2022 Volume 59 Issue 1 Pages 105-109
Considering that sweating and salivation are under the autonomic control, production of cerebrospinal fluid (CSF) is likely to be regulated by the autonomic nerves. In his first review article on CSF circulation (1936), Schaltenbrand described that CSF was a mixture of fluid from the choroid plexus and fluid from the perivascular spaces (dual CSF source theory); while the former is glandular secretion, the latter is translocation of water from blood by osmotic pressure gradient. During 1940-50s, Schaltenbrand and his colleagues were engaged in clinical research on CSF hypovolemia, and finally concluded that CSF hypovolemia was caused by decrease in the CSF production due to autonomic dysregulation. Edvinsson et al. (1972, 73) confirmed that the choroid plexus received both adrenergic sympathetic nerves and cholinergic nerves; the origin of the latter is unknowne. To measure the CSF production rate, Pappenheimer et al. (1962) developed ventriculo-cisternal perfusion method, in which ventriculo-cisternal space was perfused with artificial CSF containing the tracer (inulin), and the CSF production rate was calculated from the clearance of tracer. Utilizing this method in animals, Haywood (1976) and Lindvall et al. (1978) suggested reduction in the CSF production with electric stimulation of the sympathetic nerves. However, the ventriculo-cisternal perfusion method was proved to be unable to determine the exact CSF production rate, because the method was based on the incorrect assumption that CSF was produced exclusively from the choroid plexus (single CSF source theory). Since 1980s, no further reports on the autonomic control of the CSF production have appeared.
