A controversial Alzheimer's surgery claims to reverse symptoms — here's what scientists know
A controversial Alzheimer's surgery is said to reverse symptoms
A surgical procedure called deep cervical lymphatic-venous anastomosis (dcLVA) is being performed on Alzheimer's patients, mostly in China, despite lacking solid evidence. The surgery connects neck lymph vessels to veins to improve brain waste drainage. Early results show some cognitive improvements, but many researchers are skeptical about its durability and mechanism. Chinese regulators have restricted it to formal clinical research, and the pioneer surgeon is detained. Controlled studies are now underway worldwide.
“The hope is high,” he says, “and whenever hope is high, the hype also follows.”
- bananamogul
This article soars from hope to hype to skepticism. I guess that's a consequence of reporting on the fringes of science.
In particular, I wish there was more detail on the 100-cohort study where patients experienced "modest improvements" and how that's calculated. Is that average increase of X points on an MMSE, etc.
In my experience in my family, dementia is not a linear slide. My 85yo mother with Alzheimer's will sometimes present very well and you have to really get into conversational details to notice the dementia. On other days, she'll pick up a paperback and try to use it as a phone. Some days she's steady on her feet, some days coordinating all of those muscles is just too much.
Over the course of a couple years, you can track the decline, but it's not a straight line. "Modest improvements" makes me concerned that they measured a valley to a peak. It's only 6 months since the 100-cohort study.
- tux3
Derek Lowe's post on this: https://www.science.org/content/blog-post/new-alzheimer-s-th...
- dwroberts
The problem with this stuff is (as the article mentions) is that it’s going to take a while to figure out whether any benefit is just temporary.
I would guess that there are a lot of variables to eliminate too - eg is it possible that just having a surgery and recovering from anaesthesia can yield some of these benefits in some circumstances? Given that we don’t really understand how most inhaled anaesthetics fully work
- coef2
As an ML engineer, I improve models through trial and error. Sometimes a change improves my metrics, and other times it makes them worse, and I just revert it and try something else.
It's scary to think about neurological surgery making progress in a similar way. We may not have a good theoretical understanding of why a procedure works, but we observe positive outcomes in a small number of patients and then start looking into expanding its use.
It reminds me of procedures where doctors sever connections between the two hemispheres of the brain to reduce seizures. I've heard they can reduce symptoms, but disrupting connections in the brain can also have unexpected consequences. I hope we can do better than essentially throwing spaghetti at the wall.
- janalsncm
I wonder if there are multiple causes of Alzheimer’s, and the variability in outcome is due to the fact that the treatment only is fixing one root cause.
That said, if it turns out that a treatment for some Alzheimer’s is some kind of “brain fluid” dialysis, it would be an amazing breakthrough.