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Nikolenko VN, Oganesyan MV, Vovkogon AD, Nikitina AT, Sozonova EA, Kudryashova VA, Rizaeva NA, Cabezas R, Avila-Rodriguez M, Neganova ME, Mikhaleva LM, Bachurin SO, Somasundaram SG, Kirkland CE, Tarasov VV, Aliev G. Current Understanding of Central Nervous System Drainage Systems: Implications in the Context of Neurodegenerative Diseases. Curr Neuropharmacol 2021; 18:1054-1063. [PMID: 31729299 PMCID: PMC7709156 DOI: 10.2174/1570159x17666191113103850] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/15/2019] [Accepted: 11/10/2019] [Indexed: 12/19/2022] Open
Abstract
Until recently, it was thought that there were no lymphatic vessels in the central nervous system (CNS). Therefore, all metabolic processes were assumed to take place only in the circulation of the cerebrospinal fluid (CSF) and through the blood-brain barrier's (BBB), which regulate ion transport and ensure the functioning of the CNS. However, recent findings yield a new perspective: There is an exchange of CSF with interstitial fluid (ISF), which is drained to the paravenous space and reaches lymphatic nodes at the end. This circulation is known as the glymphatic system. The glymphatic system is an extensive network of meningeal lymphatic vessels (MLV) in the basal area of the skull that provides another path for waste products from CNS to reach the bloodstream. MLV develop postnatally, initially appearing around the foramina in the basal part of the skull and the spinal cord, thereafter sprouting along the skull's blood vessels and spinal nerves in various areas of the meninges. VEGF-C protein (vascular endothelial growth factor), expressed mainly by vascular smooth cells, plays an important role in the development of the MLV. The regenerative potential and plasticity of MLV and the novel discoveries related to CNS drainage offer potential for the treatment of neurodegenerative diseases such as dementia, hydrocephalus, stroke, multiple sclerosis, and Alzheimer disease (AD). Herein, we present an overview of the structure and function of the glymphatic system and MLV, and their potential involvement in the pathology and progression of neurodegenerative diseases.
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Affiliation(s)
- Vladimir N Nikolenko
- Department of Human Anatomy, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia,Department of Normal and Topographic Anatomy, Federal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University, Leninskie Gory, 1, Moscow, 119991, Russia
| | - Marine V Oganesyan
- Department of Human Anatomy, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia
| | - Angela D Vovkogon
- Department of Human Anatomy, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia
| | - Arina T Nikitina
- Department of Human Anatomy, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia
| | - Ekaterina A Sozonova
- Department of Human Anatomy, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia
| | - Valentina A Kudryashova
- Department of Human Anatomy, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia
| | - Negoria A Rizaeva
- Department of Human Anatomy, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia
| | - Ricardo Cabezas
- Department of Biochemistry and Nutrition, Science Faculty, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Marco Avila-Rodriguez
- Health Sciences Faculty, Clinic Sciences Department, University of Tolima, 730006 Ibague, Colombia
| | - Margarita E Neganova
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka, Moscow Region, 142432, Russia
| | - Liudmila M Mikhaleva
- Research Institute of Human Morphology, 3 Tsyurupy Street, Moscow, 117418, Russian Federation
| | - Sergey O Bachurin
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka, Moscow Region, 142432, Russia
| | | | - Cecil E Kirkland
- Department of Biological Sciences, Salem University, Salem, WV, USA
| | - Vadim V Tarasov
- Sechenov First Moscow State Medical University (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia
| | - Gjumrakch Aliev
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka, Moscow Region, 142432, Russia,Research Institute of Human Morphology, 3 Tsyurupy Street, Moscow, 117418, Russian Federation,Sechenov First Moscow State Medical University (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia,GALLY International Research Institute, 7733 Louis Pasteur Drive, #330, San Antonio, TX, 78229, USA
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Heringer LC, Sousa UDO, Oliveira MFD, Nunes AS, Alves KDA, Zancanaro ML, Botelho RV. The number of burr holes and use of a drain do not interfere with surgical results of chronic subdural hematomas. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 75:809-812. [PMID: 29236825 DOI: 10.1590/0004-282x20170136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 08/07/2017] [Indexed: 11/22/2022]
Abstract
Burr hole evacuation has been the most frequently-used procedure for the treatment of chronic subdural hematomas (CSDH). OBJECTIVE To evaluate whether the use of a drain and/or the number of burr holes for treatment of CSDH modifies the rates of recurrence and complications. METHODS A retrospective review of 142 patients operated on because of CSDH, between 2006 and 2015, analyzing recurrence and complications of the use of one or two burr holes with or without the use of a drain. RESULTS Thirty-seven patients had bilateral CSDH (26%) and 105 (73.9%) patients had unilateral CSDH. Twenty-two (59.4%) patients were given a drain and 15 (40.6%) were not. A total number of recurrences occurred in 22 (15.5%) patients and the total number of complications was in six (4.2%) patients. Mean follow-up time was 7.67 months. CONCLUSIONS The number of burr holes and the use of the drain did not alter the rates of recurrence and complications in the treatment of CSDH.
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Affiliation(s)
- Lindolfo Carlos Heringer
- Instituto de Assistência Médica ao Servidor Público Estadual, Programa de Pós Graduação, São Paulo SP, Brasil
| | - Ulysses de Oliveira Sousa
- Instituto de Assistência Médica ao Servidor Público Estadual, Programa de Pós Graduação, São Paulo SP, Brasil
| | | | - Aline Silva Nunes
- Instituto de Assistência Médica ao Servidor Público Estadual, Programa de Pós Graduação, São Paulo SP, Brasil
| | - Katiusa de Abreu Alves
- Instituto de Assistência Médica ao Servidor Público Estadual, Programa de Pós Graduação, São Paulo SP, Brasil
| | - Maria Luiza Zancanaro
- Instituto de Assistência Médica ao Servidor Público Estadual, Programa de Pós Graduação, São Paulo SP, Brasil
| | - Ricardo Vieira Botelho
- Instituto de Assistência Médica ao Servidor Público Estadual, Programa de Pós Graduação, São Paulo SP, Brasil
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