• María Toriello, Vicente González-Quintanilla, and Julio Pascual.
• Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria e IDIVAL, Santander, España.
• Med Clin (Barc). 2021 Apr 9; 156 (7): 339-343.

AbstractThe central nervous system was thought to be devoid of lymphatics. Recently, the existence of an authentic brain lymphatic system, known as the glymphatic system, composed of paravascular channels penetrating arterial and venous brain vessels and dural lymphatics cleaning the interstitial space, has been demonstrated. Aquaporin-4, located in astrocyte feet attached to the paravascular spaces, plays a key role in the clearance of waste molecules, such as beta-amyloid or tau proteins. The activity of this system is increased during sleep, mainly in the slow wave phase and while sleeping on one side, and with exercise, and is reduced with aging. Even though data are still preliminary, the glymphatic system could be decisively involved in the pathophysiology of neurological disorders such as neurodegenerative and demyelinating diseases, normal pressure hydrocephalus, stroke or certain headaches. The discovery of this system should provide new opportunities for the treatment of these neurological disorders.Copyright © 2020 Elsevier España, S.L.U. All rights reserved.

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