Glymphatic pathway in sporadic cerebral small vessel diseases: From bench to bedside.

Cerebral small vessel diseases (CSVD) consist of a group of diseases with high heterogeneity induced by pathologies of intracranial small blood vessels. Endothelium dysfunction, blood brain barrier leakage and the inflammatory response are traditionally considered to participate in the pathogenesis of CSVD. However, these features cannot fully explain the complex syndrome and related neuroimaging characteristics. In recent years, the glymphatic pathway has been discovered to play a pivotal role in clearing perivascular fluid and metabolic solutes, which has provided novel insights into neurological disorders. Researchers have also explored the potential role of perivascular clearance dysfunction in CSVD. In this review, we presented a brief overview of CSVD and the glymphatic pathway. In addition, we elucidated CSVD pathogenesis from the perspective of glymphatic failure, including basic animal models and clinical neuroimaging markers. Finally, we proposed forthcoming clinical applications targeting the glymphatic pathway, hoping to provide novel ideas on promising therapies and preventions of CSVD. • CSVD is a group of clinical syndromes with high heterogeneity and mechanistically poorly understood. • Glymphatic pathway plays a vital role in perivascular drainage of metabolites and fluid in the brain. • Evidence from clinical and basic research has showed impaired glymphatic function in CSVD. • Interventions to recover glymphatic function may shed light on CSVD treatment. [ABSTRACT FROM AUTHOR]