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Recent discoveries of the glymphatic system and of meningeal lymphatic vessels have generated a lot of excitement, along with some degree of skepticism. Here, we summarize the state of the field and point out the gaps of knowledge that should be filled through further research. We discuss the glymphatic system as a system that allows CNS perfusion by the cerebrospinal fluid (CSF) and interstitial fluid (ISF). We also describe the recently characterized meningeal lymphatic vessels and their role in drainage of the brain ISF, CSF, CNS-derived molecules, and immune cells from the CNS and meninges to the peripheral (CNS-draining) lymph nodes. We speculate on the relationship between the two systems and their malfunction that may underlie some neurological diseases. Although much remains to be investigated, these new discoveries have changed our understanding of mechanisms underlying CNS immune privilege and CNS drainage. Future studies should explore the communications between the glymphatic system and meningeal lymphatics in CNS disorders and develop new therapeutic modalities targeting these systems.
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http://dx.doi.org/10.1172/JCI90603 | DOI Listing |
Retina
September 2025
From the Vitreous, Retina, Macula Consultants of New York, New York, NY.
Purpose: To reassess the anatomic basis of optic disc pit maculopathy (OPM) using swept-source optical coherence tomography (SS-OCT) and to characterize the broader structural abnormalities comprising the optic pit complex.
Methods: Sixteen patients with OPM were imaged using a high-resolution SS-OCT system (DREAM OCT). Cross-sectional and volume-rendered scans were analyzed for lamina cribrosa defects, intraneural cavitations, and pathways for fluid entry into or beneath the retina.
Parkinsonism Relat Disord
September 2025
Translational and Clinical Research Institute, Newcastle University, UK.
Introduction: Dysfunction of the glymphatic system is thought to lead to build up of toxic proteins including β-amyloid and α-synuclein, and thus may be involved in dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). The Diffusion Tensor Image Analysis Along the Perivascular Space (DTI-ALPS) index has been proposed as a marker of glymphatic function.
Aims: To investigate DTI-ALPS in mild cognitive impairment (MCI) and dementia, and determine its relationship with cognitive decline, and biomarkers of neurodegeneration.
Magn Reson Lett
November 2024
Department of Radiology, Chinese PLA General Hospital/Chinese PLA Medical School, 28 Fuxing Road, Beijing, 100853, China.
The glymphatic system (GS) is a newly discovered brain anatomy. Its discovery improves our understanding of brain fluid flow and waste removal paths and provides an anatomical basis for the flow of cerebral interstitial fluid (ISF) and cerebrospinal fluid (CSF). GS occurs through a normal exchange within perivascular space (PVS), facilitating the elimination of metabolic wastes generated by nerve cells from the brain.
View Article and Find Full Text PDFDepress Anxiety
September 2025
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.
The therapeutic effects of vortioxetine on mood and cognition have been documented in major depressive disorder (MDD). This study aims to examine whether vortioxetine can improve brain glymphatic system function and connections among functional brain networks and to explore the underlying relationships among these changes. A total of 34 patients with MDD and 41 healthy controls (HCs) were recruited in the study.
View Article and Find Full Text PDFAm J Hypertens
September 2025
New York State Psychiatric Institute, New York NY.
Background: Blood pressure (BP) is not steady. It varies over intervals from months to consecutive cardiac cycles and this variation contains meaningful information beyond mean BP. Variability over multiple clinic visits (VVV-BP) and during 24-hour ambulatory monitoring (ABPV) is positively related to risk of stroke and coronary artery disease and negatively associated with cognitive performance.
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