脑组织液引流途径与脑内新分区系统的发现  

Discovery of a new division system in brain and the regionalized drainage route of brain interstitial fluid

作　　者：韩鸿宾[1] HAN Hong-bin(Department of Radiology, Peking University Third Hospital,Beijing Key Laboratory of Magnetic Resonance Imaging Equipment and Technique, Beijing 100191, China)

机构地区：[1]北京大学第三医院放射科,磁共振成像与技术北京市重点实验室

出　　处：《北京大学学报（医学版）》2019年第3期397-401,共5页Journal of Peking University:Health Sciences

基　　金：北京市科技计划(Z181100001518004);国家杰出青年科学基金(61625102);首都科技领军人才培养工程(Z181100006318003);国家重大科研仪器研制项目(61827808);北京大学临床科学家计划专项(BMU2019LCKXJ007)-中央高校基本科研业务费~~

摘　　要：百余年来,基于“细胞学说”的脑科学一直围绕“神经元学说”和“突触学说”展开系列研究,在各类脑细胞和神经网络研究方面的学术成绩斐然。然而,从临床角度来看,多数脑病治疗却并未因学术的进步而取得理想的效果。脑卒中、阿尔茨海默病(Alzheimer’s disease, AD)等依然摧残着人类的健康与尊严,认知、记忆依然是未解之谜[1-2]。回顾历史,从脑结构角度,脑科学研究体系尚存在未被充分认识的结构空间——脑细胞外间隙(extracellular space,ECS)[3]。脑ECS是38~64 nm宽的不规则形、多孔隙结构,占活体脑容积的15%~20%[4],而以往备受重视的脑血管系统仅占据脑容积的3%~5%。以往业界认为ECS只起到细胞间支撑和黏附的物理作用,近年来,随着探测方法的发展和进步,研究结果表明ECS在维持脑局部内环境稳态、细胞间信息传递、细胞迁移,乃至认知、睡眠等方面均发挥着重要作用[5-10]。Brain extracellular space (ECS) is a narrow, irregular space, which provides immediate living environment for neural cells and accounts for approximately 15%-20% of the total volume of living brain. Twenty-five years ago, as an interventional radiologist, the author was engaged in investigating early diagnosis and treatment of cerebral ischemic stroke, and the parameters of brain ECS was firstly derived and demonstrated during the study of the permeability of blood-brain barrier (BBB) and its diffusion changes in the cerebral ischemic tissue. Since then, the author and his team had been working on developing a novel measuring method of ECS: tracer-based magnetic resonance imaging (MRI), which could measure brain ECS parameters in the whole brain scale and make the dynamic drainage process of the labelled brain interstitial fluid (ISF) visualized. By using the new method , the team made a series of new findings about the brain ECS and ISF, including the discovery of a new division system in the brain, named regionalized ISF drainage system. We found that the ISF drainage in the deep brain was regiona- lized and the structural and functional parameters in different interstitial system (ISS) divisions were disparate. The ISF in the caudate nucleus could be drained to ipsilateral cortex and finally into the subarachnoid space, which maintained the pathway of ISF- cerebrospinal fluid (CSF) exchange. However, the ISF in the thalamus was eliminated locally in its anatomical division. After verifying the nature of the barrier structure between different drainage divisions, the author proposed the hypothesis of “regionalized brain homeostasis”. Thus, we demonstrated that the brain was protected not only by the BBB, which avoided potential exogenous damage through the vascular system, but was also protected by an internal ISF drainage barrier to avoid potentially harmful interference from other ECS divisions in the deep brain. With the new findings and the proposed hypothesis, an innovative therapeutic method for the t

关 键 词：脑细胞外间隙 磁示踪法 脑组织液 脑分区稳态 

分 类 号：R817.4[医药卫生—影像医学与核医学]