Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

microGLYMPH : a conceptual translational roadmap for microdialysis‑based assessment of CSF-interstitial solute exchange in acquired brain injury

Shanbhag, Nagesh C LU ; Zimphango, Chisomo ; Hecht, Nils ; Martin, Bryn A ; Panotopoulos, Christos ; Bogossian, Elisa Gouvea ; Taccone, Fabio S ; Rubiano, Andres M ; Hutchinson, Peter J and Marklund, Niklas LU orcid , et al. (2026) In Critical care (London, England)
Abstract

The glymphatic system facilitates cerebrospinal fluid (CSF)-interstitial fluid exchange and plays a key role in solute clearance and neurophysiological homeostasis. While dysfunction of this system has been shown in traumatic brain injury, stroke, meningitis, idiopathic normal pressure hydrocephalus and neurodegenerative diseases, direct measurement of glymphatic transport in humans remains elusive. We propose microGLYMPH as a translational, hypothesis-generating framework that combines established clinical cerebral microdialysis with controlled CSF tracer administration via existing clinical access routes, including an external ventricular drain, cisternal access during surgery, or lumbar intrathecal injection when clinically... (More)

The glymphatic system facilitates cerebrospinal fluid (CSF)-interstitial fluid exchange and plays a key role in solute clearance and neurophysiological homeostasis. While dysfunction of this system has been shown in traumatic brain injury, stroke, meningitis, idiopathic normal pressure hydrocephalus and neurodegenerative diseases, direct measurement of glymphatic transport in humans remains elusive. We propose microGLYMPH as a translational, hypothesis-generating framework that combines established clinical cerebral microdialysis with controlled CSF tracer administration via existing clinical access routes, including an external ventricular drain, cisternal access during surgery, or lumbar intrathecal injection when clinically justified. The aim is to obtain time-resolved regional tracer profiles in microdialysate and to interpret these alongside arousal state, intracranial dynamics, and, where available, complementary imaging, thereby providing an indirect measure of CSF-interstitial exchange kinetics and peripheral tracer appearance. We further define the key design, analytical and practical limitations that must be resolved before the approach can extend beyond exploratory use, notably catheter-adjacent effects, blood-brain barrier disruption, drainage practices, and the intrinsically focal nature of microdialysis. microGLYMPH is therefore intended as a staged roadmap for first-in-human feasibility studies and subsequent hypothesis-driven investigations of neurofluid solute transport after acute brain injury.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Critical care (London, England)
publisher
BioMed Central (BMC)
external identifiers
  • pmid:42087166
ISSN
1364-8535
DOI
10.1186/s13054-026-06063-0
language
English
LU publication?
yes
additional info
© 2026. The Author(s).
id
614007c4-bb15-4639-9be3-7342af956503
date added to LUP
2026-05-06 08:53:08
date last changed
2026-05-06 08:53:08
@article{614007c4-bb15-4639-9be3-7342af956503,
  abstract     = {{<p>The glymphatic system facilitates cerebrospinal fluid (CSF)-interstitial fluid exchange and plays a key role in solute clearance and neurophysiological homeostasis. While dysfunction of this system has been shown in traumatic brain injury, stroke, meningitis, idiopathic normal pressure hydrocephalus and neurodegenerative diseases, direct measurement of glymphatic transport in humans remains elusive. We propose microGLYMPH as a translational, hypothesis-generating framework that combines established clinical cerebral microdialysis with controlled CSF tracer administration via existing clinical access routes, including an external ventricular drain, cisternal access during surgery, or lumbar intrathecal injection when clinically justified. The aim is to obtain time-resolved regional tracer profiles in microdialysate and to interpret these alongside arousal state, intracranial dynamics, and, where available, complementary imaging, thereby providing an indirect measure of CSF-interstitial exchange kinetics and peripheral tracer appearance. We further define the key design, analytical and practical limitations that must be resolved before the approach can extend beyond exploratory use, notably catheter-adjacent effects, blood-brain barrier disruption, drainage practices, and the intrinsically focal nature of microdialysis. microGLYMPH is therefore intended as a staged roadmap for first-in-human feasibility studies and subsequent hypothesis-driven investigations of neurofluid solute transport after acute brain injury.</p>}},
  author       = {{Shanbhag, Nagesh C and Zimphango, Chisomo and Hecht, Nils and Martin, Bryn A and Panotopoulos, Christos and Bogossian, Elisa Gouvea and Taccone, Fabio S and Rubiano, Andres M and Hutchinson, Peter J and Marklund, Niklas and Chen, Jefferson W and Vajkoczy, Peter}},
  issn         = {{1364-8535}},
  language     = {{eng}},
  month        = {{05}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Critical care (London, England)}},
  title        = {{microGLYMPH : a conceptual translational roadmap for microdialysis‑based assessment of CSF-interstitial solute exchange in acquired brain injury}},
  url          = {{http://dx.doi.org/10.1186/s13054-026-06063-0}},
  doi          = {{10.1186/s13054-026-06063-0}},
  year         = {{2026}},
}