ArticleJCI insight2018
Brain-wide glymphatic enhancement and clearance in humans assessed with MRI.
Article in JCI insight, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06857136 (The Role of the Glymphatic System Avaluated Thourgh mr Imaging in the Diagnosis and Management of NPH), which is not on this map. Cited by 303 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Role of the Glymphatic System Avaluated Thourgh mr Imaging in the Diagnosis and Management of NPH
Who cites it
303 citing papers in PubMed, 1 synthesis or guideline pooled it, 486 citations in OpenAlex.
- Unveiling the glymphatic system's impact on neurodegenerative diseases: a comprehensive bibliometric analysis (2012-2024).Frontiers in aging neuroscience · 2025Pooled it
- Transcranial direct current stimulation improves reduced global BOLD-CSF coupling in patients with insomnia disorder and comorbid anxiety: a resting-state functional MRI study.BMC psychiatry · 2026Trial
- Acoustic stimulation as a promising technique to enhance slow-wave sleep in Alzheimer's disease: results of a pilot study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Trial
- The glymphatic-lymphatic axis: known pathways, open questions, and emerging roles in neurodegeneration.Translational neurodegeneration · 2026Review
- Glymphatic function in humans: indicators, modulators, and measurement strategies.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Review
- Spatial organization of AQP4 water channel expression in the human brain.Science advances · 2026Article
- Article
- The Glymphatic System in Neurological Diseases: Mechanisms, Imaging Surrogates, and Translational Uncertainties.Current neurology and neuroscience reports · 2026Review
- High frame ratebioRxiv : the preprint server for biology · 2026Article
- No evidence of major integrative brain clearance impairment in an Alzheimer´s disease model of transgenic APPswe/PS1dE9 mice.Fluids and barriers of the CNS · 2026Article
- Central nervous system lymphatic network: from the maintenance of brain homeostasis to emerging therapeutic perspectives in neurodegenerative diseases.Translational neurodegeneration · 2026Review
- In-silico solute transport via perivascular networks in the human intracranial space.Nature communications · 2026Article
- Objective Sleep Architecture Alterations and Sleep-Dependent Brain Clearance Dysfunction Across the Early Alzheimer's Disease Continuum: A Systematic Review.Journal of clinical medicine · 2026Review
- Parkinsonism in Idiopathic Normal Pressure Hydrocephalus or Hydrocephalic Presentation in Parkinson's Disease: A Report of Three Cases.Internal medicine (Tokyo, Japan) · 2026Article
- DTI-ALPS is not independently associated with overall survival beyond established prognostic factors in glioblastoma.Journal of neuro-oncology · 2026Article
- Longitudinal Patterns of Brain Parenchymal Damage Associated With the ALPS Index in a Community-Based Cohort.CNS neuroscience & therapeutics · 2026Article
- Article
- The Glymphatic System and Neurosurgery: A Comprehensive Narrative Review of Current Concepts and Future Directions.Journal of clinical medicine · 2026Review
- AQP4-dependent enhancement of glymphatic function attenuates tau pathology and neurodegeneration in PS19 mice.Molecular neurodegeneration · 2026Article
- Gamma Oscillations, Sensory Stimulation, and Glymphatic Function: Toward User-Friendly Auditory Interventions for Brain Health in Aging and Neurodegeneration.Medical sciences (Basel, Switzerland) · 2026Review
243 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
To what extent does the subarachnoid cerebrospinal fluid (CSF) compartment communicate directly with the extravascular compartment of human brain tissue? Interconnection between the subarachnoid CSF compartment and brain perivascular spaces is reported in some animal studies, but with controversy, and in vivo CSF tracer studies in humans are lacking. In the present work, we examined the distribution of a CSF tracer in the human brain by MRI over a prolonged time span. For this, we included a reference cohort, representing close to healthy individuals, and a cohort of patients with dementia and anticipated compromise of CSF circulation (idiopathic normal pressure hydrocephalus). The MRI contrast agent gadobutrol, which is confined to the extravascular brain compartment by the intact blood-brain barrier, was used as a CSF tracer. Standardized T1-weighted MRI scans were performed before and after intrathecal gadobutrol at defined time points, including at 24 hours, 48 hours, and 4 weeks. All MRI scans were aligned and brain regions were segmented using FreeSurfer, and changes in normalized T1 signals over time were quantified as percentage change from baseline. The study provides in vivo evidence of access to all human brain subregions of a substance administered intrathecally. Clearance of the tracer substance was delayed in the dementia cohort. These observations translate previous findings in animal studies into humans and open new prospects concerning intrathecal treatment regimens, extravascular contrast-enhanced MRI, and assessment of brain clearance function.
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What OpenQuestion holds
Registered trials
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.