Abstract
BackgroundBoth 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.MethodPhase-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.ResultsThere 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.ConclusionThe 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.
Highlights
Since the development of Phase Contrast Magnetic Resonance Imaging (PC-magnetic resonance imaging (MRI)), it is possible to assess the interaction between blood and cerebrospinal fluid (CSF) flow in the cranio-spinalLokossou et al Fluids Barriers CNS (2020) 17:1 that occurs periodically with the cardiac cycle
We found a significant increase of intracranial blood stroke volume (SV), spinal CSF SV and arterial/venous pulsatility indexes with aging
The same patterns were observed for the extra- and intracranial α venous correction values, which were similar in Healthy Young Volunteers (HYV) (1.67 ± 0.75 versus 1.52 ± 0.34; p = 0.68; Table 1), but significantly different for the Healthy Elderly Volunteers (HEV) group, with the intracranial value being significantly higher than that of the extracranial α venous correction (1.59 ± 0.41 versus 1.24 ± 0.52; p = 0.038)
Summary
Since the development of Phase Contrast Magnetic Resonance Imaging (PC-MRI), it is possible to assess the interaction between blood and CSF flow in the cranio-spinalLokossou et al Fluids Barriers CNS (2020) 17:1 that occurs periodically with the cardiac cycle. Stroke volume, i.e. the mean volume of fluid that oscillates during the cardiac cycle, is used to assess blood and CSF pulsatility between different compartments [3]. Pulsatility or resistance indexes of cerebral blood flow are used as indirect measures for the biomechanical properties of the vascular tree and blood pressure [5, 6]. 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. 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 compart‐ ment on flow patterns
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