REFERENCES
2. Iliff JJ, Wang M, Liao Y, et al. A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid β. Sci Transl Med. 2012;4:147ra111.
3. Louveau A, Smirnov I, Keyes TJ, et al. Structural and functional features of central nervous system lymphatic vessels. Nature. 2015;523:337-41.
4. Huang SY, Zhang YR, Guo Y, et al. ; Alzheimer’s Disease Neuroimaging Initiative. Glymphatic system dysfunction predicts amyloid deposition, neurodegeneration, and clinical progression in Alzheimer’s disease. Alzheimers Dement. 2024;20:3251-69.
5. Nikolenko VN, Oganesyan MV, Vovkogon AD, et al. Current understanding of central nervous system drainage systems: implications in the context of neurodegenerative diseases. Curr Neuropharmacol. 2020;18:1054-63.
6. Shan X, Lu Y, Luo Z, et al. A long-acting lyotropic liquid crystalline implant promotes the drainage of macromolecules by brain-related lymphatic system in treating aged Alzheimer’s disease. ACS Nano. 2024;18:9688-703.
7. Li Y, Zhang J, Wan J, Liu A, Sun J. Melatonin regulates Aβ production/clearance balance and Aβ neurotoxicity: a potential therapeutic molecule for Alzheimer’s disease. Biomed Pharmacother. 2020;132:110887.
9. Song YY, Xu WT, Zhang XC, Ni GX. Mechanisms of electroacupuncture on Alzheimer’s Disease: a review of animal studies. Chin J Integr Med. 2020;26:473-80.
10. Lin Y, Jin J, Lv R, et al. Repetitive transcranial magnetic stimulation increases the brain’s drainage efficiency in a mouse model of Alzheimer’s disease. Acta Neuropathol Commun. 2021;9:102.
11. Ju YS, Ooms SJ, Sutphen C, et al. Slow wave sleep disruption increases cerebrospinal fluid amyloid-β levels. Brain. 2017;140:2104-11.
12. Hablitz LM, Nedergaard M. The glymphatic system: a novel component of fundamental neurobiology. J Neurosci. 2021;41:7698-711.
13. Formolo DA, Yu J, Lin K, et al. Leveraging the glymphatic and meningeal lymphatic systems as therapeutic strategies in Alzheimer’s disease: an updated overview of nonpharmacological therapies. Mol Neurodegener. 2023;18:26.
14. Lohela TJ, Lilius TO, Nedergaard M. The glymphatic system: implications for drugs for central nervous system diseases. Nat Rev Drug Discov. 2022;21:763-79.
15. Li Y, Meng Q, Luo B, et al. Exercises in activating lymphatic system on fluid overload symptoms, abnormal weight gains, and physical functions among patients with heart failure: a randomized controlled trial. Front Cardiovasc Med. 2023;10:1094805.
16. Togre NS, Mekala N, Bhoj PS, et al. Neuroinflammatory responses and blood-brain barrier injury in chronic alcohol exposure: role of purinergic P2 × 7 Receptor signaling. J Neuroinflammation. 2024;21:244.
17. Peng W, Yuan Y, Lei J, et al. Long-term high-fat diet impairs AQP4-mediated glymphatic clearance of amyloid beta. Mol Neurobiol. 2025;62:1079-93.
18. Xie L, Kang H, Xu Q, et al. Sleep drives metabolite clearance from the adult brain. Science. 2013;342:373-7.
19. Jiang-Xie LF, Drieu A, Kipnis J. Waste clearance shapes aging brain health. Neuron. 2025;113:71-81.
20. Da Mesquita S, Louveau A, Vaccari A, et al. Functional aspects of meningeal lymphatics in ageing and Alzheimer’s disease. Nature. 2018;560:185-91.
21. Da Mesquita S, Papadopoulos Z, Dykstra T, et al. ; Dominantly Inherited Alzheimer Network. Meningeal lymphatics affect microglia responses and anti-Aβ immunotherapy. Nature. 2021;593:255-60.
22. Hong H, Hong L, Luo X, et al. ; Alzheimer’s Disease Neuroimaging Initiative (ADNI). The relationship between amyloid pathology, cerebral small vessel disease, glymphatic dysfunction, and cognition: a study based on Alzheimer’s disease continuum participants. Alzheimers Res Ther. 2024;16:43.
23. Chachaj A, Gąsiorowski K, Szuba A, Sieradzki A, Leszek J. The lymphatic system in the brain clearance mechanisms - new therapeutic perspectives for Alzheimer’s disease. Curr Neuropharmacol. 2023;21:380-91.
24. Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement. 2013;9:63.
25. Kress BT, Iliff JJ, Xia M, et al. Impairment of paravascular clearance pathways in the aging brain. Ann Neurol. 2014;76:845-61.
26. Beschorner N, Nedergaard M. Glymphatic system dysfunction in neurodegenerative diseases. Curr Opin Neurol. 2024;37:182-8.
27. Zhang S, Gao Y, Zhao Y, Huang TY, Zheng Q, Wang X. Peripheral and central neuroimmune mechanisms in Alzheimer’s disease pathogenesis. Mol Neurodegener. 2025;20:22.
28. Plog BA, Dashnaw ML, Hitomi E, et al. Biomarkers of traumatic injury are transported from brain to blood via the glymphatic system. J Neurosci. 2015;35:518-26.
29. Lundgaard I, Lu ML, Yang E, et al. Glymphatic clearance controls state-dependent changes in brain lactate concentration. J Cereb Blood Flow Metab. 2017;37:2112-24.
30. Guo C, Harshfield EL, Markus HS. Sleep characteristics and risk of stroke and dementia: an observational and mendelian randomization study. Neurology. 2024;102:e209141.
31. Yaffe K, Falvey CM, Hoang T. Connections between sleep and cognition in older adults. Lancet Neurol. 2014;13:1017-28.
32. Holth JK, Fritschi SK, Wang C, et al. The sleep-wake cycle regulates brain interstitial fluid tau in mice and CSF tau in humans. Science. 2019;363:880-4.
33. Kang J, Lim MM, Bateman RJ, et al. Amyloid-beta dynamics are regulated by orexin and the sleep-wake cycle. Science. 2009;326:1005-7.
34. Kiviniemi V, Wang X, Korhonen V, et al. Ultra-fast magnetic resonance encephalography of physiological brain activity - Glymphatic pulsation mechanisms? J Cereb Blood Flow Metab. 2016;36:1033-45.
35. Ringstad G, Valnes LM, Dale AM, et al. Brain-wide glymphatic enhancement and clearance in humans assessed with MRI. JCI Insight. 2018;3:e121537.
36. Zhu Q, Song Y, Qian Y, Zhang R, Xue J, Hou Y. Targeting glial dysfunction in Alzheimer’s disease: insights into pathogenesis and emerging therapeutics. Ageing Neur Dis. 2025;5:19.
37. Chen X, Firulyova M, Manis M, et al. Microglia-mediated T cell infiltration drives neurodegeneration in tauopathy. Nature. 2023;615:668-77.
38. Kaya T, Mattugini N, Liu L, et al. CD8+ T cells induce interferon-responsive oligodendrocytes and microglia in white matter aging. Nat Neurosci. 2022;25:1446-57.
39. Plantone D, Pardini M, Locci S, Nobili F, De Stefano N. B lymphocytes in Alzheimer’s disease - a comprehensive review. J of Alzheimers Dis. 2022;88:1241-62.
40. Paouri E, Georgopoulos S. Systemic and CNS inflammation crosstalk: implications for Alzheimer’s disease. Curr Alzheimer Res. 2019;16:559-74.
41. Wu J, Gao G, Shi F, et al. Activated microglia-induced neuroinflammatory cytokines lead to photoreceptor apoptosis in Aβ-injected mice. J Mol Med. 2021;99:713-28.
42. Unger M, Li E, Scharnagl L, et al. CD8+ T-cells infiltrate Alzheimer’s disease brains and regulate neuronal- and synapse-related gene expression in APP-PS1 transgenic mice. Brain Behav Immun. 2020;89:67-86.
44. Bettcher BM, Tansey MG, Dorothée G, Heneka MT. Peripheral and central immune system crosstalk in Alzheimer disease - a research prospectus. Nat Rev Neurol. 2021;17:689-701.
45. Wang L, Zhang Y, Zhao Y, Marshall C, Wu T, Xiao M. Deep cervical lymph node ligation aggravates AD‐like pathology of APP/PS1 mice. Brain Pathol. 2018;29:176-92.
46. Kim K, Abramishvili D, Du S, et al. Meningeal lymphatics-microglia axis regulates synaptic physiology. Cell. 2025;188:2705-19.e23.
47. Tavares GA, Louveau A. Meningeal lymphatics: an immune gateway for the central nervous system. Cells. 2021;10:3385.
48. Smith AJ, Duan T, Verkman AS. Aquaporin-4 reduces neuropathology in a mouse model of Alzheimer’s disease by remodeling peri-plaque astrocyte structure. Acta Neuropathol Commun. 2019;7:74.
49. Mestre H, Hablitz LM, Xavier AL, et al. Aquaporin-4-dependent glymphatic solute transport in the rodent brain. ELife. 2018;7:e40070.
50. Yang J, Lunde LK, Nuntagij P, et al. Loss of astrocyte polarization in the tg-ArcSwe mouse model of Alzheimer’s disease. J Alzheimers Dis. 2011;27:711-22.
51. Zeppenfeld DM, Simon M, Haswell JD, et al. Association of perivascular localization of aquaporin-4 with cognition and Alzheimer disease in aging brains. JAMA Neurol. 2017;74:91-9.
52. Mentis AA, Dardiotis E, Chrousos GP. Apolipoprotein E4 and meningeal lymphatics in Alzheimer disease: a conceptual framework. Mol Psychiatry. 2020;26:1075-97.
53. Raulin A, Doss SV, Trottier ZA, Ikezu TC, Bu G, Liu C. ApoE in Alzheimer’s disease: pathophysiology and therapeutic strategies. Mol Neurodegener. 2022;17:72.
54. Kaji S, Berghoff SA, Spieth L, et al. Apolipoprotein E aggregation in microglia initiates Alzheimer’s disease pathology by seeding β-amyloidosis. Immunity. 2024;57:2651-68.e12.
55. Bell RD, Winkler EA, Singh I, et al. Apolipoprotein E controls cerebrovascular integrity via cyclophilin A. Nature. 2012;485:512-6.
56. Kang KM, Park C, Byun MS, et al. ; KBASE Research Group. APOE4 modulates the association between DTI‐ALPS index and Alzheimer’s pathologies. Alzheimers Dement. 2025;21:e70837.
57. Achariyar TM, Li B, Peng W, et al. Glymphatic distribution of CSF-derived apoE into brain is isoform specific and suppressed during sleep deprivation. Mol Neurodegener. 2016;11:74.
58. Devenish SRA. The current landscape in Alzheimer’s disease research and drug discovery. Drug Discov Today. 2020;25:943-5.
59. Lyu D, Lyu X, Huang L, Fang B. Effects of three kinds of anti-amyloid-β drugs on clinical, biomarker, neuroimaging outcomes and safety indexes: a systematic review and meta-analysis of phase II/III clinical trials in Alzheimer’s disease. Ageing Res Rev. 2023;88:101959.
60. Yeo-Teh NSL, Tang BL. A review of scientific ethics issues associated with the recently approved drugs for Alzheimer’s disease. Sci Eng Ethics. 2023;29:2.
61. Wu YH, Feenstra MGP, Zhou JN, et al. Molecular changes underlying reduced pineal melatonin levels in Alzheimer disease: alterations in preclinical and clinical stages. J Clin Endocrinol Metab. 2003;88:5898-906.
62. Pappolla MA, Matsubara E, Vidal R, et al. Melatonin treatment enhances Aβ lymphatic clearance in a transgenic mouse model of amyloidosis. Curr Alzheimer Res. 2018;15:637-42.
63. Wade AG, Farmer M, Harari G, et al. Add-on prolonged-release melatonin for cognitive function and sleep in mild to moderate Alzheimer’s disease: a 6-month, randomized, placebo-controlled, multicenter trial. Clin Interv Aging. 2014;9:94761.
64. Manescu MD, Catalin B, Baldea I, et al. Aquaporin 4 modulation drives amyloid burden and cognitive abilities in an APPPS1 mouse model of Alzheimer’s disease. Alzheimers Dement. 2025;21:e70164.
65. Sasaki K, Fujita H, Sato T, et al. GLP-1 receptor signaling restores aquaporin 4 subcellular polarization in reactive astrocytes and promotes amyloid β clearance in a mouse model of Alzheimer’s disease. Biochem Biophys Res Commun. 2024;741:151016.
66. Zhang B, Li W, Zhuo Y, et al. L-3-n-butylphthalide effectively improves the glymphatic clearance and reduce amyloid-β deposition in Alzheimer’s transgenic mice. J Mol Neurosci. 2021;71:1266-74.
67. Zhang X, Cao R, Zhu C, et al. Mechanism of anti-AD action of OAB-14 by enhancing the function of glymphatic system. Neurochem Int. 2023;171:105633.
68. Ye C, Wang S, Niu L, et al. Unlocking potential of oxytocin: improving intracranial lymphatic drainage for Alzheimer’s disease treatment. Theranostics. 2024;14:4331-51.
69. Maki T, Okamoto Y, Carare RO, et al. Phosphodiesterase III inhibitor promotes drainage of cerebrovascular β‐amyloid. Ann Clin Transl Neurol. 2014;1:519-33.
70. Kimura T, Hamazaki TS, Sugaya M, et al. Cilostazol improves lymphatic function by inducing proliferation and stabilization of lymphatic endothelial cells. J Dermatol Sci. 2014;74:150-8.
71. Aspelund A, Antila S, Proulx ST, et al. A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules. J Exp Med. 2015;212:991-9.
72. Antila S, Karaman S, Nurmi H, et al. Development and plasticity of meningeal lymphatic vessels. J Exp Med. 2017;214:3645-67.
73. Plog BA, Mestre H, Olveda GE, et al. Transcranial optical imaging reveals a pathway for optimizing the delivery of immunotherapeutics to the brain. JCI Insight. 2018;3:e126138.
74. Lilius TO, Blomqvist K, Hauglund NL, et al. Dexmedetomidine enhances glymphatic brain delivery of intrathecally administered drugs. J Controlled Release. 2019;304:29-38.
75. Lopes DM, Wells JA, Ma D, et al. Glymphatic inhibition exacerbates tau propagation in an Alzheimer’s disease model. Alzheimers Res Ther. 2024;16:71.
76. Wang J, Wong YK, Liao F. What has traditional Chinese medicine delivered for modern medicine? Expert Rev Mol Med. 2018;20:e4.
77. Wu Y, Zhang T, Li X, et al. Borneol-driven meningeal lymphatic drainage clears amyloid-β peptide to attenuate Alzheimer-like phenotype in mice. Theranostics. 2023;13:106-24.
78. Li J, Hao Y, Wang S, et al. Yuanzhi powder facilitated Aβ clearance in APP/PS1 mice: Target to the drainage of glymphatic system and meningeal lymphatic vessels. J Ethnopharmacol. 2024;319:117195.
79. Liu X, Zhang H, Xiang J, et al. Jiawei Xionggui Decoction promotes meningeal lymphatic vessels clearance of β-amyloid by inhibiting arachidonic acid pathway. Phytomedicine. 2024;135:156041.
80. Wang FJ, Wang SX, Chai LJ, Zhang Y, Guo H, Hu LM. Xueshuantong injection (lyophilized) combined with salvianolate lyophilized injection protects against focal cerebral ischemia/reperfusion injury in rats through attenuation of oxidative stress. Acta Pharmacol Sin. 2017;39:998-1011.
81. Zheng R, Huang YM, Zhou Q. Xueshuantong improves functions of lymphatic ducts and modulates inflammatory responses in Alzheimer’s disease mice. Front Pharmacol. 2021;12:605814.
82. Song B, Ao Q, Niu Y, et al. Amyloid beta-peptide worsens cognitive impairment following cerebral ischemia-reperfusion injury. Neural Regen Res 2013;8:2449-57. DOI: 10.3969/j.issn.1673-5374.2013.26.006.
83. Wang B, Lyu Z, Chan Y, et al. Tongxinluo exerts inhibitory effects on pyroptosis and amyloid-β peptide accumulation after cerebral ischemia/reperfusion in rats. Evid Based Complement Alternat Med. 2021;2021:5788602.
84. Lyu Z, Li Q, Yu Z, et al. Yi-Zhi-Fang-Dai formula exerts neuroprotective effects against pyroptosis and blood-brain barrier-glymphatic dysfunctions to prevent amyloid-beta acute accumulation after cerebral ischemia and reperfusion in rats. Front Pharmacol. 2021;12:791059.
85. Okamoto M, Mizuuchi D, Omura K, et al. High-intensity intermittent training enhances spatial memory and hippocampal neurogenesis associated with BDNF signaling in rats. Cereb Cortex. 2021;31:4386-97.
86. Van Reet J, Tunnell K, Anderson K, et al. Evaluation of advective solute infiltration into porous media by pulsed focused ultrasound-induced acoustic streaming effects. Ultrasonography. 2024;43:35-46.
87. Lee Y, Choi Y, Park EJ, et al. Improvement of glymphatic-lymphatic drainage of beta-amyloid by focused ultrasound in Alzheimer’s disease model. Sci Rep. 2020;10:16144.
88. Mehta RI, Carpenter JS, Mehta RI, et al. Ultrasound-mediated blood-brain barrier opening uncovers an intracerebral perivenous fluid network in persons with Alzheimer’s disease. Fluids Barriers CNS. 2023;20:46.
89. Zhang X, Sun Z, Wu D, et al. Effects of cerebellar intermittent theta-burst stimulation on patients with Alzheimer’s disease: A randomized controlled trial. Journal of Alzheimer’s Disease. 2025;107:1187-99.
90. Xia KP, Pang J, Li SL, Zhang M, Li HL, Wang YJ. Effect of electroacupuncture at governor vessel on learning-memory ability and serum level of APP, Aβ1-42 in patients with Alzheimer’s disease. Zhongguo Zhen Jiu. 2020;40:375-8.
91. Feng Q, Bin LL, Zhai YB, Xu M, Liu ZS, Peng WN. Long-term efficacy and safety of electroacupuncture on improving MMSE in patients with Alzheimer’s disease. Zhongguo Zhen Jiu. 2019;39:3-8.
92. Liang P, Li L, Zhang Y, et al. Electroacupuncture Improves Clearance of Amyloid-β through the Glymphatic System in the SAMP8 Mouse Model of Alzheimer’s Disease. Neural Plast. 2021;2021:1-11.
93. Wang LM, Zhao TT, Zhou HP, et al. Effect of electroacupuncture on recognition memory and levels of Aβ, inflammatory factor proteins and aquaporin 4 in hippocampus of APP/PS1 double transgenic mice. Zhen Ci Yan Jiu. 2020;45:431-7.
94. Glass GE. Photobiomodulation: a review of the molecular evidence for low level light therapy. J Plast Reconstr Aesthet Surg. 2021;74:1050-60.
95. Santana-Blank L, Rodríguez-Santana E, Santana-Rodríguez K. Theoretic, experimental, clinical bases of the water oscillator hypothesis in near-infrared photobiomodulation. Photomed Laser Surg. 2010;28:S41-52.
96. de Freitas LF, Hamblin MR. Proposed mechanisms of photobiomodulation or low-level light therapy. IEEE J Sel Top Quantum Electron. 2016;22:37000417.
97. Ganeshan V, Skladnev NV, Kim JY, Mitrofanis J, Stone J, Johnstone DM. Pre-conditioning with remote photobiomodulation modulates the brain transcriptome and protects against MPTP insult in mice. Neuroscience. 2019;400:85-97.
98. George S, Hamblin MR, Abrahamse H. Photobiomodulation‐induced differentiation of immortalized adipose stem cells to neuronal cells. Lasers Surg Med. 2020;52:1032-40.
99. Shen Q, Guo H, Yan Y. Photobiomodulation for neurodegenerative diseases: a scoping review. Int J Mol Sci. 2024;25:1625.
100. Zinchenko E, Navolokin N, Shirokov A, et al. Pilot study of transcranial photobiomodulation of lymphatic clearance of beta-amyloid from the mouse brain: breakthrough strategies for non-pharmacologic therapy of Alzheimer’s disease. Biomed Opt Express. 2019;10:4003-17.
101. Semyachkina-Glushkovskaya O, Klimova M, Iskra T, et al. Transcranial photobiomodulation of clearance of beta-amyloid from the mouse brain: effects on the meningeal lymphatic drainage and blood oxygen saturation of the brain. Adv Exp Med Biol. 2021;1269:57-61.
102. Wang M, Yan C, Li X, et al. Non-invasive modulation of meningeal lymphatics ameliorates ageing and Alzheimer’s disease-associated pathology and cognition in mice. Nat Commun. 2024;15:1453.
103. Wu W, Zhao Y, Cheng X, et al. Modulation of glymphatic system by visual circuit activation alleviates memory impairment and apathy in a mouse model of Alzheimer’s disease. Nat Commun. 2025;16:63.
104. Lian X, Liu Z, Gan Z, et al. Targeting the glymphatic system to promote α-synuclein clearance: a novel therapeutic strategy for Parkinson’s disease. Neural Regen Res. 2026;21:233-47.
105. Vedam-Mai V, Van Battum EY, Kamphuis W, et al. Deep brain stimulation and the role of astrocytes. Mol Psychiatry. 2012;17:124-31.
106. Jang JS, Choi C, Yi J, et al. High frequency electrical stimulation promotes expression of extracellular matrix proteins from human astrocytes. Mol Biol Rep. 2019;46:4369-75.
107. Naour AL, Beziat E, Kam JH, Magistretti P, Benabid AL, Mitrofanis J. Do astrocytes respond to light, sound, or electrical stimulation? Neural Regen Res. 2023;18:2343-7.
108. Wang Y, Zhan G, Cai Z, et al. Vagus nerve stimulation in brain diseases: therapeutic applications and biological mechanisms. Neurosci Biobehav Rev. 2021;127:37-53.
109. Cheng KP, Brodnick SK, Blanz SL, et al. Clinically-derived vagus nerve stimulation enhances cerebrospinal fluid penetrance. Brain Stimul. 2020;13:1024-30.
110. Chase HW, Boudewyn MA, Carter CS, Phillips ML. Transcranial direct current stimulation: a roadmap for research, from mechanism of action to clinical implementation. Mol Psychiatry. 2019;25:397-407.
111. Wang Y, Monai H. Transcranial direct current stimulation alters cerebrospinal fluid-interstitial fluid exchange in mouse brain. Brain Stimul. 2024;17:620-32.
112. Huuha AM, Norevik CS, Moreira JBN, et al. Can exercise training teach us how to treat Alzheimer’s disease? Ageing Res Rev. 2022;75:101559.
113. Li S. Benefits of physical exercise on Alzheimer’s disease: an epigenetic view. Ageing Neur Dis. 2023;3:6.
114. Lee TH, Formolo DA, Kong T, et al. Potential exerkines for physical exercise-elicited pro-cognitive effects: Insight from clinical and animal research. Int Rev Neurobiol. 2019;147:361-95.
115. Guure CB, Ibrahim NA, Adam MB, Said SM. Impact of physical activity on cognitive decline, dementia, and its subtypes: meta-analysis of prospective studies. Biomed Res Int. 2017;2017:9016924.
116. Khodadadi D, Gharakhanlou R, Naghdi N, et al. Treadmill exercise ameliorates spatial learning and memory deficits through improving the clearance of peripheral and central amyloid-beta levels. Neurochem Res. 2018;43:1561-74.
117. He XF, Liu DX, Zhang Q, et al. Voluntary exercise promotes glymphatic clearance of amyloid beta and reduces the activation of astrocytes and microglia in aged mice. Front Mol Neurosci. 2017;10:144.
118. von Holstein-Rathlou S, Petersen NC, Nedergaard M. Voluntary running enhances glymphatic influx in awake behaving, young mice. Neurosci Lett. 2018;662:253-8.
119. Liang S, Liu H, Wang X, et al. Aerobic exercise improves clearance of amyloid-β via the glymphatic system in a mouse model of Alzheimer’s disease. Brain Res Bull. 2025;222:111263.
120. Liu Y, Hu PP, Zhai S, et al. Aquaporin 4 deficiency eliminates the beneficial effects of voluntary exercise in a mouse model of Alzheimer’s disease. Neural Regen Res. 2022;17:2079-88.
121. Li M, Xu J, Li L, et al. Voluntary wheel exercise improves glymphatic clearance and ameliorates colitis-associated cognitive impairment in aged mice by inhibiting TRPV4-induced astrocytic calcium activity. Exp Neurol. 2024;376:114770.
122. Gholipour P, Komaki A, Ramezani M, Parsa H. Effects of the combination of high-intensity interval training and ecdysterone on learning and memory abilities, antioxidant enzyme activities, and neuronal population in an amyloid-beta-induced rat model of Alzheimer’s disease. Physiol Behav. 2022;251:113817.
123. Feng S, Wu C, Zou P, et al. High-intensity interval training ameliorates Alzheimer’s disease-like pathology by regulating astrocyte phenotype-associated AQP4 polarization. Theranostics. 2023;13:3434-50.
124. Ma Y, Liang L, Zheng F, Shi L, Zhong B, Xie W. Association between sleep duration and cognitive decline. JAMA Netw Open. 2020;3:e2013573.
125. Benca R, Herring WJ, Khandker R, Qureshi ZP. Burden of insomnia and sleep disturbances and the impact of sleep treatments in patients with probable or possible Alzheimer’s disease: a structured literature review. J Alzheimers Dis. 2022;86:83-109.
126. Turton SM, Padgett S, Maisel MT, et al. Interactions between daily sleep-wake rhythms, γ-secretase, and amyloid-β peptide pathology point to complex underlying relationships. Biochim Biophys Acta Mol Basis Dis. 2025;1871:167840.
127. Thipani Madhu M, Balaji O, Kandi V, et al. Role of the glymphatic system in Alzheimer’s disease and treatment approaches: a narrative review. Cureus. 2024;16:e63448.
128. Pistollato F, Iglesias RC, Ruiz R, et al. Nutritional patterns associated with the maintenance of neurocognitive functions and the risk of dementia and Alzheimer’s disease: a focus on human studies. Pharmacol Res. 2018;131:32-43.
129. Wen J, Satyanarayanan SK, Li A, et al. Unraveling the impact of Omega-3 polyunsaturated fatty acids on blood-brain barrier (BBB) integrity and glymphatic function. Brain Behav Immun. 2024;115:335-55.
130. Ren H, Luo C, Feng Y, et al. Omega‐3 polyunsaturated fatty acids promote amyloid‐β clearance from the brain through mediating the function of the glymphatic system. FASEB J. 2017;31:282-93.
131. Jovanovic Macura I, Milanovic D, Tesic V, et al. The impact of high-dose fish oil supplementation on Mfsd2a, Aqp4, and amyloid-β expression in retinal blood vessels of 5xFAD Alzheimer’s mouse model. Int J Mol Sci. 2024;25:9400.
132. Xie Q, Louveau A, Pandey S, Zeng W, Chen WF. Rewiring the brain: the next frontier in supermicrosurgery. Plast Reconstr Surg. 2023;153:494e-5e.
133. Li X, Zhang C, Fang Y, et al. Promising outcomes 5 weeks after a surgical cervical shunting procedure to unclog cerebral lymphatic systems in a patient with Alzheimer’s disease. Gen Psychiatr. 2024;37:e101641.
134. Fang R, Jin L, Lu H, Xie Q, Yang X, Kueckelhaus M. A novel microsurgical model of cervical lymph node-to-vein anastomosis (LNVA) for studying brain lymphatic outflow. J Craniofac Surg. 2025;36:2160-3.
135. Chen JY, Zhao DW, Yin Y, et al. Deep cervical lymphovenous anastomosis (LVA) for Alzheimer’s disease: microsurgical procedure in a prospective cohort study. Int J Surg. 2025;111:4211-21.
136. Fu X, Zhang J, Xiao Q, et al. Deep cervical lymphatic-venous anastomosis attenuates cognitive dysfunction and biomarker abnormalities in severe Alzheimer’s disease: a prospective single‐arm study. Alzheimers Dement. 2026;22:e71150.




