Human Umbilical Cord Blood-Mononuclear Cell Transplantation Improves Glymphatic System Activity in Patients with Multiple System Atrophy

Motivation: Glymhatic system as a therapeutic target for multiple system atrophy (MSA) lacks imaging markers. Goal(s): Our goal was to determine changes in imaging parameters after human umbilical cord blood mononuclear cells (hUCB-MCs) transplantation. Approach: Diffusion tensor image analysis along the perivascular space (DTI-ALPS) of MSA patients were compared with healthy controls and the ALPS indices of patients were compared before and after hUCB-MCs transplantation. Results: We found that MSA patients had lower ALPS values than health controls and that ALPS values increased after treatment. Impact: Our demonstration of a detectable decline in MSA patients and an uptick after treatment utilizing ALPS metrics provides an imaging marker to monitor the glymphatic system after hUCB-MCs transplantation.