How fluid drainage systems in the brain may link brain injury to long-term brain disease

Chronic traumatic encephalopathy (CTE) is strongly linked to repetitive concussive traumatic brain injuries (TBIs).

• CTE is characterized by the buildup of hyperphosphorylated tau (P-tau) around blood vessels in the brain.
• Disruptions in the brain's fluid clearance systems, particularly the glymphatic and meningeal lymphatic pathways, may drive the onset and progression of CTE.
• TBI can impair the exchange of interstitial fluid and cerebrospinal fluid, leading to the accumulation of harmful proteins and increased inflammation.
• Meningeal lymphatic dysfunction may hinder cerebrospinal fluid drainage, contributing to ongoing neuroinflammation and further glymphatic failure.
• The effectiveness of these fluid clearance systems may vary with age, influencing both immediate and long-term outcomes after injury.
• Differences in brain fluid clearance between species complicate the translation of findings from rodent models to humans.

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