{ "abstract": "The vascular system regulates brain clearance through arterial blood flow and lymphatic drainage of cerebrospinal fluid (CSF). Idiopathic intracranial hypertension (IIH), characterized by elevated intracranial pressure and dural venous sinus stenoses, can be treated by restoring venous blood flow via venous stenting, suggesting a role for venous blood flow in brain fluid clearance. Using magnetic resonance imaging (MRI) in IIH patients and healthy controls, we identified that dural venous stenoses in IIH were associated with impaired lymphatic drainage, perivenous fluid retention, and brain fluid accumulation. To investigate this further, we developed a mouse model with bilateral jugular vein ligation (JVL), which recapitulated key human findings, including intracranial hypertension, calvarial lymphatic regression, and brain swelling due to impaired clearance. To further dissect the respective roles of dural lymphatics and venous blood flow in brain clearance, we performed JVL in mice with dural lymphatic depletion. These mice exhibited spontaneous elevated intracranial pressure, but JVL did not further exacerbate this effect. Moreover, the synchronous restoration of brain clearance and dural lymphatics observed in mice after JVL was absent in lymphatic-deficient mice.Transcriptomic analyses revealed that lymphatic remodeling induced by JVL was driven by VEGF-C signaling between dural mesenchymal and lymphatic endothelial cells. These findings establish the dural venous sinuses as a critical platform where venous blood flow interacts with mesenchymal cells to preserve dural lymphatic integrity and function, essential for brain fluid clearance.", "abstract_shown": true, "affiliations": [ "Paris Brain Institute, Université Pierre et Marie Curie Paris 06, INSERM UMRS 1127, Sorbonne Université, Paris, France", "Institut Pasteur, Université de Paris, CNRS UMR 3571, Paris, France", "Université Paris Cité, Department of Neurology, AP-HP, Hôpital Lariboisière, FHU NeuroVasc, Paris, France", "Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA", "Department of Neuroradiology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France", "Paris Cardiovascular Research Center, Université Paris Cité, INSERM U970, Paris, France", "Department of Internal Medicine, Cardiovascular Research Center, Yale University School of Medicine, New Haven, CT, USA", "Institut Pasteur, Université de Paris Cité, INSERM U1224, Paris, France", "Yale University, New Haven, CT, USA", "Department of Neurology, Yale University School of Medicine, New Haven, CT, USA", "Laboratoire Hématologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France", "Optimisation Thérapeutique en Neuropsychopharmacologie, INSERM U1144, Paris, France", "Department of Surgery, Beth Israel Deaconess Medical center, Harvard Medical School, Boston, MA, USA", "Université Paris Cité, Department of Neurology, AP-HP, Hôpital Lariboisière, FHU NeuroVasc 2030, Institut Universitaire de France, Paris, France", "Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, CT, USA", "Department of Neuroradiology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France. stephanie.lenck@icm-institute.org", "Paris Brain Institute, Université Pierre et Marie Curie Paris 06, INSERM UMRS 1127, Sorbonne Université, Paris, France. stephanie.lenck@icm-institute.org" ], "article_type": null, "arxiv": null, "author_total": 33, "authors": [ { "affs": [ 0 ], "name": "Marie-Renée El Kamouh", "orcid": "0000-0003-1918-0032" }, { "affs": [ 0 ], "name": "Myriam Spajer", "orcid": "0000-0001-7483-2983" }, { "affs": [ 0 ], "name": "Ruchith Singhabahu", "orcid": "0009-0002-1242-1534" }, { "affs": [ 0 ], "name": "Anne-Laure Joly Marolany" }, { "affs": [ 1 ], "name": "Kurt A. Sailor", "orcid": "0000-0002-9574-6838" }, { "affs": [ 0 ], "name": "Laura Mouton", "orcid": "0000-0002-6698-3412" }, { "affs": [ 2 ], "name": "Diana Doukhi", "orcid": "0009-0008-9359-0471" }, { "affs": [ 3 ], "name": "Sunil Koundal", "orcid": "0000-0003-3969-1091" }, { "affs": [ 3 ], "name": "Tanner Metcalfe" }, { "affs": [ 0 ], "name": "Dominique Langui", "orcid": "0000-0001-5484-2359" }, { "affs": [ 4, 0 ], "name": "Abel Grine" }, { "affs": [ 5 ], "name": "Kevin Boyé", "orcid": "0000-0002-5749-959X" }, { "affs": [ 6, 5 ], "name": "Felipe Saceanu Leser", "orcid": "0000-0002-7499-2765" }, { "affs": [ 7, 1 ], "name": "Justus Ninnemann", "orcid": "0000-0002-9214-4882" }, { "affs": [ 0 ], "name": "Joshua Gottschalk", "orcid": "0009-0008-2413-443X" }, { "affs": [ 0, 8 ], "name": "Cyrus Sadeghi" }, { "affs": [ 9 ], "name": "Xu Han", "orcid": "0000-0002-4289-1636" }, { "affs": [ 9 ], "name": "Lígia Simões Braga Boisserand", "orcid": "0000-0002-0058-2894" }, { "affs": [ 0 ], "name": "David Akbar" }, { "affs": [ 0 ], "name": "Jérôme Van Wassenhove", "orcid": "0000-0001-7298-465X" }, { "affs": [ 0 ], "name": "Anthony Ruze" }, { "affs": [ 0 ], "name": "Amelle Nasry" }, { "affs": [ 10, 11 ], "name": "Marie‐Charlotte Bourrienne", "orcid": "0000-0003-0125-9236" }, { "affs": [ 0 ], "name": "Elora Buscher" }, { "affs": [ 12 ], "name": "Young‐Kwon Hong", "orcid": "0000-0001-8245-875X" }, { "affs": [ 11, 13 ], "name": "Mikaël Mazighi", "orcid": "0000-0003-0911-8999" }, { "affs": [ 1 ], "name": "Pierre‐Marie Lledo", "orcid": "0000-0002-8156-7003" }, { "affs": [ 3 ], "name": "Helene Benveniste", "orcid": "0000-0002-2887-6667" }, { "affs": [ 0 ], "name": "Mathieu David Santin", "orcid": "0000-0003-4251-0538" }, { "affs": [ 14, 6, 5 ], "name": "Anne Eichmann", "orcid": "0000-0001-5563-210X" }, { "affs": [ 4, 0 ], "name": "Stéphane Lehéricy", "orcid": "0000-0002-5802-3518" }, { "affs": [ 9, 0 ], "name": "Jean‐Léon Thomas", "orcid": "0000-0003-3397-0292" }, { "affs": [ 15, 16 ], "name": "Stéphanie Lenck", "orcid": "0000-0003-4952-8490" } ], "bibtex": "https://research.draconitic.com/paper/bdsjmcdjsc869.bib", "cited_by": 10, "doi": "10.1038/s41593-026-02358-1", "fulltext_url": null, "id": "bdsjmcdjsc869", "issns": [ "1097-6256", "1546-1726" ], "landing_url": "https://doi.org/10.1038/s41593-026-02358-1", "language": "en", "licence": "CC-BY-NC-ND", "licence_label": "CC BY-NC-ND", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2728|Cerebral Venous Sinus Thrombosis" ] ], "openalex": "W7170086960", "pdf_url": null, "pmcid": "PMC13533833", "pmid": "42487032", "published": "2026-07-22", "publisher": "Nature Portfolio", "ris": "https://research.draconitic.com/paper/bdsjmcdjsc869.ris", "sources": [ { "first_seen": "2026-11-04T13:21:15Z", "native_id": "W7170086960", "source": "openalex", "url": "https://doi.org/10.1038/s41593-026-02358-1" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2728|Cerebral Venous Sinus Thrombosis", "subfield": "neurology" } ], "title": "Cerebral venous blood flow regulates intracerebral pressure and brain clearance via meningeal lymphatic vessels", "title_text": "Cerebral venous blood flow regulates intracerebral pressure and brain clearance via meningeal lymphatic vessels", "type": "peer-reviewed", "updated_at": "2026-11-04T13:21:15Z", "url": "https://research.draconitic.com/paper/bdsjmcdjsc869", "venue": "Nature Neuroscience", "versions": [] }