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Open Access 01-12-2024 | Central Nervous System Trauma | Research

The glymphatic system for neurosurgeons: a scoping review

Authors: Mohammad Al Masri, Alba Corell, Isak Michaëlsson, Asgeir S. Jakola, Thomas Skoglund

Published in: Neurosurgical Review | Issue 1/2024

Abstract

The discovery of the glymphatic system has revolutionized our understanding of cerebrospinal fluid (CSF) circulation and interstitial waste clearance in the brain. This scoping review aims to synthesize the current literature on the glymphatic system’s role in neurosurgical conditions and its potential as a therapeutic target. We conducted a comprehensive search in PubMed and Scopus databases for studies published between January 1, 2012, and October 31, 2023. Studies were selected based on their relevance to neurosurgical conditions and glymphatic function, with both animal and human studies included. Data extraction focused on the methods for quantifying glymphatic function and the main results. A total of 67 articles were included, covering conditions such as idiopathic normal pressure hydrocephalus (iNPH), idiopathic intracranial hypertension (IIH), subarachnoid hemorrhage (SAH), stroke, intracranial tumors, and traumatic brain injury (TBI). Significant glymphatic dysregulation was noted in iNPH and IIH, with evidence of impaired CSF dynamics and delayed clearance. SAH studies indicated glymphatic dysfunction with the potential therapeutic effects of nimodipine and tissue plasminogen activator. In stroke, alterations in glymphatic activity correlated with the extent of edema and neurological recovery. TBI studies highlighted the role of the glymphatic system in post-injury cognitive outcomes. Results indicate that the regulation of aquaporin-4 (AQP4) channels is a critical target for therapeutic intervention. The glymphatic system plays a critical role in the pathophysiology of various neurosurgical conditions, influencing brain edema and CSF dynamics. Targeting the regulation of AQP4 channels presents as a significant therapeutic strategy. Although promising, the translation of these findings into clinical practice requires further human studies. Future research should focus on establishing non-invasive biomarkers for glymphatic function and exploring the long-term effects of glymphatic dysfunction.

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Title: The glymphatic system for neurosurgeons: a scoping review
Authors: Mohammad Al Masri
Alba Corell
Isak Michaëlsson
Asgeir S. Jakola
Thomas Skoglund
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Central Nervous System Trauma
Subarachnoid Hemorrhage
Subarachnoid Hemorrhage
Hydrocephalus
Hydrocephalus
Hydrocephalus
Glioma
Glioma
Glioma
Brain Tumor
Edema
Published in: Neurosurgical Review / Issue 1/2024
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-024-02291-6

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Springer Medicine

The glymphatic system for neurosurgeons: a scoping review

Abstract

Keynote webinar | Spotlight on medication adherence

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Abstract

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