{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:35:25Z","timestamp":1792182925597,"version":"4.4.0"},"reference-count":109,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100016350","name":"Sichuan Provincial Administration of Traditional Chinese Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100016350","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cerebrospinal fluid (CSF) is often framed as a transport medium, yet its motion and pressure dynamics impose continuous mechanical loading on central nervous system (CNS) barrier and interface systems. These cues span scales\u2014from cilia-scale near-wall shear to craniospinal compliance-driven pulsatility\u2014and may shape barrier phenotypes, immune programs, and clearance efficiency. In simple terms, this review asks how abnormal CSF motion is converted into barrier dysfunction and disease-relevant outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main body<\/jats:title>\n                    <jats:p>We synthesize evidence that CSF mechanics is spatially heterogeneous along the production-to-outflow axis and is sensed by specialized mechanotransduction modules in choroid plexus epithelium, ventricular ependyma, perivascular astrocytic endfeet\/neurovascular unit, and meningeal outflow\/lymphatic pathways. We discuss how shear, pulsatile forcing, and pressure\u2013compliance relationships interact with mechanosensitive ion\/transport channels, ciliary polarity, glycocalyx\u2013ECM\/FAK signaling, junctional remodeling, and nuclear mechanotransduction to regulate permeability and immune\u2013metabolic states. We highlight quantitative toolkits, including low-velocity 4D flow MRI, phase-contrast MRI, waveform metrics, microfluidic barrier platforms, and computational modeling, that enable mapping of patient-relevant mechanics to cell-level exposures. Disease sections emphasize mechanical failure modes: oscillatory overload and multi-site CSF\u2013barrier disruption in hydrocephalus; loss of effective pulsatile transfer and impaired perivascular exchange in neurodegeneration; age-related stiffening and altered mechanosensitivity across barriers; meningeal outflow dysfunction with neuroinflammatory amplification; and acute mechanical disruption after trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We propose a mechanomedicine framework for CSF\u2013barrier coupling that prioritizes measurable mechanical exposures, interface-specific mechanosensors, and actionable endpoints, including barrier state, permeability, immune trafficking, and imaging-derived coupling metrics. This framework supports closed-loop translational pipelines linking human phenotyping to mechanistically calibrated models and may guide strategies that modulate CSF dynamics or target mechanotransduction nodes with quantifiable outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnins.2026.1848071","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:53:24Z","timestamp":1783490004000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Cerebrospinal fluid mechanics across CNS barriers: from production, circulation, and clearance to mechanomedicine"],"prefix":"10.3389","volume":"20","author":[{"given":"Xinglin","family":"Cheng","sequence":"first","affiliation":[{"name":"School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bei","family":"Deng","sequence":"additional","affiliation":[{"name":"School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannan","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanguang","family":"Li","sequence":"additional","affiliation":[{"name":"Sichuan Nursing Vocational College, Chengdu","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianen","family":"Zhan","sequence":"additional","affiliation":[{"name":"School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dezhong","family":"Peng","sequence":"additional","affiliation":[{"name":"School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1186\/s12974-020-02005-x","article-title":"Cellular infiltration in traumatic brain injury.","volume":"17","author":"Alam","year":"2020","journal-title":"J. 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