Beggs, CB

Belov, P

Hagemeier, J

Krawiecki, J

Magnano, C

Ramasamy, DP

Zivadinov, R

Leeds Beckett Repository

Internal jugular vein cross-sectional area and cerebrospinal fluid pulsatility in the aqueduct ofSylviusClive B. Beggs 1,2, Christopher Magnano 2,3, Pavel Belov 2, Jacqueline Krawiecki 2, Deepa P. Ramasamy 2,3, Jesper Hagemeier 2, Robert Zivadinov 2,31 Centre for Infection Control and Biophysics, University of Bradford, Richmond Road, Bradford BD7 1DP, UK; 2 Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, 100 High St., Buffalo, NY 14203, NY, USA; 3 MRI Clinical Translational Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USABackground: Constricted cerebral venous outflow has been linked with increased aqueductal CSFpulsatility in healthy individuals [1] and MS patients [2]. However, the relationship between theCSF pulsatility and internal jugular vein (IJV) cross-sectional area (CSA) is unknown. Objective: To characterise links between IJV CSA and aqueductal CSF pulsatility in MS patientsand healthy subjects.Methods: 98 relapsing-remitting MS patients (62 males and 36 females; mean age=44.2 years) and99 healthy controls (48 males and 51 females; mean age=43.9 years) were investigated. CSF flowquantification involved cine phase-contrast MRI, while IJV CSA was calculated using magneticresonance venography. Cardiovascular risk factor data were collected. Statistical analysis involvedcorrelation, and partial least squares correlation (PLSC), analysis [3]. Results: For healthy controls, PLSC revealed a significant relationship (p=0.001) between CSFpulsatility and IJV CSA in the lower neck (C5-C7), and a trend for this relationship (p=0.091) atC2-C4. PLSC revealed no relationships in MS patients. After controlling for age and cardiovascularrisk factors, many significant correlations were identified in the healthy controls between the CSFand IJV variables [e.g. net positive CSF flow and left IJV CSA at: C7-T1 (r=0.416, p=0.002) andC5-C6 (r=0.389,  p=0.003);  and net  negative  CSF flow and left  IJV CSA at:  C7-T1 (r=-0.352,p=0.008) and C5-C6 (r=-0.349, p=0.009)], whereas there were only two significant correlations inMS patients [i.e. net positive CSF flow and right IJV CSA at: C5-C6 (r=0.311, p=0.035) and C4(r=0.298, p=0.047)].Conclusions: In healthy adults, higher aqueductal CSF pulsatility is correlated with increased IJVCSA (particularly in the lower neck) in a relationship independent of age and cardiovascular riskfactors.  This  relationship  is  largely  absent  in  MS  patients.  Given  CSF  pulsatility  and  venousdrainage are linked in healthy individuals [1], it may be that  increased IJV CSA is indicative ofstasis in venous outflow.(Word count = 300 words)   References: 1. Beggs CB, et al. Aqueductal cerebrospinal fluid pulsatility in healthy individuals is affected byimpaired cerebral venous outflow.  Journal of Magnetic Resonance Imaging.  2014. 40: 1215-12222. Zamboni P, et al.  The severity of chronic cerebrospinal venous insufficiency in patients withmultiple sclerosis  is  related to altered cerebrospinal fluid dynamics.  Funct Neurol.  2009. 24:133–1383. McIntosh  AR,  Misic  B.  Multivariate  statistical  analysis  for  neuroimaging  data.  Annu.  Rev.Psychol. 2013. 64: 499–525

Internal jugular vein cross-sectional area and cerebrospinal fluid pulsatility in the aqueduct of Sylvius

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