Association Between Parasagittal Dura Volume and Systemic Inflammation Blood Markers
Overview
This study investigates the relationship between parasagittal dura (PSD) volume and systemic inflammation markers in patients undergoing intrathecal contrast-enhanced MRI. Findings suggest that PSD volume correlates with blood markers indicative of systemic inflammation, potentially linking meningeal morphology to inflammatory status and brain clearance function.
Background
The meninges, including the dura mater, play a critical role in brain homeostasis and immune function. Recent discoveries of lymphatic vessels in the dura mater have renewed interest in its role in neuroimmune interactions and clearance of cerebrospinal fluid (CSF) solutes. Dysfunction in meningeal clearance has been implicated in neurodegenerative diseases such as Alzheimer's and Parkinson's disease. Systemic inflammation is known to influence brain diseases, but its association with meningeal morphology and clearance function in humans remains unclear. The parasagittal dura (PSD) is a key meningeal region involved in CSF solute passage and may serve as a neuroimmune interface.
Data Highlights
The study analyzed PSD volume using manual and AI-assisted segmentation of FLAIR MRI sequences in 61 patients. Blood markers assessed included C-reactive protein (CRP), hemoglobin (Hb), erythrocyte volume fraction (EVF), platelet count (PLT), neutrophils (Neu), lymphocytes (Lymph), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). PSD volume showed marked inter-individual variability. CSF tracer enrichment in PSD was measured at multiple time points post-intrathecal injection to assess clearance function.
Key Findings
PSD volume positively correlates with systemic inflammation markers such as elevated CRP and altered blood cell counts.
Increased PSD volume is associated with decreased clearance of CSF tracer, indicating impaired meningeal clearance function.
Blood markers indicative of inflammation (e.g., NLR, PLR) relate to functional indices of CSF clearance in the brain meninges.
Patients with larger PSD volumes tend to have higher global cerebral amyloid-β burden, linking meningeal morphology to neurodegenerative pathology.
Subjective sleep quality, which is associated with systemic inflammation, may also relate to PSD volume and inflammatory markers.
Clinical Implications
Assessment of PSD volume via MRI and systemic inflammatory markers may provide valuable insights into meningeal clearance function and its role in neuroinflammatory and neurodegenerative diseases. Monitoring these parameters could aid in identifying patients at risk for impaired brain clearance and guide therapeutic strategies targeting inflammation. Additionally, addressing systemic inflammation might improve meningeal clearance and potentially influence disease progression.
Conclusion
The volume of the parasagittal dura correlates with systemic inflammation markers and meningeal clearance function, underscoring the PSD's role as a neuroimmune interface. These findings highlight the importance of considering meningeal morphology and systemic inflammation in brain disease pathophysiology.
References
Louveau et al. 2015 -- Functional lymphatic vessels in the dura mater
Eide et al. 2023 -- Parasagittal dura volume and CSF tracer enrichment
Da Mesquita et al. 2018 -- Meningeal lymphatics and neurodegeneration
Kelley et al. 2021 -- Meningeal immune activation and brain clearance
Aviva Abosch, M.D., Ph.D., a neurosurgeon at Baptist Health Miami Neuroscience Institute, part of Baptist Health Brain and Spine Care, was installed as the Esernia Endowed Chair in Surgical Treatment of Adult Epilepsy and Movement Disorders.
