Liu Pan, Owashi Kimi, Monnier Heimiri, Metanbou Serge, Capel Cyrille, Balédent Olivier
Medical Image Processing Department, CHU Amiens-Picardie University Hospital, Amiens, France; CHIMERE UR 7516, University of Picardie Jules Verne, Amiens, France.
Medical Image Processing Department, CHU Amiens-Picardie University Hospital, Amiens, France; CHIMERE UR 7516, University of Picardie Jules Verne, Amiens, France.
Neuroimage. 2025 Jan;305:120988. doi: 10.1016/j.neuroimage.2024.120988. Epub 2024 Dec 25.
Understanding cerebrospinal fluid (CSF) dynamics is crucial for elucidating the pathogenesis and diagnosis of neurodegenerative diseases. The primary mechanisms driving CSF oscillations remain a topic of debate. This study investigates whether cerebral blood volume displacement (CBV), modulated by breathing and cardiac activity, is the predominant drivers of CSF oscillations. We examined 12 healthy volunteers (aged 20-34 years) using a clinical 3T MRI scanner to quantify cerebral blood flow at the intracranial level and CSF flow at the C2-C3 spinal level under free and deep breathing conditions, utilizing real-time phase-contrast sequences. We then obtained CBV and CSF volume displacement (CSFV) curves by integrating the flow rate signals. Cardiac and respiratory signals were recorded during acquisition to reconstruct cardiac-driven and breath-driven CBV and CSFV curves. During deep breathing, compared to free breathing, the total cerebral arterial flow rate decreased by 29 % (from 12.5 ml/s to 8.8 ml/s), and the duration of the cardiac cycle period shortened by 15 % (0.90 s to 0.77 s), leading to reductions of 37 % and 23 % in cardiac-driven CBV and CSFV amplitudes, respectively. Conversely, breath-driven CBV and CSFV amplitudes increased substantially by 207 % and 326 %, respectively. Notably, during free breathing, cardiac-driven CBV and CSFV were significantly greater than their breath-driven counterparts; however, during deep breathing, the amplitudes of cardiac-driven and breath-driven CBV and CSFV did not differ significantly. CBV and CSFV curves demonstrated strong coupled inverse oscillation under both breathing conditions, with consistent CSF inflow toward the intracranial compartment during inspiration. This study quantifies the contributions of cardiac and breathing activities to CBV and CSFV under varying breathing patterns, confirming that CBV changes, driven by cardiac and respiratory activities, are strongly inversely coupled with CSF oscillations. These findings enhance our understanding of CSF circulation mechanisms and offer potential diagnostic implications for neurodegenerative diseases.
了解脑脊液（CSF）动力学对于阐明神经退行性疾病的发病机制和诊断至关重要。驱动脑脊液振荡的主要机制仍是一个有争议的话题。本研究调查了受呼吸和心脏活动调节的脑血容量位移（CBV）是否是脑脊液振荡的主要驱动因素。我们使用临床3T MRI扫描仪检查了12名健康志愿者（年龄20 - 34岁），利用实时相位对比序列在自由呼吸和深呼吸条件下量化颅内水平的脑血流量以及C2 - C3脊髓水平的脑脊液流量。然后，我们通过对流速信号进行积分获得了CBV和脑脊液体积位移（CSFV）曲线。在采集过程中记录心脏和呼吸信号，以重建心脏驱动和呼吸驱动的CBV和CSFV曲线。在深呼吸期间，与自由呼吸相比，总脑动脉流速降低了29%（从12.5 ml/s降至8.8 ml/s），心动周期持续时间缩短了15%（从0.90 s降至0.77 s），导致心脏驱动的CBV和CSFV振幅分别降低了37%和23%。相反，呼吸驱动的CBV和CSFV振幅分别大幅增加了207%和326%。值得注意的是，在自由呼吸期间，心脏驱动的CBV和CSFV显著大于其呼吸驱动的对应值；然而，在深呼吸期间，心脏驱动和呼吸驱动的CBV和CSFV振幅没有显著差异。CBV和CSFV曲线在两种呼吸条件下均表现出强烈的耦合反向振荡，吸气期间脑脊液持续向颅内腔流入。本研究量化了不同呼吸模式下心脏和呼吸活动对CBV和CSFV的贡献，证实由心脏和呼吸活动驱动的CBV变化与脑脊液振荡强烈反向耦合。这些发现增进了我们对脑脊液循环机制的理解，并为神经退行性疾病提供了潜在的诊断意义。
