South Korean scientists solve 250-year-old dementia-linked brain mystery

Researchers in South Korea say they have finally worked out how the brain flushes away waste – offering a clearer picture of the processes involved in dementia and other brain disorders that could one day be harnessed to treat them.

The breakthrough, published this month in journal Cell, solved a puzzle that has stumped scientists since lymphatic vessels around the brain were first discovered roughly 250 years ago: how does our body clear away the waste?

An international team led by Dr Koh Gou-young, a scientist at the Centre for Vascular Research within South Korea’s Institute for Basic Science, identified tiny openings in the tough membrane protecting the brain – dubbed arachnoid fenestrations – through which fluid drains into vessels around the nose and eyes before reaching lymph nodes in the neck.

A doctor inspects a brain scan for signs of possible disease. Dementia is characterised by a build-up of toxic brain waste. Photo: Getty Images
A doctor inspects a brain scan for signs of possible disease. Dementia is characterised by a build-up of toxic brain waste. Photo: Getty Images

The human brain constantly produces metabolic waste, which needs to be cleared away by cerebrospinal fluid: the clear, watery liquid that acts as a natural shock absorber and nutrient bath for the brain and spinal cord.

When this system slows down, toxic proteins such as amyloid beta – a hallmark of Alzheimer’s disease – can build up, raising the risk of dementia and other neurodegenerative disorders.

To understand exactly how the clearance process works, Koh and his team used 3D imaging and electron microscopy to trace the fluid’s journey in mice genetically engineered so that their lymph nodes glowed.

An electron microscope image shows the small openings that researchers dubbed “arachnoid fenestrations”. Photo: Handout
An electron microscope image shows the small openings that researchers dubbed “arachnoid fenestrations”. Photo: Handout

“We have finally clarified the long-standing mystery of how cerebrospinal fluid crosses the arachnoid membrane,” Koh said, referring to the delicate, weblike middle layer of tissue that acts as a protective wrapper for the brain and spinal cord.

  

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