Evidence map›Paper›PMID 24817998›Full record

ReviewFluids and barriers of the CNS2014

A new look at cerebrospinal fluid circulation.

Thomas Brinker, Edward Stopa, John Morrison, Petra Klinge

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Fluids and barriers of the CNS, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 404 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
404citing papers in PubMed, 4 pooled it
23.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

404 citing papers in PubMed, 4 syntheses or guidelines pooled it, 807 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Hearing loss and dementia: radiologic and biomolecular basis of their shared characteristics. A systematic review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021
    Pooled it
  5. Review
  6. Article
  7. Mapping subarachnoid cerebrospinal fluid circulation in the human brain.bioRxiv : the preprint server for biology · 2026
    Article
  8. Quantitative assessment of flow between cerebrospinal and interstitial fluid compartments in humans.Proceedings of the National Academy of Sciences of the United States of America · 2026
    Article
  9. Review
  10. Reconstructing cerebral lymphatic clearance: an emerging target in the Alzheimer's disease therapeutic pipeline.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Review
  11. Article
  12. Review
  13. Article
  14. Review
  15. Article
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344 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Thomas BrinkerDepartment of Neurosurgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, USA.
Edward StopaDepartment of Neurosurgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, USA.
John MorrisonDepartment of Neurosurgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, USA.
Petra KlingeDepartment of Neurosurgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, USA.
Rhode Island Hospital · USBrown University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

According to the traditional understanding of cerebrospinal fluid (CSF) physiology, the majority of CSF is produced by the choroid plexus, circulates through the ventricles, the cisterns, and the subarachnoid space to be absorbed into the blood by the arachnoid villi. This review surveys key developments leading to the traditional concept. Challenging this concept are novel insights utilizing molecular and cellular biology as well as neuroimaging, which indicate that CSF physiology may be much more complex than previously believed. The CSF circulation comprises not only a directed flow of CSF, but in addition a pulsatile to and fro movement throughout the entire brain with local fluid exchange between blood, interstitial fluid, and CSF. Astrocytes, aquaporins, and other membrane transporters are key elements in brain water and CSF homeostasis. A continuous bidirectional fluid exchange at the blood brain barrier produces flow rates, which exceed the choroidal CSF production rate by far. The CSF circulation around blood vessels penetrating from the subarachnoid space into the Virchow Robin spaces provides both a drainage pathway for the clearance of waste molecules from the brain and a site for the interaction of the systemic immune system with that of the brain. Important physiological functions, for example the regeneration of the brain during sleep, may depend on CSF circulation.

Indexed as

AquaporinAstrocyteBlood brain barrierCerebrospinal fluid circulationVirchow Robin space

Identifiers

PMID24817998
PMCPMC4016637
OpenAlexW2157256907

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.