Harnessing Glymphatic Clearance for Prevention of Neurodegeneration: An Integrative Approach

Poster presented at Yoga and Ayurveda in Neurosciences: Therapeutics and Research Approaches (YANTRA 2023), 2nd International Conference hosted by the Department of Integrative Medicine, NIMHANS, Bangalore.

Krithika A Ramaswamy Poster Yantra 2023



The glymphatic system is a recently discovered waste clearance pathway within the central nervous system that operates primarily during sleep. It comprises a network of perivascular channels that enable the exchange of cerebrospinal fluid (CSF) and interstitial fluid (ISF) facilitated by aquaporin-4 (AQP4) water channels, allowing for removal of metabolic waste products including pathological proteins. Dysfunction of the glymphatic system has been implicated in Alzheimer's disease, neuroinflammatory disorders and traumatic brain injury.


To explore integrated treatment strategies for enhancing glymphatic system function.


Preliminary findings suggest that lifestyle choices modulate glymphatic clearance. Yoga techniques like cyclic meditation, yoga nidra, mind sound resonance technique and ayurvedic therapies like shirodhara, nasya have independently shown efficacy in improving sleep quality (1–5). Integrated treatment approach that combines yoga and ayurvedic interventions has exhibited a synergistic effect in improving sleep quality thereby could better promote glymphatic clearance (6). A non-invasive neuroimaging study demonstrated the increase in cranially directed pulsatile CSF velocity during the practice of pranayama, suggesting a possible mechanism for enhancing glymphatic clearance (7).

The circadian rhythm significantly influences glymphatic circulation. Aligning with Ayurvedic principles, adopting dinacharya and naturopathic arogyarakshaka pancatantra can help optimize the biological rhythm, potentially enhancing glymphatic drainage. Studies indicate that Ashwagandha (Withania somnifera), an adaptogen, can also modulate this rhythm (8). Increased polyunsaturated fatty acid levels have been associated with faster CSF glymphatic influx and ISF solute clearance (9).

Electroacupuncture was observed to enhance paravascular influx, attenuate astrocytic reactivity and enhance the polarity of AQP4, thereby promoting the function of the glymphatic system (10). Photobiomodulation Therapy, has demonstrated enhanced glymphatic clearance performance (11).


Integrated treatment strategies to improve glymphatic clearance can be a novel approach to mitigate disease progression in neurodegenerative disorders.


ayurveda, glymphatic system, integrated medicine, naturopathy, neurodegenerative disorder, yoga


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