Brain Washing

Cleaning waste from the brain is an essential function of sleep—and it could help ward off dementia

- LYDIA DENWORTH

YOU CAN SEE IT COMING in right there, that little spot,” says neuroscientist and engineer Laura Lewis.

A remarkably bright pulsing dot has appeared on the monitor in front of us. We are watching, in real time, the brain activity of a graduate student named Nick, who is having an afternoon nap inside an imaging machine at the Massachusetts Institute of Technology, where Lewis has her laboratory.

The bright spot first appears toward the bottom of the screen, about where Nick’s throat meets his jaw. It moves slowly upward, fades and then is followed by another bright dot. “It really comes and goes,” says Lewis, who is also affiliated with Massachusetts General Hospital. “It’s in waves.” This moving dot depicts something few people have ever seen: fresh cerebrospinal fluid flowing from the spinal cord into the brain, part of a process that researchers are now learning is vital for keeping us healthy.

For decades biologists have pondered a basic problem. As human brains whir and wonder throughout the day, they generate waste—excess proteins and other molecules that can be toxic if not removed. Among those proteins are amyloid beta and tau, key drivers of Alzheimer’s disease. Until recently, it was entirely unclear how the brain takes out this potentially neurotoxic trash.

In the rest of the body, garbage removal is handled initially by the lymphatic system. Excess fluid and the waste it carries move from tissue into the spleen, lymph nodes and other parts of the system, where certain particles are removed and put into the bloodstream to be excreted. It was long thought that the brain can’t use the same trick, because the so-called blood-brain barrier, a protective border that keeps infections from reaching critical neural circuitry, stops the transport of most everything in and out.