First-ever images of the brain's secret cleaning system unlocked new hope against Alzheimer's.

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Researchers have captured the first images of a brain network designed to eliminate waste, potentially protecting against diseases such as Alzheimer's.

This glymphatic system was imaged in surgical patients, confirming theories that had previously only been seen in animals. The study emphasizes the system's ability to transport metabolic byproducts, including harmful proteins, out of the brain via perivascular spaces, suggesting that lifestyle changes may enhance this natural protective mechanism.

 Groundbreaking Brain Pathway Imaging
Scientists have long speculated about the existence of a network of pathways in the brain designed to clear metabolic proteins that would otherwise accumulate and cause Alzheimer's and other forms of dementia. However, until now, no one had definitively observed this network in humans.

A new study involving five patients undergoing brain surgery at Oregon Health & Science University (OHSU) has produced the first images of this network of perivascular spaces, which are fluid-filled structures along arteries and veins within the brain.  

First Definitive Evidence of Glymphatic System
"Nobody has shown it before now," said senior author Juan Piantino, M.D., an associate professor of pediatrics (neurology) in the OHSU School of Medicine and a faculty member of the Papé Family Pediatric Research Institute's Neuroscience Section. "I was always skeptical of it, and there are still many skeptics out there who do not believe it. That's what makes this discovery so remarkable.  

Imaging Methods and Findings
The study used an inert contrasting agent and a special type of magnetic resonance imaging to detect cerebrospinal fluid flowing along different pathways in the brain 12, 24, and 48 hours after surgery. The new study, which definitively reveals the presence of an efficient waste-clearance system within the human brain, supports the promotion of lifestyle changes and medications that are already being developed to maintain and improve it.  

Clearing Waste From the Brain
Scientists believe this network of pathways effectively flushes the brain of metabolic wastes caused by energy-intensive work. Proteins like amyloid and tau have been shown to form clumps and tangles in brain images of Alzheimer's patients.

Emerging research suggests that medications may be beneficial, but much of the focus on the glymphatic system has been on lifestyle-based measures to improve sleep quality, such as sticking to a regular sleep schedule, developing a relaxing routine, and avoiding screens in the bedroom before bed. Researchers believe that a well-functioning glymphatic system efficiently transports waste proteins toward veins exiting the brain, particularly at night when deep sleep occurs.