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Volume transmission-mediated encephalopathies: a possible new concept?
Hans-Peter Hartung1, Marcel Dihné
1Medical Faculty, Department of Neurology, University of Duesseldorf, Moorenstrasse 5, Duesseldorf, Germany.
Archives of Neurology
|March 14, 2012
Summary
Pathologically altered cerebrospinal fluid (CSF) actively disrupts brain function, not just indicates disease. This research proposes "volume transmission-mediated encephalopathies" (VTE) to describe this direct impact on neuronal activity.
Area of Science:
- Neuroscience
- Cerebrospinal Fluid Dynamics
- Brain Injury Research
Background:
- Cerebrospinal fluid (CSF) composition is crucial for brain development, neurogenesis, and behavior.
- Bidirectional exchange between CSF and interstitial fluid (ISF) is essential for brain function.
- Neuroactive substances in CSF and ISF influence neuronal activity via volume transmission.
Purpose of the Study:
- To investigate if pathologically altered CSF actively causes functional disturbances in the in vivo brain.
- To propose the term "volume transmission-mediated encephalopathies" (VTE) for this mechanism.
- To explore the potential of in vitro neuronal network activity (ivNNA) recordings to identify and monitor CSF-related VTEs.
Main Methods:
- Recording ivNNA using multielectrode arrays to measure synchronously bursting neural populations.
- Analyzing the effects of pathologically altered human CSF on ivNNA.
- Identifying functionally relevant neuroactive substances in altered CSF and testing pharmacologic interventions.
Main Results:
- Pathologically altered CSF from traumatic brain injury patients suppressed ivNNA.
- Specific neuroactive substances in altered CSF were identified.
- Pharmacologic interventions partially restored ivNNA.
Conclusions:
- Pathologic CSF alterations are active contributors to brain dysfunction, not merely passive markers.
- VTE is proposed as a mechanism where neuroactive substances in CSF directly impair brain activity.
- Monitoring ivNNA in response to CSF may offer insights into VTEs and potential therapeutic strategies.
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