Promising outcomes 5 weeks after a surgical cervical shunting procedure to unclog cerebral lymphatic systems in a patient with Alzheimer’s disease  

作　　者：Xia Li Chenpeng Zhang Yuan Fang Mei Xin Jianbo Shi Zhiyuan Zhang Zhen Wang Zhenhu Ren 

机构地区：[1]Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai,China [2]Alzheimer’s Disease and Related Disorders Center,Shanghai Jiao Tong University,National Center for Mental Disorders,Shanghai,China [3]Department of Nuclear Medicine,Ren Ji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China [4]Department of Oral Maxillofacial-Head Neck Oncology,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai,China [5]Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention,Shanghai,China

出　　处：《General Psychiatry》2024年第3期345-347,共3页综合精神医学（英文）

基　　金：supported by the National Key R&D Program of China(2023YFC36003200);Shanghai Mental Health Center investigator-initiated trial programme(2024-TX-001);Shanghai's Top Priority Research Center(2022ZZ01017);CAMS Innovation Fund for Medical Sciences(2019-12M-5-037).

摘　　要：Recently,the glymphatic system has been recognised as an important‘waste solutes transport channel’within the brain.1 Studies have shown that blockage of the glymphatic system leads to increased beta-amyloid deposits,accelerating the onset and progression of Alzheimer’s disease(AD).12 Given that cervical lymph nodes receive cerebrospinal fluid from the brain’s glymphatic system,34 we speculated that decompression of the lymphatic trunk and cervical lymphatic-venous anastomosis(LVA)could facilitate the flow of cerebrospinal fluid in the cranial glymphatic system,potentially accelerating the clearance of harmful beta-amyloid and tau proteins.We collaborated with surgeons who specialise in LVA supermicrosurgery for maxillofacial tumours and lymphoedema to develop a procedure to relieve the blockage of the glymphatic system.This surgery employs supermicrosurgery techniques to create LVA connecting the bilateral cervical,deep lymphatic vessels to the veins,resulting in lymphatic trunk decompression,which allows the lymph fluid in the high-pressure lymphatic vessels to flow into the low-pressure venous system.The goal of the minimally invasive surgery is to enhance the removal of proteins,such as beta-amyloid and tau,from the brain’s lymphatic systems to the maxillofacial lymphatic vessels,unclogging protein blockages within the brain.This extracranial procedure is safer than intracranial approaches.

关 键 词：LYMPHATIC CERVICAL ALZHEIMER 

分 类 号：R749.16[医药卫生—神经病学与精神病学]