Spinal CSF flow in response to forced thoracic and abdominal respiration
Abstract Background Respiration-induced pressure changes represent a powerful driving force of CSF dynamics as previously demonstrated using flow-sensitive real-time magnetic resonance imaging (MRI). The purpose of the present study was to elucidate the sensitivity of CSF flow along the spinal canal...
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doaj-b2987ee073234fe1bfa0329f3ad167442020-11-25T00:47:16ZengBMCFluids and Barriers of the CNS2045-81182019-04-011611810.1186/s12987-019-0130-0Spinal CSF flow in response to forced thoracic and abdominal respirationGökmen Aktas0Jost M. Kollmeier1Arun A. Joseph2Klaus-Dietmar Merboldt3Hans-Christoph Ludwig4Jutta Gärtner5Jens Frahm6Steffi Dreha-Kulaczewski7School of Medicine, University Medical Center GöttingenBiomedizinische NMR, Max-Planck-Institut für biophysikalische ChemieBiomedizinische NMR, Max-Planck-Institut für biophysikalische ChemieBiomedizinische NMR, Max-Planck-Institut für biophysikalische ChemieDivision of Pediatric Neurosurgery, Department of Neurosurgery, University Medical Center GöttingenDivision of Pediatric Neurology, Department of Pediatrics and Adolescent Medicine, University Medical Center GöttingenBiomedizinische NMR, Max-Planck-Institut für biophysikalische ChemieDivision of Pediatric Neurology, Department of Pediatrics and Adolescent Medicine, University Medical Center GöttingenAbstract Background Respiration-induced pressure changes represent a powerful driving force of CSF dynamics as previously demonstrated using flow-sensitive real-time magnetic resonance imaging (MRI). The purpose of the present study was to elucidate the sensitivity of CSF flow along the spinal canal to forced thoracic versus abdominal respiration. Methods Eighteen subjects without known illness were studied using real-time phase-contrast flow MRI at 3 T in the aqueduct and along the spinal canal at levels C3, Th1, Th8 and L3. Subjects performed a protocol of forced breathing comprising four cycles of 2.5 s inspiration and 2.5 s expiration. Results The quantitative results for spinal CSF flow rates and volumes confirm previous findings of an upward movement during forced inspiration and reversed downward flow during subsequent exhalation—for both breathing types. However, the effects were more pronounced for abdominal than for thoracic breathing, in particular at spinal levels Th8 and L3. In general, CSF net flow volumes were very similar for both breathing conditions pointing upwards in all locations. Conclusions Spinal CSF dynamics are sensitive to varying respiratory performances. The different CSF flow volumes in response to deep thoracic versus abdominal breathing reflect instantaneous adjustments of intrathoracic and intraabdominal pressure, respectively. Real-time MRI access to CSF flow in response to defined respiration patterns will be of clinical importance for patients with disturbed CSF circulation like hydrocephalus, pseudotumor cerebri and others.http://link.springer.com/article/10.1186/s12987-019-0130-0Flow-sensitive real-time MRICSF dynamicsRespirationHydrocephalusIntrathoracic pressureIntraabdominal pressure |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gökmen Aktas Jost M. Kollmeier Arun A. Joseph Klaus-Dietmar Merboldt Hans-Christoph Ludwig Jutta Gärtner Jens Frahm Steffi Dreha-Kulaczewski |
spellingShingle |
Gökmen Aktas Jost M. Kollmeier Arun A. Joseph Klaus-Dietmar Merboldt Hans-Christoph Ludwig Jutta Gärtner Jens Frahm Steffi Dreha-Kulaczewski Spinal CSF flow in response to forced thoracic and abdominal respiration Fluids and Barriers of the CNS Flow-sensitive real-time MRI CSF dynamics Respiration Hydrocephalus Intrathoracic pressure Intraabdominal pressure |
author_facet |
Gökmen Aktas Jost M. Kollmeier Arun A. Joseph Klaus-Dietmar Merboldt Hans-Christoph Ludwig Jutta Gärtner Jens Frahm Steffi Dreha-Kulaczewski |
author_sort |
Gökmen Aktas |
title |
Spinal CSF flow in response to forced thoracic and abdominal respiration |
title_short |
Spinal CSF flow in response to forced thoracic and abdominal respiration |
title_full |
Spinal CSF flow in response to forced thoracic and abdominal respiration |
title_fullStr |
Spinal CSF flow in response to forced thoracic and abdominal respiration |
title_full_unstemmed |
Spinal CSF flow in response to forced thoracic and abdominal respiration |
title_sort |
spinal csf flow in response to forced thoracic and abdominal respiration |
publisher |
BMC |
series |
Fluids and Barriers of the CNS |
issn |
2045-8118 |
publishDate |
2019-04-01 |
description |
Abstract Background Respiration-induced pressure changes represent a powerful driving force of CSF dynamics as previously demonstrated using flow-sensitive real-time magnetic resonance imaging (MRI). The purpose of the present study was to elucidate the sensitivity of CSF flow along the spinal canal to forced thoracic versus abdominal respiration. Methods Eighteen subjects without known illness were studied using real-time phase-contrast flow MRI at 3 T in the aqueduct and along the spinal canal at levels C3, Th1, Th8 and L3. Subjects performed a protocol of forced breathing comprising four cycles of 2.5 s inspiration and 2.5 s expiration. Results The quantitative results for spinal CSF flow rates and volumes confirm previous findings of an upward movement during forced inspiration and reversed downward flow during subsequent exhalation—for both breathing types. However, the effects were more pronounced for abdominal than for thoracic breathing, in particular at spinal levels Th8 and L3. In general, CSF net flow volumes were very similar for both breathing conditions pointing upwards in all locations. Conclusions Spinal CSF dynamics are sensitive to varying respiratory performances. The different CSF flow volumes in response to deep thoracic versus abdominal breathing reflect instantaneous adjustments of intrathoracic and intraabdominal pressure, respectively. Real-time MRI access to CSF flow in response to defined respiration patterns will be of clinical importance for patients with disturbed CSF circulation like hydrocephalus, pseudotumor cerebri and others. |
topic |
Flow-sensitive real-time MRI CSF dynamics Respiration Hydrocephalus Intrathoracic pressure Intraabdominal pressure |
url |
http://link.springer.com/article/10.1186/s12987-019-0130-0 |
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