Extracranial versus intracranial hydro-hemodynamics during aging: a PC-MRI pilot cross-sectional study

Abstract

Background: Both aging and changes in blood flow velocity between the extracranial (intraspinal) and intracranial regions of cerebral vessels have an impact on brain hydro-hemodynamics. Arterial and venous cerebral blood flows interact with cerebrospinal fluid (CSF) in the both the cranial and spinal systems. Studies suggest that increased blood and CSF flow pulsatility plays an important role in certain neurological diseases. Here, we investigated the changes in blood-CSF flow pulsatility in the cranial and spinal systems with age as well as the impact of the intracranial compartment on flow patterns. Method: Phase-contrast magnetic resonance imaging (PC-MRI) was performed in 16 young and 19 elderly healthy volunteers to measure the flows of CSF and blood. CSF stroke volume (SV), blood SV, and arterial and venous pulsatility indexes (PIs) were assessed at intra-and extracranial levels in both samples. Correlations between ventricular and spinal CSF flow, and between blood and CSF flow during aging were also assessed. Results: There was a significant decrease in arterial cerebral blood flow and intracranial venous cerebral blood flow with aging. We also found a significant increase of intracranial blood SV, spinal CSF SV and arterial/venous pulsatility indexes with aging. In regard to intracranial compartment impact, arterial and venous PIs decreased significantly at intracranial level in elderly volunteers, while young adults exhibited decrease in venous PI only. Intracranial venous PI was paradoxically lower than extracranial venous PI, regardless of age. In both sample groups, spinal CSF SV and aqueductal CSF SV were positively correlated, and so were extracranial blood and spinal CSF SVs. Conclusion: The study demonstrates that aging changes blood flow but preserves blood and CSF interactions. We also showed that many parameters related to blood and CSF flows differ between young and elderly adults.

Paracellular and Transcellular Leukocytes Diapedesis Are Divergent but Interconnected Evolutionary Events

“…Moreover, JAMs, including JAMA, JAMB, JAMC, and JAML (junctional adhesion molecule), belong to this group. Additionally, Cx43, Claudin, Occludin, Esam, and VE-CADHERIN are localized in the same area [ 32 , 33 ]. (ii) The second group is important in regulating the movement of the cells through the space between the endothelial cells.…”

The Pathogenesis Based on the Glymphatic System, Diagnosis, and Treatment of Idiopathic Normal Pressure Hydrocephalus

“… 30 Furthermore, cerebral ischemia occurs concurrently with hypoxia, which leads to significant changes in the extracellular matrix composition, endosomal lysosomal systems, and mitochondrial energy metabolic capacity. 41 This results in an imbalance in the supply of ions and metabolites, and abnormal circulation in the glymphatic system of the brain, ultimately leading to neurodegeneration. 30 …”

The relationship between cerebral blood flow and venous sinus pressure: can hyperemia induce idiopathic intracranial hypertension?

“…This has additional implications for the model, as the known total combined blood flow at the inlets and outlets of the modelled system differs by 23 %. This proportion is the total flow supplied by the combination of the additional cortical veins [38,39]. To ensure the continuity of the model, which is a requirement of CFD, an average of the inlet and outlet flow rates was used.…”