THE GLYMPHATIC SYSTEM: CEREBROSPINAL FLUID DYNAMICS AND WASTE CLEARANCE IN NEUROLOGICAL DISEASE
Authors
Akhmatova Yulduz Ablakulovna, Adxamov Asror Adxam oʻgʻli, Adxamov Oʻktam Adxam oʻgʻli, Abdunazarov Muhammadali Xojiakbarovich, Ziyatov Sardor Kildiyor ugli ()Files
Abstract
The glymphatic system is a perivascular network through which cerebrospinal fluid (CSF) enters the brain parenchyma along periarterial spaces, exchanges with interstitial fluid, and exits along perivenous pathways, facilitating clearance of metabolic waste products including amyloid-beta and tau. This bulk fluid exchange depends on astrocytic aquaporin-4 (AQP4) water channels concentrated at perivascular end-feet, arterial pulsatility, and is substantially enhanced during sleep. Downstream, meningeal lymphatic vessels provide an additional route for clearance of macromolecules and immune cells from the central nervous system. Glymphatic function declines with aging, loss of AQP4 polarization, and disruption of normal sleep architecture, and impaired clearance has been implicated in Alzheimer's disease, traumatic brain injury, idiopathic normal pressure hydrocephalus, and cerebral small-vessel disease. This review summarizes the structural and physiological basis of the glymphatic system, mechanisms underlying its dysfunction, its relevance to major neurological disorders, and emerging therapeutic and diagnostic approaches targeting cerebral waste clearance.
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