TY - JOUR
T1 - Cerebrospinal fluid turnover as a driver of brain clearance
AU - Smets, Nina G.
AU - Strijkers, Gustav J.
AU - Vinje, Vegard
AU - Bakker, Erik N. T. P.
N1 - Publisher Copyright: © 2023 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.
PY - 2023
Y1 - 2023
N2 - Cerebrospinal fluid (CSF) has historically been considered to function as a sink for brain-derived waste disposal. Recent work suggested that CSF interacts even more intensely with brain tissue than previously recognized, through perivascular spaces that penetrate the brain. Cardiac pulsations, vasomotion, and respiration have been suggested to drive CSF flow in these perivascular spaces, thereby enhancing waste clearance. However, the intrinsic role of CSF production in relation to its distribution volume (turnover) is not an explicit component of recent concepts on brain clearance. Here, we review the work on CSF turnover and volume, focusing on preclinical evidence. Herein, we highlight the use of MRI in establishing CSF-related parameters. We describe the impact of sleep, effect of anesthesia, aging, and hypertension on CSF turnover, and how this relates to brain clearance. Evaluation of the available evidence suggests that CSF turnover is a major determinant in brain clearance. In addition, we propose that several putative drivers of brain clearance, but also conditions associated with impaired clearance, such as aging, may actually relate to altered CSF turnover.
AB - Cerebrospinal fluid (CSF) has historically been considered to function as a sink for brain-derived waste disposal. Recent work suggested that CSF interacts even more intensely with brain tissue than previously recognized, through perivascular spaces that penetrate the brain. Cardiac pulsations, vasomotion, and respiration have been suggested to drive CSF flow in these perivascular spaces, thereby enhancing waste clearance. However, the intrinsic role of CSF production in relation to its distribution volume (turnover) is not an explicit component of recent concepts on brain clearance. Here, we review the work on CSF turnover and volume, focusing on preclinical evidence. Herein, we highlight the use of MRI in establishing CSF-related parameters. We describe the impact of sleep, effect of anesthesia, aging, and hypertension on CSF turnover, and how this relates to brain clearance. Evaluation of the available evidence suggests that CSF turnover is a major determinant in brain clearance. In addition, we propose that several putative drivers of brain clearance, but also conditions associated with impaired clearance, such as aging, may actually relate to altered CSF turnover.
KW - MRI
KW - brain
KW - cerebrospinal fluid
KW - glymphatic system
KW - perivascular spaces
UR - http://www.scopus.com/inward/record.url?scp=85169662816&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/nbm.5029
DO - https://doi.org/10.1002/nbm.5029
M3 - Article
C2 - 37658736
SN - 0952-3480
JO - NMR in biomedicine
JF - NMR in biomedicine
ER -