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Association between resistance to cerebrospinal fluid flow and cardiac-induced brain tissue motion for Chiari
Saeed Mohsenian1, Alaaddin Ibrahimy2, Mohamad Motaz F Al Samman3
1Department of Bioengineering, Northeastern University, 360 Huntington Ave, Boston, MA, 02115, USA. mohseniankoochaksa.s@northeastern.edu.
Insights
Chiari malformation type I (CMI) patients show a link between cerebrospinal fluid (CSF) flow resistance and cerebellum motion. This study found a positive correlation in CMI subjects, highlighting a potential connection in brain tissue dynamics.
Area of Science:
- Biomedical Engineering
- Neurology
- Medical Imaging
Background:
- Chiari malformation type I (CMI) is associated with increased resistance to cerebrospinal fluid (CSF) flow and greater cardiac-induced neural tissue motion.
- Previous research indicates these factors may be independently altered in CMI patients compared to healthy individuals.
- Understanding the interplay between CSF dynamics and neural tissue movement is crucial for CMI pathophysiology.
Purpose of the Study:
- To investigate the relationship between cerebrospinal fluid (CSF) flow resistance in the cervical spinal canal and cardiac-induced brain tissue motion in Chiari malformation type I (CMI) subjects.
- To determine if altered CSF flow resistance correlates with specific patterns of neural tissue displacement in CMI patients.
Main Methods:
- Computational fluid dynamics (CFD) was used to calculate integrated longitudinal impedance (ILI), quantifying cervical CSF flow resistance in 32 CMI subjects and 18 controls.
- Displacement encoding with stimulated echoes (DENSE) magnetic resonance imaging (MRI) assessed neural tissue motion during the cardiac cycle.
- Correlation analyses were performed between ILI and maximum cerebellar and brainstem displacement.
Main Results:
- A significant positive correlation was observed between CSF flow resistance and maximum cerebellar displacement in CMI subjects (r=0.75, p=6.77×10⁻¹⁰).
- No significant correlation was found between CSF flow resistance and brainstem displacement in either CMI or control groups.
- The magnitude of CSF flow resistance and brain tissue motion did not differ significantly between symptomatic and asymptomatic CMI individuals.
Conclusions:
- This study establishes a direct relationship between cervical CSF flow resistance and cardiac-induced cerebellar tissue motion in Chiari malformation type I patients.
- The findings suggest that altered CSF dynamics contribute to specific brain tissue movements in CMI.
- Further research is warranted to elucidate the clinical significance of these biomechanical alterations in CMI symptomatology.
Purpose:
Chiari malformation type I (CMI) patients have been independently shown to have both increased resistance to cerebrospinal fluid (CSF) flow in the cervical spinal canal and greater cardiac-induced neural tissue motion compared to healthy controls. The goal of this paper is to determine if a relationship exists between CSF flow resistance and brain tissue motion in CMI subjects.
Methods:
Computational fluid dynamics (CFD) techniques were employed to compute integrated longitudinal impedance (ILI) as a measure of unsteady resistance to CSF flow in the cervical spinal canal in thirty-two CMI subjects and eighteen healthy controls. Neural tissue motion during the cardiac cycle was assessed using displacement encoding with stimulated echoes (DENSE) magnetic resonance imaging (MRI) technique.
Results:
The results demonstrate a positive correlation between resistance to CSF flow and the maximum displacement of the cerebellum for CMI subjects (r = 0.75, p = 6.77 × 10-10) but not for healthy controls. No correlation was found between CSF flow resistance and maximum displacement in the brainstem for CMI or healthy subjects. The magnitude of resistance to CSF flow and maximum cardiac-induced brain tissue motion were not statistically different for CMI subjects with and without the presence of five CMI symptoms: imbalance, vertigo, swallowing difficulties, nausea or vomiting, and hoarseness.
Conclusion:
This study establishes a relationship between CSF flow resistance in the cervical spinal canal and cardiac-induced brain tissue motion in the cerebellum for CMI subjects. Further research is necessary to understand the importance of resistance and brain tissue motion in the symptomatology of CMI.
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