Chinese researchers have reported encouraging initial outcomes from an experimental surgical technique designed to treat Alzheimer's disease by improving the brain's waste removal processes. The study, published in General Psychiatry, details the results of a "cervical shunting" operation, specifically lymphatic venous anastomosis (LVA), performed on a patient with Alzheimer's, which led to notable improvements.
Lymphatic Venous Anastomosis (LVA) and Alzheimer's
The LVA surgery was initially performed on a 76-year-old man with moderate Alzheimer's disease. Post-surgery, the patient exhibited significant improvements in cognitive function. Follow-up results two months after the procedure indicated a marked recovery in memory and improved communication abilities.
"We speculated that decompression of the lymphatic trunk and cervical lymphatic—venous anastomosis could facilitate the flow of cerebrospinal fluid in the cranial glymphatic system, potentially accelerating the clearance of harmful beta-amyloid and tau proteins," the researchers stated.
Brain scans conducted before and after the surgery reportedly revealed changes in protein accumulation and metabolism. However, the long-term significance and durability of these changes are still under investigation.
How LVA Works
The surgical team posits that the LVA procedure creates a new pathway to aid in flushing out toxic proteins from the brain by connecting lymphatic vessels in the neck to veins. According to their report, the patient demonstrated cognitive improvements within five weeks following the surgery, as measured by standard cognitive assessments:
- The Mini-Mental Status Examination score increased from 5 to 7 points.
- The Clinical Dementia Rating-sum of boxes improved from 10 to 8.
- The Geriatric Depression Scale score decreased from 9 to 0.
Cautious Optimism and Future Research
The researchers are refraining from claiming this as a definitive cure for Alzheimer's, emphasizing that further studies are necessary. Replicating these results in a larger population is crucial before asserting that a cure has been discovered. While this surgical approach represents a novel avenue in Alzheimer's treatment research, it emerges during a period of significant advancement in the field.
Currently, nearly 200 studies are underway, evaluating 134 drugs in clinical trials, with over 77% of new treatments focused on disease-modifying strategies. Recent progress includes the drug donanemab, marketed as Kisunla, which has demonstrated a 35% reduction in cognitive decline in clinical trials. For patients treated early in their disease progression, this figure rose to 60%.
