Assessing the feasibility of a new approach to measure the full spectrum of CSF dynamics within the human brain using MRI: insights from a simulation study

Cerebrospinal fluid (CSF) dynamics are essential in waste clearance of the brain. Disruptions in CSF flow are linked to various neurological conditions, highlighting the need for accurate measurement of its dynamics. Current methods typically capture limited aspects of CSF movement or focus on a single anatomical region, presenting challenges for comprehensive analysis. This study proposes a novel approach using Displacement Encoding with Stimulated Echoes (DENSE) MRI to assess the full spectrum of CSF motion within the brain. Through simulations, we evaluated the feasibility of disentangling distinct CSF motion components, including heartbeat- and respiration-driven flows, as well as a net velocity component due to continuous CSF turnover, and tested the performance of our method under incorrect assumptions about the underlying model of CSF motion. Results demonstrate that DENSE MRI can accurately separate these components, and reliably estimated a net velocity, even when periodic physiological motions vary over time. The method proved to be robust for including low frequency components (LFO), incorrect assumption on the nature of the net velocity component and missing CSF components in the model. This approach offers a comprehensive measurement technique for quantifying CSF dynamics, advancing our understanding of the relative role of various drivers of CSF dynamics in brain clearance.