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2017 ; 37
(11
): 2904-2915
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Cortical Spreading Depression Closes Paravascular Space and Impairs Glymphatic
Flow: Implications for Migraine Headache
#MMPMID28193695
Schain AJ
; Melo-Carrillo A
; Strassman AM
; Burstein R
J Neurosci
2017[Mar]; 37
(11
): 2904-2915
PMID28193695
show ga
Functioning of the glymphatic system, a network of paravascular tunnels through
which cortical interstitial solutes are cleared from the brain, has recently been
linked to sleep and traumatic brain injury, both of which can affect the
progression of migraine. This led us to investigate the connection between
migraine and the glymphatic system. Taking advantage of a novel in vivo method we
developed using two-photon microscopy to visualize the paravascular space (PVS)
in naive uninjected mice, we show that a single wave of cortical spreading
depression (CSD), an animal model of migraine aura, induces a rapid and nearly
complete closure of the PVS around surface as well as penetrating cortical
arteries and veins lasting several minutes, and gradually recovering over 30 min.
A temporal mismatch between the constriction or dilation of the blood vessel
lumen and the closure of the PVS suggests that this closure is not likely to
result from changes in vessel diameter. We also show that CSD impairs glymphatic
flow, as indicated by the reduced rate at which intraparenchymally injected dye
was cleared from the cortex to the PVS. This is the first observation of a PVS
closure in connection with an abnormal cortical event that underlies a
neurological disorder. More specifically, the findings demonstrate a link between
the glymphatic system and migraine, and suggest a novel mechanism for regulation
of glymphatic flow.SIGNIFICANCE STATEMENT Impairment of brain solute clearance
through the recently described glymphatic system has been linked with traumatic
brain injury, prolonged wakefulness, and aging. This paper shows that cortical
spreading depression, the neural correlate of migraine aura, closes the
paravascular space and impairs glymphatic flow. This closure holds the potential
to define a novel mechanism for regulation of glymphatic flow. It also implicates
the glymphatic system in the altered cortical and endothelial functioning of the
migraine brain.