{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:30:48Z","timestamp":1790962248856,"version":"4.1.0"},"reference-count":92,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["RF1 AG057494"],"award-info":[{"award-number":["RF1 AG057494"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["RO1 NS108463"],"award-info":[{"award-number":["RO1 NS108463"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background and objective<\/jats:title><jats:p>Pituitary tumor in patients induces adverse alterations in the brain, accompanied by cognitive deficits. Dysfunction of glymphatic waste clearance results in accumulation of neurotoxic products within the brain, leading to cognitive impairment. However, the status of glymphatic function in the brain with pituitary tumor is unknown. Using magnetic resonance imaging (MRI) and an advanced mathematical modeling, we investigated the changes of glymphatic transport in the rats carrying spontaneous pituitary tumor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Rats (22\u201324\u2009months, female, Wistar) with and without pituitary tumor (<jats:italic>n<\/jats:italic>\u2009=\u20097\/per group) underwent the identical experimental protocol. MRI measurements, including T2-weighted imaging and dynamic 3D T1-weighted imaging with intracisternal administration of contrast agent, were performed on each animal. The contrast-induced enhancement in the circle of Willis and in the glymphatic influx nodes were observed on the dynamic images and verified with time-signal-curves (TSCs). Model-derived parameters of infusion rate and clearance rate that characterize the kinetics of glymphatic tracer transport were evaluated in multiple representative brain regions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our imaging data demonstrated a higher incidence of partially enhanced circle of Willis (86 vs. 14%; <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.033) and a lower incidence of enhancement in glymphatic influx nodes of pituitary (71 vs. 100%) and pineal (57 vs. 86%) recesses in the rats with pituitary tumor than in the rats with normal appearance of pituitary gland, indicating an intensification of impaired peri-vascular pathway and impeded glymphatic transport due to the presence of pituitary tumor. Consistently, our kinetic modeling and regional cerebral tissue quantification revealed significantly lower infusion and clearance rates in all examined regions in rats with spontaneous pituitary tumor than in non-tumor rats, representing a suppressed glymphatic transport in the brain with pituitary tumor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study demonstrates the compromised glymphatic transport in the rat brain with spontaneous pituitary tumor. The reduced efficiency in cerebral waste clearance increases the risk for neurodegeneration in the brain that may underlie the cognitive impairment commonly seen in patients with pituitary tumors.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1189614","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T11:29:14Z","timestamp":1691148554000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Glymphatic transport is reduced in rats with spontaneous pituitary tumor"],"prefix":"10.3389","volume":"10","author":[{"given":"Lian","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangliang","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esmaeil","family":"Davoodi-Bojd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingjiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Chopp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng Gang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,8,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1007\/s10143-019-01134-z","article-title":"Pituitary adenomas and neuropsychological status: a systematic literature review","volume":"43","author":"Pertichetti","year":"2020","journal-title":"Neurosurg Rev"},{"key":"ref2","first-page":"1","article-title":"Epidemiology and pathogenesis of pituitary adenomas","volume":"129","author":"Faglia","year":"1993","journal-title":"Acta Endocrinol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"635","DOI":"10.3171\/2021.10.JNS21659","article-title":"Outcomes and surgical nuances in management of giant pituitary adenomas: a review of 108 cases in the endoscopic era","volume":"137","author":"Makarenko","year":"2022","journal-title":"J Neurosurg"},{"key":"ref4","article-title":"Non-functioning pituitary adenomas","volume-title":"Endotext","author":"Drummond","year":"2000"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1507\/endocrj.EJ20-0185","article-title":"Silent pituitary adenoma and metabolic disorders: obesity, abnormal glucose tolerance, hypertension and dyslipidemia","volume":"68","author":"Baba","year":"2021","journal-title":"Endocr J"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1111\/joim.13056","article-title":"Psychiatric and neurocognitive consequences of endogenous hypercortisolism","volume":"288","author":"Piasecka","year":"2020","journal-title":"J Intern Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"R1","DOI":"10.1530\/EJE-14-1101","article-title":"Mechanisms in endocrinology: Cushing\u2019s syndrome causes irreversible effects on the human brain: a systematic review of structural and functional magnetic resonance imaging studies","volume":"173","author":"Andela","year":"2015","journal-title":"Eur J Endocrinol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"507","DOI":"10.4103\/ijem.IJEM_542_20","article-title":"Structural and functional consequences of hypercortisolism on brain: are the brain and psycho-neuro-cognitive manifestations reversible?","volume":"24","author":"Garg","year":"2020","journal-title":"Indian J Endocrinol Metab"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1097\/MED.0000000000000414","article-title":"Structural brain abnormalities in Cushing\u2019s syndrome","volume":"25","author":"Bauduin","year":"2018","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.neulet.2015.03.006","article-title":"Chronic corticosterone exposure reduces hippocampal astrocyte structural plasticity and induces hippocampal atrophy in mice","volume":"592","author":"Zhang","year":"2015","journal-title":"Neurosci Lett"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1016\/j.nicl.2017.10.038","article-title":"Voxel-based comparison of brain glucose metabolism between patients with Cushing\u2019s disease and healthy subjects","volume":"17","author":"Liu","year":"2018","journal-title":"NeuroImage Clin"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"357","DOI":"10.2147\/DMSO.S86319","article-title":"Metabolic abnormalities in pituitary adenoma patients: a novel therapeutic target and prognostic factor","volume":"8","author":"Zheng","year":"2015","journal-title":"Diabetes, Metab Syndr Obes"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1007\/s12020-016-0963-0","article-title":"Brain metabolite abnormalities in ventromedial prefrontal cortex are related to duration of hypercortisolism and anxiety in patients with Cushing\u2019s syndrome","volume":"53","author":"Crespo","year":"2016","journal-title":"Endocrine"},{"key":"ref14","first-page":"786","article-title":"Decreased brain glucose utilization in patients with Cushing\u2019s disease","volume":"39","author":"Brunetti","year":"1998","journal-title":"J Nucl Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1111\/j.1365-2265.2011.04019.x","article-title":"The effects of long-term growth hormone and insulin-like growth factor-1 exposure on the development of cardiovascular, cerebrovascular and metabolic co-morbidities in treated patients with acromegaly","volume":"75","author":"Jayasena","year":"2011","journal-title":"Clin Endocrinol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1016\/j.tem.2005.07.004","article-title":"Cerebrovascular disease in patients with pituitary tumors","volume":"16","author":"Erfurth","year":"2005","journal-title":"Trends Endocrinol Metab"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"948971","DOI":"10.3389\/fonc.2022.948971","article-title":"Presence of cerebral microbleeds is associated with cognitive decline in acromegaly","volume":"12","author":"Xie","year":"2022","journal-title":"Front Oncol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1064216","DOI":"10.3389\/fendo.2022.1064216","article-title":"Pituitary adenomas and cerebrovascular disease: a review on pathophysiology, prevalence, and treatment","volume":"13","author":"Osorio","year":"2022","journal-title":"Front Endocrinol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1111\/j.1600-0404.1992.tb05500.x","article-title":"Neuropsychological abnormalities in patients with pituitary tumours","volume":"86","author":"Grattan-Smith","year":"1992","journal-title":"Acta Neurol Scand"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1159\/000012277","article-title":"Neurobehavioral functioning of adults with pituitary disease","volume":"67","author":"Meyers","year":"1998","journal-title":"Psychother Psychosom"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1007\/s10072-017-2980-z","article-title":"The impact on cognitive functions of patients with pituitary adenoma before and after surgery","volume":"38","author":"Wang","year":"2017","journal-title":"Neurol Sci"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/brainsci12081091","article-title":"Hyperprolactinemia associated with attentional processing and interference control impairments in patients with prolactinomas","volume":"12","author":"Chen","year":"2022","journal-title":"Brain Sci"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s12902-019-0401-4","article-title":"Improvement in cognitive impairment following the successful treatment of endogenous Cushing\u2019s syndrome-a case report and literature review","volume":"19","author":"Brzozowska","year":"2019","journal-title":"BMC Endocr Disord"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"656255","DOI":"10.3389\/fneur.2021.656255","article-title":"Improvement in attention processing after surgical treatment in functional pituitary adenomas: evidence from ERP study","volume":"12","author":"Cao","year":"2021","journal-title":"Front Neurol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.1530\/EC-21-0385","article-title":"Trends in regional morphological changes in the brain after the resolution of hypercortisolism in Cushing\u2019s disease: a complex phenomenon, not mere partial reversibility","volume":"10","author":"Jiang","year":"2021","journal-title":"Endocr Connect"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/2019.5.JNS19595","article-title":"Cognitive functioning in patients with nonfunctioning pituitary adenoma before and after endoscopic endonasal transsphenoidal surgery","volume":"23","author":"Butterbrod","year":"2019","journal-title":"J Neurosurg"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e60041","DOI":"10.1371\/journal.pone.0060041","article-title":"Neurocognitive function in acromegaly after surgical resection of GH-secreting adenoma versus na\u00efve acromegaly","volume":"8","author":"Mart\u00edn-Rodr\u00edguez","year":"2013","journal-title":"PLoS One"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1530\/EJE-18-0370","article-title":"Comorbidities in patients with non-functioning pituitary adenoma: influence of long-term growth hormone replacement","volume":"179","author":"Hammarstrand","year":"2018","journal-title":"Eur J Endocrinol"},{"key":"ref29","first-page":"2730","article-title":"Mortality and cancer incidence in acromegaly: a retrospective cohort study. United Kingdom acromegaly study group","volume":"83","author":"Orme","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1001\/jamaneurol.2016.1017","article-title":"Association of Cerebral Microbleeds with Cognitive Decline and Dementia","volume":"73","author":"Akoudad","year":"2016","journal-title":"JAMA Neurol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"667","DOI":"10.3233\/JAD-215094","article-title":"Role of white matter abnormalities in the relationship between microbleed burden and cognitive impairment in cerebral amyloid angiopathy","volume":"86","author":"Jo","year":"2022","journal-title":"J Alzheimer\u2019s Dis JAD"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"103245","DOI":"10.1016\/j.nicl.2022.103245","article-title":"Frequency-dependent white-matter functional network changes associated with cognitive deficits in subcortical vascular cognitive impairment","volume":"36","author":"Ma","year":"2022","journal-title":"NeuroImage Clin"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"2583","DOI":"10.1007\/s11064-015-1581-6","article-title":"The glymphatic system: a Beginner\u2019s guide","volume":"40","author":"Jessen","year":"2015","journal-title":"Neurochem Res"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1146\/annurev-pathol-051217-111018","article-title":"The glymphatic system in central nervous system health and disease: past, present, and future","volume":"13","author":"Plog","year":"2018","journal-title":"Annu Rev Pathol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"7","DOI":"10.7554\/eLife.40070","article-title":"Aquaporin-4-dependent glymphatic solute transport in the rodent brain","volume":"7","author":"Mestre","year":"2018","journal-title":"elife"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1126\/scitranslmed.3003748","article-title":"A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid beta","volume":"4","author":"Iliff","year":"2012","journal-title":"Sci Transl Med"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"15","DOI":"10.29245\/2572.942X\/2016\/7.1082","article-title":"Cerebral waste accumulation and glymphatic clearance as mechanisms of human neurological diseases","volume":"1","author":"Dadas","year":"2016","journal-title":"J Neurol Neuromed"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.nbd.2016.05.015","article-title":"Suppression of glymphatic fluid transport in a mouse model of Alzheimer\u2019s disease","volume":"93","author":"Peng","year":"2016","journal-title":"Neurobiol Dis"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1007\/s11102-022-01291-3","article-title":"Vascular anomalies in patients with growth hormone-secreting pituitary adenomas: illustrative case report and systematic review of the literature","volume":"26","author":"Spille","year":"2022","journal-title":"Pituitary"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1016\/j.neuroimage.2018.12.039","article-title":"Modeling glymphatic system of the brain using MRI","volume":"188","author":"Davoodi-Bojd","year":"2019","journal-title":"NeuroImage"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1326","DOI":"10.1177\/0271678X16654702","article-title":"Impairment of the glymphatic system after diabetes","volume":"37","author":"Jiang","year":"2017","journal-title":"J Cereb Blood Flow Metab"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.1172\/JCI67677","article-title":"Brain-wide pathway for waste clearance captured by contrast-enhanced MRI","volume":"123","author":"Iliff","year":"2013","journal-title":"J Clin Invest"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"16180","DOI":"10.1523\/JNEUROSCI.3020-14.2014","article-title":"Impairment of glymphatic pathway function promotes tau pathology after traumatic brain injury","volume":"34","author":"Iliff","year":"2014","journal-title":"J Neurosci"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1016\/j.neuroimage.2017.03.021","article-title":"Cerebrospinal and interstitial fluid transport via the glymphatic pathway modeled by optimal mass transport","volume":"152","author":"Ratner","year":"2017","journal-title":"NeuroImage"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"11034","DOI":"10.1523\/JNEUROSCI.1625-15.2015","article-title":"The effect of body posture on brain glymphatic transport","volume":"35","author":"Lee","year":"2015","journal-title":"J Neurosci"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1097\/MCP.0000000000000923","article-title":"Glymphatic MRI techniques in sleep and neurodegenerative diseases","volume":"28","author":"Lee","year":"2022","journal-title":"Curr Opin Pulm Med"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1002\/jmri.26892","article-title":"Glymphatic imaging using MRI","volume":"51","author":"Taoka","year":"2020","journal-title":"J Magn Reson Imaging (JMRI)"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"118257","DOI":"10.1016\/j.neuroimage.2021.118257","article-title":"Glymphatic clearance function in patients with cerebral small vessel disease","volume":"238","author":"Zhang","year":"2021","journal-title":"NeuroImage"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"2691","DOI":"10.1093\/brain\/awx191","article-title":"Glymphatic MRI in idiopathic normal pressure hydrocephalus","volume":"140","author":"Ringstad","year":"2017","journal-title":"Brain"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"3092","DOI":"10.1161\/STROKEAHA.114.006617","article-title":"Impaired glymphatic perfusion after strokes revealed by contrast-enhanced MRI: a new target for fibrinolysis?","volume":"45","author":"Gaberel","year":"2014","journal-title":"Stroke"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"6254","DOI":"10.1038\/s41598-020-63022-7","article-title":"Repetitive mild traumatic brain injury alters glymphatic clearance rates in limbic structures of adolescent female rats","volume":"10","author":"Christensen","year":"2020","journal-title":"Sci Rep"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"6365","DOI":"10.1523\/JNEUROSCI.1974-18.2019","article-title":"Impaired glymphatic transport in spontaneously hypertensive rats","volume":"39","author":"Mortensen","year":"2019","journal-title":"J Neurosci"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s13195-023-01175-z","article-title":"Altered dynamics of glymphatic flow in a mature-onset Tet-off APP mouse model of amyloidosis","volume":"15","author":"Ben-Nejma","year":"2023","journal-title":"Alzheimers Res Ther"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"147062","DOI":"10.1016\/j.brainres.2020.147062","article-title":"MRI detection of impairment of glymphatic function in rat after mild traumatic brain injury","volume":"1747","author":"Li","year":"2020","journal-title":"Brain Res"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"841798","DOI":"10.3389\/fnagi.2022.841798","article-title":"Aging-related alterations of glymphatic transport in rat: in vivo magnetic resonance imaging and kinetic study","volume":"14","author":"Li","year":"2022","journal-title":"Front Aging Neurosci"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1007\/BF03344942","article-title":"Acromegaly: an epidemiological study","volume":"16","author":"Etxabe","year":"1993","journal-title":"J Endocrinol Investig"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1177\/030098589202900403","article-title":"Correlations between presence of spontaneous lesions of the pituitary (adenohypophysis) and plasma prolactin concentration in aged Wistar rats","volume":"29","author":"van Nesselrooij","year":"1992","journal-title":"Vet Pathol"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1538\/expanim.50.99","article-title":"Spontaneous neoplastic lesions in aged Sprague-Dawley rats","volume":"50","author":"Nakazawa","year":"2001","journal-title":"Exp Anim"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1538\/expanim1957.26.1_13","article-title":"Spontaneous tumors in aged SD-JCL rats (author\u2019s transl)","volume":"26","author":"Muraoka","year":"1977","journal-title":"Jikken Dobutsu"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"1449","DOI":"10.1093\/jnci\/54.6.1449","article-title":"Incidence of spontaneous neoplasms in F344 rats throughout the natural life-span","volume":"54","author":"Sass","year":"1975","journal-title":"J Natl Cancer Inst"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1046\/j.1365-2826.1999.00333.x","article-title":"The effects of age and spontaneous adenoma formation on trophic activity in the rat pituitary gland: a comparison with trophic activity in the human pituitary and in human pituitary adenomas","volume":"11","author":"Nolan","year":"1999","journal-title":"J Neuroendocrinol"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"1876","DOI":"10.1002\/jnr.24325","article-title":"MRI investigation of glymphatic responses to Gd-DTPA infusion rates","volume":"96","author":"Ding","year":"2018","journal-title":"J Neurosci Res"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1007\/s10143-018-1049-7","article-title":"MRI criteria of subtypes of adenomas and epithelial cysts of the pituitary gland","volume":"43","author":"Bette","year":"2020","journal-title":"Neurosurg Rev"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1002\/mrm.1910070305","article-title":"Quantitative magnetic resonance imaging of estradiol-induced pituitary hyperplasia in rats","volume":"7","author":"Rudin","year":"1988","journal-title":"Magn Reson Med"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1093\/carcin\/12.2.289","article-title":"Magnetic resonance imaging compared with hormonal effects and histopathology of estrogen-induced pituitary lesions in the rat","volume":"12","author":"van Nesselrooij","year":"1991","journal-title":"Carcinogenesis"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1002\/mrm.1910110204","article-title":"Magnetic resonance imaging of estrogen-induced pituitary hypertrophy in rats","volume":"11","author":"van Nesselrooij","year":"1989","journal-title":"Magn Reson Med"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"656","DOI":"10.2460\/javma.239.5.656","article-title":"Extralabel use of cabergoline in the treatment of a pituitary adenoma in a rat","volume":"239","author":"Mayer","year":"2011","journal-title":"J Am Vet Med Assoc"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1038\/nmeth.2089","article-title":"NIH image to ImageJ: 25 years of image analysis","volume":"9","author":"Schneider","year":"2012","journal-title":"Nat Methods"},{"key":"ref69","article-title":"Physiology, pituitary gland","volume-title":"StatPearls","author":"El Sayed","year":"2022"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1159\/000490349","article-title":"The glymphatic system and waste clearance with brain aging: a review","volume":"65","author":"Benveniste","year":"2019","journal-title":"Gerontology"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1002\/ana.25670","article-title":"Impairment of the glymphatic pathway and putative meningeal lymphatic vessels in the aging human","volume":"87","author":"Zhou","year":"2020","journal-title":"Ann Neurol"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1007\/s00401-011-0801-7","article-title":"Perivascular drainage of solutes is impaired in the ageing mouse brain and in the presence of cerebral amyloid angiopathy","volume":"121","author":"Hawkes","year":"2011","journal-title":"Acta Neuropathol"},{"key":"ref73","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1038\/jcbfm.2013.30","article-title":"\u2018Hit & Run\u2019 model of closed-skull traumatic brain injury (TBI) reveals complex patterns of post-traumatic AQP4 dysregulation","volume":"33","author":"Ren","year":"2013","journal-title":"J Cereb Blood Flow Metab"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/1750-1172-7-41","article-title":"Cushing\u2019s disease","volume":"7","author":"Castinetti","year":"2012","journal-title":"Orphanet J Rare Dis"},{"key":"ref75","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1530\/EJE-18-0015","article-title":"Decreasing mortality and changes in treatment patterns in patients with acromegaly from a nationwide study","volume":"178","author":"Esposito","year":"2018","journal-title":"Eur J Endocrinol"},{"key":"ref76","doi-asserted-by":"publisher","first-page":"M133","DOI":"10.1530\/EJE-15-0354","article-title":"Metabolic comorbidities in Cushing\u2019s syndrome","volume":"173","author":"Ferra\u00f9","year":"2015","journal-title":"Eur J Endocrinol"},{"key":"ref77","doi-asserted-by":"publisher","first-page":"447","DOI":"10.4158\/EP13173.OR","article-title":"Preclinical atherosclerosis in patients with prolactinoma","volume":"20","author":"Arslan","year":"2014","journal-title":"Endocr Pract"},{"key":"ref78","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1055\/s-0035-1547234","article-title":"Increased risk of Unfavorable metabolic outcome in patients with clinically nonfunctioning pituitary adenomas","volume":"47","author":"Do\u011fan","year":"2015","journal-title":"Horm Metab Res"},{"key":"ref79","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1016\/j.jocn.2013.08.002","article-title":"Pituitary macroadenoma causing symptomatic internal carotid artery compression: surgical treatment through transsphenoidal tumor resection","volume":"21","author":"Rey-Dios","year":"2014","journal-title":"J Clin Neurosci"},{"key":"ref80","doi-asserted-by":"publisher","first-page":"48","DOI":"10.2176\/nmc.51.48","article-title":"Pituitary apoplexy causing internal carotid artery occlusion -case report","volume":"51","author":"Chokyu","year":"2011","journal-title":"Neurol Med Chir"},{"key":"ref81","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.3346\/jkms.2008.23.6.1113","article-title":"Pituitary apoplexy producing internal carotid artery compression: a case report","volume":"23","author":"Yang","year":"2008","journal-title":"J Korean Med Sci"},{"key":"ref82","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.1210\/jc.2010-2721","article-title":"Increased rate of intracranial saccular aneurysms in acromegaly: an MR angiography study and review of the literature","volume":"96","author":"Manara","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"ref83","doi-asserted-by":"publisher","first-page":"e526","DOI":"10.1016\/j.wneu.2019.02.084","article-title":"Prevalence of unruptured intracranial aneurysms coexisting with pituitary adenomas","volume":"126","author":"Hu","year":"2019","journal-title":"World Neurosurg"},{"key":"ref84","doi-asserted-by":"publisher","first-page":"942","DOI":"10.3171\/2011.12.JNS11875","article-title":"Coexistence of intracranial aneurysm in 800 patients with surgically confirmed pituitary adenoma","volume":"116","author":"Oh","year":"2012","journal-title":"J Neurosurg"},{"key":"ref85","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1055\/s-0042-1749662","article-title":"Giant prolactinoma embedded by pseudoaneurysm of the cavernous carotid artery treated with a tailored therapeutic scheme","volume":"13","author":"Mercuri","year":"2022","journal-title":"J Neurosci Rural Pract"},{"key":"ref86","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1186\/s12957-015-0653-z","article-title":"Pituitary adenoma apoplexy caused by rupture of an anterior communicating artery aneurysm: case report and literature review","volume":"13","author":"Xu","year":"2015","journal-title":"World J Surg Oncol"},{"key":"ref87","doi-asserted-by":"publisher","first-page":"701","DOI":"10.4103\/1793-5482.215760","article-title":"Unruptured internal carotid artery aneurysm associated with functional pituitary adenoma: a true association","volume":"12","author":"Satyarthee","year":"2017","journal-title":"Asian J Neurosurg"},{"key":"ref88","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1590\/S0004-282X2008000100026","article-title":"Intrasellar internal carotid aneurysm coexisting with GH-secreting pituitary adenoma in an acromegalic patient","volume":"66","author":"Seda","year":"2008","journal-title":"Arq Neuropsiquiatr"},{"key":"ref89","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.2967\/jnumed.116.187211","article-title":"Cerebrospinal fluid clearance in Alzheimer disease measured with dynamic PET","volume":"58","author":"de Leon","year":"2017","journal-title":"J Nucl Med"},{"key":"ref90","doi-asserted-by":"publisher","first-page":"1016","DOI":"10.1016\/S1474-4422(18)30318-1","article-title":"The glymphatic pathway in neurological disorders","volume":"17","author":"Rasmussen","year":"2018","journal-title":"Lancet Neurol"},{"key":"ref91","doi-asserted-by":"publisher","first-page":"8","DOI":"10.7554\/eLife.44278","article-title":"Anatomical basis and physiological role of cerebrospinal fluid transport through the murine cribriform plate","volume":"8","author":"Norwood","year":"2019","journal-title":"elife"},{"key":"ref92","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/2045-8118-11-12","article-title":"Cerebrospinal fluid is drained primarily via the spinal canal and olfactory route in young and aged spontaneously hypertensive rats","volume":"11","author":"Murtha","year":"2014","journal-title":"Fluids Barriers CNS"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1189614\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T11:29:22Z","timestamp":1691148562000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1189614\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,4]]},"references-count":92,"alternative-id":["10.3389\/fmed.2023.1189614"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1189614","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,4]]},"article-number":"1189614"}}