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The Potential Connection Between the Brain and Neck: Exploring the Meningeal-Cervical Lymphatic Pathway in Primate Models.

Title: The Potential Connection Between the Brain and Neck: Exploring the Meningeal-Cervical Lymphatic Pathway in Primate Models.
Authors: Wong AW; Plastic Reconstructive & Aesthetic Surgery Service, Sengkang General Hospital, Singapore.; Sim NHS; Plastic, Reconstructive and Aesthetic Surgery Service, Tan Tock Seng Hospital, Singapore.; Thng CB; Plastic Reconstructive & Aesthetic Surgery Service, Sengkang General Hospital, Singapore.; Sim DPY; Department of Surgery, Sengkang General Hospital.; Low ZL; Department of Surgery, Sengkang General Hospital.; Foo ASC; Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore.; Dept of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.; Neurobiology Programme, Life Sciences Institute, Singapore.
Source: Plastic and reconstructive surgery [Plast Reconstr Surg] 2025 Nov 17. Date of Electronic Publication: 2025 Nov 17.
Publication Model: Ahead of Print
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 1306050 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1529-4242 (Electronic) Linking ISSN: 00321052 NLM ISO Abbreviation: Plast Reconstr Surg Subsets: MEDLINE
Imprint Name(s): Publication: : Hagerstown, MD : Lippincott Williams & Wilkins; Original Publication: Baltimore : Williams & Wilkins
Abstract: Background: There is burgeoning interest in the role of lymphatic drainage in Alzheimer's Disease. The brain was historically regarded as an immune-privileged organ devoid of lymphatic drainage. Recent discoveries of the glymphatic and meningeal lymphatic systems have challenged this view, suggesting that cerebrospinal fluid (CSF) and interstitial waste may drain into the deep cervical lymph nodes (dcLN). However, this pathway has not been conclusively demonstrated in non-human primates.; Methods: Two Non-Human Primates (NHPs) (Macaca fascicularis species) underwent craniotomy with catheter insertion into the subarachnoid space. Indocyanine green (ICG) was injected intracranially and tracked using near-infrared (NIR) imaging.; Results: In both NHPs, ICG was detected in the peri-jugular dcLN within an average of 613.5 seconds post-injection.; Conclusion: This study provides the first in vivo primate evidence of a potential meningeal lymphatic drainage pathway to the dcLN, supporting its anatomical and functional relevance. Our findings suggest that dcLNs may facilitate clearance of neuropathological proteins. The use of a clinically ubiquitous imaging agent like ICG underscores its translational potential in future human studies.; (Copyright © 2025 by the American Society of Plastic Surgeons.)
Competing Interests: Conflicts of interest: None of the authors has conflicts of interest regarding any of the products, devices, or drugs mentioned in this manuscript.
Entry Date(s): Date Created: 20251118 Latest Revision: 20251118
Update Code: 20260130
DOI: 10.1097/PRS.0000000000012627
PMID: 41253126
Database: MEDLINE

Journal Article