CSF in the ventricles of the brain behaves as a relay medium for arteriovenous pulse wave phase coupling
CSF in the ventricles of the brain behaves as a relay medium for arteriovenous pulse wave phase coupling
复制标题
DOI：
10.1371/journal.pone.0181025
复制
发表时间：
2017-11-15
期刊：
影响因子：
3.7
通讯作者：
Codd, Patrick
中科院分区：
文献类型：
--
作者：
Butler, William E.;Agarwalla, Pankaj K.;Codd, Patrick
脑室可能仍然是人体最大的解剖结构，但尚未确定其主要用途，尽管至少自从亚里士多德描述以来就已经知道它们的存在。我们假设，通过在空间上配置脑脊液（CSF）作为动静脉脉搏波（PW）相位耦合的低粘度中继介质，心室有助于将到达刚性颅骨的动脉血的每搏输出量与喷射的静脉血的体积相当。我们通过比较仔猪心室表面血管 PW 的时空行为与人类心室壁运动和邻近脑脊液压力变化的内部观察结果来探讨这一假设。利用从仔猪获得的小波脑血管造影数据，我们绘制了心室表面上动脉和静脉 PW 相对于脑脉冲运动的行程。我们发现，在心室表面上，动脉 PW 的 CF 相位与静脉 PW 不同，这与动静脉 PW 相位耦合一致。我们发现腹侧和背侧心室表面之间的血管 PW 相位存在时空差异，PW 稍早到达腹侧表面。在接受脑积水神经内窥镜手术的人类中，我们直接测量心室壁运动和邻近的内部脑脊液压力变化。我们发现腹侧第三脑室的脑脊液压力比背侧侧脑室稍早达到峰值。当解剖学上匹配时，仔猪的心室周围血管 PW 相位分布与人类的心室内 CSF PW 相位分布互补。这与心室在动静脉 PW 耦合中的作用一致，并且可能为理解脑积水和其他颅内压紊乱添加一个框架。
The ventricles of the brain remain perhaps the largest anatomic structure in the human body without established primary purpose, even though their existence has been known at least since described by Aristotle. We hypothesize that the ventricles help match a stroke volume of arterial blood that arrives into the rigid cranium with an equivalent volume of ejected venous blood by spatially configuring cerebrospinal fluid (CSF) to act as a low viscosity relay medium for arteriovenous pulse wave (PW) phase coupling. We probe the hypothesis by comparing the spatiotemporal behavior of vascular PW about the ventricular surfaces in piglets to internal observations of ventricle wall motions and adjacent CSF pressure variations in humans. With wavelet brain angiography data obtained from piglets, we map the travel relative to brain pulse motion of arterial and venous PWs over the ventricle surfaces. We find that arterial PWs differ in CF phase from venous PWs over the surfaces of the ventricles consistent with arteriovenous PW phase coupling. We find a spatiotemporal difference in vascular PW phase between the ventral and dorsal ventricular surfaces, with the PWs arriving slightly sooner to the ventral surfaces. In humans undergoing neuroendoscopic surgery for hydrocephalus, we measure directly ventricle wall motions and the adjacent internal CSF pressure variations. We find that CSF pressure peaks slightly earlier in the ventral Third Ventricle than the dorsal Lateral Ventricle. When matched anatomically, the peri-ventricular vascular PW phase distribution in piglets complements the endo-ventricular CSF PW phase distribution in humans. This is consistent with a role for the ventricles in arteriovenous PW coupling and may add a framework for understanding hydrocephalus and other disturbances of intracranial pressure.