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Research advances in the potential association between the glymphatic system and pain mechanisms and its assessment by MRI
MAO Jiaojiao  YANG Wei  LIU Yuqing  QIU Zhiqiang  XU Xiaoxue 

Cite this article as MAO J J, YANG W, LIU Y Q, et al. Research advances in the potential association between the glymphatic system and pain mechanisms and its assessment by MRI[J]. Chin J Magn Reson Imaging, 2026, 17(6): 162-172. DOI:10.12015/issn.1674-8034.2026.06.021.


[Abstract] The glymphatic system (GS) is a crucial pathway for interstitial fluid drainage and waste clearance in the central nervous system, playing a key role in removing metabolic byproducts from the brain and maintaining neuronal microenvironment homeostasis. In recent years, advances in MRI have enabled in vivo assessment of the GS. Previous studies have demonstrated that GS dysfunction is associated not only with neurodegenerative diseases and cerebral small vessel disease, but also potentially with the development and persistence of certain pain conditions. However, due to the limited number of studies investigating GS functional alterations in pain states, a unified understanding of the underlying mechanisms remains lacking. Therefore, this article aims to elucidate the structural and functional mechanisms of the GS from the perspective of the brain's metabolic waste clearance axis, and to explore the potential pathways through which pain may influence different components of this system. In addition, it summarizes recent advances in the application of various MRI techniques for evaluating the GS and related structures, and reviews imaging evidence across different pain conditions. Finally, the limitations and future directions of the current research are summarized and discussed, with the aim of providing new insights into pain mechanism research and imaging evaluation.
[Keywords] glymphatic system；pain；magnetic resonance imaging；multimodal magnetic resonance imaging；diffusion magnetic resonance imaging

MAO Jiaojiao   YANG Wei   LIU Yuqing   QIU Zhiqiang   XU Xiaoxue*  

Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China

Corresponding author: XU X X, E-mail: nclittlesnownc@163.com

Conflicts of interest   None.

Received  2026-03-23
Accepted  2026-05-25
DOI: 10.12015/issn.1674-8034.2026.06.021
Cite this article as MAO J J, YANG W, LIU Y Q, et al. Research advances in the potential association between the glymphatic system and pain mechanisms and its assessment by MRI[J]. Chin J Magn Reson Imaging, 2026, 17(6): 162-172. DOI:10.12015/issn.1674-8034.2026.06.021.

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