Neurodegenerative Disease:
The Glymphatic System, Cervical Spine and Omega-3 Fatty Acids
Sarah Kotlerman, DC Clinical Lead, Averio Health Institute
Neurodegenerative diseases are defined as the progressive loss of nerve function over time that ultimately leads to nerve death.1 The Institute of Health Metrics and Evaluation estimates that neurological diseases have a global prevalence of 43% of all diagnosed diseases, and these numbers are growing each year.2 According to NIH data published in 2022, Alzheimer’s dementia affects approximately 6 million people in the United States.3 Alzheimer’s dementia diagnoses represents 60% of reported neurodegenerative diagnoses in the United States.
NIH data makes a strong argument for Alzheimer’s disease being an age-related disease, with over 50% of people over 85 years of age in the United States diagnosed with Alzheimer’s disease.2, 3, 4 However, this aggressive trend of aging people being diagnosed with dementia or Alzheimer’s dementia does not exist globally. The lack of global comparison data suggests that there are additional factors beyond age that are affecting the brains of Americans and increasing the presentation of neurodegenerative disease. It would be appropriate to label these forces as “root causes” or subclinical findings that drive inflammaging in the brain and body, thereby challenging tissue function and integrity over time. The million-dollar question, or billion-dollar question in the case of Alzheimer’s dementia, is whether there could be a clinical consensus on what is causing and predisposing the American population towards Alzheimer’s disease, and what do we do as a society if it is determined that drugs and surgery, the bulk of our American healthcare system, cannot be used as a positive intervention towards the root cause of neurodegenerative disease. A staggering fact about Alzheimer’s dementia is that over 300 billion dollars are spent each year to support live-in care for those diagnosed with Alzheimer’s dementia.5, 6
Alzheimer’s disease
places a tremendous economic burden on American society, and with annual numbers rising each year, it is hard to comprehend how valuable it would be to American society to have a solution to slow, prevent, and/or reverse Alzheimer’s dementia.
The primary diagnostic difference between Alzheimer’s dementia and other non-specific dementias is the accumulation of abnormal proteins in the brain tissues.7
So while all Alzheimer’s is a type
of dementia, not all dementia is Alzheimer’s dementia. During Alzheimer’s dementia, there is a progressive accumulation of
22 www .ch ir oh ealth.or g
abnormal proteins in the brain; these proteins are often referred to as amyloid plaques or tau proteins. These proteins are normally found in the intestines of meat-eaters, so there is significant scientific effort and interest in understanding the mechanisms by which these proteins can and do travel from the gut to the brain in neurodegenerative cases. One primary system being studied as a potential transport for abnormal proteins is the glymphatic system. The glymphatic system is a specialized, pulsating fluid movement system around the brain that contains over 300 different proteins, as well as glucose, lipids, amino acids, growth factors, and neuromodulators.8
The glymphatic system is also responsible
for the removal of abnormal proteins, metabolic waste, and toxins from the brain. In simple terms, your glymphatic system removes toxins and delivers nutrients.
Damage or blockage to the glymphatic system can have widespread pathological consequences, especially in neurodegenerative diseases. A 2024 study goes as far as to call “glymphatic failure a predictor of amyloid deposition, neurodegeneration, and the clinical presentation of Alzheimer’s dementia”.9
Additional studies note that blockage or damage
to the glymphatic system can reduce neural plasticity, impair neural cell repair, impair sleep, cause systemic inflammation, suppress the immune system, and more.10, 11
Your brain’s glymphatic system connects directly to your spinal lymphatic system, which moves fluid that washes, buffers, and protects the brainstem and spinal cord. Whereas the spinal lymphatic system is largely pumped by repetitive movement stimulated by the movement of the sacrum (i.e. walking, rocking chair, exercise), the glymphatic system is primary activated during sleep through a respiratory pulse that moves fluid from the anterior spinal canal up and over the frontal area of the brain, over the middle part of the brain (into various deep sinuses of the brain) down the back of the brain, around the cerebellum and then down the posterior spinal cord space. There is additional evidence that posture during sleep is critical for optimal glymphatic function, with a 2005 MRI study reporting a 58% reduction in cerebrospinal fluid flow between the cranium and the spinal canal when a person was seated during sleep compared with lying supine.12
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