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Impact of supine and upright positions on cerebral hydrodynamics in healthy subjects: A study using domestic multi-position helium-free MRI
ZHANG Yukun  HU Liang  QI Rongfeng  DAI Qi  FAN Shenyu  ZHANG Xin  CHEN Jun  ZHENG Jianjun  ZHANG Bing 

DOI:10.12015/issn.1674-8034.2026.05.002.


[Abstract] Objective To investigate the impact of postural shifts between supine and upright positions on cerebral hydrodynamics in healthy individuals using a domestic multi-position helium-free 1.5 T magnetic resonance imaging (MRI).Materials and Methods In a prospective study, 30 healthy volunteers underwent MRI examinations in upright and supine positions. The imaging protocol included phase-contrast MRI (PC-MRI) sequences of the brain in both postures. PC-MRI was used to measure blood flow, blood velocity, pulsatility index (PI), and resistance index (RI) in the middle cerebral artery (MCA) and superior sagittal sinus (SSS). Additionally, the corresponding hydrodynamic parameters of cerebrospinal fluid (CSF) in the cerebral aqueduct were measured. The arterial blood flow, venous blood flow and CSF hydrodynamic characteristics of healthy brains in the standing and lying positions were compared. Under the premise of controlling blood pressure, the correlation among the change rates of the three was analyzed.Results Comparison of hemodynamic parameters revealed that in the upright position, the mean and peak velocities of the MCA and SSS were significantly lower than those in the supine position (P < 0.05); the PI and RI of the SSS were significantly higher in the upright position (P < 0.05). Analysis of CSF hydrodynamic in the cerebral aqueduct showed that the mean flow, mean velocity, and peak velocity during both systole and diastole were significantly lower in the upright position compared to the supine position (P < 0.05); the minimum velocity during systole was also significantly reduced (P < 0.05); the stroke volume of CSF per cardiac cycle was significantly reduced in the upright position (P < 0.05). Partial correlation analysis showed that mean MCA flow was positively correlated with peak diastolic CSF velocity, mean MCA velocity with mean systolic CSF flow, peak MCA velocity with mean CSF flow and minimum CSF velocity during systole, minimum MCA velocity with mean diastolic CSF flow and stroke volume, and MCA PI and RI with mean diastolic CSF velocity (P < 0.05).Conclusions The change in body position significantly affects the hemodynamic characteristics of the brain's arteries, veins, and CSF in healthy individuals, and the rate of change in arterial blood flow is correlated with the change in CSF hemodynamic characteristics between the upright and supine positions. The domestic multi-position helium-free 1.5 T MRI expands the clinical applications of MRI, providing new insights into brain fluid regulation mechanisms and offering theoretical foundations for optimizing the diagnosis and treatment strategies of related diseases.
[Keywords] helium-free magnetic resonance imaging；body position；phase contrast magnetic resonance imaging；cerebral blood flow；cerebrospinal fluid hydrodynamics

ZHANG Yukun1, 2   HU Liang1   QI Rongfeng1   DAI Qi3, 4   FAN Shenyu1   ZHANG Xin1   CHEN Jun1   ZHENG Jianjun3, 4*   ZHANG Bing1, 5*  

1 Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China

2 School of Social and Behavioral Sciences, Nanjing University, Nanjing 210008, China

3 Department of Radiology, Ningbo No. 2 Hospital, Ningbo 315010, China

4 Zhejiang Engineering Research Center for New Technologies and Applications of Helium-Free Magnetic Resonance Imaging, Ningbo 315000, China

5 Nanjing Key Laboratory for Cardiovascular Information and Health Engineering Medicine, Nanjing 210008, China

Corresponding author: ZHENG J J, E-mail: zhjjnb2@163.com ZHANG B, E-mail: zhangbing_nanjing@nju.edu.cn

Conflicts of interest   None.

Received  2025-01-10
Accepted  2025-04-30
DOI: 10.12015/issn.1674-8034.2026.05.002
DOI:10.12015/issn.1674-8034.2026.05.002.

[1]
MUCCIO M, CHU D, MINKOFF L, et al. Upright versus supine MRI: effects of body position on craniocervical CSF flow[J/OL]. Fluids Barriers CNS, 2021, 18(1): 61 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/34952607/. DOI: 10.1186/s12987-021-00296-7.
[2]
FITZGIBBON-COLLINS L K, NOGUCHI M, HECKMAN G A, et al. Acute reduction in cerebral blood velocity on supine-to-stand transition increases postural instability in young adults[J/OL]. Am J Physiol Heart Circ Physiol, 2019, 317(6): H1342-H1353 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/31674810/. DOI: 10.1152/ajpheart.00360.2019.
[3]
LINDÉN C, QVARLANDER S, JÓHANNESSON G, et al. Normal-tension glaucoma has normal intracranial pressure: a prospective study of intracranial pressure and intraocular pressure in different body positions[J]. Ophthalmology, 2018, 125(3): 361-368. DOI: 10.1016/j.ophtha.2017.09.022.
[4]
IRISAWA H, INUI N, MIZUSHIMA T, et al. Cerebral blood deoxygenation by a postural change detected by near-infrared spectroscopy has a close association with cerebral infarction[J/OL]. Brain Sci, 2022, 12(10): 1419 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/36291352/. DOI: 10.3390/brainsci12101419.
[5]
FAVRE M E, LIM V, FALVO M J, et al. Cerebrovascular reactivity and cerebral autoregulation are improved in the supine posture compared to upright in healthy men and women[J/OL]. PLoS One, 2020, 15(3): e0229049 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/32119678/. DOI: 10.1371/journal.pone.0229049.
[6]
MIKKONEN M, LAAKSO I. Effects of posture on electric fields of non-invasive brain stimulation[J/OL]. Phys Med Biol, 2019, 64(6): 065019 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/30708366/. DOI: 10.1088/1361-6560/ab03f5.
[7]
AVELAR-PEREIRA B, TAM G K, HADI HOSSEINI S M. The effect of body posture on resting-state functional connectivity[J]. Brain Connect, 2022, 12(3): 275-284. DOI: 10.1089/brain.2021.0013.
[8]
OGOH S, WASHIO T, PATON J F R, et al. Gravitational effects on intracranial pressure and blood flow regulation in young men: a potential shunting role for the external carotid artery[J]. J Appl Physiol (1985), 2020, 129(4): 901-908. DOI: 10.1152/japplphysiol.00369.2020.
[9]
ALPERIN N, LEE S H, BAGCI A M. MRI measurements of intracranial pressure in the upright posture: The effect of the hydrostatic pressure gradient[J]. J Magn Reson Imaging, 2015, 42(4): 1158-1163. DOI: 10.1002/jmri.24882.
[10]
KODA H, OKADA Y, FUKUMOTO T, et al. Effect of tilt-in-space and reclining angles of wheelchairs on normal force and shear force in the gluteal region[J/OL]. Int J Environ Res Public Health, 2022, 19(9): 5299 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/35564695/. DOI: 10.3390/ijerph19095299.
[11]
CHEN H, LI H T, XIE H, et al. Impact of ROI size on hemodynamic parameters of basilar artery measured with PC-MRI[J]. Chin J Med Imag Technol, 2020, 36(11): 1714-1717. DOI: 10.13929/j.issn.1003-3289.2020.11.029.
[12]
SHI Y L, THRIPPLETON M J, BLAIR G W, et al. Small vessel disease is associated with altered cerebrovascular pulsatility but not resting cerebral blood flow[J]. J Cereb Blood Flow Metab, 2020, 40(1): 85-99. DOI: 10.1177/0271678X18803956.
[13]
OTA A, TAKEDA R, IMAI D, et al. The effects of aging on the distribution of cerebral blood flow with postural changes and mild hyperthermia[J]. Eur J Appl Physiol, 2019, 119(5): 1261-1272. DOI: 10.1007/s00421-019-04118-5.
[14]
BAKER R, COENEN P, HOWIE E, et al. Musculoskeletal and cognitive effects of a movement intervention during prolonged standing for office work[J]. Hum Factors, 2018, 60(7): 947-961. DOI: 10.1177/0018720818783945.
[15]
DAI Q Q, ZHANG M M, GUO Y L, et al. A study on the effects of different positions on the clinical prognosis of patients with acute ischemic stroke[J]. Curr Neurovasc Res, 2024, 21(3): 337-342. DOI: 10.2174/0115672026316069240502120918.
[16]
ASHBY J W, MACK J J. Endothelial control of cerebral blood flow[J]. Am J Pathol, 2021, 191(11): 1906-1916. DOI: 10.1016/j.ajpath.2021.02.023.
[17]
KERMORGANT M, LABRUNÉE M, DESPAS F, et al. How does head position induced intracranial pressure changes impact sympathetic activity and cerebral blood flow?[J/OL]. Auton Neurosci, 2022, 243: 103036 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/36279623/. DOI: 10.1016/j.autneu.2022.103036.
[18]
CLOUGH R H, PANERAI R B, LADTHAVORLAPHATT K, et al. The complexity of cerebral blood flow regulation: the interaction of posture and vasomotor reactivity[J]. J Appl Physiol (1985), 2024, 137(4): 892-902. DOI: 10.1152/japplphysiol.00851.2023.
[19]
CHACÓN M, ROJAS-PESCIO H, PEÑALOZA S, et al. Machine learning models and statistical complexity to analyze the effects of posture on cerebral hemodynamics[J/OL]. Entropy (Basel), 2022, 24(3): 428 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/35327938/. DOI: 10.3390/e24030428.
[20]
KOSUGI K, YAMADA Y, YAMADA M, et al. Posture-induced changes in the vessels of the head and neck: evaluation using conventional supine CT and upright CT[J/OL]. Sci Rep, 2020, 10(1): 16623 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/33024196/. DOI: 10.1038/s41598-020-73658-0.
[21]
KHAN M S, MILLER A J, EJAZ A, et al. Cerebral blood flow in orthostatic intolerance[J/OL]. J Am Heart Assoc, 2025, 14(3): e036752 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/39895557/. DOI: 10.1161/jaha.124.036752.
[22]
JOHNSON J N, TETON Z E, LEE J E, et al. The human craniospinal venous system and its influence on postural intracranial pressure: a review[J]. J Neurosurg, 2024, 141(6): 1484-1493. DOI: 10.3171/2024.4.JNS232254.
[23]
MIZUTANI K, MIYAUCHI T, YAMADA Y, et al. Exploration of postural effects on the external jugular and diploic venous system using upright computed tomography scanning[J]. Neuroradiology, 2024, 66(6): 963-971. DOI: 10.1007/s00234-024-03357-4.
[24]
SIMKA M, CZAJA J, KOWALCZYK D. Collapsibility of the internal jugular veins in the lateral decubitus body position: a potential protective role of the cerebral venous outflow against neurodegeneration[J/OL]. Med Hypotheses, 2019, 133: 109397 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/31526984/. DOI: 10.1016/j.mehy.2019.109397.
[25]
VAN ZANDWIJK J K, KUIJER K M, STASSEN C M, et al. Internal jugular vein geometry under multiple inclination angles with 3D low-field MRI in healthy volunteers[J]. J Magn Reson Imaging, 2022, 56(5): 1302-1308. DOI: 10.1002/jmri.28182.
[26]
ALPERIN N, BURMAN R, LEE S H. Role of the spinal canal compliance in regulating posture-related cerebrospinal fluid hydrodynamics in humans[J]. J Magn Reson Imaging, 2021, 54(1): 206-214. DOI: 10.1002/jmri.27505.
[27]
CHU D, MUCCIO M, DAMADIAN B, et al. The influence of body position on cerebrospinal fluid circulation[J/OL]. Veins Lymphatics, 2022, 11(1) [2025-01-09]. https://www.researchgate.net/publication/365699317_The_influence_of_body_position_on_cerebrospinal_fluid_circulation. DOI: 10.4081/vl.2022.10947.
[28]
YOKOYAMA Y, YAMADA Y, KOSUGI K, et al. Effect of gravity on brain structure as indicated on upright computed tomography[J/OL]. Sci Rep, 2021, 11(1): 392 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/33431952/. DOI: 10.1038/s41598-020-79695-z.
[29]
CZARNIAK N, KAMIŃSKA J, MATOWICKA-KARNA J, et al. Cerebrospinal fluid-basic concepts review[J/OL]. Biomedicines, 2023, 11(5): 1461 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/37239132/. DOI: 10.3390/biomedicines11051461.
[30]
WANG Z, LI J J, GAO R, et al. Spontaneous intracranial hypotension caused by cerebrospinal fluid venous fistula: a case report[J]. Natl Med J China, 2024, 104(9): 712-714. DOI: 10.3760/Cma.J.Cn112137-20230717-00010.
[31]
FORD R L, FRANKFORT B J, FLEISCHMAN D. Cerebrospinal fluid and ophthalmic disease[J]. Curr Opin Ophthalmol, 2022, 33(2): 73-79. DOI: 10.1097/ICU.0000000000000818.
[32]
BEDUSSI B, ALMASIAN M, DE VOS J, et al. Paravascular spaces at the brain surface: low resistance pathways for cerebrospinal fluid flow[J]. J Cereb Blood Flow Metab, 2018, 38(4): 719-726. DOI: 10.1177/0271678X17737984.
[33]
BRADLEY W G. CSF flow in the brain in the context of normal pressure Hydrocephalus[J]. AJNR Am J Neuroradiol, 2015, 36(5): 831-838. DOI: 10.3174/ajnr.A4124.
[34]
MUCCIO M, SUN Z, CHU D, et al. The impact of body position on neurofluid dynamics: present insights and advancements in imaging[J/OL]. Front Aging Neurosci, 2024, 16: 1454282 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/39582951/. DOI: 10.3389/fnagi.2024.1454282.
[35]
ILIFF J J, WANG M H, ZEPPENFELD D M, et al. Cerebral arterial pulsation drives paravascular CSF-interstitial fluid exchange in the murine brain[J]. J Neurosci, 2013, 33(46): 18190-18199. DOI: 10.1523/JNEUROSCI.1592-13.2013.
[36]
NORAGER N H, OLSEN M H, PEDERSEN S H, et al. Reference values for intracranial pressure and lumbar cerebrospinal fluid pressure: a systematic review[J/OL]. Fluids Barriers CNS, 2021, 18(1): 19 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/33849603/. DOI: 10.1186/s12987-021-00253-4.
[37]
TARUMI T, YAMABE T, FUKUIE M, et al. Brain blood and cerebrospinal fluid flow dynamics during rhythmic handgrip exercise in young healthy men and women[J]. J Physiol, 2021, 599(6): 1799-1813. DOI: 10.1113/JP281063.
[38]
CLAASSEN J A H R, THIJSSEN D H J, PANERAI R B, et al. Regulation of cerebral blood flow in humans: physiology and clinical implications of autoregulation[J]. Physiol Rev, 2021, 101(4): 1487-1559. DOI: 10.1152/physrev.00022.2020.
[39]
KLEIN T, BAILEY T G, WOLLSEIFFEN P, et al. The effect of age on cerebral blood flow responses during repeated and sustained stand to sit transitions[J/OL]. Physiol Rep, 2020, 8(9): e14421 [2025-01-09]. https://pubmed.ncbi.nlm.nih.gov/32378357/. DOI: 10.14814/phy2.14421.

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