Xie Qingping, Pak Changsik John, Kwon Jingeun, Chao Sung-Chuan, Hong Joon Pio
Department of Plastic and Reconstructive Surgery, Hangzhou Qiushi Hospital, Hangzhou, Zhejiang, People's Republic of China.
Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Seoul Asan Medical Center, Seoul, Korea (the Republic of).
Arch Plast Surg. 2025 Jul 23;52(4):247-252. doi: 10.1055/a-2627-9243. eCollection 2025 Jul.
This case report explores the therapeutic potential of lymphovenous bypass (LVB) surgery performed at the neck in neurodegenerative diseases, specifically Alzheimer's disease (AD) dementia. The subject is a 58-year-old woman who was previously healthy but began experiencing unexplained memory decline and frequent disorientation in the past 7 years, leading to an AD diagnosis. Despite ongoing pharmaceutical therapy, her symptoms progressed to severe dementia accompanied by behavioral and psychological symptoms of dementia (BPSD). Her Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores were both 0/30, and F-AV-45 PET/CT revealed abnormal brain amyloid load. For salvage therapy, she underwent LVBs on her neck bilaterally. Postoperatively, she got better MMSE and MoCA scores with dramatic improvement in communication and activity. F-AV-45 PET/CT scans 4 months after surgery indicated a reduction in abnormal brain amyloid deposits. This case report highlights the potential effectiveness of LVB surgery in reducing brain amyloid load and attenuating cognitive impairment and BPSD. Further research with animal experiments and clinical trials is necessary to confirm these findings.
本病例报告探讨了在颈部进行的淋巴静脉搭桥(LVB)手术在神经退行性疾病,特别是阿尔茨海默病(AD)痴呆症中的治疗潜力。患者为一名58岁女性,既往身体健康,但在过去7年中开始出现无法解释的记忆力下降和频繁定向障碍,最终被诊断为AD。尽管持续进行药物治疗,她的症状仍进展为严重痴呆,并伴有痴呆的行为和心理症状(BPSD)。她的简易精神状态检查表(MMSE)和蒙特利尔认知评估量表(MoCA)得分均为0/30,F-AV-45 PET/CT显示脑部淀粉样蛋白负荷异常。为了进行挽救治疗,她双侧颈部接受了LVB手术。术后,她的MMSE和MoCA得分有所提高,沟通和活动能力有显著改善。术后4个月的F-AV-45 PET/CT扫描显示脑部异常淀粉样蛋白沉积减少。本病例报告强调了LVB手术在降低脑部淀粉样蛋白负荷、减轻认知障碍和BPSD方面的潜在有效性。需要通过动物实验和临床试验进行进一步研究以证实这些发现。