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Wright AM, Wu YC, Feng L, Wen Q. Diffusion magnetic resonance imaging of cerebrospinal fluid dynamics: Current techniques and future advancements. NMR IN BIOMEDICINE 2024; 37:e5162. [PMID: 38715420 PMCID: PMC11303114 DOI: 10.1002/nbm.5162] [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: 09/30/2023] [Revised: 02/20/2024] [Accepted: 03/30/2024] [Indexed: 05/22/2024]
Abstract
Cerebrospinal fluid (CSF) plays a critical role in metabolic waste clearance from the brain, requiring its circulation throughout various brain pathways, including the ventricular system, subarachnoid spaces, para-arterial spaces, interstitial spaces, and para-venous spaces. The complexity of CSF circulation has posed a challenge in obtaining noninvasive measurements of CSF dynamics. The assessment of CSF dynamics throughout its various circulatory pathways is possible using diffusion magnetic resonance imaging (MRI) with optimized sensitivity to incoherent water movement across the brain. This review presents an overview of both established and emerging diffusion MRI techniques designed to measure CSF dynamics and their potential clinical applications. The discussion offers insights into the optimization of diffusion MRI acquisition parameters to enhance the sensitivity and specificity of diffusion metrics on underlying CSF dynamics. Lastly, we emphasize the importance of cautious interpretations of diffusion-based imaging, especially when differentiating between tissue- and fluid-related changes or elucidating structural versus functional alterations.
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Affiliation(s)
- Adam M. Wright
- Department of Radiology and Imaging Sciences, Indiana
University School of Medicine, Indianapolis, Indiana, USA
- Weldon School of Biomedical Engineering Department, Purdue
University, West Lafayette, Indiana, USA
| | - Yu-Chien Wu
- Department of Radiology and Imaging Sciences, Indiana
University School of Medicine, Indianapolis, Indiana, USA
- Weldon School of Biomedical Engineering Department, Purdue
University, West Lafayette, Indiana, USA
- Stark Neurosciences Research Institute, Indiana University
School of Medicine, Indianapolis, Indiana, USA
| | - Li Feng
- Center for Advanced Imaging Innovation and Research
(CAI2R), New York University Grossman School of Medicine, New York, New York,
USA
| | - Qiuting Wen
- Department of Radiology and Imaging Sciences, Indiana
University School of Medicine, Indianapolis, Indiana, USA
- Weldon School of Biomedical Engineering Department, Purdue
University, West Lafayette, Indiana, USA
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2
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Ryman SG, Vakhtin AA, Mayer AR, van der Horn HJ, Shaff NA, Nitschke SR, Julio KR, Tarawneh RM, Rosenberg GA, Diaz SV, Pirio Richardson SE, Lin HC. Abnormal Cerebrovascular Activity, Perfusion, and Glymphatic Clearance in Lewy Body Diseases. Mov Disord 2024; 39:1258-1268. [PMID: 38817039 PMCID: PMC11341260 DOI: 10.1002/mds.29867] [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: 03/21/2024] [Revised: 05/01/2024] [Accepted: 05/09/2024] [Indexed: 06/01/2024] Open
Abstract
Cerebrovascular activity is not only crucial to optimal cerebral perfusion, but also plays an important role in the glymphatic clearance of interstitial waste, including α-synuclein. This highlights a need to evaluate how cerebrovascular activity is altered in Lewy body diseases. This review begins by discussing how vascular risk factors and cardiovascular autonomic dysfunction may serve as upstream or direct influences on cerebrovascular activity. We then discuss how patients with Lewy body disease exhibit reduced and delayed cerebrovascular activity, hypoperfusion, and reductions in measures used to capture cerebrospinal fluid flow, suggestive of a reduced capacity for glymphatic clearance. Given the lack of an existing framework, we propose a model by which these processes may foster α-synuclein aggregation and neuroinflammation. Importantly, this review highlights several avenues for future research that may lead to treatments early in the disease course, prior to neurodegeneration. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Sephira G Ryman
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, New Mexico, USA
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, The University of New Mexico, Albuquerque, New Mexico, USA
- Center for Memory and Aging, The University of New Mexico, Albuquerque, New Mexico, USA
| | - Andrei A Vakhtin
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, New Mexico, USA
| | - Andrew R Mayer
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, New Mexico, USA
| | - Harm Jan van der Horn
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, New Mexico, USA
| | - Nicholas A Shaff
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, New Mexico, USA
| | - Stephanie R Nitschke
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, New Mexico, USA
| | - Kayla R Julio
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, New Mexico, USA
| | - Rawan M Tarawneh
- Center for Memory and Aging, The University of New Mexico, Albuquerque, New Mexico, USA
- Cognitive Neurology Section, Department of Neurology, The University of New Mexico, Albuquerque, New Mexico, USA
| | - Gary A Rosenberg
- Center for Memory and Aging, The University of New Mexico, Albuquerque, New Mexico, USA
| | - Shanna V Diaz
- Department of Internal Medicine, The University of New Mexico, Albuquerque, New Mexico, USA
| | - Sarah E Pirio Richardson
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, The University of New Mexico, Albuquerque, New Mexico, USA
- New Mexico VA Health Care System, Albuquerque, New Mexico, USA
| | - Henry C Lin
- Department of Internal Medicine, The University of New Mexico, Albuquerque, New Mexico, USA
- New Mexico VA Health Care System, Albuquerque, New Mexico, USA
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Boyd ED, Kaur J, Ding G, Chopp M, Jiang Q. Clinical magnetic resonance imaging evaluation of glymphatic function. NMR IN BIOMEDICINE 2024; 37:e5132. [PMID: 38465514 DOI: 10.1002/nbm.5132] [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: 06/07/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 03/12/2024]
Abstract
The glymphatic system is a system of specialized perivascular spaces in the brain that facilitates removal of toxic waste solutes from the brain. Evaluation of glymphatic system function by means of magnetic resonance imaging (MRI) has thus far been largely focused on rodents because of the limitations of intrathecal delivery of gadolinium-based contrast agents to humans. This review discusses MRI methods that can be employed clinically for glymphatic-related measurements intended for early diagnosis, prevention, and the treatment of various neurological conditions. Although glymphatic system-based MRI research is in its early stages, recent studies have identified promising noninvasive MRI markers associated with glymphatic system alterations in neurological diseases. However, further optimization in data acquisition, validation, and modeling are needed to investigate the glymphatic system within the clinical setting.
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Affiliation(s)
- Edward D Boyd
- Department of Neurology, Henry Ford Health System, Detroit, Michigan, USA
- Department of Radiology, Michigan State University, East Lansing, Michigan, USA
| | - Jasleen Kaur
- Department of Neurology, Henry Ford Health System, Detroit, Michigan, USA
- Department of Physics, Oakland University, Rochester, Michigan, USA
| | - Guangliang Ding
- Department of Neurology, Henry Ford Health System, Detroit, Michigan, USA
- Department of Radiology, Michigan State University, East Lansing, Michigan, USA
| | - Michael Chopp
- Department of Neurology, Henry Ford Health System, Detroit, Michigan, USA
- Department of Physics, Oakland University, Rochester, Michigan, USA
| | - Quan Jiang
- Department of Neurology, Henry Ford Health System, Detroit, Michigan, USA
- Department of Radiology, Michigan State University, East Lansing, Michigan, USA
- Department of Physics, Oakland University, Rochester, Michigan, USA
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4
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van der Voort EC, Tong Y, van Grinsven EE, Zwanenburg JJM, Philippens MEP, Bhogal AA. CO 2 as an engine for neurofluid flow: Exploring the coupling between vascular reactivity, brain clearance, and changes in tissue properties. NMR IN BIOMEDICINE 2024; 37:e5126. [PMID: 38403795 PMCID: PMC11236526 DOI: 10.1002/nbm.5126] [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: 10/09/2023] [Revised: 01/08/2024] [Accepted: 01/28/2024] [Indexed: 02/27/2024]
Abstract
The brain relies on an effective clearance mechanism to remove metabolic waste products for the maintenance of homeostasis. Recent studies have focused on elucidating the forces that drive the motion of cerebrospinal fluid (CSF), responsible for removal of these waste products. We demonstrate that vascular responses evoked using controlled manipulations of partial pressure of carbon dioxide (PaCO2) levels, serve as an endogenous driver of CSF clearance from the brain. To demonstrate this, we retrospectively surveyed our database, which consists of brain metastases patients from whom blood oxygen level-dependent (BOLD) images were acquired during targeted hypercapnic and hyperoxic respiratory challenges. We observed a correlation between CSF inflow signal around the fourth ventricle and CO2-induced changes in cerebral blood volume. By contrast, no inflow signal was observed in response to the nonvasoactive hyperoxic stimulus, validating our measurements. Moreover, our results establish a link between the rate of the hemodynamic response (to elevated PaCO2) and peritumoral edema load, which we suspect may affect CSF flow, consequently having implications for brain clearance. Our expanded perspective on the factors involved in neurofluid flow underscores the importance of considering both cerebrovascular responses, as well as the brain mechanical properties, when evaluating CSF dynamics in the context of disease processes.
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Affiliation(s)
| | - Yunjie Tong
- Purdue University, West Lafayette, Indiana, USA
| | | | | | | | - Alex A. Bhogal
- Center for Image Sciences, UMC Utrecht, Utrecht, The Netherlands
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Chen Y, Hong H, Nazeri A, Markus HS, Luo X. Cerebrospinal fluid-based spatial statistics: towards quantitative analysis of cerebrospinal fluid pseudodiffusivity. Fluids Barriers CNS 2024; 21:59. [PMID: 39026214 PMCID: PMC11256588 DOI: 10.1186/s12987-024-00559-z] [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: 02/14/2024] [Accepted: 06/29/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Cerebrospinal fluid (CSF) circulation is essential in removing metabolic wastes from the brain and is an integral component of the glymphatic system. Abnormal CSF circulation is implicated in neurodegenerative diseases. Low b-value magnetic resonance imaging quantifies the variance of CSF motion, or pseudodiffusivity. However, few studies have investigated the relationship between the spatial patterns of CSF pseudodiffusivity and cognition. METHODS We introduced a novel technique, CSF-based spatial statistics (CBSS), to automatically quantify CSF pseudodiffusivity in each sulcus, cistern and ventricle. Using cortical regions as landmarks, we segmented each CSF region. We retrospectively analyzed a cohort of 93 participants with varying degrees of cognitive impairment. RESULTS We identified two groups of CSF regions whose pseudodiffusivity profiles were correlated with each other: one group displaying higher pseudodiffusivity and near large arteries and the other group displaying lower pseudodiffusivity and away from the large arteries. The pseudodiffusivity in the third ventricle positively correlated with short-term memory (standardized slope of linear regression = 0.38, adjusted p < 0.001) and long-term memory (slope = 0.37, adjusted p = 0.005). Fine mapping along the ventricles revealed that the pseudodiffusivity in the region closest to the start of the third ventricle demonstrated the highest correlation with cognitive performance. CONCLUSIONS CBSS enabled quantitative spatial analysis of CSF pseudodiffusivity and suggested the third ventricle pseudodiffusivity as a potential biomarker of cognitive impairment.
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Affiliation(s)
- Yutong Chen
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK
| | - Hui Hong
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China
| | - Arash Nazeri
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Hugh S Markus
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK
| | - Xiao Luo
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China.
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6
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Kish B, Jean Chen J, Tong Y. Effects of clamping end-tidal CO 2 on neurofluidic low-frequency oscillations. NMR IN BIOMEDICINE 2024; 37:e5084. [PMID: 38104563 PMCID: PMC11162899 DOI: 10.1002/nbm.5084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/17/2023] [Accepted: 11/11/2023] [Indexed: 12/19/2023]
Abstract
In recent years, low-frequency oscillations (LFOs) (0.01-0.1 Hz) have been a subject of interest in resting-state functional magnetic resonance imaging research. They are believed to have many possible driving mechanisms, from both regional and global sources. Internal fluctuations in the partial pressure of CO2 (PCO2) has long been thought of as one of these major driving forces, but its exact contributions compared with other mechanisms have yet to be fully understood. This study examined the effects of end-tidal PCO2 (PetCO2) oscillations on LF cerebral hemodynamics and cerebrospinal fluid (CSF) dynamics under "clamped PetCO2" and "free-breathing" conditions. Under clamped PetCO2, a participant's PetCO2 levels were fixed to their baseline average, whereas PetCO2 was not controlled in free breathing. Under clamped PetCO2, the fractional amplitude of hemodynamic LFOs in the occipital and sensorimotor cortex and temporal lobes were found to be significantly reduced. Additionally, the fractional amplitude of CSF LFOs, measured at the fourth ventricle, was found to be reduced by almost one-half. However, the spatiotemporal distributions of blood and CSF delay times, as measured by cross-correlation in the LF domain, were not significantly altered between conditions. This study demonstrates that, while PCO2 oscillations significantly mediate LFOs, especially those observed in the CSF, other mechanisms are able to maintain LFOs, with high correlation, even in their absence.
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Affiliation(s)
- Brianna Kish
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - J. Jean Chen
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Yunjie Tong
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
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Diorio TC, Nair VV, Patel NM, Hedges LE, Rayz VL, Tong Y. Real-time quantification of in vivo cerebrospinal fluid velocity using the functional magnetic resonance imaging inflow effect. NMR IN BIOMEDICINE 2024:e5200. [PMID: 38881247 DOI: 10.1002/nbm.5200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/22/2024] [Accepted: 05/21/2024] [Indexed: 06/18/2024]
Abstract
In vivo estimation of cerebrospinal fluid (CSF) velocity is crucial for understanding the glymphatic system and its potential role in neurodegenerative disorders such as Alzheimer's disease and Parkinson's disease. Current cardiac or respiratory-gated approaches, such as 4D flow magnetic resonance imaging (MRI), cannot capture CSF movement in real time because of limited temporal resolution and, in addition, deteriorate in accuracy at low fluid velocities. Other techniques like real-time phase-contrast-MRI or time-spatial labeling inversion pulse are not limited by temporal averaging but have limited availability, even in research settings. This study aims to quantify the inflow effect of dynamic CSF motion on functional MRI (fMRI) for in vivo, real-time measurement of CSF flow velocity. We considered linear and nonlinear models of velocity waveforms and empirically fit them to fMRI data from a controlled flow experiment. To assess the utility of this methodology in human data, CSF flow velocities were computed from fMRI data acquired in eight healthy volunteers. Breath-holding regimens were used to amplify CSF flow oscillations. Our experimental flow study revealed that CSF velocity is nonlinearly related to inflow effect-mediated signal increase and well estimated using an extension of a previous nonlinear framework. Using this relationship, we recovered velocity from in vivo fMRI signal, demonstrating the potential of our approach for estimating CSF flow velocity in the human brain. This novel method could serve as an alternative approach to quantifying slow flow velocities in real time, such as CSF flow in the ventricular system, thereby providing valuable insights into the glymphatic system's function and its implications for neurological disorders.
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Affiliation(s)
- Tyler C Diorio
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | | | - Neal M Patel
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Lauren E Hedges
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Vitaliy L Rayz
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Yunjie Tong
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
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Zhang Y, Peng B, Chen S, Liang Q, Zhang Y, Lin S, Xu Z, Zhang J, Hou G, Qiu Y. Reduced coupling between global signal and cerebrospinal fluid inflow in patients with depressive disorder: A resting state functional MRI study. J Affect Disord 2024; 354:136-142. [PMID: 38484877 DOI: 10.1016/j.jad.2024.03.023] [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: 01/04/2024] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Depressed patients often suffer from sleep disturbance, which has been recognized to be responsible for glymphatic dysfunction. The purpose of this study was to investigate the coupling strength of global blood‑oxygen-level-dependent (gBOLD) signals and cerebrospinal fluid (CSF) inflow dynamics, which is a biomarker for glymphatic function, in depressed patients and to explore its potential relationship with sleep disturbance by using resting-state functional MRI. METHODS A total of 138 depressed patients (112 females, age: 34.70 ± 13.11 years) and 84 healthy controls (29 females, age: 36.6 ± 11.75 years) participated in this study. The gBOLD-CSF coupling strength was calculated to evaluate glymphatic function. Sleep disturbance was evaluated using the insomnia items (item 4 for insomnia-early, item 5 for insomnia-middle, and item 6 for insomnia-late) of The 17-item Hamilton Depression Rating Scale for depressed patients, which was correlated with the gBOLD-CSF coupling strength. RESULTS The depressed patients exhibited weaker gBOLD-CSF coupling relative to healthy controls (p = 0.022), possibly due to impairment of the glymphatic system. Moreover, the gBOLD-CSF coupling strength correlated with insomnia-middle (r = 0.097, p = 0.008) in depressed patients. Limitations This study is a cross-sectional study. CONCLUSION Our findings shed light on the pathophysiology of depression, indicating that cerebral waste clearance system deficits are correlated with poor sleep quality in depressed patients.
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Affiliation(s)
- Yanyu Zhang
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Duobao AVE 56, Liwan district, Guangzhou 510145, People's Republic of China
| | - Bo Peng
- Department of Depressive Disorder, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong 518020, People's Republic of China
| | - Shengli Chen
- Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518000, People's Republic of China
| | - Qunjun Liang
- Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518000, People's Republic of China
| | - Yingli Zhang
- Department of Depressive Disorder, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong 518020, People's Republic of China
| | - Shiwei Lin
- Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518000, People's Republic of China
| | - Ziyun Xu
- Neuropsychiatry Imaging Center, Department of Radiology, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong 518020, People's Republic of China
| | - Jiayun Zhang
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Duobao AVE 56, Liwan district, Guangzhou 510145, People's Republic of China
| | - Gangqiang Hou
- Neuropsychiatry Imaging Center, Department of Radiology, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong 518020, People's Republic of China.
| | - Yingwei Qiu
- Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518000, People's Republic of China.
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Martins T, de Almeida B, Wu M, Wilckens KA, Minhas D, Ibinson JW, Aizenstein HJ, Santini T, Ibrahim TS. Characterization of pulsations in the brain and cerebrospinal fluid using ultra-high field magnetic resonance imaging. Front Neurosci 2024; 18:1305939. [PMID: 38784099 PMCID: PMC11112101 DOI: 10.3389/fnins.2024.1305939] [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: 10/02/2023] [Accepted: 04/08/2024] [Indexed: 05/25/2024] Open
Abstract
The development of innovative non-invasive neuroimaging methods and biomarkers is critical for studying brain disease. Imaging of cerebrospinal fluid (CSF) pulsatility may inform the brain fluid dynamics involved in clearance of cerebral metabolic waste. In this work, we developed a methodology to characterize the frequency and spatial localization of whole brain CSF pulsations in humans. Using 7 Tesla (T) human magnetic resonance imaging (MRI) and ultrafast echo-planar imaging (EPI), in-vivo images were obtained to capture pulsations of the CSF signal. Physiological data were simultaneously collected and compared with the 7 T MR data. The primary components of signal pulsations were identified using spectral analysis, with the most evident frequency bands identified around 0.3, 1.2, and 2.4 Hz. These pulsations were mapped spatially and temporally onto the MR image domain and temporally onto the physiological measures of electrocardiogram and respiration. We identified peaks in CSF pulsations that were distinct from peaks in grey matter and white matter regions. This methodology may provide novel in vivo biomarkers of disrupted brain fluid dynamics.
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Affiliation(s)
- Tiago Martins
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bruno de Almeida
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Minjie Wu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kristine A. Wilckens
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Davneet Minhas
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - James W. Ibinson
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Howard J. Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tales Santini
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tamer S. Ibrahim
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
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10
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Kim JH, Im JG, Park SH. Measurement of changes in cerebrospinal fluid pulsation after traumatic brain injury using echo-planar imaging-based functional MRI. NMR IN BIOMEDICINE 2024; 37:e5061. [PMID: 37839870 DOI: 10.1002/nbm.5061] [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: 03/23/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/17/2023]
Abstract
Traumatic brain injury (TBI) is a major public health concern worldwide, with a high incidence and a significant impact on morbidity and mortality. The alteration of cerebrospinal fluid (CSF) dynamics after TBI is a well-known phenomenon; however, the underlying mechanisms and their implications for cognitive function are not fully understood. In this study, we propose a new approach to studying the alteration of CSF dynamics in TBI patients. Our approach involves using conventional echo-planar imaging-based functional MRI with no additional scan, allowing for simultaneous assessment of functional CSF dynamics and blood oxygen level-dependent-based functional brain activities. We utilized two previously suggested indices of (i) CSFpulse, and (ii) correlation between global brain activity and CSF inflow. Using CSFpulse, we demonstrated a significant decrease in CSF pulsation following TBI (p < 0.05), which was consistent with previous studies. Furthermore, we confirmed that the decrease in CSF pulsation was most prominent in the early months after TBI, which could be explained by ependymal ciliary loss, intracranial pressure increment, or aquaporin-4 dysregulation. We also observed a decreasing trend in the correlation between global brain activity and CSF inflow in TBI patients (p < 0.05). Our findings suggest that the decreased CSF pulsation after TBI could lead to the accumulation of toxic substances in the brain and an adverse effect on brain function. Further longitudinal studies with larger sample sizes, TBI biomarker data, and various demographic information are needed to investigate the association between cognitive decline and CSF dynamics after TBI. Overall, this study sheds light on the potential role of altered CSF dynamics in TBI-induced neurologic symptoms and may contribute to the development of novel therapeutic interventions.
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Affiliation(s)
- Jun-Hee Kim
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Jae-Geun Im
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Sung-Hong Park
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
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11
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Martins T, Santini T, de Almeida B, Wu M, Wilckens KA, Minhas D, Ibinson JW, Aizenstein HJ, Ibrahim TS. Characterization of oscillations in the brain and cerebrospinal fluid using ultra-high field magnetic resonance imaging. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.05.23299452. [PMID: 38105931 PMCID: PMC10723515 DOI: 10.1101/2023.12.05.23299452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Development of innovative non-invasive neuroimaging methods and biomarkers are critical for studying brain disease. In this work, we have developed a methodology to characterize the frequency responses and spatial localization of oscillations and movements of cerebrospinal fluid (CSF) flow in the human brain. Using 7 Tesla human MRI and ultrafast echo-planar imaging (EPI), in-vivo images were obtained to capture CSF oscillations and movements. Physiological data was simultaneously collected and correlated with the 7T MR data. The primary components of CSF oscillations were identified using spectral analysis (with frequency bands identified around 0.3Hz, 1.2Hz and 2.4Hz) and were mapped spatially and temporally onto the MR image domain and temporally onto the physiological domain. The developed methodology shows a good consistency and repeatability (standard deviation of 0.052 and 0.078 for 0.3Hz and 1.2Hz bands respectively) in-vivo for potential brain dynamics and CSF flow and clearance studies.
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Affiliation(s)
- Tiago Martins
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tales Santini
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bruno de Almeida
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Minjie Wu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kristine A. Wilckens
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Davneet Minhas
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - James W. Ibinson
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Howard J. Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tamer S. Ibrahim
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
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12
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Liu X. Decoupling Between Brain Activity and Cerebrospinal Fluid Movement in Neurological Disorders. J Magn Reson Imaging 2023:10.1002/jmri.29148. [PMID: 37991132 PMCID: PMC11109023 DOI: 10.1002/jmri.29148] [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: 09/01/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/23/2023] Open
Abstract
Recent research has identified a link between the global mean signal of resting-state functional MRI (fMRI) and macro-scale cerebrospinal fluid movement, indicating the potential link between this resting-state dynamic and brain waste clearance. Consistent with this notion, the strength of this coupling has been associated with multiple neurodegenerative disease pathologies, especially the build-up of toxic proteins. This article aimed to review the latest advancements in this research area, emphasizing studies on spontaneous global brain activity that is tightly linked to the global mean resting-state fMRI signal, and aimed to discuss potential mechanisms through which this activity and associated physiological modulations might affect brain waste clearance. The available evidence supports the presence of a highly organized global brain activity that is linked to arousal and memory systems. This global brain dynamic, along with its associated physiological modulations, has the potential to influence brain waste clearance through multiple pathways through multiple pathways. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Xiao Liu
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, 16802, USA
- Institute for Computational and Data Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
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Diorio TC, Nair VV, Patel NM, Hedges LE, Rayz VL, Tong Y. Real-time Quantification of in vivo cerebrospinal fluid velocity using fMRI inflow effect. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.14.553250. [PMID: 37961095 PMCID: PMC10634978 DOI: 10.1101/2023.08.14.553250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
In vivo estimation of cerebrospinal fluid (CSF) velocity is crucial for understanding the glymphatic system and its potential role in neurodegenerative disorders such as Alzheimer's disease and Parkinson's disease. Current cardiac or respiratory gated approaches, such as 4D flow MRI, cannot capture CSF movement in real time due to limited temporal resolution and in addition deteriorate in accuracy at low fluid velocities. Other techniques like real-time PC-MRI or time-spatial labeling inversion pulse are not limited by temporal averaging but have limited availability even in research settings. This study aims to quantify the inflow effect of dynamic CSF motion on functional magnetic resonance imaging (fMRI) for in vivo, real-time measurement of CSF flow velocity. We considered linear and nonlinear models of velocity waveforms and empirically fit them to fMRI data from a controlled flow experiment. To assess the utility of this methodology in human data, CSF flow velocities were computed from fMRI data acquired in eight healthy volunteers. Breath holding regimens were used to amplify CSF flow oscillations. Our experimental flow study revealed that CSF velocity is nonlinearly related to inflow effect-mediated signal increase and well estimated using an extension of a previous nonlinear framework. Using this relationship, we recovered velocity from in vivo fMRI signal, demonstrating the potential of our approach for estimating CSF flow velocity in the human brain. This novel method could serve as an alternative approach to quantifying slow flow velocities in real time, such as CSF flow in the ventricular system, thereby providing valuable insights into the glymphatic system's function and its implications for neurological disorders.
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Affiliation(s)
- Tyler C Diorio
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
| | | | - Neal M Patel
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
| | - Lauren E Hedges
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
| | - Vitaliy L Rayz
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
| | - Yunjie Tong
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
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14
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Vijayakrishnan Nair V, Kish BR, Chong PL, Yang HCS, Wu YC, Tong Y, Schwichtenberg AJ. Neurofluid coupling during sleep and wake states. Sleep Med 2023; 110:44-53. [PMID: 37536211 PMCID: PMC11022242 DOI: 10.1016/j.sleep.2023.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/17/2023] [Accepted: 07/22/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND In clinical populations, the movement of cerebrospinal fluid (CSF) during sleep is a growing area of research with potential mechanistic connections in both neurodegenerative (e.g., Alzheimer's Disease) and neurodevelopmental disorders. However, we know relatively little about the processes that influence CSF movement. To inform clinical intervention targets this study assesses the coupling between (a) real-time CSF movement, (b) neuronal-driven movement, and (c) non-neuronal systemic physiology driven movement. METHODS This study included eight young, healthy volunteers, with concurrently acquired neurofluid dynamics using functional Magnetic Resonance Imaging (MRI), neural activity using Electroencephalography (EEG), and non-neuronal systemic physiology with peripheral functional Near-Infrared Spectroscopy (fNIRS). Neuronal and non-neuronal drivers were assessed temporally; wherein, EEG measured slow wave activity that preceded CSF movement was considered neuronally driven. Similarly, slow wave oscillations (assessed via fNIRS) that coupled with CSF movement were considered non-neuronal systemic physiology driven. RESULTS AND CONCLUSIONS Our results document neural contributions to CSF movement were only present during light NREM sleep but low-frequency non-neuronal oscillations were strongly coupled with CSF movement in all assessed states - awake, NREM-1, NREM-2. The clinical/research implications of these findings are two-fold. First, neuronal-driven oscillations contribute to CSF movement outside of deep sleep (NREM-3); therefore, interventions aimed at increasing CSF movement may yield meaningful increases with the promotion of NREM sleep more generally - a focus on NREM S3 may not be needed. Second, non-neuronal systemic oscillations contribute across wake and sleep stages; therefore, interventions may increase CSF movement by manipulating systemic physiology.
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Affiliation(s)
| | - Brianna R Kish
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - Pearlynne Lh Chong
- Department of Human Development and Family Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN, 47907, USA
| | - Ho-Ching Shawn Yang
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Yu-Chien Wu
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, 46202, USA; Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Yunjie Tong
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA.
| | - A J Schwichtenberg
- Department of Human Development and Family Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN, 47907, USA.
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15
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Ma Y, Luo K, Ding P, Yin S, Li X, Li Y. Differences in symmetrical low-frequency oscillations among healthy subjects, and those with stroke or peripheral arterial disease. Heliyon 2023; 9:e17015. [PMID: 37484434 PMCID: PMC10361110 DOI: 10.1016/j.heliyon.2023.e17015] [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: 03/06/2023] [Revised: 05/30/2023] [Accepted: 06/04/2023] [Indexed: 07/25/2023] Open
Abstract
Low-frequency oscillations (LFOs) observed in near-infrared spectroscopy (NIRS) reflect autonomic physiological processes, and may serve as useful indicators for detecting and monitoring circulatory dysfunction. The aim of this study was to reveal whether LFOs can be used as vascular perfusion biomarkers to differentiate different types and degrees of vascular lesions based on clinical patient data. Materials and Methods: In this study, healthy controls, ischemic stroke patients and peripheral atherosclerosis patients completed a resting-state LFO detection experiment. LFOs were collected simultaneously at peripheral right and left earlobes, fingertips and toes, along with coherence and phase shift analyses processing. Results: The results showed that the coherence coefficients of symmetric peripheral positions and the absolute value-phase shifts of fingers and toes can be used to distinguish healthy individuals, ischemic stroke patients and peripheral atherosclerosis patients. The symmetric earlobes' absolute value-phase shifts could be used to differentiate mild and severe ischemic stroke patients; the coherence coefficients and absolute value-phase shifts of the symmetric toes could be used to differentiate mild and severe peripheral arteriosclerosis patients. The accuracy of differentiating between types of patients was 70%; those with different degrees of peripheral atherosclerosis was 85%, and those with different degrees of ischemic stroke was 72%. Conclusions: LFOs can serve as vascular perfusion biomarkers to differentiate types and degrees of vascular lesions. Therefore, LFOs have the potential to provide valuable patient information to assist researchers and clinicians in identifying specific peripheral circulatory damage subgroups.
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Affiliation(s)
- Yunfei Ma
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, Hebei, 066004, China
| | - Kexin Luo
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, Hebei, 066004, China
| | - Peng Ding
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, Hebei, 066004, China
| | - Shimin Yin
- Department of Neurology, PLA Rocket Force Characteristic Medical Center, Beijing, 100088, China
| | - Xiaoli Li
- Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, 100875, China
| | - Yingwei Li
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, Hebei, 066004, China
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Keep RF, Jones HC, Hamilton MG, Drewes LR. A year in review: brain barriers and brain fluids research in 2022. Fluids Barriers CNS 2023; 20:30. [PMID: 37085841 PMCID: PMC10120509 DOI: 10.1186/s12987-023-00429-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Indexed: 04/23/2023] Open
Abstract
This aim of this editorial is to highlight progress made in brain barrier and brain fluid research in 2022. It covers studies on the blood-brain, blood-retina and blood-CSF barriers (choroid plexus and meninges), signaling within the neurovascular unit and elements of the brain fluid systems. It further discusses how brain barriers and brain fluid systems are impacted in CNS diseases, their role in disease progression and progress being made in treating such diseases.
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Affiliation(s)
- Richard F Keep
- Department of Neurosurgery, University of Michigan, R5018 BSRB 109 Zina Pitcher Place, Ann Arbor, MI, 48109-2200, USA.
| | | | - Mark G Hamilton
- Department of Clinical Neurosciences, Division of Neurosurgery, University of Calgary, Alberta, Canada
| | - Lester R Drewes
- Department of Biomedical Sciences, University of Minnesota Medical School Duluth, Duluth, MN, 55812, USA
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17
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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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18
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Zhang Y, Zhang R, Wang S, Hong H, Jiaerken Y, Li K, Zeng Q, Luo X, Yu X, Zhang M, Huang P. Reduced coupling between the global blood-oxygen-level-dependent signal and cerebrospinal fluid inflow is associated with the severity of small vessel disease. Neuroimage Clin 2022; 36:103229. [PMID: 36252555 PMCID: PMC9668594 DOI: 10.1016/j.nicl.2022.103229] [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: 06/23/2022] [Revised: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Small vessel disease (SVD) is highly prevalent in the elderly and associated with an increased risk of dementia and stroke. SVD may have disturbed cerebrospinal fluid (CSF) flow, which can compromise waste clearance and accelerate disease progression. METHODS We retrospectively included 146 SVD patients from a prospectively collected dataset, with one- or two-year follow-up data in 61 patients. The coupling strength between the global blood-oxygen-level-dependent (gBOLD) signal and CSF inflow was used to reflect CSF dynamics. We performed regression analyses to investigate the association between the gBOLD-CSF coupling index and the severity of SVD and vascular risk factors. Longitudinal analysis was carried out to investigate causal relationships. RESULTS Patients with severe SVD had significantly decreased gBOLD-CSF coupling (β = -0.180, p = 0.032). Dilation of perivascular spaces in the basal ganglia area (β = -0.172, p = 0.033) and diabetes (β = -0.204, p = 0.014) were associated with reduced gBOLD-CSF coupling. In longitudinal analyses, diabetes was associated with faster decline in gBOLD-CSF coupling (β = 0.20, p = 0.039), while perivascular space (PVS) dilation in the centrum semiovale showed a opposite relationship (β = -0.20, p = 0.041). The gBOLD-CSF coupling could not predict SVD progression. CONCLUSION Altered CSF flow is associated with the severity of SVD.
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Affiliation(s)
- Yao Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Ruiting Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China,Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Shuyue Wang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Hui Hong
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Yeerfan Jiaerken
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Kaicheng Li
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Qingze Zeng
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Xiao Luo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Xinfeng Yu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China,Corresponding authors at: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China.
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China,Corresponding authors at: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China.
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Gonzalez-Castillo J, Fernandez IS, Handwerker DA, Bandettini PA. Ultra-slow fMRI fluctuations in the fourth ventricle as a marker of drowsiness. Neuroimage 2022; 259:119424. [PMID: 35781079 PMCID: PMC9377091 DOI: 10.1016/j.neuroimage.2022.119424] [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: 03/30/2022] [Revised: 06/16/2022] [Accepted: 06/29/2022] [Indexed: 10/17/2022] Open
Abstract
Wakefulness levels modulate estimates of functional connectivity (FC), and, if unaccounted for, can become a substantial confound in resting-state fMRI. Unfortunately, wakefulness is rarely monitored due to the need for additional concurrent recordings (e.g., eye tracking, EEG). Recent work has shown that strong fluctuations around 0.05Hz, hypothesized to be CSF inflow, appear in the fourth ventricle (FV) when subjects fall asleep, and that they correlate significantly with the global signal. The analysis of these fluctuations could provide an easy way to evaluate wakefulness in fMRI-only data and improve our understanding of FC during sleep. Here we evaluate this possibility using the 7T resting-state sample from the Human Connectome Project (HCP). Our results replicate the observation that fourth ventricle ultra-slow fluctuations (∼0.05Hz) with inflow-like characteristics (decreasing in intensity for successive slices) are present in scans during which subjects did not comply with instructions to keep their eyes open (i.e., drowsy scans). This is true despite the HCP data not being optimized for the detection of inflow-like effects. In addition, time-locked BOLD fluctuations of the same frequency could be detected in large portions of grey matter with a wide range of temporal delays and contribute in significant ways to our understanding of how FC changes during sleep. First, these ultra-slow fluctuations explain half of the increase in global signal that occurs during descent into sleep. Similarly, global shifts in FC between awake and sleep states are driven by changes in this slow frequency band. Second, they can influence estimates of inter-regional FC. For example, disconnection between frontal and posterior components of the Defulat Mode Network (DMN) typically reported during sleep were only detectable after regression of these ultra-slow fluctuations. Finally, we report that the temporal evolution of the power spectrum of these ultra-slow FV fluctuations can help us reproduce sample-level sleep patterns (e.g., a substantial number of subjects descending into sleep 3 minutes following scanning onset), partially rank scans according to overall drowsiness levels, and predict individual segments of elevated drowsiness (at 60 seconds resolution) with 71% accuracy.
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Affiliation(s)
- Javier Gonzalez-Castillo
- Section on Functional Imaging Methods, Laboratory of Brain and Cognition, National Institute of Mental Health, National Institutes of Health, Bethesda, MD.
| | - Isabel S Fernandez
- Section on Functional Imaging Methods, Laboratory of Brain and Cognition, National Institute of Mental Health, National Institutes of Health, Bethesda, MD
| | - Daniel A Handwerker
- Section on Functional Imaging Methods, Laboratory of Brain and Cognition, National Institute of Mental Health, National Institutes of Health, Bethesda, MD
| | - Peter A Bandettini
- Section on Functional Imaging Methods, Laboratory of Brain and Cognition, National Institute of Mental Health, National Institutes of Health, Bethesda, MD; Functional MRI Core, National Institutes of Health, Bethesda, MD
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20
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Wang Y, van Gelderen P, de Zwart JA, Özbay PS, Mandelkow H, Picchioni D, Duyn JH. Cerebrovascular activity is a major factor in the cerebrospinal fluid flow dynamics. Neuroimage 2022; 258:119362. [PMID: 35688316 PMCID: PMC9271599 DOI: 10.1016/j.neuroimage.2022.119362] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/02/2022] [Accepted: 06/06/2022] [Indexed: 11/17/2022] Open
Abstract
Cerebrospinal fluid (CSF) provides physical protection to the central nervous system as well as an essential homeostatic environment for the normal functioning of neurons. Additionally, it has been proposed that the pulsatile movement of CSF may assist in glymphatic clearance of brain metabolic waste products implicated in neurodegeneration. In awake humans, CSF flow dynamics are thought to be driven primarily by cerebral blood volume fluctuations resulting from a number of mechanisms, including a passive vascular response to blood pressure variations associated with cardiac and respiratory cycles. Recent research has shown that mechanisms that rely on the action of vascular smooth muscle cells ("cerebrovascular activity") such as neuronal activity, changes in intravascular CO2, and autonomic activation from the brainstem, may lead to CSF pulsations as well. Nevertheless, the relative contribution of these mechanisms to CSF flow remains unclear. To investigate this further, we developed an MRI approach capable of disentangling and quantifying CSF flow components of different time scales associated with these mechanisms. This approach was evaluated on human control subjects (n = 12) performing intermittent voluntary deep inspirations, by determining peak flow velocities and displaced volumes between these mechanisms in the fourth ventricle. We found that peak flow velocities were similar between the different mechanisms, while displaced volumes per cycle were about a magnitude larger for deep inspirations. CSF flow velocity peaked at around 10.4 s (range 7.1-14.8 s, n = 12) following deep inspiration, consistent with known cerebrovascular activation delays for this autonomic challenge. These findings point to an important role of cerebrovascular activity in the genesis of CSF pulsations. Other regulatory triggers for cerebral blood flow such as autonomic arousal and orthostatic challenges may create major CSF pulsatile movement as well. Future quantitative comparison of these and possibly additional types of CSF pulsations with the proposed approach may help clarify the conditions that affect CSF flow dynamics.
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Affiliation(s)
- Yicun Wang
- Advanced MRI Section, Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States.
| | - Peter van Gelderen
- Advanced MRI Section, Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Jacco A de Zwart
- Advanced MRI Section, Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Pinar S Özbay
- Advanced MRI Section, Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Hendrik Mandelkow
- Advanced MRI Section, Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Dante Picchioni
- Advanced MRI Section, Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Jeff H Duyn
- Advanced MRI Section, Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
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21
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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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22
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Measurement of CSF pulsation from EPI-based human fMRI. Neuroimage 2022; 257:119293. [PMID: 35551990 DOI: 10.1016/j.neuroimage.2022.119293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/01/2022] [Accepted: 05/08/2022] [Indexed: 11/22/2022] Open
Abstract
It is recently discovered that the glymphatic system and meningeal lymphatic system are the primary routes for the clearance of brain waste products. The CSF flow is part of these systems, facilitating the clearance procedure. Nonetheless, the relationship between CSF flow and brain functional activity has been underexplored. To investigate CSF dynamics and functional brain activity simultaneously, recent studies have proposed a CSF inflow index measured on edge slices (CSFedge) of echo-planar imaging (EPI) based functional magnetic resonance imaging (fMRI), however, it lacks the quantitative aspect of the CSF pulsation. We proposed a new method for quantifying CSF pulsation (CSFpulse) based on an interslice CSF pulsation model in the 4th ventricle of EPI-based fMRI. The proposed CSFpulse successfully detected the higher CSF flow during the resting state than the typical task states (visual and motor) (p<.05), which is consistent with previous studies based on phase contrast (PC) MRI and CSF volume MRI, while it was not detected in CSFedge based indices or baseline CSF signals in various regions of interest (ROIs). Moreover, CSFpulse demonstrated dynamic functional changes in CSF pulsation: it decreased during the activation-on blocks while it increased during the activation-off blocks. CSFpulse significantly correlated with stroke volume measured using PC MRI, a standard method for CSF pulsation quantification, under the same functional state, while CSFedge based indices or CSF ROIs showed no correlation with the PC MRI stroke volume. Lastly, the correlation of CSFpulse with global BOLD was weaker than that of CSFedge, suggesting that CSFpulse may reflect distinct CSF physiological information that is less affected by global BOLD effects. Based on these results, the proposed CSFpulse provides CSF pulsatility information more accurately in a quantitative manner than CSFedge based indices from the recent CSF studies or the conventional ROI-based analysis. In addition to the high correlation with PC MRI, CSFpulse is much faster than PC MRI and provides information of functional brain activations simultaneously, advantageous over PC MRI or CSF volume MRI. Accordingly, the suggested CSFpulse can be used for investigating intra-subject functional changes in BOLD and CSF pulsation simultaneously and inter-subject CSF pulsation variations based on conventional EPI-based fMRI, which warrants further investigation.
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