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      The Effect of Body Posture on Brain Glymphatic Transport.

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          Abstract

          The glymphatic pathway expedites clearance of waste, including soluble amyloid β (Aβ) from the brain. Transport through this pathway is controlled by the brain's arousal level because, during sleep or anesthesia, the brain's interstitial 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 Aβ, 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 in the most upright position (mimicking posture during the awake state), transport was characterized by "retention" of the tracer, slower clearance, and more CSF efflux along larger caliber cervical vessels. The optical imaging and radiotracer studies confirmed that glymphatic transport and Aβ 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.

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          Author and article information

          Journal
          J. Neurosci.
          The Journal of neuroscience : the official journal of the Society for Neuroscience
          1529-2401
          0270-6474
          Aug 5 2015
          : 35
          : 31
          Affiliations
          [1 ] Department of Anesthesiology, Department of Radiology, and.
          [2 ] Center for Translational Neuromedicine, University of Rochester, Rochester, New York 14627.
          [3 ] Department of Anesthesiology.
          [4 ] Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, New York 11794.
          [5 ] Department of Radiology, New York University Langone Medical Center, New York, New York 10016, and.
          [6 ] Department of Anesthesiology, Department of Radiology, and Helene.Benveniste@stonybrookmedicine.edu.
          Article
          35/31/11034
          10.1523/JNEUROSCI.1625-15.2015
          4524974
          26245965
          cb62b0ff-c628-4f4c-aad9-f08453d96b02
          Copyright © 2015 the authors 0270-6474/15/3511034-11$15.00/0.
          History

          CSF,brain,posture,sleep,unconsciousness,waste removal
          CSF, brain, posture, sleep, unconsciousness, waste removal

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