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Longitudinal analysis of cerebral aqueduct flow measures: multiple sclerosis flow changes driven by brain atrophy
Dejan Jakimovski1, Robert Zivadinov1,2, Bianca Weinstock-Guttman3
1Buffalo Neuroimaging Analysis Center (BNAC), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
Fluids and Barriers of the CNS
|February 1, 2020
Summary
Multiple sclerosis patients show significant changes in cerebrospinal fluid (CSF) dynamics, including aqueduct of Sylvius (AoS) enlargement over five years. These changes correlate with brain atrophy and ventricular CSF expansion.
Area of Science:
- Neuroimaging
- Cerebrospinal Fluid Dynamics
- Multiple Sclerosis Pathophysiology
Background:
- Previous studies on cerebrospinal fluid (CSF) flow in multiple sclerosis (MS) have yielded inconsistent findings.
- Longitudinal data on CSF dynamics in MS patients are currently lacking.
Purpose of the Study:
- To investigate longitudinal changes in CSF dynamics at the aqueduct of Sylvius (AoS) in MS patients.
- To compare these changes with those observed in healthy controls (HCs).
Main Methods:
- 3T MRI cine phase contrast imaging was used to assess AoS cross-sectional area (CSA), CSF velocity, and flow rates at baseline and 5-year follow-up.
- High-resolution 3D T1-weighted imaging was performed in MS patients to determine brain atrophy and ventricular CSF (vCSF) expansion rates.
- Statistical analyses included ANCOVA and paired t-tests, with FDR correction for significance.
Main Results:
- MS patients exhibited a significant increase in maximal diastolic peak velocity, diastolic peak flow rate, and AoS CSA over five years.
- A larger AoS CSA was the primary differentiator between MS patients and HCs.
- Changes in AoS CSA were significantly associated with vCSF expansion rate, suggesting a link between atrophy and CSF space changes.
Conclusions:
- MS patients experience significant longitudinal enlargement of the AoS.
- This enlargement is likely attributed to regional atrophy and subsequent ex-vacuo expansion of the aqueduct.
- Findings highlight the dynamic nature of CSF spaces in MS progression.
