Although the pool of cholesterol in the adult central nervous system (CNS) is large and of constant size, little is known of the process(es) involved in regulation of sterol turnover in this pool. In 7-week-old mice, net excretion of cholesterol from the brain equaled 1.4 mg/day/kg body weight, and from the whole animal was 179 mg/day/kg. Deletion of cholesterol 24-hydroxylase, an enzyme highly expressed in the CNS, did not alter brain growth or myelination, but reduced sterol excretion from the CNS 64% to 0.5 mg/day/kg. In mice with a mutation in the Niemann-Pick C gene that had ongoing neurodegeneration, sterol excretion from the CNS was increased to 2.3 mg/day/kg. Deletion of cholesterol 24-hydroxylase activity in these animals reduced net excretion only 22% to 1. The cells of all extrahepatic tissues outside of the central nervous system (CNS) continuously acquire cholesterol from two sources, de novo synthesis and the uptake of sterol carried in LDLs. In the mouse, as in other species (1), the predominant source for this sterol is de novo synthesis ( ف 100 mg/day/kg body weight), while cellular uptake of LDL cholesterol through the clathrin-coated pit/ lysosomal pathway contributes only a small amount ( ف 5-10 mg/day/kg) to this acquisition process (2-4). Within the cells of these tissues, this newly acquired sterol is transported outwardly to the cell surface, where it apparently continuously replaces cholesterol within the bulk phase and sphingolipid-rich microdomains of the plasma membrane (5, 6). Because the pool of cholesterol in these extrahepatic tissues remains constant ( ف 2,200 mg/kg), each day an amount of sterol equal to that newly acquired must be removed from these cells and carried by lipoproteins back to the liver for excretion from the body as either neutral, i.e., cholesterol or acidic, i.e., bile acid, sterols. While it is not entirely clear why the integrity of these cells depends upon this continuous flow of sterol from the endoplasmic reticulum and lysosomes to the plasma membrane, several lines of evidence suggest this movement may be involved in the regulation of certain proteins and in the function of a number of specific transporters on the cell surface (7-11). Because of this continuous replacement, in a species with a very high metabolic rate like the mouse, ف 7-9% of the total body pool of cholesterol is turned over each day (2, 4).Much less is understood about cholesterol turnover in the brain. As in most of the other extrahepatic organs, sterol in the brain is essentially all unesterified, but unlike in these other tissues, this cholesterol is present in two functionally distinct pools, the plasma membranes of glial and nerve cells, and the multi-layered myelin sheaths elaborated by support cells that surround the processes of neurons. While the concentration of unesterified cholesterol in most organs varies from ف 1.4 mg/g wet weight (muscle) to ف 5.0 mg/g (lung) (2), in the brain, these concentrations vary from ف 8 mg/g (gray matter) to ف 40 mg/g (sp...