May Glymphatic Drainage Improve Life Quality in Progressive Multiple Sclerosis Outpatients?

Sandro Mandolesi,1 Tarcisio Niglio,2 Chiara Lenci3 1Research Department of the Mediterranean Pole, Technoscience, Science and Technology Park, San Severo, Italy; 2Istituto Superiore di Sanità, Roma, Italy; 3“la Sapienza” University, Roma, ItalyCorrespondence: Tarcisio Niglio, Email [email protected]: The cerebral fluid-dynamic system plays a critical role in maintaining brain health and function. Recent studies identify the glymphatic system as primarily responsible for removing waste products and toxins from brain tissue. In recent years, we have achieved beneficial improvements in MS patients’ symptoms and lifestyle using a specific Fluid Dynamic Intensive MAM (FD-MAM) protocol.Methods: We treated 40 outpatients with progressive MS, aged 45– 55 years and with EDSS scores from 6 to 9. We applied FD-MAM in 10 daily sessions over two weeks. Before and after glymphatic drainage by FD-MAM, we assessed each patient’s clinical status and quality of life using six validated questionnaires.Results: Data from the six validated questionnaires administered to the 40 MS patients show an improvement in 83% of the scores. At the same time, we observed a shift from pathological to physiological values in 50% of the pathological scores after 10 sessions of FD-MAM protocol.Conclusion: This study confirms the positive improvements on life quality in outpatients with progressive multiple sclerosis after one cycle of Fluid Dynamic Intensive MAM (FD-MAM) protocol. Initial follow-up on few patients treated with the FD-MAM protocol suggests that the results persist for six to ten months post-treatment. Future detailed studies, on MS outpatients’ larger cohort, are essential to assess the duration of results and its effect on glymphatic system.Keywords: D009103 Multiple Sclerosis, D020528 Multiple Sclerosis, Chronic Progressive, D000077502 Glymphatic system, Fluid Dynamic MAM