Deep cervical lymphovenous anastomosis (LVA) for Alzheimer's disease microsurgical procedure in a prospective cohort study
Abstract
OBJECTIVES
Alzheimer's disease (AD) is a prevalent neurodegenerative disorder, characterized by progressive cognitive decline. Current approved drugs merely relieve symptoms rather than halt or reverse disease progression. The role of the brain lymphatic system in clearing harmful substances in the brain has provided new insights for AD treatment. The goal of this study was to assess the efficacy and safety of deep cervical lymphovenous anastomosis (LVA) in treating AD patients.
MATERIALS AND METHODS
A single-center, prospective, single-arm exploratory study was conducted on 26 AD patients who met the clinical and biomarker diagnostic criteria of the National Institute on Aging-Alzheimer's Association (NIA-AA). Deep cervical LVA was performed with modified technique from lymphatic vessel-vein to lymphatic flap-vein anastomosis. Preoperative and follow-up neuropsychological tests were carried out using Mini-Mental Status Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Neuropsychiatric Inventory (NPI) scores. Cerebrospinal fluid (CSF) biomarkers (Aβ42, Aβ40, p-Tau, T-Tau) were collected and analyzed via single-molecule immunoassay in the early postoperative period.
RESULTS
One month after surgery, about 60% of caregivers reported varying degrees of overall symptom improvement in patients. MMSE scores of patients significantly increased after surgery compared with before surgery (3 [0, 6] vs. 5 [0, 7], P = 0.022). Although, 15% of patients had increased MoCA…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 26 participants or records.
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