title: Cerebellomedullary Cistern Delivery for AAV-Based Gene Therapy: A Technical Note for Nonhuman Primates.
abstract: Accessing cerebrospinal fluid (CSF) from the craniocervical junction through the posterior atlanto-occipital membrane via cerebellomedullary injection (also known as cisternal puncture or cisterna magna injection) has become a standard procedure in preclinical studies. Such delivery provides broader coverage to the central and peripheral nervous system unlike local parenchymal delivery alone. As a clinical application, this approach offers a more reliable method for neurological gene replacement delivery in infants, where skull-mounted devices are not indicated. Here we describe a consistent, precise, and safe method for CSF injection with minimal equipment and technical skills.
authors.affiliation: Department of Neurological Surgery, Interventional Neurology Center, University of California-San Francisco , San Francisco, California.
authors.forename: Lluis
authors.initials: L
authors.lastname: Samaranch
authors.affiliation: Department of Neurological Surgery, Interventional Neurology Center, University of California-San Francisco , San Francisco, California.
authors.forename: John
authors.initials: J
authors.lastname: Bringas
authors.affiliation: Department of Neurological Surgery, Interventional Neurology Center, University of California-San Francisco , San Francisco, California.
authors.forename: Philip
authors.initials: P
authors.lastname: Pivirotto
authors.affiliation: Department of Neurological Surgery, Interventional Neurology Center, University of California-San Francisco , San Francisco, California.
authors.forename: Waldy San
authors.initials: WS
authors.lastname: Sebastian
authors.affiliation: Department of Neurological Surgery, Interventional Neurology Center, University of California-San Francisco , San Francisco, California.
authors.forename: John
authors.initials: J
authors.lastname: Forsayeth
authors.affiliation: Department of Neurological Surgery, Interventional Neurology Center, University of California-San Francisco , San Francisco, California.
authors.forename: Krystof
authors.initials: K
authors.lastname: Bankiewicz
mesh_terms: D000818:Animals; D002490:Central Nervous System / Q000378:metabolism*; D002946:Cisterna Magna; D000229:Dependovirus / Q000235:genetics*; D005260:Female; D018014:Gene Transfer Techniques; D015316:Genetic Therapy; D005822:Genetic Vectors / Q000008:administration & dosage* / Q000235:genetics*; D006801:Humans; D007268:Injections, Epidural; D008297:Male; D011323:Primates