Cerebrospinal fluid pathways are perturbed in aging and prodromal Alzheimer’s disease

Cerebrospinal fluid (CSF) circulation through the parenchyma by the glymphatic system has been suggested to play a role in the clearance of metabolic waste from the brain, including Amyloid β. In this 7T MRI study of CSF flow in the cerebral aqueduct, we find that ageing, cognitive status and amyloid status influence CSF dynamics and morphology of the aqueduct. These changes appear to precede major cognitive changes in Alzheimer’s disease. Disruption of flow dynamics and anatomy of CSF flow pathways may reflect dysfunctional CSF circulation in downstream compartments of the glymphatic system, and contribute to amyloid accumulation in the brain.