The glymphatic system and Amyotrophic lateral sclerosis

The glymphatic system may influence ALS through its role in clearing toxic materials from the brain.

• The glymphatic system and meningeal lymphatic vessels help transport solutes and eliminate toxic materials from the brain.
• TDP-43 and glutamate are key components in the disease process of ALS and are affected by this clearance system.
• Arterial pulsation, respiration, posture, and aquaporin-4 channels are involved in propelling the flow within the glymphatic system.
• Non-REM slow wave sleep is crucial for effective glymphatic drainage, which stops during wakefulness.
• Sleep impairments are noted in ALS and may be an overlooked risk factor for the disease.
• Potential therapeutic strategies to enhance glymphatic flow are discussed as a means to address sleep-related issues in ALS.

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