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Deep Cervical Lymphatlc-Venous Anastomosis Surgery for the Treatment of Alzheimer's Disease: A Pilot Study (DIVA Study)

Phase 3
Recruiting
Conditions
Alzheimer's Disease
Interventions
Procedure: Deep Cervical lymphatlc-Venous Anastomosis Surgery
Registration Number
NCT06530732
Lead Sponsor
Zhejiang Provincial People's Hospital
Brief Summary

The goal of this clinical trial is to To demonstrate the Safety and Efficacy of dcLVA Surgery for the Treatment of Alzheimer's Disease. Patients who meet the inclusion and exclusion criteria and consent to participate will be randomly assigned to either the experimental group (receiving dcLVA surgery plus standard medication) or the control group (receiving standard medication alone)

Participants will:

Undergo cognitive assessment and brain MRI assessment; Undergo a lumbar puncture; Undergo an injection of 20ml of gadodiamide contrast agent at a concentration of 0.5 mmol/L (1ml gadodiamide: 20ml 0.9% saline).

Primary Outcome Measures: The change in the sum of Clinical Dementia Rating Scale (CDR) scores at 12-month in relative to baseline

Detailed Description

This study aims to enroll patients diagnosed with AD. Patients who meet the inclusion and exclusion criteria and consent to participate will be randomly assigned to either the experimental group (receiving dcLVA surgery plus standard medication) or the control group (receiving standard medication alone). Following randomization, patients will undergo cognitive and brain MRI assessments, a lumbar puncture, and an injection of 20ml of gadodiamide contrast agent at a concentration of 0.5 mmol/L (1ml gadodiamide: 20ml 0.9% saline). MRI imaging scans will be conducted at 4 hours, 24 hours, and 48 hours post-injection to measure the dural signal unit ratio, which will be used to assess glymphatic clearance function. The study will track changes in cognitive function and glymphatic clearance function at baseline and during follow-up periods (7 days post-surgery, 6 months, and 12 months) and will evaluate the safety of the two treatment approaches.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Diagnosed as an AD patient according to biological markers and clinical symptoms;
  • Over 35 years old and with an MMSE or MOCA score ≤ 26;
  • The patient or family member has signed an informed consent form.
Exclusion Criteria
  • Inability to cooperate with lumbar puncture;
  • Cognitive impairment due to neurological infections (e.g., HIV, neurosyphilis, autoimmune encephalitis) or systemic diseases (e.g., diabetes, thyroid dysfunction);
  • Significant organ dysfunction (heart, lung, liver, kidney);
  • Coagulation disorders or contraindications to surgery;
  • Inability to fully cooperate with follow-up visits.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
experimental groupDeep Cervical lymphatlc-Venous Anastomosis Surgeryreceiving dcLVA surgery plus standard medication
experimental groupLecanemabreceiving dcLVA surgery plus standard medication
control groupLecanemabreceiving standard medication alone
Primary Outcome Measures
NameTimeMethod
The rate of change in the total score of the Clinical Dementia Rating ScaleTime Frame: baseline,7 days post-surgery,3-month,6-month and 12-month

The change in the sum of Clinical Dementia Rating Scale (CDR) scores at 12-month in relative to baseline , using the Chinese version of the CDR scale, with a score range of 0-3 points for each item.The total score ranges from a minimum of 0 points to a maximum of 18 points, where a higher score indicates a worse outcome.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Zhejiang Provincial People's Hospital

🇨🇳

Hangzhou, Zhejiang, China

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