Purple hands and purple feet of Multiple System Atrophy. This is a vasomotor autonomic dysfunction and nice paper in @journal_PD by Campese and colleagues.

Boom! Cerebrospinal fluid (CSF) flow extends to peripheral nerves. Alexander Ligocki, Ed Scott and colleagues @UF @UFHealth blow our minds. New paper @ScienceAdvances. What will we call it now? Cerebro-spinal-nerve fluid (CSNF)? or maybe brain-spinal-nerve fluid (BSN)? Just when you think you have a few ground truths of the brain and nervous system, you are humbled again. Key Points: - The authors point out that dogma holds that cerebrospinal fluid is responsible for 'maintaining brain homeostasis through nutrient delivery and waste removal for only the central nervous system.' - They show extensive CSF flow throughout the peripheral nervous system. - They traced multimodal 1.9-nanometer gold nanoparticles. - These nanoparticles were roughly the size of CSF circulating proteins. - They squirted them into the lateral cerebral ventricle. -They showed incredibly that the particles transitioned from central to peripheral nervous systems at root attachments and transition zones. - They showed the particles could make it all the way to the axoplasm of distal peripheral nerves. - Bigger 15-nanometer gold particles were not able to make the journey. My take: We know that the nervous system does not contain the more traditional lymphatics and has a force field called the blood brain barrier. We know that CSF delivers nutrients and removes waste from the brain and central nervous system. Our previous ground truth was established by studies using dye tracers. Using small gold nanoparticles these authors 'tore down the dogma.' So the real question is whether it is time for a name change? Cerebrospinal fluid (CSF) or cerebro-spinal-nerve fluid (CSNF)? or maybe brain-spinal-nerve fluid (BSN)? Thoughts? Sartor resartus – the tailor re-tailored our view on this important aspect of neuroscience. BRAVO! science.org/doi/10.1126/scia… #parkinson #CSF #cerebrospinal #Alzheimers