ArticleAnesthesiology2017
Anesthesia with Dexmedetomidine and Low-dose Isoflurane Increases Solute Transport via the Glymphatic Pathway in Rat Brain When Compared with High-dose Isoflurane.
Article in Anesthesiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 142 papers, 2 of them syntheses that pooled it.
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Who cites it
142 citing papers in PubMed, 2 syntheses or guidelines pooled it, 228 citations in OpenAlex.
- A Review of Translational Magnetic Resonance Imaging in Human and Rodent Experimental Models of Small Vessel Disease.Translational stroke research · 2021Pooled it
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- Astrocyte-centered temporal resilience at the brain-behavior-immunity interface: sleep-circadian disruption and perioperative cognitive vulnerability in older adults.Brain, behavior, & immunity - health · 2026Review
- The glymphatic-lymphatic axis: known pathways, open questions, and emerging roles in neurodegeneration.Translational neurodegeneration · 2026Review
- The Glymphatic System in Neurological Diseases: Mechanisms, Imaging Surrogates, and Translational Uncertainties.Current neurology and neuroscience reports · 2026Review
- Novel Therapeutic Insights Into Alzheimer's Disease: Glymphatic System and Meningeal Lymphatic Vessels.Aging cell · 2026Review
- Serial failure of the brain clearance continuum in Alzheimer's disease: mechanisms and therapeutic perspectives.Journal of neurology · 2026Review
- The Glymphatic System and Neurosurgery: A Comprehensive Narrative Review of Current Concepts and Future Directions.Journal of clinical medicine · 2026Review
- The glymphatic system in sleep: a nexus of waste clearance, brain homeostasis, and disease intervention.Molecular psychiatry · 2026Review
- Enhanced glymphatic CSF tracer influx during α2-adrenergic agonist anesthesia is independent of tracer injection duration.bioRxiv : the preprint server for biology · 2026Article
- Mapping cardiac and respiratory pulsations simultaneously with functional connectivity in the rat brain using zero echo time fMRI.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026Article
- Glymphatic dysfunction: a unifying hypothesis for delirium.Nature reviews. Neurology · 2026Review
- Increased MRI-derived parenchymal cerebral spinal fluid mapping in untreated obstructive sleep apnea patients.Neurobiology of disease · 2026Article
- Quantitative Imaging of the Heterogeneity of Brain Potassium Depletion in Experimental Focal Ischemia.bioRxiv : the preprint server for biology · 2026Article
- Quantifying cerebrospinal fluid flow in pial perivascular spaces of rats.Fluids and barriers of the CNS · 2026Article
- Impact of infusion conditions and anesthesia on CSF tracer dynamics in mouse brain.Fluids and barriers of the CNS · 2026Article
- Perivascular pathology, not macrovascular complexity, governs glymphatic-related dysfunction in preclinical cerebral small vessel disease.Scientific reports · 2026Article
- Rethinking cervical deep lymphovenous anastomosis in Alzheimer's disease: problems and prospects.Frontiers in aging neuroscience · 2026Article
- Imaging the therapeutic effects of cerebral endothelial cell derived exosome treatment of a preclinical model of Alzheimer's disease.Frontiers in aging neuroscience · 2026Article
82 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundThe glymphatic pathway transports cerebrospinal fluid through the brain, thereby facilitating waste removal. A unique aspect of this pathway is that its function depends on the state of consciousness of the brain and is associated with norepinephrine activity. A current view is that all anesthetics will increase glymphatic transport by inducing unconsciousness. This view implies that the effect of anesthetics on glymphatic transport should be independent of their mechanism of action, as long as they induce unconsciousness. We tested this hypothesis by comparing the supplementary effect of dexmedetomidine, which lowers norepinephrine, with isoflurane only, which does not.
methodsFemale rats were anesthetized with either isoflurane (N = 8) or dexmedetomidine plus low-dose isoflurane (N = 8). Physiologic parameters were recorded continuously. Glymphatic transport was quantified by contrast-enhanced magnetic resonance imaging. Cerebrospinal fluid and gray and white matter volumes were quantified from T1 maps, and blood vessel diameters were extracted from time-of-flight magnetic resonance angiograms. Electroencephalograms were recorded in separate groups of rats.
resultsGlymphatic transport was enhanced by 32% in rats anesthetized with dexmedetomidine plus low-dose isoflurane when compared with isoflurane. In the hippocampus, glymphatic clearance was sixfold more efficient during dexmedetomidine plus low-dose isoflurane anesthesia when compared with isoflurane. The respiratory and blood gas status was comparable in rats anesthetized with the two different anesthesia regimens. In the dexmedetomidine plus low-dose isoflurane rats, spindle oscillations (9 to 15 Hz) could be observed but not in isoflurane anesthetized rats.
conclusionsWe propose that anesthetics affect the glymphatic pathway transport not simply by inducing unconsciousness but also by additional mechanisms, one of which is the repression of norepinephrine release.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.