Deep Cervical Lymphovenous Anastomosis for Severe Alzheimer's Disease (DCLVA-AD)
A Single-arm, Prospective, Self-controlled Study on Efficacy and Safety of Deep Cervical Lymphovenous Anastomosis for Neurological Function in Patients With Severe Alzheimer's Disease
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Rong Hu, MD
- Numero di telefono: +8602368765911
- Email: huchrong@tmmu.edu.cn
Backup dei contatti dello studio
- Nome: Jingyu Chen, MD
- Numero di telefono: +8602368765911
- Email: 283686484@qq.com
Luoghi di studio
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Chongqing Municipality
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Chongqing, Chongqing Municipality, Cina, 400038
- The First Affiliated Hospital of Army Medical University (Southwest Hospital)
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Contatto:
- Jingyu Chen, MD
- Numero di telefono: +8602368765911
- Email: 283686484@qq.com
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Meet the 2011 NIA-AA clinical diagnostic criteria for probable Alzheimer's disease dementia and the 2018 NIA-AA research framework biomarker criteria for AD.
- Aged 50 to 80 years (inclusive) at the time of signing informed consent.
- Severe cognitive dysfunction: Mini-Mental State Examination (MMSE) score < 10 points.
- Progressive cognitive deterioration for more than 6 months reported by patient or caregiver.
- No clinical improvement after more than 6 months of standardized drug treatment.
- Have a designated study companion who signs informed consent, contacts the patient at least 10 hours per week and accompanies study visits.
- Able to complete scale assessments and examinations independently or with companion assistance.
- Voluntarily comply with study procedures, examinations and surgical treatment.
- Patient or legal representative can sign written informed consent and abide by trial requirements.
- Patients and families are informed of study purpose, expected efficacy and potential risks, and voluntarily provide biological samples and participate in the study.
Exclusion Criteria:
- Severe central nervous system diseases (other than AD) that affect cognitive function or study compliance.
- Severe/unstable systemic diseases (cardiovascular, hepatic, renal, respiratory, endocrine, hematological, psychiatric diseases); life expectancy less than 24 months.
- Surgical contraindications: severe coagulation disorders, severe -cardiopulmonary diseases (myocardial infarction/respiratory failure within recent 30 days); severe liver damage (ALT/AST > 3 times upper limit of normal); severe renal insufficiency (eGFR < 30ml/min).
- Severe primary mental disorders (other than AD) that interfere with efficacy evaluation and cognitive assessment.
- History of intracranial hemorrhage or craniocerebral trauma within recent 1 year.
- Alcohol or drug abuse/dependence within recent 1 year.
- Allergy to indocyanine green, gadolinium contrast agent, 18F-florbetapir or 18F-flortaucipir.
- Contraindications for PET examination.
- Other conditions judged by investigators unsuitable for enrollment.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: N / A
- Modello interventistico: Assegnazione di gruppo singolo
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Sperimentale: Deep Cervical Lymphovenous Anastomosis plus Routine Treatment
All participants receive one-time bilateral deep cervical lymphovenous anastomosis under microsurgery with indocyanine green lymphatic tracing.
Conventional anti-Alzheimer's drugs are maintained throughout the study.
All outcomes are compared with pre-operation baseline.
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A one-time microsurgical procedure performed under general anesthesia.
Indocyanine green (ICG) is injected for intraoperative lymphatic vessel tracing under a fluorescent surgical microscope.
Lymphatic vessels or lymphatic flaps are anastomosed to cervical veins via end-to-side or end-to-end technique to improve intracranial lymphatic drainage.
No additional surgical interventions are applied.
Stable administration of standard drugs for Alzheimer's disease, including cholinesterase inhibitors and/or NMDA receptor antagonists, following clinical guidelines.
Participants continue their original medication regimen throughout the whole study period without dose adjustment or drug switching.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Sum of Boxes (CDR-SB) Total Score
Lasso di tempo: Baseline (pre-operation), 12 months after surgery
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The CDR-SB total score ranges from 0 to 18 points.
Higher scores indicate more severe cognitive impairment and functional decline.
This outcome evaluates the change of total CDR-SB score in patients with severe Alzheimer's disease after receiving deep cervical lymphovenous anastomosis, to assess the therapeutic effect on neurological function.
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Baseline (pre-operation), 12 months after surgery
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Sum of Boxes (CDR-SB) Total Score
Lasso di tempo: Baseline (pre-operation), 1 month and 6 months after surgery
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The CDR-SB total score ranges from 0 to 18 points.
Higher scores indicate more severe cognitive impairment and functional decline.
This outcome evaluates the change of total CDR-SB score in patients with severe Alzheimer's disease after receiving deep cervical lymphovenous anastomosis, to assess the therapeutic effect on neurological function.
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Baseline (pre-operation), 1 month and 6 months after surgery
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Mini-Mental State Examination (MMSE) Score
Lasso di tempo: Baseline (pre-operation), 1 month, 6 months and 12 months after surgery
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MMSE total score ranges from 0 to 30.
Higher scores represent better cognitive function.
A score below 10 indicates severe cognitive impairment.
This measure assesses changes in overall cognitive status after surgical intervention.
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Baseline (pre-operation), 1 month, 6 months and 12 months after surgery
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Zarit Burden Interview (ZBI) Score
Lasso di tempo: Baseline (pre-operation), 1 month, 6 months and 12 months after surgery
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ZBI total score ranges from 0 to 88.
Higher scores mean heavier caregiver burden.
It is used to evaluate the impact of treatment on the psychological and life burden of patients' caregivers.
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Baseline (pre-operation), 1 month, 6 months and 12 months after surgery
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Amyloid-beta (Aβ) PET-CT Centiloid Value
Lasso di tempo: Baseline (pre-operation), 12 months after surgery
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Centiloid value reflects the level of cerebral amyloid-beta deposition.
Detect and compare the difference of brain Aβ deposition between baseline and 12 months post-operation.
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Baseline (pre-operation), 12 months after surgery
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Collaboratori e investigatori
Sponsor
Sponsor
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- KY2026120
- (A)KY2024136 (Altro identificatore: Ethics Committee of the First Affiliated Hospital of the Army Medical University)
Piano per i dati dei singoli partecipanti (IPD)
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Descrizione del piano IPD
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