What is it about?
This study provides the first quantitative measurements of fluid exchange between cerebrospinal fluid (CSF) and interstitial fluid (ISF) in the human brain. Using quantitative MRI and compartment modeling after intrathecal and intravenous contrast administration, we estimate CSF–ISF inflow and demonstrate substantial recirculation of fluid back to the subarachnoid space.
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Why is it important?
Brain clearance of metabolic waste is believed to depend on fluid exchange between CSF and brain tissue, yet this process has been difficult to quantify in humans. By establishing estimates of flow rates and showing that CSF–ISF exchange is decoupled from overall CSF turnover, this work provides a quantitative framework for studying brain clearance in aging and neurological disease.
Perspectives
Quantifying fluid exchange between cerebrospinal and interstitial compartments has been a challenge in human neuroscience. Our results suggest that brain clearance involves a locally recirculating system rather than an outflow through the tissue. We hope this approach will help clarify how impaired fluid transport may contribute to disorders such as normal pressure hydrocephalus and Alzheimer’s disease.
Anders Eklund
Umea Universitet
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This page is a summary of: Quantitative assessment of flow between cerebrospinal and interstitial fluid compartments in humans, Proceedings of the National Academy of Sciences, April 2026, Proceedings of the National Academy of Sciences,
DOI: 10.1073/pnas.2526239123.
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