January 13, 2019

Central Nervous System Lymphatic Unit, Immunity and Epilepsy: Is There a Link?

The recent definition of a network of lymphatic vessels in the meninges surrounding the brain and the spinal cord has advanced our knowledge on the functional anatomy of fluid movements within the central nervous system (CNS). Meningeal lymphatic vessels, along dural sinuses and main nerves, contribute to the cerebrospinal fluid (CSF) drainage, integrating the cerebrovascular and periventricular routes, and forming a circuit that we here outline as the CNS-lymphatic unit. The latter is important for parenchyma waste clearance, brain homeostasis, and the regulation of immune or inflammatory processes within the brain.

Disruption of fluid drain rules may promote or sustain CNS disease, conceivably applicable to epilepsy where extracellular accumulation of macromolecules and metabolic by-products occur at the interstitial and perivascular spaces.