Research, Articles & Case Studies

Introduction: Research in body based complementary ther­apies such as Craniosacral Therapy (CST) is often focused on physical outcome measures. This study therefore investigated patients' experiences of CST to reveal additional outcome domains for further clinical trials. 

The glymphatic pathway expedites clearance of waste, including soluble amyloid(A) from the brain. Transport through this pathway is controlled bythe brain’s arousal level because, during sleep or anesthesia,the brain’sinterstitial space volume expands (compared with wakefulness), resulting in faster waste removal. Humans, as well as animals, exhibit different body postures during sleep, which may also affect waste removal. Therefore, not only the level of consciousness, but also body posture, might affect CSF–interstitial fluid (ISF) exchange efficiency. We used dynamic-contrast-enhanced MRI and kinetic modeling to quantify CSF-ISF exchange rates in anesthetized rodents’ brains in supine, prone, or lateral positions. To validate the MRI data and to assess specifically the influence of body posture on clearance of A, we used fluorescence microscopy and radioactive tracers, respectively. The analysis showed that glymphatic transport was most efficient in the lateral position compared with the supine or prone positions. In the prone position, in which the rat’s head was inthe most upright position (mimicking posture duringthe awake state),transport was characterized by “retention” ofthetracer, slower clearance, and more CSF efflux along larger caliber cervical vessels. The optical imaging and radiotracer studies confirmed that glymphatic transport and A clearance were superior in the lateral and supine positions. We propose that the most popular sleep posture (lateral) has evolved to optimize waste removal during sleep and that posture must be considered in diagnostic imaging procedures developed in the future to assess CSF-ISF transport in humans.

This article is about the CNS (Central nervous system) and the constant immune surveillance that takes place within the meningeal compartment. The mechanisms governing the entrance and exit of immune cells from the CNS remain poorly understood. In searching for T cells gateways into and out of the meninges, we discovered functional lymphatic vessels lining the dural sinuses. These structures express all of the molecular hallmarks of lymphatic endothelial cells, are able to carry both fluid and immune cells from CSF, and are connected to the deep cervical lymph nodes. The discovery of the CNS lymphatic system may call for a reassessment of basic assumptions in neuroimmunology and shed new light on the etiology of neuroinflammatory and neurodegenerative diseases associated with immune system dysfunction.