Abstract
Brinker et al. extensively reviewed recent findings about CSF circulation in a recent article: “A new look at cerebrospinal circulation”, but did not analyze some important available data in sufficient detail. For example, our findings as well as some clinical data and experimental results obtained from different animal species, do not support unidirectional CSF circulation but strongly suggest that there are cardiac cycle-dependent systolic-diastolic to-and-fro cranio-spinal CSF movements. These are based on: a) physiological oscillations of arterial and venous blood during cranio-spinal blood circulation; b) respiratory activity, and c) body activity and posture. That kind of complex CSF movement could explain the observed distribution of many different substances in all directions along the CSF system and within central nervous system tissue. It seems that efflux transport systems at capillary endothelium may be more important for brain homeostasis than the removal of metabolites by CSF flow. Thus, when discussing the CSF dynamics we suggest that a more appropriate term would be CSF movement rather than CSF circulation.
Highlights
Brinker et al [1] have described some recent views on cerebrospinal fluid (CSF) circulation
Numerous findings on experimental animals, as well as novel insights obtained by molecular, cellular and neuroimaging approaches indicate that CSF physiology is, much more complex
Brinker et al concur with our long-standing argument for developing new approaches to CSF physiology, they, failed to correctly interpret some of our published results
Summary
Brinker et al [1] have described some recent views on cerebrospinal fluid (CSF) circulation. Brinker et al concur with our long-standing argument for developing new approaches to CSF physiology, they, failed to correctly interpret some of our published results They state that: For example, Klarica et al failed to reproduce the historical experiments of Dandy [2], since no circulation of CSF was found along a plastic cannula introduced into the aqueduct of cats [3]. Subsequent experiments demonstrated that the CSF pressure is not increased during first hours after the occlusion of aqueduct of Sylvius [4] Since they showed that following its intraventricular injection radioactive water is almost completely absorbed in the ventricles and does not reach the basal cisterns [5], they concluded that choroid plexus is not the major site of CSF production and that no direct CSF circulation according classical understanding exists. As in the original experiments of Dandy, the experiments of Klarica et al may be criticized since they are surgically invasive and results should be interpreted cautiously”
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