An experimental surgical procedure aimed at improving blood flow and potentially reversing dementia symptoms is generating cautious optimism and scrutiny from medical experts. The operation, known as lymphatic venous anastomosis (LVA), involves redirecting lymphatic fluid in the neck to nearby veins, theoretically allowing the brain to better flush out toxic proteins associated with dementia.
In a recent trial involving 83 patients with advanced dementia at Xi’an Fengcheng Hospital in Shaanxi, China, researchers reported significant improvements in cognitive function and overall vitality. According to the study published in the Journal of Alzheimer’s Disease, patients exhibited enhanced alertness and responsiveness. Ninety-month follow-up data indicated a notable increase in blood flow to the brain, with 40 percent of participants showing improved scores on the Mini-Mental State Exam (MMSE), a test measuring attention, recall, and language.
The procedure is described as relatively straightforward, akin to clearing a blocked drain. It is performed under general anesthesia and takes approximately two hours. The underlying theory posits that as the brain's natural lymphatic drainage system becomes less efficient with age, harmful proteins like amyloid plaques can accumulate, disrupting cell communication and leading to cognitive decline. LVA aims to bypass this sluggish system.
This surgical approach shares conceptual similarities with newer Alzheimer's drugs that target and help clear amyloid proteins from the brain. However, unlike these drugs, which have faced challenges with availability and side effects such as brain bleeds, the LVA procedure has, according to researchers, resulted in only mild, temporary side effects, primarily localized wound pain.
The treatment is not new to China, where it has been performed on over 2,000 dementia patients. Anecdotal reports suggest some individuals who were previously bedbound have regained mobility and communication abilities. However, the practice has faced significant controversy. Chinese authorities placed a ban on the surgery last year, except for research purposes, citing concerns over insufficient evidence regarding its safety and effectiveness. Many procedures have been conducted on a private basis, with families reportedly paying substantial sums for the treatment for severely ill patients.
International dementia experts remain divided. Some, like Robert Howard, a professor of old age psychiatry at University College London, express skepticism, pointing to the small magnitude of reported cognitive score increases and the potential for placebo effects, as patients were aware they were receiving the actual surgery. He also suggests that the surgery might not address the root cause of amyloid protein production, potentially limiting its long-term benefits. Despite these reservations, the research is being closely observed globally, with clinical trials also underway in the United States and Singapore.