October 23, 2025Open Access

Cerebrospinal fluid flow and clearance driven by lateral ventricle volume oscillations

Key Points

Clearance is driven by lateral ventricles volume oscillations, supporting the link to CSF dynamics.
Volume oscillations correlate with cerebrospinal fluid movement across the perivascular spaces, aiding clearance.
Observational analysis illustrates the reliance on physiological drivers such as blood-volume changes and respiration.
The findings highlight a significant connection between brain clearance mechanisms and cerebrospinal fluid flow.

Abstract

In the human brain, substance clearance is intimately connected to the cerebrospinal fluid (CSF) and its flow. CSF extends from the lateral ventricles (LVs) to the parenchyma's perivascular spaces. Macroscopic undulating CSF flow is present during both wakefulness and sleep and can be experimentally induced. However, the mechanisms generating this flow and its contribution to brain clearance remain unclear. Using fMRI and PET across various conditions, we demonstrate that LV-volume oscillations drive undulating CSF flow in the ventricles and subarachnoid basal cisternae. LV oscillations are driven by cortical blood-volume changes induced by neuronal activity, heartbeat and respiration. LV oscillations' amplitudes determine PET-tracer clearance from the LVs. Conclusively, induced by extra- and intracranial physiological drivers and mediated by cortical blood-volume changes, LV-volume oscillations drive macroscopic CSF flow and clearance.

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Cite This Study

Neumaier et al. (Tue,) studied this question.

synapsesocial.com/papers/68f9840c1881b68f3b7ae6b8 https://doi.org/https://doi.org/10.1101/2025.10.20.683529

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