Head-nodding: a driving force for the circulation of cerebrospinal fluid

Abstract The myodural bridge (MDB) is a dense connective tissue bridge connecting the suboccipital muscles to the spinal dura mater, and it has been proven to be a normal common existing structure in humans and mammals. Some scholars believe that the suboccipital muscles can serve as a dynamic cereb...

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Autores principales:	Qiang Xu, Chang-Xi Shao, Ying Zhang, Yu Zhang, Cong Liu, Yu-Xiao Chen, Xue-Mei Wang, Yan-Yan Chi, Sheng-Bo Yu, Hong-Jin Sui
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c5ce29f7e5734f5a967b4fc1a2e82d34
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spelling	oai:doaj.org-article:c5ce29f7e5734f5a967b4fc1a2e82d342021-12-02T15:39:50ZHead-nodding: a driving force for the circulation of cerebrospinal fluid10.1038/s41598-021-93767-82045-2322https://doaj.org/article/c5ce29f7e5734f5a967b4fc1a2e82d342021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93767-8https://doaj.org/toc/2045-2322Abstract The myodural bridge (MDB) is a dense connective tissue bridge connecting the suboccipital muscles to the spinal dura mater, and it has been proven to be a normal common existing structure in humans and mammals. Some scholars believe that the suboccipital muscles can serve as a dynamic cerebrospinal fluid (CSF) pump via the MDB, and they found head rotations promote the CSF flow in human body, which provided evidence for this hypothesis. Head movement is a complex motion, but the effects of other forms of head movement on CSF circulation are less known. The present study explored the effects of head-nodding on CSF circulation. The CSF flow of 60 healthy volunteers was analyzed via cine phase-contrast magnetic resonance imaging at the level of the occipitocervical junction before and after one-minute-head-nodding period. Furthermore, the CSF pressures of 100 volunteers were measured via lumbar puncture before and after 5 times head-nodding during their anesthetizing for surgical preparation. As a result, it was found that the maximum and average CSF flow rates at the level of the upper border of atlas during ventricular diastole were significantly decreased from 1.965 ± 0.531 to 1.839 ± 0.460 ml/s and from 0.702 ± 0.253 to 0.606 ± 0.228 ml/s respectively. In the meantime, the changes in the ratio of cranial and caudal orientation of the net flow volume were found differed significantly after the one-minute-head-nodding period (p = 0.017). And on the other hand, the CSF pressures at the L3–L4 level were markedly increased 116.03 ± 26.13 to 124.64 ± 26.18 mmH2O. In conclusion, the head-nodding has obvious effects on CSF circulation and head movement is one of the important drivers of cerebrospinal fluid circulation. We propose that the suboccipital muscles, participating in various head movements, might pull the dura sac via the myodural bridge, and thus, head movement provides power for the CSF circulation.Qiang XuChang-Xi ShaoYing ZhangYu ZhangCong LiuYu-Xiao ChenXue-Mei WangYan-Yan ChiSheng-Bo YuHong-Jin SuiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Qiang Xu Chang-Xi Shao Ying Zhang Yu Zhang Cong Liu Yu-Xiao Chen Xue-Mei Wang Yan-Yan Chi Sheng-Bo Yu Hong-Jin Sui Head-nodding: a driving force for the circulation of cerebrospinal fluid
description	Abstract The myodural bridge (MDB) is a dense connective tissue bridge connecting the suboccipital muscles to the spinal dura mater, and it has been proven to be a normal common existing structure in humans and mammals. Some scholars believe that the suboccipital muscles can serve as a dynamic cerebrospinal fluid (CSF) pump via the MDB, and they found head rotations promote the CSF flow in human body, which provided evidence for this hypothesis. Head movement is a complex motion, but the effects of other forms of head movement on CSF circulation are less known. The present study explored the effects of head-nodding on CSF circulation. The CSF flow of 60 healthy volunteers was analyzed via cine phase-contrast magnetic resonance imaging at the level of the occipitocervical junction before and after one-minute-head-nodding period. Furthermore, the CSF pressures of 100 volunteers were measured via lumbar puncture before and after 5 times head-nodding during their anesthetizing for surgical preparation. As a result, it was found that the maximum and average CSF flow rates at the level of the upper border of atlas during ventricular diastole were significantly decreased from 1.965 ± 0.531 to 1.839 ± 0.460 ml/s and from 0.702 ± 0.253 to 0.606 ± 0.228 ml/s respectively. In the meantime, the changes in the ratio of cranial and caudal orientation of the net flow volume were found differed significantly after the one-minute-head-nodding period (p = 0.017). And on the other hand, the CSF pressures at the L3–L4 level were markedly increased 116.03 ± 26.13 to 124.64 ± 26.18 mmH2O. In conclusion, the head-nodding has obvious effects on CSF circulation and head movement is one of the important drivers of cerebrospinal fluid circulation. We propose that the suboccipital muscles, participating in various head movements, might pull the dura sac via the myodural bridge, and thus, head movement provides power for the CSF circulation.
format	article
author	Qiang Xu Chang-Xi Shao Ying Zhang Yu Zhang Cong Liu Yu-Xiao Chen Xue-Mei Wang Yan-Yan Chi Sheng-Bo Yu Hong-Jin Sui
author_facet	Qiang Xu Chang-Xi Shao Ying Zhang Yu Zhang Cong Liu Yu-Xiao Chen Xue-Mei Wang Yan-Yan Chi Sheng-Bo Yu Hong-Jin Sui
author_sort	Qiang Xu
title	Head-nodding: a driving force for the circulation of cerebrospinal fluid
title_short	Head-nodding: a driving force for the circulation of cerebrospinal fluid
title_full	Head-nodding: a driving force for the circulation of cerebrospinal fluid
title_fullStr	Head-nodding: a driving force for the circulation of cerebrospinal fluid
title_full_unstemmed	Head-nodding: a driving force for the circulation of cerebrospinal fluid
title_sort	head-nodding: a driving force for the circulation of cerebrospinal fluid
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/c5ce29f7e5734f5a967b4fc1a2e82d34
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Head-nodding: a driving force for the circulation of cerebrospinal fluid

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