Effectiveness of Non-Invasive NESA Neuromodulation in Patients with Multiple Sclerosis: A Case Series Study

Abstract

Multiple sclerosis (MS) is a chronic, progressive neurological condition characterized by a wide variety of symptoms that significantly impact patients’ quality of life. Non-pharmacological treatments such as non-invasive neuromodulation have gained relevance in recent years. This study aimed to evaluate the effects of non-invasive NESA neuromodulation on sleep quality, fatigue, heart rate variability (HRV), and neurogenic urinary incontinence in patients with MS. A retrospective case series was conducted with eight patients diagnosed with different types of MS. All participants underwent 15 sessions of NESA neuromodulation (3 times/week over 5 weeks). The Pittsburgh Sleep Quality Index (PSQI), Modified Fatigue Impact Scale (MFIS), International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and HRV measures (SDNN and RMSSD) were assessed before and after the intervention. Statistical analysis revealed a significant improvement in sleep quality (p = 0.020), while other variables such as urinary incontinence, fatigue, and HRV showed clinical improvements that were not statistically significant. Most participants reported subjective benefits, including fewer nocturnal awakenings, improved perceived rest, enhanced concentration, and better urinary control during the day. Non-invasive NESA neuromodulation significantly improved sleep quality and demonstrated clinically relevant improvements in fatigue, autonomic function, and urinary symptoms in patients with MS. Given the small sample size, further research is warranted to confirm these preliminary findings and explore neuromodulation as a complementary therapy in MS rehabilitation programs.