Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes
Open accessAbstract
Pre-clinical research in rodents provides evidence that the central nervous system (CNS) has functional lymphatic vessels. In-vivo observations in humans, however, are not demonstrated. We here show data on CNS lymphatic drainage to cervical lymph nodes in-vivo by magnetic resonance imaging (MRI) enhanced with an intrathecal contrast agent as a cerebrospinal fluid (CSF) tracer. Standardized MRI of the intracranial compartment and the neck were acquired before and up to 24–48 hours following intrathecal contrast agent administration in 19 individuals. Contrast enhancement was radiologically confirmed by signal changes in CSF nearby inferior frontal gyrus, brain parenchyma of inferior frontal gyrus, parahippocampal gyrus, thalamus and pons, and parenchyma of cervical lymph node, and with sagittal sinus and neck muscle serving as reference tissue for cranial and neck MRI acquisitions, respectively. Time series of changes in signal intensity shows that contrast enhancement within CSF precedes glymphatic enhancement and peaks at 4–6 hours following intrathecal injection. Cervical lymph node enhancement coincides in time with peak glymphatic enhancement, with peak after 24 hours. Our findings provide in-vivo evidence of CSF tracer drainage to cervical lymph nodes in humans. The time course of lymph node enhancement coincided with brain glymphatic enhancement rather than with CSF enhancement.
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The coincidence of neck lymph node and brain tracer enhancement indicates this drainage is from the brain rather than directly from CSF.
“indicating this drainage is from the brain rather than directly from CSF (53).”
From Brain-wide glymphatic enhancement and clearance in humans assessed with MRI. (2018) · cites this paper as [53]
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- Authors
- Eide, P. K., Vatnehol, S. A. S., Emblem, K. E., & Ringstad, G.
- Affiliations
- Oslo University Hospital (NO)
- Corresponding author
- Eide, Per Kristian
- Venue
- Scientific Reports
- Published
- 2018-05-08
- Volume
- 8
- Issue
- 1
- Pages
- 7194-7194
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC5940793
- OpenAlex
- W2801863964
- Cited by
- 299
- References
- 10
- Citations by year
- 2026: 31 · 2025: 38 · 2024: 39 · 2023: 47 · 2022: 44 · 2021: 36 · 2020: 32 · 2019: 23 · 2018: 9
- FWCI
- 11.38
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Cerebrospinal fluid and hydrocephalus
- Health Sciences › Medicine › Oncology › Lymphatic System and Diseases
- Health Sciences › Medicine › Surgery › Lymphatic Disorders and Treatments
- Keywords
- glymphatic system, cerebrospinal fluid drainage, cervical lymph nodes, human brain
- MeSH terms
- Parenchymal Tissue, Glymphatic System, Adult, Aged, Contrast Media, Female, Humans, Hydrocephalus, Injections, Spinal, Lymph Nodes, Lymphatic System, Lymphography, Magnetic Resonance Imaging, Male, Middle Aged, Organometallic Compounds, Pons, Thalamus, Cohort Studies, Arachnoid Cysts, Prefrontal Cortex, Intracranial Hypotension, Intracranial Hypertension, Parahippocampal Gyrus, Lymphatic Vessels
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