Effect of Long-Term Head and Neck Venous Outflow Obstruction on Cognitive Function: Evidence From Patients With Internal Jugular Vein Stenosis

November 3, 2026 updated by: Bei Bei Mao, Beijing Shijitan Hospital, Capital Medical University

Long-Term Head and Neck Venous Outflow Obstruction and Cognitive Function: Evidence From Patients With Internal Jugular Vein Stenosis-A Case-Control Study Combined With a Prospective Observational Cohort Study

This study aims to determine the effect of long-term head and neck venous outflow obstruction-specifically internal jugular vein stenosis (IJVS) caused by atlas transverse process compression with a stenosis rate ≥50%-on cognitive function, and to observe the cognitive outcomes of atlas transverse process resection combined with release and perfusion technique in routine clinical care. The study uses a case-control design to compare cognitive function between patients with IJVS and matched healthy controls, and a prospective cohort design to follow surgical and non-surgical cohorts for 6 months. The Montreal Cognitive Assessment (MoCA) total score is the primary cognitive measure. The target population per the protocol summary is image-confirmed IJVS due to atlas transverse process compression (stenosis ≥50%), with mild-to-moderate cognitive impairment (MoCA <26), aged 18-65 years.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Detailed Description

Internal jugular vein stenosis is an important cause of head and neck venous outflow obstruction, and extrinsic stenosis caused by bony compression of the atlas transverse process is common in clinical practice. Atlas transverse process decompression is currently used mainly to relieve somatic symptoms such as pulsatile tinnitus, headache, and dizziness; however, high-quality evidence on its systematic effect on cognitive function is lacking. This study is conducted within routine clinical care and does not add any additional invasive sampling or traumatic examinations. During standard management-surgical decompression or conservative treatment-cognitive function and imaging-based venous outflow indicators are observed longitudinally.

In the case-control component, patients with IJVS (disease duration ≥6 months) are matched 1:1 to healthy controls by age, sex, and years of education; MoCA total scores and cognitive subdomain scores are compared. In the cohort component, patients are assigned to a surgical cohort or a non-surgical cohort according to clinical indications and patient preference, without randomization or inducement. Follow-up is conducted at 1, 3, and 6 months after surgery or enrollment. The planned total cohort sample size is 72 participants (36 surgical and 36 non-surgical, allowing for a 10% dropout rate). Healthy controls for the case-control analysis are matched 1:1 and are not counted within the 72 cohort participants.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
72

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.
  • Name: Zhiqiang Hu
  • Phone Number: +8613144628367
  • Email: neuro7@163.com

Study Contact Backup

  • Name: Junpeng Xu
  • Phone Number: +8613144628367

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Surgical cohort Procedure (routine clinical care, not a study intervention) Patients undergo atlas transverse process resection combined with release and perfusion technique according to clinical indications. The procedure aims to relieve bony compression of the internal jugular vein by the atlas transverse process. Postoperative follow-up is performed according to routine care. The study does not alter surgical indications or the operative procedure; it only observes changes in MoCA scores and imaging-based venous outflow indicators at 1, 3, and 6 months after surgery.

Healthy control group (case-control component) Observational comparator group Age-, sex-, and education-matched individuals without IJVS or head and neck venous outflow obstruction, matched 1:1 to the case group.

Description

Inclusion Criteria:

Cohort study (surgical cohort / non-surgical cohort):

Age 18-65 years, either sex. Confirmed by head and neck CT venography (CTV), MR venography (MRV), and jugular vein ultrasound as extrinsic IJVS caused by atlas transverse process compression, with a stenosis rate ≥50%.

Voluntary participation and signed written informed consent. Able to cooperate with MoCA cognitive assessment and related examinations at all scheduled time points.

No severe hepatic or renal insufficiency, coagulation disorders, or other severe underlying diseases.

Surgical cohort: no surgical contraindication and willingness to undergo atlas transverse process resection combined with release and perfusion technique. Non-surgical cohort: willingness to receive conservative treatment without surgery and no urgent surgical indication during follow-up.

Case-control study-case group:

Clinically confirmed IJVS with disease duration ≥6 months. CTV-confirmed IJVS caused by atlas transverse process compression. No history of previous cerebral infarction, intracranial hemorrhage, Alzheimer's disease, or other known causes of cognitive decline.

Complete baseline clinical and imaging data available.

Case-control study-healthy control group:

Age-, sex-, and education-matched individuals without IJVS, without head and neck venous outflow obstruction, and without severe organic disease or a history of cognitive impairment.

Exclusion Criteria

Cohort study:

Cognitive impairment caused by another definite etiology (e.g., Alzheimer's disease, cerebral infarction, cerebral hemorrhage, hypothyroidism).

Severe psychiatric disease preventing cooperation with cognitive assessment and study procedures.

Neck surgery, radiotherapy, or internal jugular vein intervention within the previous 3 months.

Pregnancy or breastfeeding. Malignant tumor, autoimmune disease, or other condition with an expected survival of less than 1 year.

Long-term use of sedative-hypnotics or cognitive-enhancing drugs that may affect MoCA assessment.

Refusal to participate in follow-up or inability to complete all scheduled assessments.

Case-control study:

Other imaging-detected venous abnormalities, such as venous sinus stenosis or jugular vein reflux, or the styloid process identified as the main compressive structure causing IJVS.

Severe heart failure or other major cardiac dysfunction. Severe hearing impairment or other conditions that may affect the validity or completion of cognitive assessment.

Intrathoracic or intracranial space-occupying lesions, cerebral vascular malformations, or other abnormalities on high-resolution chest CT, brain MRI, or CT that may constitute a major hemodynamic obstruction.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: COHORT
  • Time Perspectives: PROSPECTIVE

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
IJVS

Internal Jugular Vein Stenosis
HC

healthy controls

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in MoCA total score
Time Frame: Baseline, 1 month, 3 months, and 6 months after surgery/follow-up

Change in the Montreal Cognitive Assessment total score from baseline to 6 months after surgery/follow-up. In the cohort component, between-group differences and repeated-measures trends are compared between the surgical and non-surgical cohorts. In the case-control component, baseline differences between cases and healthy controls are compared.
Baseline, 1 month, 3 months, and 6 months after surgery/follow-up

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
IJV stenosis improvement rate
Time Frame: Baseline, 1, 3, and 6 months after surgery/follow-up

Imaging-based quantitative assessment of improvement in IJVS severity by CTV/ultrasound.
Baseline, 1, 3, and 6 months after surgery/follow-up
Head and neck venous outflow patency
Time Frame: Baseline, 1, 3, and 6 months

CTV/MRV assessment of venous sinus morphology, patency, and collateral circulation; ultrasound assessment of blood flow velocity and reflux.
Baseline, 1, 3, and 6 months
Incidence of postoperative complications/adverse events
Time Frame: Intraoperative period through 6-month follow-up

Bleeding, infection, hematoma, nerve stimulation, venous thrombosis, contrast agent reactions, etc.
Intraoperative period through 6-month follow-up

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Beijing Shijitan Hospital, Capital Medical University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 10, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
July 30, 2028

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2028

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 3, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 3, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 10, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 10, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 3, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • BJSJTYY-IJVS-COG-2026
  • IIT2026-063-001 (Other Identifier: Ethics approval number)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

We do not plan to share individual participant data (IPD). This is due to the strict requirements of the Personal Information Protection Law of the People's Republic of China and the local Ethics Committee regarding the protection of patient privacy and medical data, as the participants did not explicitly provide consent for public data sharing at the time of enrollment.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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