Paravascular drainage of solutes, including b-amyloid (Ab), appears to be an important process in brain health and diseases such as Alzheimer's disease (AD) and cerebral amyloid angiopathy (CAA). However, the major driving force for clearance remains largely unknown. Here we used in vivo twophoton microscopy in awake head-fixed mice to assess the role of spontaneous vasomotion in paravascular clearance. Vasomotion correlated with paravascular clearance of fluorescent dextran from the interstitial fluid. Increasing the amplitude of vasomotion by means of visually evoked vascular responses resulted in increased clearance rates in the visual cortex of awake mice. Evoked vascular reactivity was impaired in mice with CAA, which corresponded to slower clearance rates. Our findings suggest that low-frequency arteriolar oscillations drive drainage of solutes. Targeting naturally occurring vasomotion in patients with CAA or AD may be a promising early therapeutic option for prevention of Ab accumulation in the brain.

Mitochondria contribute to shape intraneuronal Ca 2+ signals. Excessive Ca 2+ taken up by mitochondria could lead to cell death. Amyloid beta (Aβ) causes cytosolic Ca 2+ overload, but the effects of Aβ on mitochondrial Ca 2+ levels in Alzheimer's disease (AD) remain unclear. Using a ratiometric Ca 2+ indicator targeted to neuronal mitochondria and intravital multiphoton microscopy, we find increased mitochondrial Ca 2+ levels associated with plaque deposition and neuronal death in a transgenic mouse model of cerebral β-amyloidosis. Naturally secreted soluble Aβ applied onto the healthy brain increases Ca 2+ concentration in mitochondria, which is prevented by blockage of the mitochondrial calcium uniporter. RNAsequencing from post-mortem AD human brains shows downregulation in the expression of mitochondrial influx Ca 2+ transporter genes, but upregulation in the genes related to mitochondrial Ca 2+ efflux pathways, suggesting a counteracting effect to avoid Ca 2+ overload. We propose lowering neuronal mitochondrial Ca 2+ by inhibiting the mitochondrial Ca 2+ uniporter as a novel potential therapeutic target against AD.