Brain Fluid Clearance After Traumatic Brain Injury Measured Using Dynamic Positron Emission Tomography
Brain fluid clearance by pathways including the recently described paravascular glymphatic system is a critical homeostatic mechanism by which metabolic products, toxins, and other wastes are removed from the brain. Brain fluid clearance may be especially important after traumatic brain injury (TBI)...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Mary Ann Liebert
2024-04-01
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| Series: | Neurotrauma Reports |
| Subjects: | |
| Online Access: | https://www.liebertpub.com/doi/full/10.1089/NEUR.2024.0010 |
| _version_ | 1827276242842288128 |
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| author | Tracy Butler Julia Schubert Nikolaos A. Karakatsanis Xiuyuan Hugh Wang Ke Xi Yeona Kang Kewei Chen Liangdong Zhou Edward K. Fung Abigail Patchell Abhishek Jaywant Yi Li Gloria Chiang Lidia Glodzik Henry Rusinek Mony de Leon Federico Turkheimer Sudhin A. Shah |
| author_facet | Tracy Butler Julia Schubert Nikolaos A. Karakatsanis Xiuyuan Hugh Wang Ke Xi Yeona Kang Kewei Chen Liangdong Zhou Edward K. Fung Abigail Patchell Abhishek Jaywant Yi Li Gloria Chiang Lidia Glodzik Henry Rusinek Mony de Leon Federico Turkheimer Sudhin A. Shah |
| author_sort | Tracy Butler |
| collection | DOAJ |
| description | Brain fluid clearance by pathways including the recently described paravascular glymphatic system is a critical homeostatic mechanism by which metabolic products, toxins, and other wastes are removed from the brain. Brain fluid clearance may be especially important after traumatic brain injury (TBI), when blood, neuronal debris, inflammatory cells, and other substances can be released and/or deposited. Using a non-invasive dynamic positron emission tomography (PET) method that models the rate at which an intravenously injected radiolabeled molecule (in this case 11C-flumazenil) is cleared from ventricular cerebrospinal fluid (CSF), we estimated the overall efficiency of brain fluid clearance in humans who had experienced complicated-mild or moderate TBI 3?6 months before neuroimaging (n?=?7) as compared to healthy controls (n?=?9). While there was no significant difference in ventricular clearance between TBI subjects and controls, there was a significant group difference in dependence of ventricular clearance upon tracer delivery/blood flow to the ventricles. Specifically, in controls, ventricular clearance was highly, linearly dependent upon blood flow to the ventricle, but this relation was disrupted in TBI subjects. When accounting for blood flow and group-specific alterations in blood flow, ventricular clearance was slightly (non-significantly) increased in TBI subjects as compared to controls. Current results contrast with past studies showing reduced glymphatic function after TBI and are consistent with possible differential effects of TBI on glymphatic versus non-glymphatic clearance mechanisms. Further study using multi-modal methods capable of assessing and disentangling blood flow and different aspects of fluid clearance is needed to clarify clearance alterations after TBI. |
| first_indexed | 2024-04-24T06:39:45Z |
| format | Article |
| id | doaj.art-416f7eb348bb4d079b21ecc32ecb50a0 |
| institution | Directory Open Access Journal |
| issn | 2689-288X |
| language | English |
| last_indexed | 2024-04-24T06:39:45Z |
| publishDate | 2024-04-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Neurotrauma Reports |
| spelling | doaj.art-416f7eb348bb4d079b21ecc32ecb50a02024-04-23T03:00:33ZengMary Ann LiebertNeurotrauma Reports2689-288X2024-04-015135936610.1089/NEUR.2024.0010Brain Fluid Clearance After Traumatic Brain Injury Measured Using Dynamic Positron Emission TomographyTracy ButlerJulia SchubertNikolaos A. KarakatsanisXiuyuan Hugh WangKe XiYeona KangKewei ChenLiangdong ZhouEdward K. FungAbigail PatchellAbhishek JaywantYi LiGloria ChiangLidia GlodzikHenry RusinekMony de LeonFederico TurkheimerSudhin A. ShahBrain fluid clearance by pathways including the recently described paravascular glymphatic system is a critical homeostatic mechanism by which metabolic products, toxins, and other wastes are removed from the brain. Brain fluid clearance may be especially important after traumatic brain injury (TBI), when blood, neuronal debris, inflammatory cells, and other substances can be released and/or deposited. Using a non-invasive dynamic positron emission tomography (PET) method that models the rate at which an intravenously injected radiolabeled molecule (in this case 11C-flumazenil) is cleared from ventricular cerebrospinal fluid (CSF), we estimated the overall efficiency of brain fluid clearance in humans who had experienced complicated-mild or moderate TBI 3?6 months before neuroimaging (n?=?7) as compared to healthy controls (n?=?9). While there was no significant difference in ventricular clearance between TBI subjects and controls, there was a significant group difference in dependence of ventricular clearance upon tracer delivery/blood flow to the ventricles. Specifically, in controls, ventricular clearance was highly, linearly dependent upon blood flow to the ventricle, but this relation was disrupted in TBI subjects. When accounting for blood flow and group-specific alterations in blood flow, ventricular clearance was slightly (non-significantly) increased in TBI subjects as compared to controls. Current results contrast with past studies showing reduced glymphatic function after TBI and are consistent with possible differential effects of TBI on glymphatic versus non-glymphatic clearance mechanisms. Further study using multi-modal methods capable of assessing and disentangling blood flow and different aspects of fluid clearance is needed to clarify clearance alterations after TBI.https://www.liebertpub.com/doi/full/10.1089/NEUR.2024.0010adult brain injurycerebrospinal fluidclearanceglymphatic systemPET scanning |
| spellingShingle | Tracy Butler Julia Schubert Nikolaos A. Karakatsanis Xiuyuan Hugh Wang Ke Xi Yeona Kang Kewei Chen Liangdong Zhou Edward K. Fung Abigail Patchell Abhishek Jaywant Yi Li Gloria Chiang Lidia Glodzik Henry Rusinek Mony de Leon Federico Turkheimer Sudhin A. Shah Brain Fluid Clearance After Traumatic Brain Injury Measured Using Dynamic Positron Emission Tomography Neurotrauma Reports adult brain injury cerebrospinal fluid clearance glymphatic system PET scanning |
| title | Brain Fluid Clearance After Traumatic Brain Injury Measured Using Dynamic Positron Emission Tomography |
| title_full | Brain Fluid Clearance After Traumatic Brain Injury Measured Using Dynamic Positron Emission Tomography |
| title_fullStr | Brain Fluid Clearance After Traumatic Brain Injury Measured Using Dynamic Positron Emission Tomography |
| title_full_unstemmed | Brain Fluid Clearance After Traumatic Brain Injury Measured Using Dynamic Positron Emission Tomography |
| title_short | Brain Fluid Clearance After Traumatic Brain Injury Measured Using Dynamic Positron Emission Tomography |
| title_sort | brain fluid clearance after traumatic brain injury measured using dynamic positron emission tomography |
| topic | adult brain injury cerebrospinal fluid clearance glymphatic system PET scanning |
| url | https://www.liebertpub.com/doi/full/10.1089/NEUR.2024.0010 |
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