Convective influx/glymphatic system: tracers injected into the CSF enter and leave the brain along separate periarterial basement membrane pathways

A Paravascular Pathway Facilitates CSF Flow Through the Brain Parenchyma and the Clearance of Interstitial Solutes, Including Amyloid β

Iliff, J. J., Wang, M., Liao, Y., Plogg, B. A., Peng, W., Gundersen, G. A., Benveniste, H., Vates, G. E., Deane, R., Goldman, S. A., et al. (2012) · Science Translational Medicine · doi:10.1126/scitranslmed.3003748 · Cited by 5,824 · see citing works

Structural and functional features of central nervous system lymphatic vessels

Louveau, A., Smirnov, I., Keyes, T. J., Eccles, J. D., Rouhani, S. J., Peske, J. D., Derecki, N. C., Castle, D., Mandell, J. W., Lee, K. S., et al. (2015) · Nature · doi:10.1038/nature14432 · Cited by 4,413 · see citing works

A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules

Aspelund, A., Antila, S., Proulx, S. T., Karlsen, T. V., Karaman, S., Detmar, M., Wiig, H., & Alitalo, K. (2015) · Journal of Experimental Medicine · doi:10.1084/jem.20142290 · Cited by 2,198 · see citing works

Antisense oligonucleotides: the next frontier for treatment of neurological disorders

Rinaldi, C., & Wood, M. J. A. (2018) · Nature Reviews Neurology · doi:10.1038/nrneurol.2017.148 · Cited by 788 · see citing works

Evidence for a ‘Paravascular’ fluid circulation in the mammalian central nervous system, provided by the rapid distribution of tracer protein throughout the brain from the subarachnoid space

Rennels, M. L., Gregory, T. F., Blaumanis, O. R., Fujimoto, K., & Grady, P. A. (1985) · Brain Research · doi:10.1016/0006-8993(85)91383-6 · Cited by 752 · see citing works

Solutes, but not cells, drain from the brain parenchyma along basement membranes of capillaries and arteries: significance for cerebral amyloid angiopathy and neuroimmunology

Carare, R. O., Bernardes‐Silva, M., Newman, T. A., Page, A. M., Nicoll, J. A. R., Perry, V. H., & Weller, R. O. (2008) · Neuropathology and Applied Neurobiology · doi:10.1111/j.1365-2990.2007.00926.x · Cited by 665 · see citing works

Cervical lymphatics, the blood-brain barrier and the immunoreactivity of the brain: a new view

Cserr, H. F., & Knopf, P. M. (1992) · Immunology Today · doi:10.1016/0167-5699(92)90027-5 · Cited by 648 · see citing works

Results from a phase 1 study of nusinersen (ISIS-SMN Rx ) in children with spinal muscular atrophy

Chiriboga, C. A., Swoboda, K. J., Darras, B. T., Iannaccone, S. T., Montes, J., Vivo, D. C. D., Norris, D. A., Bennett, C. F., & Bishop, K. M. (2016) · Neurology · doi:10.1212/wnl.0000000000002445 · Cited by 613 · see citing works

The role of brain barriers in fluid movement in the CNS: is there a ‘glymphatic’ system?

Abbott, N. J., Pizzo, M. E., Preston, J. E., Janigro, D., & Thorne, R. G. (2018) · Acta Neuropathologica · doi:10.1007/s00401-018-1812-4 · Cited by 593 · see citing works

Evidence of connections between cerebrospinal fluid and nasal lymphatic vessels in humans, non-human primates and other mammalian species

Johnston, M., Zakharov, A., Papaiconomou, C., Salmasi, G., & Armstrong, D. (2004) · Cerebrospinal Fluid Research · doi:10.1186/1743-8454-1-2 · Cited by 572 · see citing works

CSF drains directly from the subarachnoid space into nasal lymphatics in the rat. Anatomy, histology and immunological significance

Kida, S., Pantazis, A., & Weller, R. O. (1993) · Neuropathology and Applied Neurobiology · doi:10.1111/j.1365-2990.1993.tb00476.x · Cited by 520 · see citing works

Interrelationships of the pia mater and the perivascular (Virchow-Robin) spaces in the human cerebrum.

(1990) · Europe PMC (PubMed Central) · Cited by 463 · see citing works

Vascular, glial, and lymphatic immune gateways of the central nervous system

Engelhardt, B., Carare, R. O., Bechmann, I., Flügel, A., Laman, J. D., & Weller, R. O. (2016) · Acta Neuropathologica · doi:10.1007/s00401-016-1606-5 · Cited by 362 · see citing works

Test of the 'glymphatic' hypothesis demonstrates diffusive and aquaporin-4-independent solute transport in rodent brain parenchyma

Smith, A. J., Yao, X., Dix, J. A., Jin, B.-J., & Verkman, A. S. (2017) · eLife · doi:10.7554/elife.27679 · Cited by 362 · see citing works

Drainage of interstitial fluid from different regions of rat brain

Szentistvanyi, I., Patlak, C. S., Ellis, R. A., & Cserr, H. F. (1984) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.1984.246.6.f835 · Cited by 355 · see citing works

Vascular basement membranes as pathways for the passage of fluid into and out of the brain

Morris, A. W. J., Sharp, M. M., Albargothy, N. J., Fernandes, R., Hawkes, C. A., Verma, A., Weller, R. O., & Carare, R. O. (2016) · Acta Neuropathologica · doi:10.1007/s00401-016-1555-z · Cited by 289 · see citing works

Intrathecal antibody distribution in the rat brain: surface diffusion, perivascular transport and osmotic enhancement of delivery

Pizzo, M. E., Wolak, D. J., Kumar, N. N., Brunette, E., Brunnquell, C. L., Hannocks, M., Abbott, N. J., Meyerand, M. E., Sorokin, L., Stanimirovic, D. B., et al. (2018) · The Journal of Physiology · doi:10.1113/jp275105 · Cited by 272 · see citing works

Interstitial fluid drainage is impaired in ischemic stroke and Alzheimer’s disease mouse models

Arbel‐Ornath, M., Hudry, E., Eikermann‐Haerter, K., Hou, S. S., Gregory, J. L., Zhao, L., Betensky, R. A., Frosch, M. P., Greenberg, S. M., & Bacskai, B. J. (2013) · Acta Neuropathologica · doi:10.1007/s00401-013-1145-2 · Cited by 256 · see citing works

Capillary and arterial cerebral amyloid angiopathy in Alzheimer's disease: defining the perivascular route for the elimination of amyloid β from the human brain

Preston, S., Steart, P. V., Wilkinson, A., Nicoll, J. A. R., & Weller, R. O. (2003) · Neuropathology and Applied Neurobiology · doi:10.1046/j.1365-2990.2003.00424.x · Cited by 238 · see citing works

Analysis of the brain mural cell transcriptome

He, L., Vanlandewijck, M., Raschperger, E., Andaloussi Mäe, M., Jung, B., Lebouvier, T., Ando, K., Hofmann, J., Keller, A., & Betsholtz, C. (2016) · Scientific Reports · doi:10.1038/srep35108 · Cited by 233 · see citing works

The meninges as barriers and facilitators for the movement of fluid, cells and pathogens related to the rodent and human CNS.

Weller, R. O., Sharp, M. M., Christodoulides, M., Carare, R. O., & Møllgård, K. (2018) · Acta Neuropathologica · doi:10.1007/s00401-018-1809-z · Cited by 222 · cited 2× · see citing works

Perivascular spaces in the basal ganglia of the human brain: their relationship to lacunes

POLLOCK, H., HUTCHINGS, M., WELLER, R. O., & ZHANG, E. (1997) · Journal of Anatomy · doi:10.1046/j.1469-7580.1997.19130337.x · Cited by 220 · see citing works

Review: Cerebral amyloid angiopathy, prion angiopathy, <scp>CADASIL</scp> and the spectrum of protein elimination failure angiopathies (<scp>PEFA</scp>) in neurodegenerative disease with a focus on therapy

Carare, R. O., Hawkes, C. A., Jeffrey, M., Kalaria, R. N., & Weller, R. O. (2013) · Neuropathology and Applied Neurobiology · doi:10.1111/nan.12042 · Cited by 207 · see citing works

Molecular characterization of perivascular drainage pathways in the murine brain

Hannocks, M.-J., Pizzo, M. E., Huppert, J., Deshpande, T., Abbott, N. J., Thorne, R. G., & Sorokin, L. (2018) · Journal of Cerebral Blood Flow &amp; Metabolism · doi:10.1177/0271678x17749689 · Cited by 201 · see citing works

Deposition of amyloid β in the walls of human leptomeningeal arteries in relation to perivascular drainage pathways in cerebral amyloid angiopathy

Keable, A., Fenna, K., Yuen, H. M., Johnston, D. A., Smyth, N. R., Smith, C., Salman, R. A., Samarasekera, N., Nicoll, J. A. R., Attems, J., et al. (2015) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2015.08.024 · Cited by 179 · see citing works

Albumin outflow into deep cervical lymph from different regions of rabbit brain

Yamada, S., Depasquale, M. J., Patlak, C. S., & Cserr, H. F. (1991) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.1991.261.4.h1197 · Cited by 165 · see citing works

Failure of Perivascular Drainage of β‐amyloid in Cerebral Amyloid Angiopathy

Hawkes, C. A., Jayakody, N., Johnston, D. A., Bechmann, I., & Carare, R. O. (2014) · Brain Pathology · doi:10.1111/bpa.12159 · Cited by 164 · see citing works

?-Amyloid formation by myocytes of leptomeningeal vessels

Wisniewski, H. M., & Węgiel, J. (1994) · Acta Neuropathologica · doi:10.1007/bf00296738 · Cited by 162 · see citing works

The “glymphatic” mechanism for solute clearance in Alzheimer's disease: game changer or unproven speculation?

Smith, A. J., & Verkman, A. S. (2017) · The FASEB Journal · doi:10.1096/fj.201700999 · Cited by 160 · see citing works

Non-Fibrillar β-Amyloid Protein is Associated with Smooth Muscle Cells of Vessel Walls in Alzheimer Disease

Frackowiak, J., Żółtowska, A., & Wı́sniewski, H. M. (1994) · Journal of Neuropathology & Experimental Neurology · doi:10.1097/00005072-199411000-00011 · Cited by 128 · see citing works

Amyloid β‐proteins 1—40 and 1—42(43) in the soluble fraction of extra‐ and intracranial blood vessels

Shinkai, Y., Yoshimura, M., Ito, Y., Odaka, A., Suzuki, N., Yanagisawa, K., & Ihara, Y. (1995) · Annals of Neurology · doi:10.1002/ana.410380312 · Cited by 127 · see citing works

Baseline results of the Neuro NEXT spinal muscular atrophy infant biomarker study

Kolb, S. J., Coffey, C. S., Yankey, J. W., Krosschell, K. J., Arnold, W. D., Rutkove, S. B., Swoboda, K. J., Reyna, S. P., Sakonju, A., Darras, B. T., et al. (2016) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.283 · Cited by 126 · see citing works

Physiology of the Intrathecal Bolus: The Leptomeningeal Route for Macromolecule and Particle Delivery to CNS

Papisov, M. I., Belov, V. V., & Gannon, K. S. (2013) · Molecular Pharmaceutics · doi:10.1021/mp300474m · Cited by 97 · see citing works

Preclinical amyloid pathology biomarker positivity: effects on tau pathology and neurodegeneration

Höglund, K., Kern, S., Zettergren, A., Börjesson‐Hanson, A., Zetterberg, H., Skoog, I. G., & Blennow, K. (2017) · Translational Psychiatry · doi:10.1038/tp.2016.252 · Cited by 72 · see citing works

Evidence for lymphatic Aβ clearance in Alzheimer's transgenic mice

Pappolla, M., Sambamurti, K., Vidal, R., Pacheco-Quinto, J., Poeggeler, B., & Matsubara, E. (2014) · Neurobiology of Disease · doi:10.1016/j.nbd.2014.07.012 · Cited by 69 · see citing works

Vascular laminins in physiology and pathology

Russo, J. D., Hannocks, M., Luik, A., Song, J., Zhang, X., Yousif, L. F., Aspite, G., Hallmann, R., & Sorokin, L. M. (2016) · Matrix Biology · doi:10.1016/j.matbio.2016.06.008 · Cited by 62 · see citing works

Topography and Determinants of Magnetic Resonance Imaging (MRI)‐Visible Perivascular Spaces in a Large Memory Clinic Cohort

Shams, S., Martola, J., Charidimou, A., Larvie, M., Granberg, T., Shams, M., Wiberg, M. K., & Wahlund, L. (2017) · Journal of the American Heart Association · doi:10.1161/jaha.117.006279 · Cited by 56 · see citing works

The fine anatomy of the perivascular compartment in the human brain: relevance to dilated perivascular spaces in cerebral amyloid angiopathy

Sharp, M. M., Bulters, D. O., Brandner, S., Holton, J. L., Verma, A., Werring, D. J., & Carare, R. O. (2018) · Neuropathology and Applied Neurobiology · doi:10.1111/nan.12480 · Cited by 30 · see citing works

Cervical lymph nodes are found in direct relationship with the internal carotid artery: Significance for the lymphatic drainage of the brain

Clapham, R., O’Sullivan, E. P., Weller, R. O., & Carare, R. O. (2009) · Clinical Anatomy · doi:10.1002/ca.20887 · Cited by 27 · see citing works

The perivascular pathways for influx of cerebrospinal fluid are most efficient in the midbrain

Dobson, H., Sharp, M. M., Cumpsty, R., Criswell, T. P., Wellman, T., Finucane, C., Sullivan, J. M., Weller, R. O., Verma, A., & Carare, R. O. (2017) · Clinical Science · doi:10.1042/cs20171265 · Cited by 27 · see citing works

Molecular and cellular mechanisms underlying the pathogenesis of Alzheimer’s disease

Guo, T., Zhang, D., Zeng, Y., Huang, T. Y., Xu, H., & Zhao, Y. (2020) · Molecular Neurodegeneration · doi:10.1186/s13024-020-00391-7 · Cited by 994 · see citing works

Cerebral amyloid angiopathy and Alzheimer disease — one peptide, two pathways

Greenberg, S. M., Bacskai, B. J., Hernandez-Guillamon, M., Pruzin, J., Sperling, R., & van Veluw, S. J. (2020) · Nature Reviews Neurology · doi:10.1038/s41582-019-0281-2 · Cited by 947 · see citing works

Perivascular spaces in the brain: anatomy, physiology and pathology

Wardlaw, J. M., Benveniste, H., Nedergaard, M., Zlokovic, B. V., Mestre, H., Lee, H., Doubal, F. N., Brown, R., Ramirez, J., MacIntosh, B. J., et al. (2020) · Nature Reviews Neurology · doi:10.1038/s41582-020-0312-z · Cited by 870 · see citing works

The Brain’s Glymphatic System: Current Controversies

Mestre, H., Mori, Y., & Nedergaard, M. (2020) · Trends in Neurosciences · doi:10.1016/j.tins.2020.04.003 · Cited by 609 · see citing works

Fluid transport in the brain

Rasmussen, M. K., Mestre, H., & Nedergaard, M. (2021) · Physiological Reviews · doi:10.1152/physrev.00031.2020 · Cited by 622 · see citing works

Vasomotion as a Driving Force for Paravascular Clearance in the Awake Mouse Brain

van Veluw, S. J., Hou, S. S., Calvo-Rodríguez, M., Arbel‐Ornath, M., Snyder, A. C., Frosch, M. P., Greenberg, S. M., & Bacskai, B. J. (2019) · Neuron · doi:10.1016/j.neuron.2019.10.033 · Cited by 492 · see citing works

Glymphatic System Impairment in Alzheimer’s Disease and Idiopathic Normal Pressure Hydrocephalus

Reeves, B. C., Karimy, J. K., Kundishora, A. J., Mestre, H., Cerci, H. M., Matouk, C., Alper, S. L., Lundgaard, I., Nedergaard, M., & Kahle, K. T. (2020) · Trends in Molecular Medicine · doi:10.1016/j.molmed.2019.11.008 · Cited by 403 · see citing works

The glymphatic system: Current understanding and modeling

Bohr, T., Hjorth, P. G., Holst, S. C., Hrabětová, S., Kiviniemi, V. J., Lilius, T. O., Lundgaard, I., Mardal, K., Martens, E. A., Mori, Y., et al. (2022) · iScience · doi:10.1016/j.isci.2022.104987 · Cited by 381 · see citing works

Pathophysiology and probable etiology of cerebral small vessel disease in vascular dementia and Alzheimer’s disease

Inoue, Y., Shue, F., Bu, G., & Kanekiyo, T. (2023) · Molecular Neurodegeneration · doi:10.1186/s13024-023-00640-5 · Cited by 356 · see citing works

Cerebrovascular Smooth Muscle Cells as the Drivers of Intramural Periarterial Drainage of the Brain

Aldea, R., Weller, R. O., Wilcock, D. M., Carare, R. O., & Richardson, G. W. (2019) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2019.00001 · Cited by 335 · see citing works

Neurofilaments: neurobiological foundations for biomarker applications

Gafson, A., Barthélemy, N. R., Bomont, P., Carare, R. O., Durham, H. D., Julien, J., Kühle, J., Leppert, D., Nixon, R. A., Weller, R. O., et al. (2020) · Brain · doi:10.1093/brain/awaa098 · Cited by 327 · see citing works

Neurofilament Proteins as Biomarkers to Monitor Neurological Diseases and the Efficacy of Therapies

Yuan, A., & Nixon, R. A. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.689938 · Cited by 290 · see citing works

Glymphatic system impairment in multiple sclerosis: relation with brain damage and disability

Carotenuto, A., Cacciaguerra, L., Pagani, E., Preziosa, P., Filippi, M., & Rocca, M. A. (2021) · Brain · doi:10.1093/brain/awab454 · Cited by 280 · see citing works

The glymphatic hypothesis: the theory and the evidence

Hladky, S. B., & Barrand, M. A. (2022) · Fluids and Barriers of the CNS · doi:10.1186/s12987-021-00282-z · Cited by 271 · see citing works

Glymphatic imaging using MRI

Taoka, T., & Naganawa, S. (2019) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.26892 · Cited by 243 · see citing works

Rapid lymphatic efflux limits cerebrospinal fluid flow to the brain

Ma, Q., Ries, M., Decker, Y., Müller, A., Riner, C., Bücker, A., Fassbender, K., Detmar, M., & Proulx, S. T. (2019) · Acta Neuropathologica · doi:10.1007/s00401-018-1916-x · Cited by 210 · see citing works

Elimination of substances from the brain parenchyma: efflux via perivascular pathways and via the blood–brain barrier

Hladky, S. B., & Barrand, M. A. (2018) · Fluids and Barriers of the CNS · doi:10.1186/s12987-018-0113-6 · Cited by 206 · see citing works

Dysfunction of the blood–brain barrier in Alzheimer's disease: Evidence from human studies

Kurz, C., Walker, L., Rauchmann, B., & Perneczky, R. (2022) · Neuropathology and Applied Neurobiology · doi:10.1111/nan.12782 · Cited by 183 · see citing works

Perivascular spaces and brain waste clearance systems: relevance for neurodegenerative and cerebrovascular pathology

Gouveia-Freitas, K., & de Bastos-Leite, A. J. (2021) · Neuroradiology · doi:10.1007/s00234-021-02718-7 · Cited by 161 · see citing works

The Neurovasculome: Key Roles in Brain Health and Cognitive Impairment: A Scientific Statement From the American Heart Association/American Stroke Association

Iadecola, C., Smith, E. E., Anrather, J., Gu, C., Mishra, A., Misra, S., Pérez‐Pinzón, M. A., Shih, A. Y., Sorond, F. A., van Veluw, S. J., et al. (2023) · Stroke · doi:10.1161/str.0000000000000431 · Cited by 156 · see citing works

Neurofilament Light Chain as Biomarker for Amyotrophic Lateral Sclerosis and Frontotemporal Dementia

Verde, F., Otto, M., & Silani, V. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.679199 · Cited by 152 · see citing works

Sleep cycle-dependent vascular dynamics in male mice and the predicted effects on perivascular cerebrospinal fluid flow and solute transport

Bojarskaite, L., Vallet, A., Bjørnstad, D. M., Gullestad Binder, K. M., Cunen, C., Heuser, K., Kuchta, M., Mardal, K.-A., & Enger, R. (2023) · Nature Communications · doi:10.1038/s41467-023-36643-5 · Cited by 149 · see citing works

Emerging links between cerebrovascular and neurodegenerative diseases—a special role for pericytes

Lendahl, U., Nilsson, P., & Betsholtz, C. (2019) · EMBO Reports · doi:10.15252/embr.201948070 · Cited by 141 · see citing works

Blood biomarkers for mild traumatic brain injury: a selective review of unresolved issues

Hier, D. B., Obafemi-Ajayi, T., Thimgan, M. S., Olbricht, G. R., Azizi, S., Allen, B., Hadi, B., & Wunsch, D. C. (2021) · Biomarker Research · doi:10.1186/s40364-021-00325-5 · Cited by 130 · see citing works

Dynamic ¹¹ C-PiB PET Shows Cerebrospinal Fluid Flow Alterations in Alzheimer Disease and Multiple Sclerosis

Schubert, J. J., Veronese, M., Marchitelli, L., Bodini, B., Tonietto, M., Stankoff, B., Brooks, D. J., Bertoldo, A., Edison, P., & Turkheimer, F. E. (2019) · Journal of Nuclear Medicine · doi:10.2967/jnumed.118.223834 · Cited by 121 · see citing works

Frontotemporal Dementia, Where Do We Stand? A Narrative Review

Antonioni, A., Raho, E. M., Lopriore, P., Pace, A. P., Latino, R. R., Assogna, M., Mancuso, M., Gragnaniello, D., Granieri, E., Pugliatti, M., et al. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms241411732 · Cited by 133 · see citing works

The pathogenesis of cerebral small vessel disease and vascular cognitive impairment

Markus, H. S., & Joutel, A. (2025) · Physiological Reviews · doi:10.1152/physrev.00028.2024 · Cited by 130 · see citing works

The Glymphatic System: A Review of the Challenges in Visualizing its Structure and Function with MR Imaging

Naganawa, S., & Taoka, T. (2020) · Magnetic Resonance in Medical Sciences · doi:10.2463/mrms.rev.2020-0122 · Cited by 120 · see citing works

Brain pharmacology of intrathecal antisense oligonucleotides revealed through multimodal imaging

Mazur, C., Powers, B., Zasadny, K., Sullivan, J. M., Dimant, H., Kamme, F., Hesterman, J., Matson, J., Oestergaard, M., Seaman, M., et al. (2019) · JCI Insight · doi:10.1172/jci.insight.129240 · Cited by 114 · see citing works

Perivascular and Perineural Pathways Involved in Brain Delivery and Distribution of Drugs after Intranasal Administration

Lochhead, J. J., & Davis, T. P. (2019) · Pharmaceutics · doi:10.3390/pharmaceutics11110598 · Cited by 108 · see citing works

Convection-Enhanced Delivery: Connection to and Impact of Interstitial Fluid Flow

Stine, C. A., & Munson, J. M. (2019) · Frontiers in Oncology · doi:10.3389/fonc.2019.00966 · Cited by 107 · see citing works

Physiology and Clinical Relevance of Enlarged Perivascular Spaces in the Aging Brain

Bown, C. W., Carare, R. O., Schrag, M., & Jefferson, A. L. (2021) · Neurology · doi:10.1212/wnl.0000000000013077 · Cited by 106 · see citing works

Decreased CSF clearance and increased brain amyloid in Alzheimer’s disease

Li, Y., Rusinek, H., Butler, T., Glodzik, L., Pirraglia, E., Babich, J. W., Mozley, P. D., Nehmeh, S. A., Pahlajani, S. S., Wang, X. H., et al. (2022) · Fluids and Barriers of the CNS · doi:10.1186/s12987-022-00318-y · Cited by 105 · see citing works

Cerebrospinal Fluid Flow

Kelley, D. H., & Thomas, J. H. (2022) · Annual Review of Fluid Mechanics · doi:10.1146/annurev-fluid-120720-011638 · Cited by 106 · see citing works

Waste Clearance in the Brain

Kaur, J., Fahmy, L. M., Davoodi‐Bojd, E., Zhang, L., Ding, G., Hu, J., Zhang, Z., Chopp, M., & Jiang, Q. (2021) · Frontiers in Neuroanatomy · doi:10.3389/fnana.2021.665803 · Cited by 104 · see citing works

Aquaporin-4 reduces neuropathology in a mouse model of Alzheimer’s disease by remodeling peri-plaque astrocyte structure

Smith, A. J., Duan, T., & Verkman, A. S. (2019) · Acta Neuropathologica Communications · doi:10.1186/s40478-019-0728-0 · Cited by 97 · see citing works

The meningeal lymphatic vessels and the glymphatic system: Potential therapeutic targets in neurological disorders

Li, G., Cao, Y., Tang, X., Huang, J., Cai, L., & Zhou, L. (2022) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1177/0271678x221098145 · Cited by 99 · see citing works

Brain perivascular macrophages: Recent advances and implications in health and diseases

Yang, T., Guo, R., & Zhang, F. (2019) · CNS Neuroscience &amp; Therapeutics · doi:10.1111/cns.13263 · Cited by 97 · see citing works

Periarteriolar spaces modulate cerebrospinal fluid transport into brain and demonstrate altered morphology in aging and Alzheimer’s disease

Mestre, H., Verma, N., Greene, T. D., Lin, L. A., Ladrón-de-Guevara, A., Sweeney, A. M., Liu, G., Thomas, V. K., Galloway, C. A., Bentley, K. L. D. M., et al. (2022) · Nature Communications · doi:10.1038/s41467-022-31257-9 · Cited by 94 · see citing works

The relationship between amyloid-beta and brain capillary endothelial cells in Alzheimer’s disease

Su, Q., Guo, J.-H., Zhang, Y.-L., Wang, J., & Zhang, Z.-N. (2022) · Neural Regeneration Research · doi:10.4103/1673-5374.335829 · Cited by 91 · see citing works

Are Porphyromonas gingivalis Outer Membrane Vesicles Microbullets for Sporadic Alzheimer’s Disease Manifestation?

Singhrao, S. K., & Olsen, I. (2018) · Journal of Alzheimer s Disease Reports · doi:10.3233/adr-180080 · Cited by 90 · see citing works

Subdural haematomas drain into the extracranial lymphatic system through the meningeal lymphatic vessels

Liu, X., Gao, C., Yuan, J., Xiang, T., Gong, Z., Luo, H., Jiang, W., Song, Y., Huang, J., Quan, W., et al. (2020) · Acta Neuropathologica Communications · doi:10.1186/s40478-020-0888-y · Cited by 88 · see citing works

Glymphatic dysfunction in Alzheimer’s disease: A critical appraisal

Keil, S. A., Jansson, D., Braun, M., & Iliff, J. J. (2025) · Science · doi:10.1126/science.adv8269 · Cited by 96 · see citing works

Ultra-long-TE arterial spin labeling reveals rapid and brain-wide blood-to-CSF water transport in humans

Petitclerc, L., Hirschler, L., Wells, J. A., Thomas, D. L., van Walderveen, M. A. A., van Buchem, M. A., & van Osch, M. J. P. (2021) · NeuroImage · doi:10.1016/j.neuroimage.2021.118755 · Cited by 81 · see citing works

The role of glymphatic system in the cerebral edema formation after ischemic stroke

Ji, C., Yu, X., Xu, W., Lenahan, C., Tu, S., & Shao, A. (2021) · Experimental Neurology · doi:10.1016/j.expneurol.2021.113685 · Cited by 82 · see citing works

The mechanisms behind perivascular fluid flow

Daversin, C., Vinje, V., Mardal, K., & Rognes, M. E. (2020) · PLoS ONE · doi:10.1371/journal.pone.0244442 · Cited by 79 · see citing works

Central nervous system zoning: How brain barriers establish subdivisions for CNS immune privilege and immune surveillance

Proulx, S. T., & Engelhardt, B. (2022) · Journal of Internal Medicine · doi:10.1111/joim.13469 · Cited by 83 · see citing works

Border-associated macrophages promote cerebral amyloid angiopathy and cognitive impairment through vascular oxidative stress

Uekawa, K., Hattori, Y., Ahn, S. J., Seo, J., Casey, N., Anfray, A., Zhou, P., Luo, W., Anrather, J., Park, L., et al. (2023) · Molecular Neurodegeneration · doi:10.1186/s13024-023-00660-1 · Cited by 80 · see citing works

Cerebral Microcirculation, Perivascular Unit, and Glymphatic System: Role of Aquaporin-4 as the Gatekeeper for Water Homeostasis

Szczygielski, J., Kopańska, M., Wysocka, A., & Oertel, J. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.767470 · Cited by 78 · see citing works

Structural and Functional Remodeling of the Brain Vasculature Following Stroke

Andrade, M. F., Raman‐Nair, J., & Lacoste, B. (2020) · Frontiers in Physiology · doi:10.3389/fphys.2020.00948 · Cited by 78 · see citing works

Cerebral amyloid angiopathy aggravates perivascular clearance impairment in an Alzheimer’s disease mouse model

Kim, S. H., Ahn, J. H., Yang, H. J., Lee, P., Koh, G. Y., & Jeong, Y. (2020) · Acta Neuropathologica Communications · doi:10.1186/s40478-020-01042-0 · Cited by 76 · see citing works

Cerebral amyloid angiopathy is associated with glymphatic transport reduction and time-delayed solute drainage along the neck arteries

Chen, X., Liu, X., Koundal, S., Elkin, R., Zhu, X. A., Monte, B., Xu, F., Dai, F., Pedram, M., Lee, H., et al. (2022) · Nature Aging · doi:10.1038/s43587-022-00181-4 · Cited by 78 · see citing works

Basal lamina changes in neurodegenerative disorders

Nguyen, B., Bix, G., & Yao, Y. (2021) · Molecular Neurodegeneration · doi:10.1186/s13024-021-00502-y · Cited by 75 · see citing works

Clearance of interstitial fluid (ISF) and CSF (CLIC) group—part of Vascular Professional Interest Area (PIA)

Carare, R. O., Aldea, R., Agarwal, N., Bacskai, B. J., Bechman, I., Boche, D., Bu, G., Bulters, D. O., Alt, C., Counts, S., et al. (2020) · Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring · doi:10.1002/dad2.12053 · Cited by 76 · see citing works

The microcirculation, the blood-brain barrier, and the neurovascular unit in health and Alzheimer disease: The aberrant pericyte is a central player

Divecha, Y. A., Rampes, S., Tromp, S., Boyanova, S., Fleckney, A. L., Fidanboylu, M., & Thomas, S. A. (2025) · Pharmacological Reviews · doi:10.1016/j.pharmr.2025.100052 · Cited by 79 · see citing works

Fluid Flow and Mass Transport in Brain Tissue

Ray, L., & Heys, J. J. (2019) · Fluids · doi:10.3390/fluids4040196 · Cited by 75 · see citing works

Dissecting the Crosstalk between Endothelial Mitochondrial Damage, Vascular Inflammation, and Neurodegeneration in Cerebral Amyloid Angiopathy and Alzheimer’s Disease

Parodi‐Rullán, R. M., Javadov, S. A., & Fossati, S. (2021) · Cells · doi:10.3390/cells10112903 · Cited by 75 · see citing works

Direct imaging of glymphatic transport using H217O MRI

Alshuhri, M. S., Gallagher, L., Work, L. M., & Holmes, W. M. (2021) · JCI Insight · doi:10.1172/jci.insight.141159 · Cited by 74 · see citing works

Cerebrospinal Fluid Biomarkers in Cerebral Amyloid Angiopathy

Banerjee, G., Ambler, G., Keshavan, A., Paterson, R. W., Foiani, M. S., Toombs, J., Heslegrave, A., Dickson, J. C., Fraioli, F., Groves, A. M., et al. (2020) · Journal of Alzheimer s Disease · doi:10.3233/jad-191254 · Cited by 72 · see citing works

Functional hyperemia drives fluid exchange in the paravascular space

Kedarasetti, R. T., Turner, K. L., Echagarruga, C., Gluckman, B. J., Drew, P. J., & Costanzo, F. (2020) · Fluids and Barriers of the CNS · doi:10.1186/s12987-020-00214-3 · Cited by 70 · see citing works

Inflammation and neural repair after ischemic brain injury

Sakai, S., & Shichita, T. (2018) · Neurochemistry International · doi:10.1016/j.neuint.2018.10.013 · Cited by 67 · see citing works

Inhibition of Aquaporin 4 Decreases Amyloid Aβ40 Drainage Around Cerebral Vessels

Roşu, G. C., Cătălin, B., Bălşeanu, T. A., Mogoantă, L., Mărgăritescu, C., Kumar‐Singh, S., & Pirici, D. N. (2020) · Molecular Neurobiology · doi:10.1007/s12035-020-02044-8 · Cited by 65 · see citing works

Retention of Gadolinium in Brain Parenchyma: Pathways for Speciation, Access, and Distribution. A Critical Review

Rasschaert, M., Weller, R. O., Schroeder, J. A., Brochhausen, C., & Idée, J. (2020) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.27124 · Cited by 64 · see citing works

Enlarged Perivascular Spaces and Dementia: A Systematic Review

Smeijer, J. D., Ikram, M. K., & Hilal, S. (2019) · Journal of Alzheimer s Disease · doi:10.3233/jad-190527 · Cited by 63 · see citing works

Glymphatic dysfunction correlates with severity of small vessel disease and cognitive impairment in cerebral amyloid angiopathy

Xu, J., Su, Y., Fu, J., Wang, X., Nguchu, B. A., Qiu, B., Dong, Q., & Cheng, X. (2022) · European Journal of Neurology · doi:10.1111/ene.15450 · Cited by 61 · see citing works

Neurofilament Light Chain (NfL) in Blood—A Biomarker Predicting Unfavourable Outcome in the Acute Phase and Improvement in the Late Phase after Stroke

Pekny, M., Wilhelmsson, U., Stokowska, A., Tatlisumak, T., Jood, K., & Pekna, M. (2021) · Cells · doi:10.3390/cells10061537 · Cited by 60 · see citing works

Cerebral Amyloid Angiopathy and Blood-Brain Barrier Dysfunction

Gireud, M., Mack, A. F., McCullough, L. D., & Urayama, A. (2020) · The Neuroscientist · doi:10.1177/1073858420954811 · Cited by 61 · see citing works

Physiology of Glymphatic Solute Transport and Waste Clearance from the Brain

Zhao, L., Tannenbaum, A., Bakker, E. N. T. P., & Benveniste, H. (2022) · Physiology · doi:10.1152/physiol.00015.2022 · Cited by 61 · see citing works

A Kinetic Model for Blood Biomarker Levels After Mild Traumatic Brain Injury

Azizi, S., Hier, D. B., Allen, B., Obafemi-Ajayi, T., Olbricht, G. R., Thimgan, M. S., & Wunsch, D. C. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.668606 · Cited by 58 · see citing works

Glymphatic clearance estimated using diffusion tensor imaging along perivascular spaces is reduced after traumatic brain injury and correlates with plasma neurofilament light, a biomarker of injury severity

Butler, T., Zhou, L., Özşahin, İ., Wang, X. H., Garetti, J., Zetterberg, H., Blennow, K., Jamison, K. W., de Leon, M. J., Li, Y., et al. (2023) · Brain Communications · doi:10.1093/braincomms/fcad134 · Cited by 60 · see citing works

The Brain-Nose Interface: A Potential Cerebrospinal Fluid Clearance Site in Humans

Mehta, N. H., Sherbansky, J., Kamer, A. R., Carare, R. O., Butler, T., Rusinek, H., Chiang, G. C.-Y., Li, Y., Strauß, S., Saint-Louis, L. A., et al. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2021.769948 · Cited by 58 · see citing works

The Pattern of AQP4 Expression in the Ageing Human Brain and in Cerebral Amyloid Angiopathy

Owasil, R., O’Neill, R., Keable, A., Nimmo, J., Sharp, M. M., Kelly, L., Saitô, S., Simpson, J. E., Weller, R. O., Smith, C., et al. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21041225 · Cited by 52 · see citing works

Regulation of brain fluid volumes and pressures: basic principles, intracranial hypertension, ventriculomegaly and hydrocephalus

Hladky, S. B., & Barrand, M. A. (2024) · Fluids and Barriers of the CNS · doi:10.1186/s12987-024-00532-w · Cited by 58 · see citing works

The Role of Basement Membranes in Cerebral Amyloid Angiopathy

Howe, M. D., McCullough, L. D., & Urayama, A. (2020) · Frontiers in Physiology · doi:10.3389/fphys.2020.601320 · Cited by 49 · see citing works

Physiological and Pathological Factors Affecting Drug Delivery to the Brain by Nanoparticles

Islam, Y., Leach, A. G., Smith, J. A., Pluchino, S., Coxon, C. R., Sivakumaran, M., Downing, J. R., Fatokun, A. A., Teixidò, M., & Ehtezazi, T. (2021) · Advanced Science · doi:10.1002/advs.202002085 · Cited by 51 · see citing works

FDA‐approved carbonic anhydrase inhibitors reduce amyloid β pathology and improve cognition, by ameliorating cerebrovascular health and glial fitness

Canepa, E., Parodi‐Rullán, R. M., Vázquez‐Torres, R., Gamallo‐Lana, B., Guzman‐Hernandez, R. A., Lemon, N. L., Angiulli, F., Debure, L., Ilies, M. A., Østergaard, L., et al. (2023) · Alzheimer s & Dementia · doi:10.1002/alz.13063 · Cited by 52 · see citing works

Paravascular spaces: entry to or exit from the brain?

Bakker, E. N. T. P., Naessens, D. M. P., & VanBavel, E. (2018) · Experimental Physiology · doi:10.1113/ep087424 · Cited by 49 · see citing works

Uncertainty quantification of parenchymal tracer distribution using random diffusion and convective velocity fields

Croci, M., Vinje, V., & Rognes, M. E. (2019) · Fluids and Barriers of the CNS · doi:10.1186/s12987-019-0152-7 · Cited by 48 · see citing works

Emerging Biomarkers of Multiple Sclerosis in the Blood and the CSF: A Focus on Neurofilaments and Therapeutic Considerations

Biernacki, T., Kokas, Z., Sandi, D., Füvesi, J., Fricska‐Nagy, Z., Faragó, P., Kincses, Z. T., Klivènyi, P., Bencsik, K., & Vécsei, L. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23063383 · Cited by 47 · see citing works

Peristaltic flow in the glymphatic system

Romanò, F., Suresh, V., Galie, P. A., & Grotberg, J. B. (2020) · Scientific Reports · doi:10.1038/s41598-020-77787-4 · Cited by 48 · see citing works

Is CAA a perivascular brain clearance disease? A discussion of the evidence to date and outlook for future studies

van Veluw, S. J., Benveniste, H., Bakker, E. N. T. P., Carare, R. O., Greenberg, S. M., Iliff, J. J., Lorthois, S., Nostrand, W. E. V., Petzold, G. C., Shih, A. Y., et al. (2024) · Cellular and Molecular Life Sciences · doi:10.1007/s00018-024-05277-1 · Cited by 50 · see citing works

CrossTalk opposing view: Going against the flow: interstitial solute transport in brain is diffusive and aquaporin‐4 independent

Smith, A. J., & Verkman, A. S. (2019) · The Journal of Physiology · doi:10.1113/jp277636 · Cited by 51 · see citing works

Long-wavelength traveling waves of vasomotion modulate the perfusion of cortex

Broggini, T., Duckworth, J. C., Ji, X., Liu, R., Xia, X., Mächler, P., Shaked, I., Munting, L. P., Iyengar, S., Kotlikoff, M. I., et al. (2024) · Neuron · doi:10.1016/j.neuron.2024.04.034 · Cited by 44 · see citing works

The blood–CSF–brain route of neurological disease: The indirect pathway into the brain

Cousins, O., Hodges, A., Schubert, J. J., Veronese, M., Turkheimer, F., Miyan, J. A., Engelhardt, B., & Roncaroli, F. (2021) · Neuropathology and Applied Neurobiology · doi:10.1111/nan.12789 · Cited by 44 · see citing works

Low b‐value diffusion tensor imaging for measuring pseudorandom flow of cerebrospinal fluid

Bito, Y., Harada, K., Ochi, H., & Kudo, K. (2021) · Magnetic Resonance in Medicine · doi:10.1002/mrm.28806 · Cited by 44 · see citing works

Apolipoprotein E and clusterin inhibit the early phase of amyloid-β aggregation in an in vitro model of cerebral amyloid angiopathy

Endo, Y., Hasegawa, K., Nomura, R., Arishima, H., Kikuta, K., Yamashita, T., Inoue, Y., Ueda, M., Ando, Y., Wilson, M. R., et al. (2019) · Acta Neuropathologica Communications · doi:10.1186/s40478-019-0662-1 · Cited by 43 · see citing works

Transforming growth factor-β promotes basement membrane fibrosis, alters perivascular cerebrospinal fluid distribution, and worsens neurological recovery in the aged brain after stroke

Howe, M. D., Furr, J. W., Munshi, Y., Roy-O’Reilly, M. A., Maniskas, M. E., Koellhoffer, E. C., d’Aigle, J., Sansing, L. H., McCullough, L. D., & Urayama, A. (2019) · GeroScience · doi:10.1007/s11357-019-00118-7 · Cited by 43 · see citing works

Cerebrospinal Fluid Production and Absorption and Ventricular Enlargement Mechanisms in Hydrocephalus

Yamada, S., & Mase, M. (2023) · Neurologia medico-chirurgica · doi:10.2176/jns-nmc.2022-0331 · Cited by 42 · see citing works

Glymphatic-lymphatic coupling: assessment of the evidence from magnetic resonance imaging of humans

Ringstad, G. A., & Eide, P. K. (2024) · Cellular and Molecular Life Sciences · doi:10.1007/s00018-024-05141-2 · Cited by 42 · see citing works

Crossing borders in Alzheimer’s disease: A T cell’s perspective

van Olst, L., Coenen, L., Nieuwland, J. M., Rodriguez-Mogeda, C., de Wit, N. M., Kamermans, A., Middeldorp, J., & de Vries, H. E. (2022) · Advanced Drug Delivery Reviews · doi:10.1016/j.addr.2022.114398 · Cited by 44 · see citing works

Cerebrospinal fluid: A unique source of circulating tumor DNA with broad clinical applications

Hickman, R. A., Miller, A. M., & Arcila, M. E. (2023) · Translational Oncology · doi:10.1016/j.tranon.2023.101688 · Cited by 41 · see citing works

A control mechanism for intra-mural peri-arterial drainage via astrocytes: How neuronal activity could improve waste clearance from the brain

Diem, A. K., Carare, R. O., Weller, R. O., & Bressloff, N. W. (2018) · PLoS ONE · doi:10.1371/journal.pone.0205276 · Cited by 40 · see citing works

Subpial Hemorrhage in Neonates: What Radiologists Need to Know

Barreto, A. R. F., Carrasco, M., Dabrowski, A. K., Sun, L. R., & Tekes, A. (2021) · American Journal of Roentgenology · doi:10.2214/ajr.20.22999 · Cited by 40 · see citing works

The lymphatic system: a therapeutic target for central nervous system disorders

Lü, H., Cao, Y., Hu, J., Xu, J., Liu, Q., Huang, S., & Duan, C. (2022) · Neural Regeneration Research · doi:10.4103/1673-5374.355741 · Cited by 39 · see citing works

Cerebral hemorrhagic stroke associated with cerebral amyloid angiopathy in young adults about 3 decades after neurosurgeries in their infancy

Hamaguchi, T., Komatsu, J., Sakai, K., Noguchi‐Shinohara, M., Aoki, S., Ikeuchi, T., & Yamada, M. (2019) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2019.01.051 · Cited by 39 · see citing works

3D Multi-Resolution Optical Flow Analysis of Cardiovascular Pulse Propagation in Human Brain

Rajna, Z., Raitamaa, L., Tuovinen, T., Heikkilä, J., Kiviniemi, V. J., & Seppänen, T. (2019) · IEEE Transactions on Medical Imaging · doi:10.1109/tmi.2019.2904762 · Cited by 39 · see citing works

Antigen-Dependent T Cell Response to Neural Peptides After Human Ischemic Stroke

Miró‐Mur, F., Urra, X., Ruíz-Jaén, F., Pedragosa, J., Chamorro, Á., & Planas, A. M. (2020) · Frontiers in Cellular Neuroscience · doi:10.3389/fncel.2020.00206 · Cited by 38 · see citing works

Role of alarmins in poststroke inflammation and neuronal repair

Sakai, S., & Shichita, T. (2022) · Seminars in Immunopathology · doi:10.1007/s00281-022-00961-5 · Cited by 38 · see citing works

Engorgement of Deep Medullary Veins in Neurosarcoidosis: A Common-Yet-Underrecognized Cerebrovascular Finding on SWI

Zamora, C. A., Hung, S., Tomingas, C., Atkinson, C., & Castillo, M. (2018) · American Journal of Neuroradiology · doi:10.3174/ajnr.a5783 · Cited by 37 · see citing works

Monomeric C‐reactive protein: A novel biomarker predicting neurodegenerative disease and vascular dysfunction

Pastorello, Y., Carare, R. O., Bănescu, C. V., Potempa, L. A., Napoli, M. D., & SLEVIN, M. A. (2023) · Brain Pathology · doi:10.1111/bpa.13164 · Cited by 36 · see citing works

F1‐03‐01: CONVECTIVE INFLUX/GLYMPHATIC SYSTEM: TRACERS INJECTED INTO THE CSF ENTER AND LEAVE THE BRAIN ALONG SEPARATE PERIARTERIAL BASEMENT MEMBRANE PATHWAYS

Albargothy, N. J., Sharp, M. T. M., Johnsotn, D. A., Weller, R. O., Verma, A., Hawkes, C. A., & Carare, R. O. (2018) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2018.06.2311

Solutes, but not cells, drain from the brain parenchyma along basement membranes of capillaries and arteries: significance for cerebral amyloid angiopathy and neuroimmunology

Carare, R. O., Bernardes‐Silva, M., Newman, T. A., Page, A. M., Nicoll, J. A. R., Perry, V. H., & Weller, R. O. (2008) · Neuropathology and Applied Neurobiology · doi:10.1111/j.1365-2990.2007.00926.x · Cited by 665 · see citing works

Connections between perivascular interstitial fluid drainage pathways in the brain: significance for Alzheimer's disease and neuroimmunology

Carare‐Nnadi, R., Bernardes-Silva, M., Subash, M., Perry, V. H., & Weller, R. O. (2006) · ePrints Soton (University of Southampton) · doi:10.1111/j.1365-2990.2006.00749.x · Cited by 3 · see citing works

Vascular basement membranes as pathways for the passage of fluid into and out of the brain

Morris, A. W. J., Sharp, M. M., Albargothy, N. J., Fernandes, R., Hawkes, C. A., Verma, A., Weller, R. O., & Carare, R. O. (2016) · Acta Neuropathologica · doi:10.1007/s00401-016-1555-z · Cited by 289 · see citing works

Pathways of communication between the subarachnoid space and the brain parenchyma : are they relevant to neurodegenerative diseases?

Albargothy, N. J. (2017) · ePrints Soton (University of Southampton)