ArticleFluids and barriers of the CNS2022
Population pharmacokinetic modeling of CSF to blood clearance: prospective tracer study of 161 patients under work-up for CSF disorders.
Article in Fluids and barriers of the CNS, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.
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.
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.
Who cites it
37 citing papers in PubMed.
- A conversation on human brain clearance.Nature communications · 2026Article
- Improving T-cell engager efficacy in glioblastoma with multi-antigen targeting and novel delivery approaches.Acta neuropathologica · 2026Review
- Artificial intelligence-based segmentation of perisinusoidal tissue along the superior sagittal sinus in human brain magnetic resonance imaging.Neuroradiology · 2026Article
- Ventricular CSF-to-blood water transport kinetics in adult hydrocephalus.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026Article
- Estimation of human brain fluid clearance using intrathecal imaging contrast agents.Fluids and barriers of the CNS · 2026Observational
- 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 · 2026Article
- microGLYMPH: a conceptual translational roadmap for microdialysis‑based assessment of CSF-interstitial solute exchange in acquired brain injury.Critical care (London, England) · 2026Review
- Glymphatic System Visualized With Intrathecal Gadoterate Meglumine Administered via External Ventricular Drain.Cureus · 2026Article
- The impact of human brain geometry on the transport of an intrathecal tracer.Fluids and barriers of the CNS · 2026Article
- When blood hits the brain: altered glymphatic and dural lymphatic function after surface bleeds.Acta neurochirurgica · 2026Article
- Lymphatic-Immune Microenvironment Engineering via Rapamycin-Eluting Nanofibers for Meningeal Repair and Neuroprotection in Traumatic Brain Injury Rats.Research (Washington, D.C.) · 2026Article
- Variability in the circulation of cerebrospinal fluid: causes and clinical implications for intraventricular drug delivery.Frontiers in drug delivery · 2026Review
- Volume of parasagittal dura is associated with blood markers of systemic inflammation.Acta neurochirurgica · 2025Article
- Overcoming the blood-brain barrier (BBB) in pediatric CNS tumors: immunotherapy and nanomedicine-driven strategies.Medical oncology (Northwood, London, England) · 2025Review
- The pathogenesis of cerebral small vessel disease and vascular cognitive impairment.Physiological reviews · 2025Review
- Altered brain fluid dynamics in spontaneous intracranial hypotension.Fluids and barriers of the CNS · 2025Observational
- U-Net-Based Prediction of Cerebrospinal Fluid Distribution and Ventricular Reflux Grading.NMR in biomedicine · 2025Article
- Assessing glymphatic-associated fluid dynamics in psychiatric disorders: evidence from neuroimaging - a review.Psychoradiology · 2025Review
- Metabolic Dysfunction in Idiopathic Intracranial Hypertension: Current Theories and Updates.Aging and disease · 2024Review
- CSF formation rate-a potential glymphatic flow parameter in hydrocephalus?Fluids and barriers of the CNS · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundQuantitative measurements of cerebrospinal fluid to blood clearance has previously not been established for neurological diseases. Possibly, variability in cerebrospinal fluid clearance may affect the underlying disease process and may possibly be a source of under- or over-dosage of intrathecally administered drugs. The aim of this study was to characterize the cerebrospinal fluid to blood clearance of the intrathecally administered magnetic resonance imaging contrast agent gadobutrol (Gadovist, Bayer Pharma AG, GE). For this, we established a population pharmacokinetic model, hypothesizing that cerebrospinal fluid to blood clearance differs between cerebrospinal fluid diseases.
methodsGadobutrol served as a surrogate tracer for extra-vascular pathways taken by several brain metabolites and drugs in cerebrospinal fluid. We estimated cerebrospinal fluid to blood clearance in patients with different cerebrospinal fluid disorders, i.e. symptomatic pineal and arachnoid cysts, as well as tentative spontaneous intracranial hypotension due to cerebrospinal fluid leakage, idiopathic intracranial hypertension, or different types of hydrocephalus (idiopathic normal pressure hydrocephalus, communicating- and non-communicating hydrocephalus). Individuals with no verified cerebrospinal fluid disturbance at clinical work-up were denoted references.
resultsPopulation pharmacokinetic modelling based on 1,140 blood samples from 161 individuals revealed marked inter-individual variability in pharmacokinetic profiles, including differences in absorption half-life (time to 50% of tracer absorbed from cerebrospinal fluid to blood), time to maximum concentration in blood and the maximum concentration in blood as well as the area under the plasma concentration time curve from zero to infinity. In addition, the different disease categories of cerebrospinal fluid diseases demonstrated different profiles.
conclusionsThe present observations of considerable variation in cerebrospinal fluid to blood clearance between individuals in general and across neurological diseases, may suggest that defining cerebrospinal fluid to blood clearance can become a useful diagnostic adjunct for work-up of cerebrospinal fluid disorders. We also suggest that it may become useful for assessing clearance capacity of endogenous brain metabolites from cerebrospinal fluid, as well as measuring individual cerebrospinal fluid to blood clearance of intrathecal drugs.
Indexed as
Identifiers
What OpenQuestion holds
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.