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Croatian medical journal, Vol.55 No.4 August 2014. -

Recent studies have strongly indicated that the classic circulation

model of cerebrospinal fluid CSF is no longer

valid. The production of CSF is not only dependent on

the choroid plexus but also on water flux in the peri-capillary

Virchow Robin space. Historically, CSF flow through

the Virchow Robin space is known as interstitial flow, the

physiological significance of which is now fully understood.

This article briefly reviews the modern concept of

CSF physiology and the Virchow-Robin space, in particular

its functionalities critical for central nervous system neural

activities. Water influx into the Virchow Robin space

and, hence, interstitial flow is regulated by aquaporin-4

AQP-4 localized in the endfeet of astrocytes, connecting

the intracellular cytosolic fluid space of astrocytes and the

Virchow Robin space. Interstitial flow has a functionality

equivalent to systemic lymphatics, on which clearance of

β-amyloid is strongly dependent. Autoregulation of brain

blood flow serves to maintain a constant inner capillary

fluid pressure, allowing fluid pressure of the Virchow Robin

space to regulate regional cerebral blood flow rCBF

based on AQP-4 gating. Excess heat produced by neural

activities is effectively removed from the area of activation

by increased rCBF by closing AQP-4 channels. This neural

flow coupling NFC is likely mediated by heat generated

proton channels.

Author: Tsutomu Nakada - ; Center for Integrated Human Brain Science, Brain Research Institute University of Niigata, Niigata, Japan



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