AJNR Am J Neuroradiol 2022; 43:1369-1374. [PMID: 35981761 PMCID: PMC9451622 DOI: 10.3174/ajnr.a7603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/24/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE Forced respirations reportedly have an effect on CSF movement in the spinal canal. We studied respiratory-related CSF motion during normal respiration. MATERIALS AND METHODS Six healthy subjects breathed at their normal rate with a visual guide to ensure an unchanging rhythm. Respiratory-gated phase-contrast MR flow images were acquired at 5 selected axial planes along the spine. At each spinal level, we computed the flow rate voxelwise in the spinal canal, together with the associated stroke volume. From these data, we computed the periodic volume changes of spinal segments. A phantom was used to quantify the effect of respiration-related magnetic susceptibility changes on the velocity data measured. RESULTS At each level, CSF moved cephalad during inhalation and caudad during expiration. While the general pattern of fluid movement was the same in the 6 subjects, the flow rates, stroke volumes, and spine segment volume changes varied among subjects. Peak flow rates ranged from 0.60 to 1.59 mL/s in the cervical region, 0.46 to 3.17 mL/s in the thoracic region, and 0.75 to 3.64 mL/s in the lumbar region. The differences in flow rates along the canal yielded cyclic volume variations of spine segments that were largest in the lumbar spine, ranging from 0.76 to 3.07 mL among subjects. In the phantom study, flow velocities oscillated periodically during the respiratory cycle by up to 0.02 cm/s or 0.5%. CONCLUSIONS Respiratory-gated measurements of the CSF motion in the spinal canal showed cyclic oscillatory movements of spinal fluid correlated to the breathing pattern.
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Affiliation(s)
- C Gutiérrez-Montes
- From the Department of Mechanical and Mining Engineering (C.G.-M.), University of Jaén, Jaén, Andalucía, Spain
| | - W Coenen
- Grupo de Mecánica de Fluidos, Departamento de Ingeniería Térmica y de Fluidos (W.C.), Universidad Carlos III de Madrid, Madrid, Spain
| | | | - S Sincomb
- Department of Mechanical and Aerospace Engineering (S.S., A.L.S.), University of California San Diego, San Diego, California
| | - C Martínez-Bazán
- Department of Structural Mechanics and Hydraulic Engineering (C.M.-B.), University of Granada, Granada, Spain
| | - A L Sánchez
- Department of Mechanical and Aerospace Engineering (S.S., A.L.S.), University of California San Diego, San Diego, California
| | - V Haughton
- Department of Radiology (V.H.), School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
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