Press Releases & Research Commentary

Pulling the Plug on Brain Injury

Wednesday, November 15, 2023

Manipulating Fluid Flows Could Save Lives, Improve Recovery Post-TBI

Cerebral edema, the dangerous brain swelling that occurs after traumatic brain injury (TBI), can increase risk of death tenfold and significantly worsen prospects for recovery in brain function.  In extreme cases, surgeons will remove a portion of the skull to relieve pressure, but this has significant risks and is not viable for the vast majority of TBI cases. Physicians have very few tools at their disposal that are effective in treating cerebral edema, which is one of the leading causes of in-hospital deaths and is associated with long-term neurological disability.

New research appearing today in the journal Nature could change all that, showing that a cocktail of drugs already approved to treat high blood pressure quickly reduces brain swelling and improves outcomes in animal models of brain injury.

“Our research shows that cerebral edema is the consequence of impaired fluid flow through the glymphatic system and its associated lymphatic drainage,” said Maiken Nedergaard, MD, DMSc, co-director of the University of Rochester Center for Translational Neuromedicine and senior author of the study.  “This impairment is under adrenergic control, and can therefore be rescued pharmacologically by broadly inhibiting adrenergic receptors. Because these drugs are already being used clinically and have observed neurological benefits, there is the potential to move quickly to clinical studies to confirm these findings.”      

The glymphatic system holds key to relieving brain pressure

The glymphatic system was first described by Nedergaard’s lab in 2012 as the brain’s unique waste removal process. Since then, a growing understanding of the mechanics of the system–aided by advanced imaging technologies and AI-driven models of fluid dynamics—has allowed researchers to better predict and manipulate the movement of cerebrospinal fluid (CSF) in the central nervous system.  This research has opened new possibilities to treat Alzheimer’s and other neurological disorders and more effectively deliver and distribute drugs in the central and peripheral nervous system, including the inner ear.  

The new study points to the potential to repurpose the glymphatic system to act as an emergency pressure release valve.  Cerebral edema is a common consequence of moderate and severe cases of TBI.  “In other parts of the body, edema helps with tissue repair, but because of the skull, the brain has limited capacity for expansion.  As a result, pressure increases, blood supply decreases, and debris and toxic proteins are trapped at the injury site, compounding the damage and impairing recovery,” said Rashad Hussain, PhD, an assistant professor in the Center for Translational Neuromedicine and first author of the study.

An Unexpected Doorway into the Ear Opens New Possibilities for Hearing Restoration

Wednesday, June 28, 2023

An international team of researchers led by the co-director of the Center for Translational Neuromedicine developed a new method to deliver drugs into the inner ear. It harnesses the natural flow of fluids in the brain and employs a little-understood back door into the cochlea.

Anders Jahre Main Award for Medical Research given to Maiken Nedergaard

Tuesday, June 13, 2023

The professor of Neurology and co-director of the Center for Translational Neuromedicine at the University of Rochester and University of Copenhagen received the award from the University of Oslo. Nedergaard was recognized for her research on astrocytes and the glymphatic system, which "has far-reaching implications both for understanding how the brain normally works and what goes wrong when the brain is affected by disease."

Maiken Nedergaard's lab just discovered a new part of the brain's waste disposal system

Thursday, January 5, 2023

New Scientist, January 5

The new structure is a fourth membrane, lying on top of the innermost membrane, called the subarachnoid lymphatic-like membrane (SLYM). The SLYM hadn’t been noticed before, partly because the membrane disintegrates when the brain is removed from the skull in post-mortems, says Maiken Nedergaard, a professor of neurology and of neurosurgery and codirector of the Center for Translational Neuromedicine, who helped discover the structure. It is also too thin to be seen in living people via brain-scanning machines.

Newly Discovered Anatomy Shields and Monitors Brain

Thursday, January 5, 2023

From the complexity of neural networks to basic biological functions and structures, the human brain only reluctantly reveals its secrets.  Advances in neuro-imaging and molecular biology have only recently enabled scientists to study the living brain at level of detail not previously achievable, unlocking many of its mysteries.  The latest discovery, described today in the journal Science, is a previously unknown component of brain anatomy that acts as both a protective barrier and platform from which immune cells monitor the brain for infection and inflammation.

The new study comes from the labs of Maiken Nedergaard, co-director of the Center for Translational Neuromedicine at University of Rochester and the University of Copenhagen and Kjeld Møllgård, M.D., a professor of neuroanatomy at the University of Copenhagen.  Nedergaard and her colleagues have transformed our understanding of the fundamental mechanics of the human brain and made significant findings in the field of neuroscience, including detailing the many critical functions of previously overlooked cells in the brain called glia and the brain’s unique process of waste removal, which the lab named the glymphatic system.

“The discovery of a new anatomic structure that segregates and helps control the flow of cerebrospinal fluid (CSF) in and around the brain now provides us much greater appreciation of the sophisticated role that CSF plays not only in transporting and removing waste from the brain, but also in supporting its immune defenses,” said Nedergaard. 

The study focuses on the series of membranes that encase the brain, creating a barrier from the rest of the body and keeping the brain bathed in CSF.  The traditional understanding of what is collectively called the meningeal layer identifies the three individual layers as dura, arachnoid, and pia matter.