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

3. november 2026 opdateret af: 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.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Detaljeret beskrivelse

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.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

72

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

  • Navn: Zhiqiang Hu
  • Telefonnummer: +8613144628367
  • E-mail: neuro7@163.com

Undersøgelse Kontakt Backup

  • Navn: Junpeng Xu
  • Telefonnummer: +8613144628367

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 65 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

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.

Beskrivelse

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.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: COHORT
  • Tidsperspektiver: PROSPECTIVE

Kohorter og interventioner

Gruppe / kohorte
IJVS

Internal Jugular Vein Stenosis

HC

healthy controls

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in MoCA total score
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
IJV stenosis improvement rate
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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

Samarbejdspartnere og efterforskere

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Sponsor

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

10. november 2026

Primær færdiggørelse (Anslået)

30. juli 2028

Studieafslutning (Anslået)

1. december 2028

Datoer for studieregistrering

Først indsendt

3. november 2026

Først indsendt, der opfyldte QC-kriterier

3. november 2026

Først opslået (Faktiske)

10. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

10. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

3. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • BJSJTYY-IJVS-COG-2026
  • IIT2026-063-001 (Anden identifikator: Ethics approval number)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

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.

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