Araştırma özeti
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The discovery of the glymphatic system and meningeal lymphatic vessels established that the brain possesses an organized lymphatic clearance network that drains to the deep cervical lymphatics, and that disruption of this system contributes to the accumulation of pathogenic proteins implicated in neurodegeneration. Cervical lymphatic reconstruction has shown early neurological benefit in Alzheimer’s and Parkinson’s disease, and preclinical work demonstrates that noninvasive manipulation of superficial cervical lymphatics increases cerebrospinal fluid outflow. Whether noninvasive cervicofacial lymphedema therapy can produce comparable neurological effects remains unknown. We report two men with Parkinson’s disease (Hoehn and Yahr stages 2.5 and 3) treated with a standardized cervicofacial lymphedema therapy protocol targeting cervical and facial lymphatic pathways. Total MDS-UPDRS scores improved in both patients, by 19 points (−34.5%) in Patient 1 and 5 points in Patient 2, each meeting or exceeding the minimal clinically important difference. Improvements were reproducible and session-linked, and were accompanied by motor and non-motor gains in cognition, alertness, mood, energy, and sleep; interruption of therapy was associated with return toward baseline. Cervicofacial lymphedema therapy may represent a low-risk, noninvasive strategy for modulating brain lymphatic clearance in Parkinson’s disease.
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