Could dexmedetomidine be repurposed as a glymphatic enhancer?

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Cerebrospinal fluid (CSF) flows through the central nervous system (CNS) via the glymphatic pathway to clear the interstitium of metabolic waste. In preclinical studies, glymphatic fluid flow rate increases with low central noradrenergic tone and slow-wave activity during natural sleep and general anesthesia. By contrast, sleep deprivation reduces glymphatic clearance and leads to intracerebral accumulation of metabolic waste, suggesting an underlying mechanism linking sleep disturbances with neurodegenerative diseases. The selective α2-adrenergic agonist dexmedetomidine is a sedative drug that induces slow waves in the electroencephalogram, suppresses central noradrenergic tone, and preserves glymphatic outflow. As recently developed dexmedetomidine formulations enable self-administration, we suggest that dexmedetomidine could serve as a sedative-hypnotic drug to enhance clearance of harmful waste from the brain of those vulnerable to neurodegeneration.

Original languageEnglish
JournalTrends in Pharmacological Sciences
Volume43
Issue number12
Pages (from-to)1030-1040
Number of pages11
ISSN0165-6147
DOIs
Publication statusPublished - 2022

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© 2022 The Authors

    Research areas

  • cerebrospinal fluid, delirium, dexmedetomidine, glymphatic system, neurodegeneration, α-adrenergic agonist

ID: 345371961