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血管生成后脉络丛灌注和颅内脑脊液变化。

Choroid plexus perfusion and intracranial cerebrospinal fluid changes after angiogenesis.

机构信息

Department of Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA.

Department of Neurosurgery, Vanderbilt University School of Medicine, Nashville, TN, USA.

出版信息

J Cereb Blood Flow Metab. 2020 Aug;40(8):1658-1671. doi: 10.1177/0271678X19872563. Epub 2019 Sep 9.

Abstract

Recent studies have provided evidence that cortical brain ischemia may influence choroid plexus function, and such communication may be mediated by either traditional CSF circulation pathways and/or a possible glymphatic pathway. Here we investigated the hypothesis that improvements in arterial health following neoangiogenesis alter (i) intracranial CSF volume and (ii) choroid plexus perfusion in humans. CSF and tissue volume measurements were obtained from -weighted MRI, and cortical and choroid plexus perfusion were obtained from perfusion-weighted arterial spin labeling MRI, in patients with non-atherosclerotic intracranial stenosis (e.g. Moyamoya). Measurements were repeated after indirect surgical revascularization, which elicits cortical neoangiogenesis near the revascularization site ( = 23; age = 41.8 ± 13.4 years), or in a cohort of participants at two time points without interval surgeries ( = 10; age = 41.7 ± 10.7 years). Regression analyses were used to evaluate dependence of perfusion and volume on state (time 1 vs. 2). Post-surgery, neither CSF nor tissue volumes changed significantly. In surgical patients, cortical perfusion increased and choroid plexus perfusion decreased after surgery; in participants without surgeries, cortical perfusion reduced and choroid plexus perfusion increased between time points. Findings are discussed in the context of a homeostatic mechanism, whereby arterial health, paravascular flow, and/or ischemia can affect choroid plexus perfusion.

摘要

最近的研究提供了证据表明皮质脑缺血可能会影响脉络丛的功能,这种通讯可能是通过传统的脑脊液循环途径和/或可能的神经胶质淋巴途径来介导的。在这里,我们研究了这样一个假设,即新生血管形成后动脉健康的改善会改变 (i) 颅内 CSF 体积和 (ii) 人类脉络丛的灌注。通过加权 MRI 获得 CSF 和组织体积测量值,通过灌注加权动脉自旋标记 MRI 获得皮质和脉络丛灌注测量值,在非动脉粥样硬化性颅内狭窄(例如,烟雾病)患者中进行。在间接血管重建后重复测量,这会在血管重建部位附近引起皮质新生血管形成( = 23;年龄 = 41.8 ± 13.4 岁),或在没有间隔手术的两组参与者的两个时间点重复测量( = 10;年龄 = 41.7 ± 10.7 岁)。回归分析用于评估灌注和体积与状态(第 1 次与第 2 次)的依赖性。手术后,CSF 和组织体积均无明显变化。在手术患者中,皮质灌注在手术后增加,脉络丛灌注减少;在没有手术的参与者中,皮质灌注在两个时间点之间减少,脉络丛灌注增加。这些发现是在稳态机制的背景下讨论的,其中动脉健康、旁血管流动和/或缺血会影响脉络丛的灌注。

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