Liquorpheresis Cerebrospinal Fluid Filtration to Treat CNS Conditions

This book provides an overview of emerging CSF management systems that filter or clear cerebrospinal fluid (CSF) as a therapeutic approach for several CNS conditions. While the term "liquorpheresis" most accurately refers to extracorporeal procedures that filter CSF (similar to plasmapheresis), this book covers any method based on devices that -either alone or in combination with drugs- can clear CSF or enhance its turnover, which in turn dilutes toxins.

The book begins with an overview of CSF anatomy and physiology, followed by a discussion of the role of CSF clearance and flow dysfunction in various CNS conditions. The next section describes the different CSF management systems and procedures that are currently available or under development. The book then reviews the potential applications of these systems for treating subarachnoid hemorrhage, CNS infections, meningeal carcinomatosis, autoimmune encephalitis, polyradiculomyelitis, and neurodegenerativediseases. Finally, a chapter discusses future advances in liquorpheresis systems and applications.

This book is intended for clinicians, neuro-researchers, academics, and students who are interested in the development and application of CSF management systems. It is also relevant to the medical device industry, particularly those that develop apheresis and CSF management devices, and the drug-delivery industry.

Anatomy and Physiology.- The four layers of meninges.- The BBB.- The cerebrospinal fluid (CSF) and the Interstitial fluid (ISF).- Introduction to liquorpheresis.- Clearing the CSF as a therapeutic strategy in neurodegenerative diseases.- Definitions of procedures, including a historical perspective.- Systems and procedures.- Types of procedures and systems.- Classification and definitions of the different types of procedures for mechanical filtration of the CSF.- The mechanism of action.- The regime of usage.- The implantability.- The power for CSF flow.- The CSF filtrating or neutralizing method.- Applications and industry.- Multiple sclerosis, autoimmune encephalitis, and polyradiculomyelitis.- Meningeal carcinomatosis and leptomeningeal metastases.- Infectious diseases.- Viral encephalitis and viral myelitis.- Bacterial meningoencephalitis.- Fungal meningitis and fungal encephalitis.- Brain aging and neurodegenerative diseases.- Future advances in liquorpheresis systems and applications.- New technical developments.- New applications.

Prof. Menéndez is a neurologist at Hospital Universitario Central de Asturias (Oviedo, Spain) and professor of Neurology at Oviedo University. He has a wide research experience in clinical and translational neuroscience at Oviedo University and at the Instituto de Investigación Sanitaria del Principado de Asturias. Prof. Menéndez main field of interest is focused on neurodegenerative diseases, from neuropsychology to neuroimaging and from neurogenetics to phenotypes. In the last few years, he is particularly interested in studying and understanding the molecular mechanisms of neurodegeneration (genes, and proteins) and in brain clearance systems and the molecular dynamics between cells, the interstitial fluid and the cerebrospinal fluid (CSF). He is also interested in developing new systems for targeted drug delivery to the CNS and for the filtration of the CSF (liquorpheresis).