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Fig. 1 | Molecular Neurodegeneration

Fig. 1

From: Leveraging the glymphatic and meningeal lymphatic systems as therapeutic strategies in Alzheimer’s disease: an updated overview of nonpharmacological therapies

Fig. 1

The glymphatic and meningeal lymphatic pathways for central solute clearance and their major components. Cerebrospinal fluid (CSF) enters the brain by moving from the subarachnoid space (superior image) into the space surrounding penetrating arteries (i.e., the periarterial or Virchow-Robin space, as shown in the amplified image), mostly driven by the convective force originated from pulsatile penetrating arteries. From the periarterial space, convective and diffusive forces guide the CSF inflow into the brain parenchyma, aided by polarized aquaporin 4 (AQP4) water channels expressed at astrocyte endfeet. CSF moves along the parenchyma towards the perivenous space, mixing with the interstitial fluid (ISF) and carrying the metabolic waste. The respiration cycle has been suggested as the main force driving CSF-ISF movement through the perivenous space. From the perivenous space, CSF-ISF and the metabolic waste exit the brain mostly through the meningeal lymphatic system (green circles, upper image) that drain into the deep cervical lymph nodes, although outflow along the olfactory, cranial, and spinal nerves into other cervical lymph nodes are also observed

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