Choroid plexus perfusion and intracranial cerebrospinal fluid changes after angiogenesis

J Cereb Blood Flow Metab. 2020 Aug;40(8):1658-1671. doi: 10.1177/0271678X19872563. Epub 2019 Sep 9.

Abstract

Recent studies have provided evidence that cortical brain ischemia may influence choroid plexus function, and such communication may be mediated by either traditional CSF circulation pathways and/or a possible glymphatic pathway. Here we investigated the hypothesis that improvements in arterial health following neoangiogenesis alter (i) intracranial CSF volume and (ii) choroid plexus perfusion in humans. CSF and tissue volume measurements were obtained from T1-weighted MRI, and cortical and choroid plexus perfusion were obtained from perfusion-weighted arterial spin labeling MRI, in patients with non-atherosclerotic intracranial stenosis (e.g. Moyamoya). Measurements were repeated after indirect surgical revascularization, which elicits cortical neoangiogenesis near the revascularization site (n = 23; age = 41.8 ± 13.4 years), or in a cohort of participants at two time points without interval surgeries (n = 10; age = 41.7 ± 10.7 years). Regression analyses were used to evaluate dependence of perfusion and volume on state (time 1 vs. 2). Post-surgery, neither CSF nor tissue volumes changed significantly. In surgical patients, cortical perfusion increased and choroid plexus perfusion decreased after surgery; in participants without surgeries, cortical perfusion reduced and choroid plexus perfusion increased between time points. Findings are discussed in the context of a homeostatic mechanism, whereby arterial health, paravascular flow, and/or ischemia can affect choroid plexus perfusion.

Keywords: Cerebrospinal fluid; arterial spin labeling; choroid plexus; glymphatic; ischemia; perfusion.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cerebrospinal Fluid / diagnostic imaging*
  • Choroid Plexus / diagnostic imaging*
  • Cohort Studies
  • Female
  • Glymphatic System / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Moyamoya Disease / cerebrospinal fluid*
  • Moyamoya Disease / diagnostic imaging
  • Moyamoya Disease / surgery
  • Neovascularization, Physiologic / physiology*
  • Percutaneous Coronary Intervention*