ArticlePhysiological reports2020
Assessing lymphatic route of CSF outflow and peripheral lymphatic contractile activity during head-down tilt using near-infrared fluorescence imaging.
Article in Physiological reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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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.
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Who cites it
25 citing papers in PubMed, 32 citations in OpenAlex.
- Spaceflight-associated neuro-ocular syndrome (SANS): expert consensus on diagnosis and management.Eye (London, England) · 2026Review
- Optic nerve cerebrospinal fluid drainage via lymphatic vessels in its sheath.NPJ microgravity · 2026Article
- Anterior segment biomechanics and intraocular pressure in microgravity: implications for future spaceflight studies.NPJ microgravity · 2026Review
- AstroOphthalmology: Basic and Pathophysiological Concepts of Space-Induced Ocular Changes.Eye and brain · 2026Review
- Cervical Oculopathy: The Cervical Spine Etiology of Visual Symptoms and Eye Diseases-A Hypothesis Exploring Mechanisms Linking the Neck and the Eye.Diagnostics (Basel, Switzerland) · 2025Article
- Spaceflight Associated Neuro-ocular Syndrome (SANS) and its countermeasures.Progress in retinal and eye research · 2025Review
- Hypothesis on the outflow of optic nerve cerebrospinal fluid in spaceflight associated neuro ocular syndrome.NPJ microgravity · 2024Review
- Artificial gravity: an effective countermeasure for microgravity-induced headward fluid shift?Journal of applied physiology (Bethesda, Md. : 1985) · 2024Article
- Using noninvasive imaging to assess manual lymphatic drainage on lymphatic/venous responses in a spaceflight analog.NPJ microgravity · 2024Article
- Fluid dynamics and leukocyte transit in the lymphatic system.PNAS nexus · 2024Article
- The nasal lymphatic route of CSF outflow: implications for neurodegenerative disease diagnosis and monitoring.Animal cells and systems · 2024Review
- The ligamentous cervical instability etiology of human disease from the forward head-facedown lifestyle: emphasis on obstruction of fluid flow into and out of the brain.Frontiers in neurology · 2024Article
- Near-Infrared Fluorescence Tomography and Imaging of Ventricular Cerebrospinal Fluid Flow and Extracranial Outflow in Non-Human Primates.IEEE transactions on medical imaging · 2023Article
- Imaging peripheral lymphatic dysfunction in chronic conditions.Frontiers in physiology · 2023Review
- Article
- Gravity and lymphodynamics.Physiological reports · 2022Article
- Cardiovascular, Lymphatic, and Ocular Health in Space.Life (Basel, Switzerland) · 2022Review
- Cerebrospinal fluid dynamics along the optic nerve.Frontiers in neurology · 2022Review
- Degradation of lymphatic anatomy and function in early venous insufficiency.Journal of vascular surgery. Venous and lymphatic disorders · 2021Observational
- Neuroinflammation-Driven Lymphangiogenesis in CNS Diseases.Frontiers in cellular neuroscience · 2021Review
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
Evidence overwhelmingly suggests that the lymphatics play a critical role in the clearance of cerebrospinal fluid (CSF) from the cranial space. Impairment of CSF outflow into the lymphatics is associated with a number of pathological conditions including spaceflight-associated neuro-ocular syndrome (SANS), a problem that limits long-duration spaceflight. We used near-infrared fluorescence lymphatic imaging (NIRFLI) to dynamically visualize the deep lymphatic drainage pathways shared by CSF outflow and disrupted during head-down tilt (HDT), a method used to mimic the cephalad fluid shift that occurs in microgravity. After validating CSF clearance into the lymph nodes of the neck in swine, a pilot study was conducted in human volunteers to evaluate the effect of gravity on the flow of lymph through these deep cervical lymphatics. Injected into the palatine tonsils, ICG was imaged draining into deep jugular lymphatic vessels and subsequent cervical lymph nodes. NIRFLI was performed under HDT, sitting, and supine positions. NIRFLI shows that lymphatic drainage through pathways shared by CSF outflow are dependent upon gravity and are impaired under short-term HDT. In addition, lymphatic contractile rates were evaluated from NIRFLI following intradermal ICG injections of the lower extremities. Lymphatic contractile activity in the legs was slowed in the gravity neutral, supine position, but increased under the influence of gravity regardless of whether its force direction opposed (sitting) or favored (HDT) lymphatic flow toward the heart. These studies evidence the role of a lymphatic contribution in SANS.
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Registered trials
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.