Structural and Functional Features of the Glymphatic System: a Contemporary Perspective

The aging of the population in developed countries is a trend of major medical and social significance. In this regard, the study of the etiology and pathogenesis of neurodegenerative diseases, as well as the search for effective treatment methods, is of particular relevance. For a long time, it was believed that metabolic waste products were drained from the brain parenchyma’s interstitial fluid into the ventricular system. However, the discovery of the brain’s glymphatic system has significantly advanced our understanding of the mechanisms underlying pathologies associated with impaired clearance of metabolites from the brain. This scientific review outlines the main directions in the study of the functional morphology of the glymphatic system under normal conditions. It provides a detailed description of two theories of cerebrospinal fluid outflow and presents a critical analysis of both Russian and international research data. Under normal conditions, the function of the glymphatic system is influenced by heart rate, intracranial pressure, pulse and arterial pressure, as well as the phase of the respiratory cycle. In addition, sleep quality, head position during sleep, and exposure to toxic substances directly affect glymphatic system activity. The review also highlights recent data on the glymphatic system of the visual organs. Further research into the morphofunctional characteristics of the glymphatic system under normal conditions may greatly expand our fundamental understanding of disease pathogenesis and contribute to the development of new approaches to treatment and prevention.