Impaired Glymphatic Clearance Linked to Neuroinflammation and Disability in Multiple Sclerosis

Motivation: Multiple sclerosis (MS) involves a proinflammatory state leading to cellular waste accumulation and disability. This study investigates the glymphatic system's waste clearance role, hypothesizing that lymphatic dysfunction contributes to MS-related disability. Goal(s): Explore the relationship between glymphatic function, meningeal lymphatic vessels (mLV), and MS-related disability. Approach: The study examined 49 MS patients using MRI to visualize mLVs and evaluate glymphatic stasis via CSF fraction (CSFF), analyzing links between mLV volume, CSFF, and MS outcomesResults: With age, cortical CSFF increases. mLV volume also increases with CSFF. Higher cortical CSFF is associated with more lesions and disability, suggesting glymphatic dysfunction contributes to MS-related disability. Impact: Our study suggests that glymphatic dysfunction contributes to lesion burden and disability in multiple sclerosis, highlighting the importance of lymphatic clearance mechanisms in disease progression.