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Related Experiment Video

Updated: Feb 24, 2026

In Vivo Imaging of Cerebrospinal Fluid Transport through the Intact Mouse Skull using Fluorescence Macroscopy
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Perivascular spaces, glymphatic dysfunction, and small vessel disease.

Humberto Mestre1,2, Serhii Kostrikov3, Rupal I Mehta1,2,4,5

  • 1Department of Neurosurgery, Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, NY 14642, U.S.A.

Clinical Science (London, England : 1979)
|August 12, 2017
PubMed
Summary

The glymphatic system, crucial for brain waste removal, may explain gaps in understanding cerebral small vessel diseases (SVDs). Impaired glymphatic function, involving aquaporin-4 (AQP4) and metabolite clearance, could drive SVD progression.

Keywords:
CNS clearanceCerebrospinal fluidGlymphaticPerivascular spaceSmall vessel disease

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Area of Science:

  • Neuroscience
  • Cerebrovascular Biology
  • Physiology

Background:

  • Cerebral small vessel diseases (SVDs) present overlapping pathologies not fully explained by current models.
  • Enlarged perivascular spaces (EPVS) and protein deposits are key SVD features needing further mechanistic insight.

Purpose of the Study:

  • To comprehensively review factors regulating glymphatic function.
  • To explore the role of glymphatic impairment in SVD inception and progression.
  • To identify novel therapeutic targets for SVD.

Main Methods:

  • Review of existing literature on glymphatic system physiology and SVD pathophysiology.
  • Analysis of the role of aquaporin-4 (AQP4)-lined perivascular spaces (PVSs).
  • Examination of cerebrovascular pulsatility and metabolite clearance in CNS health.

Main Results:

  • Glymphatic system dysfunction offers a new perspective on SVD mechanisms.
  • Aquaporin-4 (AQP4) and impaired metabolite clearance are implicated in glymphatic impairment.
  • Cerebrovascular pulsatility influences glymphatic function and SVD.

Conclusions:

  • Glymphatic impairment is a potential key factor in SVD development and progression.
  • Understanding glymphatic mechanisms may reveal novel therapeutic strategies for SVD.
  • Further research is needed to address key unanswered questions regarding glymphatic function and SVD.