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Makaila Banks¹, Nicholas Cicero¹, Daniel Gomez^2,3, Ewa Beldzik⁴, Vitaly Napadow^2,3, Jonathan Polimeni^2,3, and Laura Lewis^4
1Neuroscience, Boston University, Boston, MA, United States, ²Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, United States, ³Department of Radiology, Harvard Medical School, Charlestown, MA, United States, ⁴Biomedical Engineering, Boston University, Boston, MA, United States

Keywords: Neurofluids, Neurofluids, Cerebrospinal Fluid, CSF

We used flow-sensitive fMRI to explore the effect of paced respiration on cerebrospinal fluid (CSF) flow. Results indicate that paced breathing tasks at rates between 0.1 Hz and 0.25 Hz increase CSF flow. All breathing paces showed a striking increase in CSF inflow-enhanced signals with the highest group-averaged amplitude being 26% during the 0.1 Hz breathing task. We conclude that diaphragmatic paced breathing is an effective modulator of CSF flow that may represent increased fluid transport relative to free breathing.

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Yufei David Zhu¹, Donghoon Kim¹, Youngkyoo Jung^1,2, and Audrey Peiwen Fan^1,3
1Biomedical Engineering, University of California, Davis, Davis, CA, United States, ²Radiology, University of California, Davis, Davis, CA, United States, ³Neurology, University of California, Davis, Davis, CA, United States

Keywords: Neurofluids, Arterial spin labelling, Blood-Brain Barrier

Arterial spin labeling (ASL) MRI is noninvasive and has the potential to become a sensitive, clinically useful way to measure blood-brain barrier (BBB) permeability. Here, we focused on two different ASL sequences, diffusion-weighted (DW) and multi-echo (T2), and performed simulations to compare the robustness of BBB permeability (Texch) measurement to different levels of noise. We conclude that the Texch fitting for DW ASL is more robust to noise at a physiological arterial transit time (ATT) of 1000ms at the expense of being more vulnerable to bias when the assumed ATT deviates from the true underlying ATT. 

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Ruitian Song¹, John O. Glass¹, Giles W. Robinson², Amar Gajja³, Thomas E. Merchant⁴, and Wilburn E. Reddick^1
1Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, TN, United States, ²Oncology, St Jude Children's Research Hospital, Memphis, TN, United States, ³Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, United States, ⁴Radiation Oncology, St Jude Children's Research Hospital, Memphis, TN, United States

Keywords: Neurofluids, Brain, Perivascular Space Imaging

Patients with medulloblastoma treated with radio-chemotherapy (N=211) were examined by perivascular space (PVS) imaging at three time points: 0, 3, and 12 months. The patients were treated with different dose level based on risk factors.  For low dose radiation, there were no significant changes in PVS between time points. A transient increase in PVS was observed for high and standard dose radiation during radiotherapy which subsequently resolved during chemotherapy. Perivascular space imaging is a potential biomarker to monitor the side effects from combined modality therapy.

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Haribalan Kumar^1,2,3, Matthew Mcdonald^3,4, Alireza Sharifzadeh², Jet Wright³, Eryn Kwon^2,3, Leigh Potter³, Paul Condron^3,5, Taylor Emsden^3,5, Daniel Cornfeld³, Graham Wilson^3,6, David Freschini⁶, David Dubowitz⁷, Miriam Scadeng⁷, Helen Danesh-Meyer^4,8, Samantha Holdsworth^3,7, Sarah-Jane Guild^2,9, Soroush Safaei², and Gonzalo Maso Tolou^2
1GE Healthcare, Gisborne, New Zealand, ²Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand, ³Mātai Medical Research Institute, Gisborne, New Zealand, ⁴Department of Opthalmology, University of Auckland, Auckland, New Zealand, ⁵Faculty of Medical and Health Sciences & Centre for Brain Research, University of Auckland, Auckland, New Zealand, ⁶Chelsea Hospital, Gisborne, New Zealand, ⁷Department of Anatomy & Medical Imaging, Faculty of Medical and Health Sciences, Centre for Brain Research, University of Auckland, Auckland, New Zealand, ⁸Eye Institute, Auckland, New Zealand, ⁹Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

Keywords: Neurofluids, Brain, IIH, Intracranial Pressure

Heartbeat-driven brain motion has historically remained limited to the domain of research. Such motion may provide a window to characterise parenchymal and CSF pressures where direct, invasive measurements are disruptive and difficult to justify. Amplified MRI (aMRI) is a recently developed method which amplifies subtle brain motion. We show preliminary data that aMRI can be used to detect changes in brain motion associated with increased intracranial pressure in idiopathic intracranial hypertension (IIH), suggesting a potential non-invasive method for evaluating pressure levels of the subarachnoid space in patients with altered intracranial pressure.  

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Hendrik Mattern^1,2 and Oliver Speck^1,2,3,4
1Biomedical Magnetic Resonance, Otto von Guericke University, Magdeburg, Germany, ²German Center for Neurodegenerative Disease, Magdeburg, Germany, ³Center for Behavioral Brain Sciences, Magdeburg, Germany, ⁴Leibniz Institute for Neurobiology, Magdeburg, Germany

Keywords: Data Acquisition, Neurofluids

In this proof-of-principle study the currently untapped potential of UHF MRI is shown. Two young, healthy volunteers were scanned at 7T with 2D 0.25x0.25x1.0mm T2w TSE depicting a substantial number of PVS. At this high resolution, vessel segments inside the PVS could be studied and quantified. Further, hyperintense structures around and inside the dura and sinuses were depicted clearly.

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Alex A Bhogal¹, Yunjie Tong², Eva van Grinsven³, Jaco J.M. Zwanenburg¹, and Marielle E.P. Philippens^3
1Center for Imaging Science, UMC Utrecht, Utrecht, Netherlands, ²Purdue University, West Lafayette, IN, United States, ³Radiotherapy, UMC Utrecht, Utrecht, Netherlands

Keywords: Neurofluids, Neurofluids

We use Blood Oxygen Level Dependent BOLD in combination with controlled hypercapnic stimulus to investigate the relationship between presumed cerebral blood volume changes and CSF flow in the brain. In a group of 11 subjects, we observe strong CSF inflow to the brain as a result of contracting cerebro-vasculature conforming to the Monro-Kellie Doctrine. Our results suggest that changes in arterial blood gases may provide an ‘engine’ through which to potentially enhance the clearance of waste from the brain.

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Adam Martinac¹, Robert Lloyd¹, Stean Waters¹, and Lynne Bilston^1
1Neuroscience Research Australia, Sydney, Australia

Keywords: Neurofluids, Neurofluids, Yawning, CSF

Despite being a common behaviour amongst many animals, research into the mechanics of yawning is limited. We have attempted to address this by performing sagittal real time scans and phase contrast scans to observe the flow of cerebrospinal fluid and blood through the midplane of the C3 vertebra of the spine during induced yawning. We found that over the course of a yawn venous flow and CSF flow both moved caudally during inspiration and rostrally during expiration.

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Pragalv Karki¹, Petrice M Cogswell¹, Matthew C Murphy¹, Sandeep K Ganji¹, Jonathan Graff-Radford², David T Jones², Benjamin D Alder², and John Huston III^1
1Department of Radiology, Mayo Clinic, Rochester, MN, United States, ²Department of Neurology, Mayo Clinic, Rochester, MN, United States

Keywords: Neurofluids, Brain, Cerebrospinal fluid dynamics

Normal pressure hydrocephalus (NPH) is a brain pathology with enlarged ventricles and is diagnosed as a cerebrospinal fluid (CSF) dynamics disorder based on a delayed ascent of radiotracer over the cerebral convexity and elevated flow through the cerebral aqueduct. In this study, we provide fluid dynamics-based evidence of disruption in CSF oscillation within the cerebral aqueduct in NPH patients. Particularly, we show that the peak volumetric flow is delayed with respect to peak transmantle pressure in NPH patients as compared to healthy control participants.

Chen Wang¹, Xiaolei Wang¹, Leilei Li¹, and Yuanqiang Zhu^1
1Department of Radiology, Xijing Hospital, Air Force Medical University, Xi'an, China

Keywords: Neurofluids, Nervous system

ASL has been widely used in neuroimaging studies to measure the metabolic activity of local brain microstructure due to its advantages of no radiation damage, no introduction of exogenous contrast agent, high repeatability and fast scanning time.In this study, ASL perfusion imaging was used to analyze the changes of cerebral blood perfusion during normal sleep and sleep deprivation.

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Di Cao^1,2,3, Yuanqi Sun^1,2,3, Su Pan⁴, Jay J. Pillai^5,6,7, Ye Qiao⁵, Hanzhang Lu^1,2,3, Peter C.M. Van Zijl^1,2, Linda Knutsson^1,2,8, and Jun Hua^1,2
1F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States, ²Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, United States, ³Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD, United States, ⁴School of Medicine, University of Maryland, Baltimore, MD, United States, ⁵Neuroradiology, Department of Radiology, Johns Hopkins University, Baltimore, MD, United States, ⁶Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, United States, ⁷Neuroradiology, Mayo Clinic, Rochester, MN, United States, ⁸Department of Medical Radiation Physics, Lund University, Lund, Sweden

Keywords: Neurofluids, DSC & DCE Perfusion

Accumulating evidence has indicated the importance of studying the interaction between the microvascular and lymphatic systems in the brain. To date, most imaging methods can only measure blood or lymphatic vessels separately. This study proposes an MRI approach for concurrent measurement of perfusion parameters related to small blood and lymphatic vessels within one single scan. A dual-echo TSE sequence was optimized for the measurement of gadolinium(Gd)-induced blood and CSF signal changes. The proposed method showed consistent results in human brains as previous studies using separate methods. Signal changes from small blood vessels occurred faster than lymphatic vessels after intravenous Gd-injection.

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Xue Zhang^1,2, Wei Wang³, Xueyan Zhang⁴, Xiaoyan Bai^1,2, Ziyu Yuan³, Ruiliang Bai^5,6,7, Bingjie Jiao⁶, Yingkui Zhang², Zhiye Li^1,2, Peng Zhang³, Hefei Tang³, Yaqing Zhang³, Xueying Yu³, Yonggang Wang³, and Binbin Sui^2
1Department of Radiology, Beijing Tiantan hospital, Capital Medical University, Beijing, China, ²Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China, ³Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China, ⁴Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ⁵Department of Physical Medicine and Rehabilitation of the Affiliated Sir Run Shumen Shaw Hospital and Interdisciplinary Institute of Neuroscience and Technology, School of Medicine, Zhejiang University, Hangzhou, China, ⁶key Laboratory of Biomedical Engineering of Education Ministry, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China, ⁷MOE Frontier Science Center for Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China

Keywords: Neurofluids, Diffusion Tensor Imaging, Headache

Chronic migraine (CM) is a common and highly disabling primary headache associated with vasomotion dysfunction. It is unclear whether glymphatic dysfunction develops due to frequent and chronic headache attacks in CM. In the current study, we evaluated the glymphatic system function in patients with CM using diffusion tensor image analysis along the perivascular space (DTI-ALPS) technique. We found a significantly higher ALPS index compared with healthy controls, and the alteration was significant only observed in the right hemisphere. Patients with CM have abnormalities in glymphatic function, and the right-prominent alterations might be a certain feature of CM.

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Mira Liu¹, Julian Bertini¹, Niloufar Saadat², Chisondi Simba Warioba¹, Donovan Gorre¹, Timothy Carroll¹, and Gregory Christoforidis^2
1University of Chicago, Chicago, IL, United States, ²Interventional Radiology, University of Chicago, Chicago, IL, United States

Keywords: Neurofluids, Perfusion

Intravoxel Incoherent Motion (IVIM) is a non-contrast perfusion scan that measures various speeds of molecular movement. Segmentation of IVIM signal origin, i.e. from blood, cerebrospinal fluid (CSF), or tissue water, is crucial. Simulation suggested Inversion Recovery should not be used in IVIM to remove CSF, and analysis of signal patterns suggested differing signal decay as a method of removing CSF during post-processing. A threshold determined by k-fold leave-one-out cross-validation on IVIM diffusion coefficient returned successful CSF segmentation (dice = .69), and CSF removal by supervised machine learning via linear discriminant analysis returned quantitative IVIM with strong agreement to microsphere perfusion.

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Xiaodan Liu^1,2,3, Giuseppe Barisano⁴, Xingfeng Shao³, Kay Jann³, Hanzhang Lu⁵, Konstantinos Arfanakis^6,7, Arvind Caprihan Caprihan ⁸, Charles DeCarli⁹, Brian T. Gold¹⁰, Pauline Maillard⁹, Clandia L. Satizabal¹¹, Elyas Fadaee¹², Mohamad Habes¹², Lara Stables¹³, Herpreet Singh¹⁴, Bruce Fischl^15,16,17,18, Andre van der Kouwe^15,18,19, Kristin Schwab¹⁴, Karl G. Helmer^15,18,19, Steven M. Greenberg¹⁴, and Danny JJ Wang^3
1Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States, ²Zilkha Neurogenetic Institue, University of Southern California, Los Angeles, CA, United States, ³Mark & Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, United States, ⁴Neurosurgery, Stanford University, Palo Alto, CA, United States, ⁵Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ⁶Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, United States, ⁷Diagnostic Radiology and Nuclear Medicine, Rush University, Chicago, IL, United States, ⁸The Mind Research Network, Albuquerque, NM, United States, ⁹Neurology, University of California, Davis, Davis, Davis, CA, United States, ¹⁰Neuroscience, University of Kentucky, Lexington, KY, United States, ¹¹Population Health Sciences and Glenn Biggs Institute for Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States, ¹²Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States, ¹³Neurology, University of California, San Francisco, San Francisco, CA, United States, ¹⁴Neurology, Massachusetts General Hospital, Boston, MA, United States, ¹⁵Radiology, Harvard Medical School, Boston, MA, United States, ¹⁶Athinoula A. Martinos Center for Biomedical Imaging,Massachusetts General Hospital, Charlestown, MA, United States, ¹⁷Computer Science and AI Lab, Massachusetts Institute of Technology, Cambridge, MA, United States, ¹⁸Radiology, Massachusetts General Hospital, Boston, MA, United States, ¹⁹Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States

Keywords: Neurofluids, Brain, glymphatic system

The diffusion tensor image analysis along the perivascular space (DTI-ALPS) method was proposed to evaluate glymphatic system (GS) function. However, few studies validate its reliability and reproducibility. 50 participants’ DTI data from the MarkVICD consortium were recruited in this study. Two pipelines by using DSI studio and FSL software were developed for data processing and ALPS-index calculation. The mean ALPS-index was obtained by the average of bilateral ALPS-index and was used for testing the cross vendors test-retest reliability by using R studio. Mean ALPS-index demonstrated favorable inter-scanner reproducibility, inter-rater reliability and test-retest repeatability, offering a potential biomarker for GS function.

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Hiroyuki Kameda^1,2, Taisuke Harada^1,3, Hiroyuki Sugimori⁴, Xiawei Bai³, Kazuyuki Minowa², and Kohsuke Kudo^3,5
1Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan, ²Department of Raiology, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan, ³Department of Diagnostic Imaging, Facaulty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan, ⁴Faculty of Health Sciences, Hokkaido University, Sapporo, Japan, ⁵Global Center for Biomedical Science and Engineering, Hokkaido University, Sapporo, Japan

Keywords: Neurofluids, Neurofluids

Imaging of neurofluids dynamics is a promising aspect in clinical imaging. Only few methods of long-term water tracking in the brain have been described for diagnostic purposes. Herein, we examined water circulation between the CSF and ISF using an intrathecal injection of ¹⁷O-labeled water and 3T-MRI in two patients with dementia. Signal changes were detected in the brain parenchyma after the intrathecal administration. This visualization technique can detect the distribution of water tracers to the CSF and brain parenchyma and could become a clinical tool for evaluating neurofluids dynamics in humans.

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Shutao Wang¹, Pascal Spincemaille², Magdy Selim³, Ajith J Thomas⁴, Aristotelis Filippidis⁵, Yan Wen⁶, Yi Wang², and Salil Soman^1
1Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States, ²Department of Radiology, Weill Cornell Medicine, New York, NY, United States, ³Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States, ⁴Department of Neurological Surgery, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ, United States, ⁵Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States, ⁶GE Healthcare, New York, NY, United States

Keywords: Neurofluids, Quantitative Susceptibility mapping, CSF Blood

QSM is an emerging MR technique with many clinical applications, especially in the brain. CSF has been used by many researchers as the reference region to obtain quantitative QSM values for inter-subject comparison. Here, we demonstrate the QSM values at hemorrhagic CSF sites are significantly different from that at non-hemorrhagic CSF sites in the same patient with various types of intracranial hemorrhage. This finding has significant clinical implication as selection of CSF as the reference region should be made with caution in patients with intracranial hemorrhage.

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Elisabeth C. van der Voort¹, Merlijn C.E. van der Plas¹, and Jacobus J.M. Zwanenburg^1
1Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands

Keywords: Neurofluids, Velocity & Flow

Continuous secretion and absorption of cerebrospinal fluid (CSF) cause a net velocity that is important for cerebral clearance. However, measuring this net velocity is hampered by the cardiac and respiratory cycle which induce additional CSF motions. We show, with both simulations and in vivo measurements, that net velocity of CSF in the subarachnoid space can be measured using displacement encoding with stimulated echoes (DENSE), when contributions from heartbeat and respiration are accounted for during the analysis. Measured net velocity was 4.41±1.57 µm/s (6 subjects). Further research is needed to properly account for possible phase wraps in the measurements.

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Ria Sharma¹, Geunwon Kim², Magdy Selim³, Ajith J Thomas⁴, Aristotelis Filippidis⁵, Yan Wen⁶, Pascal Spincemaille⁷, Yi Wang⁷, and Salil Soman^1
1Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States, ²Atrius Health, Boston, MA, United States, ³Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States, ⁴Department of Neurological Surgery, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ, United States, ⁵Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States, ⁶GE Healthcare, New York, NY, United States, ⁷Department of Radiology, Weill Cornell Medicine, New York, NY, United States

Keywords: Neurofluids, Brain, Intracranial Hemorrhage, ABC/2, Bleed Volume Estimation

Intracranial hemorrhage (ICH) volume estimation is important for patient management. ABC/2 is a validated method of volume estimation using CT (2). Differing appearance of blood across MRI imaging techniques and blood age limits the ability of MRI to evaluate ICH volume. The QSM technique mcTFI has features well suited to bleed measurement. In this study we show that the widely used ABC/2 CT technique for ICH volume measurement applied to mcTFI QSM MRI yields ICH volumes strongly correlated with those obtained using CT.

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Manuel Taso¹ and David C Alsop^1
1Division of MRI Research, department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States

Keywords: Neurofluids, Brain

The cerebrospinal fluid plays an essential role in cerebral homeostasis, contributing to the delivery of oxygen and nutrients to brain tissue as well as clearing waste products. However, the mechanisms and functions of CSF oxygenation and their potential disturbance in pathology remain unknown. Dissolved O₂ shortens T1 of water due to its paramagnetic properties. Because of its extremely long T2, selective CSF imaging can be achieved by using extremely long TE (>500ms) Spin-Echo based acquisitions. Therefore, we report here a study using ultra long TE Fluid-Attenuated Inversion Recovery to image baseline CSF oxygenation with minimal tissue contribution.