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Deep Cervical Lymphovenous Anastomosis for Severe Alzheimer's Disease (DCLVA-AD)

2026年6月21日 更新者：Rong Hu, MD、Southwest Hospital, China

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

Alzheimer's disease (AD) is a severe neurodegenerative disease with heavy social burden. Current drugs cannot reverse disease progression. Brain glymphatic system and meningeal lymphatic dysfunction lead to impaired clearance of Aβ and Tau protein, which is an important pathogenesis of AD. Deep cervical lymphovenous anastomosis (DCLVA) can improve intracranial lymphatic drainage, promote the clearance of toxic proteins, and improve neurological function. This is a single-arm, prospective, self-controlled study to enroll 59 patients with severe AD (MMSE < 10). All patients receive bilateral DCLVA plus routine medication. The primary endpoint is change of CDR-SB score at 12 months post-operation. Secondary endpoints include MMSE, ZBI scores and Aβ PET-CT Centiloid value. This study aims to verify the efficacy and safety of DCLVA for severe AD.

研究概览

地位

尚未招聘

条件

干预/治疗

研究类型

介入性

注册 (估计的)

59

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

研究联系人备份

  • 姓名：Jingyu Chen, MD
  • 电话号码：+8602368765911
  • 邮箱：283686484@qq.com

学习地点

  • 中国
    • Chongqing Municipality
      • Chongqing、Chongqing Municipality、中国、400038
        • The First Affiliated Hospital of Army Medical University (Southwest Hospital)
        • 接触：

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 成人
  • 年长者

接受健康志愿者

不

描述

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.

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：不适用
  • 介入模型：单组作业
  • 屏蔽：无（打开标签）

武器和干预

参与者组/臂
干预/治疗
实验性的：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.
程序：Deep Cervical Lymphovenous Anastomosis
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.
其他：Routine Treatment
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.

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Sum of Boxes (CDR-SB) Total Score
大体时间：Baseline (pre-operation), 12 months after surgery
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.
Baseline (pre-operation), 12 months after surgery

次要结果测量

结果测量
措施说明
大体时间
Sum of Boxes (CDR-SB) Total Score
大体时间：Baseline (pre-operation), 1 month and 6 months after surgery
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.
Baseline (pre-operation), 1 month and 6 months after surgery
Mini-Mental State Examination (MMSE) Score
大体时间：Baseline (pre-operation), 1 month, 6 months and 12 months after surgery
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.
Baseline (pre-operation), 1 month, 6 months and 12 months after surgery
Zarit Burden Interview (ZBI) Score
大体时间：Baseline (pre-operation), 1 month, 6 months and 12 months after surgery
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.
Baseline (pre-operation), 1 month, 6 months and 12 months after surgery
Amyloid-beta (Aβ) PET-CT Centiloid Value
大体时间：Baseline (pre-operation), 12 months after surgery
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.
Baseline (pre-operation), 12 months after surgery

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Southwest Hospital, China

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2026年10月1日

初级完成 (估计的)

2028年9月30日

研究完成 (估计的)

2029年9月30日

研究注册日期

首次提交

2026年6月21日

首先提交符合 QC 标准的

2026年6月21日

首次发布 (实际的)

2026年6月25日

研究记录更新

最后更新发布 (实际的)

2026年6月25日

上次提交的符合 QC 标准的更新

2026年6月21日

最后验证

2026年6月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • KY2026120
  • (A)KY2024136 (其他标识符：Ethics Committee of the First Affiliated Hospital of the Army Medical University)

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

未定

IPD 计划说明

Individual participant data (IPD) will not be shared externally. All participant data is stored and managed locally in compliance with Chinese medical data privacy regulations and hospital internal management rules.

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

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