title: A new look at cerebrospinal fluid movement.
abstract: Brinker et al. extensively reviewed recent findings about CSF circulation in a recent article: "A new look at cerebrospinal circulation", but did not analyze some important available data in sufficient detail. For example, our findings as well as some clinical data and experimental results obtained from different animal species, do not support unidirectional CSF circulation but strongly suggest that there are cardiac cycle-dependent systolic-diastolic to-and-fro cranio-spinal CSF movements. These are based on: a) physiological oscillations of arterial and venous blood during cranio-spinal blood circulation; b) respiratory activity, and c) body activity and posture. That kind of complex CSF movement could explain the observed distribution of many different substances in all directions along the CSF system and within central nervous system tissue. It seems that efflux transport systems at capillary endothelium may be more important for brain homeostasis than the removal of metabolites by CSF flow. Thus, when discussing the CSF dynamics we suggest that a more appropriate term would be CSF movement rather than CSF circulation.
authors.affiliation: Ruđer Bošković Institute, Department of Molecular Biology, Bijenička 54, 10 000 Zagreb, Croatia.
authors.forename: Darko
authors.initials: D
authors.lastname: Orešković
authors.affiliation: Department of Pharmacology and Croatian Institute for Brain Research, School of Medicine University of Zagreb, Zagreb, Croatia ; Ruđer Bošković Institute, Department of Molecular Biology, Bijenička 54, 10 000 Zagreb, Croatia.
authors.forename: Marijan
authors.initials: M
authors.lastname: Klarica
keywords: Aquaporin; Cerebrospinal fluid circulation; Cerebrospinal fluid movement; Cerebrospinal fluid secretion; Classic hypothesis of cerebrospinal physiology; Orešković and Klarica hypothesis
references.citation: Ann Surg. 1919 Aug;70(2):129-42
references.pmid: 17864139
references.citation: Med Hypotheses. 2001 May;56(5):622-4
references.pmid: 11388778
references.citation: Acta Physiol Scand. 1975 Mar;93(3):415-22
references.pmid: 1146583
references.citation: PLoS One. 2014 Apr 18;9(4):e95229
references.pmid: 24748150
references.citation: J Magn Reson Imaging. 2005 Nov;22(5):591-6
references.pmid: 16217773
references.citation: Brain Res Rev. 2010 Sep 24;64(2):241-62
references.pmid: 20435061
references.citation: Life Sci. 2000 Sep 29;67(19):2375-85
references.pmid: 11065184
references.citation: Fluids Barriers CNS. 2014 May 01;11:10
references.pmid: 24817998
references.citation: Brain Res. 1985 Feb 4;326(1):47-63
references.pmid: 3971148
references.citation: Neuroscience. 2009 Feb 18;158(4):1397-405
references.pmid: 19111908
references.citation: Neuroreport. 2014 Jan 8;25(1):39-43
references.pmid: 24231830
references.citation: Coll Antropol. 2008 Jan;32 Suppl 1:43-50
references.pmid: 18405057
references.citation: Brain Pathol. 1992 Oct;2(4):277-84
references.pmid: 1341963
references.citation: Brain Res Rev. 2011 Jan 1;65(2):99-112
references.pmid: 20817024
references.citation: Acta Neurochir Suppl. 2005;95:177-81
references.pmid: 16463846
references.citation: Sci Transl Med. 2012 Aug 15;4(147):147ra111
references.pmid: 22896675
references.citation: J Neurosurg. 1977 Sep;47(3):391-6
references.pmid: 894342
references.citation: Neuroscience. 2013 Sep 17;248:278-89
references.pmid: 23806710
references.citation: Neurosci Lett. 2002 Jul 19;327(2):103-6
references.pmid: 12098646
references.citation: Neurosci Lett. 2002 Mar 15;321(1-2):123-5
references.pmid: 11872271
references.citation: J Clin Invest. 2013 Mar;123(3):1299-309
references.pmid: 23434588
references.citation: J Neurol Neurosurg Psychiatry. 1972 Aug;35(4):468-73
references.pmid: 5049806
references.citation: J Neurosurg. 1952 May;9(3):275-87
references.pmid: 14939058