An Exploratory Study of Deep Cervical Lymphovenous Bypass (LVB) in Alzheimer's Disease

Detecting changes in the brain's amyloid and tau protein burden before and after surgery.Aβ/tau positron emission tomography (PET) facilitates spatial visualization and quantitative analysis of abnormal protein accumulations in the brains of Alzheimer's disease (AD) patients, offering objective imaging data crucial for early diagnosis, disease assessment, post-operative efficacy monitoring, and prognostic evaluations. Interpretations and quantitative assessments of Aβ-PET images are primarily focused on four cerebral regions: the lateral temporal cortex, frontal lobe, posterior cingulate gyrus/precuneus, and parietal lobe, aiding in the diagnosis of AD. The deposition of tau protein is positively correlated with disease severity; it initially accumulates predominantly in the medial temporal lobe and extends to neocortical regions during the middle and late stages. Tau PET is instrumental for monitoring disease progression and evaluating treatment outcomes.

The change in iADRS scores before and after surgery. The iADRS is a simple linear combination of two recognized, treatment-sensitive, and widely accepted measures of Alzheimer's Disease (AD), namely the AD Assessment Scale-Cognitive Subscale (ADAS-Cog) and the Alzheimer's Disease Cooperative Study-Instrumental Activities of Daily Living (ADCS-iADL), used for the measurement of core assessment domains in AD.The total score of ADAS-Cog ranges from 0 to 70, with higher scores indicating greater cognitive impairment. The total score of ADCS-iADL ranges from 0 to 78, assessing the ability to perform complex activities of daily living, with higher scores indicating greater functional impairment.

Elevated preoperatively, postoperatively the indicators have decreased, with reference values being plasma Aβ1-42 ≤ 110.00 pg/mL; plasma p-tau181 ≤ 30.00 pg/mL.

The MMSE score is a widely used brief cognitive assessment scale for the rapid screening of cognitive functions, especially dementia. It encompasses various aspects such as orientation to time, place, immediate memory, attention and calculation, delayed memory, language, and visuospatial abilities.The total score of MMSE is 0-30,with higher scores mean a better outcome.

The MoCA (Montreal Cognitive Assessment) score is a specialized tool for the rapid screening of Mild Cognitive Impairment (MCI). The MoCA scale includes tests across various cognitive domains, such as attention and concentration, executive functions, memory, language, visuospatial skills, abstract thinking, calculation, and orientation, comprising a total of 11 examination items. The total score of the MoCA scale is 30 points, with a score of 26 points or above typically considered to indicate normal cognitive function, while a score below 26 may suggest the presence of cognitive dysfunction.