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In a medical breakthrough, researchers from China have reported initial results from an experimental surgical procedure they say aims to address Alzheimer's disease by manipulating the brain's waste clearance systems.

The findings of this study, published in General Psychiatry, detail outcomes from what the team describes as a “cervical shunting” operation performed on a patient with Alzheimer’s who was able to achieve what the researchers have called promising results.

According to the study, a surgery – lymphatic venous anastomosis or LVA was performed on neck lymphatic and so far, 42 clinical trials have been successful.

The LVA surgery was first conducted on a 76-year-old man with moderate Alzheimer’s and subsequently, his symptoms significantly improved. Also, the follow-up results two months after the surgery showed that the old man not only had a significant recovery in memory but also could communicate normally with others.

“We speculated that decompression of the lymphatic trunk and cervical lymphatic—venous anastomosis could facilitate the flow of cerebrospinal fluid in the cranial glymphatic system, potentially accelerating the clearance of harmful beta-amyloid and tau proteins,” the researchers hypothesized.

Brain scans performed before and after the procedure reportedly showed changes in protein accumulation and metabolism, though the significance and durability of these changes remain to be determined.

The study was conducted through a collaboration between Shanghai Mental Health Center, Shanghai Ninth People's Hospital, and Shanghai Jiao Tong University. Researchers said the patient met the stringent biological diagnostic criteria set by the National Institute on Aging-Alzheimer's Association. These criteria require evidence of both memory decline and biological markers of the disease, confirmed through brain scans showing protein deposits.

The surgical team claims the procedure connects lymphatic vessels in the neck to veins, theoretically creating a new pathway to help flush out toxic proteins from the brain.

According to their report, the patient has shown cognitive improvements five weeks after surgery, measured through standard tests:

• The Mini-Mental Status Examination, which evaluates cognitive function, rose from 5 to 7 points
• The Clinical Dementia Rating-sum of boxes, measuring dementia severity, improved from 10 to 8
• The Geriatric Depression Scale, assessing depression in older adults, dropped from 9 to 0

Is this a cure for Alzheimer’s?

Researchers say they have not made any such claims as studies on the subject are still going on. Also, it’s important to replicate such results on a broader population in order to claim a cure has been found, and that is still far from happening. Even though this surgical approach has represented a novel direction in Alzheimer's treatment research, it comes during what experts describe as a new era in the field.

At present, there are nearly 200 studies and 134 drugs being tested in clinical trials, with over 77 per cent of new treatments targeting disease-modifying approaches.

Recent developments have shown promise in slowing cognitive decline. The drug donanemab, recently approved and marketed as Kisunla, has demonstrated a 35 per cent slowing of cognitive decline in clinical trials.

For patients who received the drug early in their disease progression, this figure climbed to 60 per cent.

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