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Dannie Peng

A new surgical treatment for Alzheimer’s disease is showing promise in a clinical trial under way in Chinese hospitals.
One doctor taking part in the trial at a hospital in Changsha, Hunan province, says the results so far have been positive.
Dr Tang Juyu, a professor at the Xiangya Hospital of Central South University, told the Post that his team had already performed the procedure – known as lymphatic-venous anastomosis, or LVA – on more than 70 patients.
According to Tang, they have seen improvement in about 80 per cent of those patients, though he stressed that was just a preliminary, qualitative observation.
As Tang made his ward rounds last week, the wife of one patient, surnamed Wu, gushed about the changes she had noticed just four days after the experimental operation.
That morning Wu had indicated that he needed to go to the toilet – an urge he had no longer been aware of before the surgery. He was also lifting his head and making eye contact with others, which he was not doing previously.
“I’m really so happy,” she told the Post. “It like I’ve been thrown a lifeline.”

A former mechanic in his 50s from Chengdu in Sichuan, Wu has early onset Alzheimer’s. His condition has rapidly deteriorated in the past four years since he stopped working – his symptoms include memory loss, cognitive problems, incontinence and mobility issues – and he needs 24-hour care, which has taken a heavy toll on his wife.
She heard about the trial online and is hoping the procedure – which involved making two small incisions in Wu’s neck – will be a game changer.
“[If not] it will only get worse and worse, and he may end up bedridden,” she said.
Alzheimer’s disease – the leading cause of dementia – is a brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks.
Dr Fan Dongsheng, a professor with the neurology department at Peking University Third Hospital, said the scientific mechanism behind the treatment had not been well studied and was at present not convincing.
He noted that reported improvements in patient symptoms were qualitative and not made using the accepted evaluation system.
Tang echoed that view, saying it would be irresponsible to promote the treatment “blindly without more evidence” from scientific studies.
So far, the only scientific literature published on the surgery is from a group of clinical experts in Shanghai who reported that six people who underwent the treatment showed a slight improvement, particularly in attention and reaction time. Their findings were published as a letter in the journal General Psychiatry in June.
The experimental treatment was developed in China and has been conducted on hundreds of patients at top public hospitals like Xiangya across the country in recent months. Tang said patients from overseas could also take part if they met the requirements.
Tang, who heads the hospital’s microsurgery unit, noted that nearly 10 million people in China were living with Alzheimer’s. And contrary to popular belief, many of them – some 70 per cent, according to Tang – are younger than 65, like Wu.
Of the more than 55 million people worldwide with dementia, an estimated 60 to 70 per cent have Alzheimer’s disease. In the US, about 6.9 million people aged 65 and older are living with the disease.
Since the disease was first described by German neurologist and psychiatrist Alois Alzheimer in 1906, scientists and doctors have been unable to find an effective treatment for the condition.
“There’s a bottleneck when it comes to internal medicine therapies,” Tang said. “So perhaps surgery can open a new window and a new direction for treatment.”

While the cause of Alzheimer’s is not known, one theory is that a build-up of a substance in the brain known as beta-amyloid – which can induce the death of nerve cells – accelerates the onset and progression of the disease.
Based on this theory, Dr Xie Qingping, a microsurgery expert and director of the private Qiushi Hospital in Hangzhou, Zhejiang province, first performed the LVA procedure to treat Alzheimer’s in 2021, according to Tang.
The surgery connects the patient’s lymph vessels to veins near the neck, speeding up the flow and drainage of lymph fluid.
Tang said the procedure had been used to treat conditions like lymphoedema, which causes swelling most commonly in the arms and legs. But recent research has shown that the human brain also has a lymphatic system, prompting Chinese doctors to explore its potential for treating brain disorders such as Alzheimer’s disease.
They believe the surgery could help remove harmful proteins, including beta-amyloid, from the brain, thereby slowing the progression of the disease.
The procedure is not new, but it requires microscopic guidance. That drew the interest of Tang, a microsurgery expert. He put together a team of specialists from the hospital’s neurology and other departments in 2023 and they launched their LVA clinical trial to treat Alzheimer’s in early 2024 after receiving ethical approval.
Those taking part must have no serious chronic disease of the heart, lungs, liver, kidneys or other organs, according to the hospital’s advertisement for the clinical trial. In addition, their brain imaging scans should also show a build-up of beta-amyloid and tau – another protein thought to contribute to Alzheimer’s symptoms.




Tang said patients from other countries were welcome to join the trial if they met enrolment criteria and could comply with follow-up requirements – for example, a patient’s primary carer must observe and record any changes on a daily basis.
They would also have to arrange their own visas to travel to China. Beijing has eased visa rules in the past year, with passport holders from 38 countries now able to enter China without a visa and stay for more than 30 days for business, tourism, family visits or transits.
Lymph nodes … can be compared to the cartridges used to filter tap water, which get old and clogged over time
Dr Tang Juyu, Xiangya Hospital
Tang noted there was already a waiting list of several months to receive the treatment at Xiangya. Located in central China, Xiangya is one of the country’s top research hospitals with more than 160 doctoral supervisors and 3,500 beds.
He said the team was starting to understand how LVA worked.
“We’ve found that substances in the brain are actually mainly filtered through the lymph nodes before returning to the body’s circulatory system,” Tang said.
“So the lymph nodes are a core part of that – they can be compared to the cartridges used to filter tap water, which get old and clogged over time.”
He said there had not been any serious complications in any of the patients who underwent the treatment at his hospital, and side effects observed so far had been relatively mild.
But while the treatment looks promising, some medical experts are sceptical and say further studies are needed to test it.


In April, Shanghai Ninth People’s Hospital also launched a clinical trial to test the surgical treatment. Dr Zhang Yixin, a leading surgeon at the hospital, told Shanghai-based news outlet The Paper in early December that the surgery could not restore a patient’s cognitive level and the long-term effects of the treatment remained to be seen.
“The longest follow-up [in trials] now is only seven or eight months, and we need to collect longer follow-up evidence and a larger sample size to confirm its efficacy,” Zhang was quoted as saying.
Tang said he hoped to carry out the procedure on 100 patients and then analyse the follow-up data after a year to determine the true therapeutic potential of the surgery.


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Could lymph node surgery be the answer for treating Alzheimer’s disease?

Dr Tang Juyu (right), who heads the microsurgery unit at Xiangya Hospital of Central South University in Changsha, says his team has performed an experimental procedure on more than 70 Alzheimer’s patients so far. Photo: Handout

Nearly 10 million people in China are living with Alzheimer’s disease. Photo: Shutterstock

Tang says the results of the trial have been positive so far. Photo: Handout

Why is a simple neck surgery raising hopes for China’s Alzheimer’s disease patients?

Of the more than 55 million people worldwide with dementia, an estimated 60 to 70 per cent have Alzheimer’s disease. Photo: Xinhua 

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Craniopharyngioma, shown here in the brain of a mouse, can cause symptoms including obesity, diabetes, visual effects and decreased hormone secretion in humans affected by the tumour. Photo: Chinese Academy of Sciences Institute of Genetics and Developmental Biology

Chinese scientists show animal brain changes while awake through neural imaging

A Chinese Academy of Sciences team says their microscopy technique overcomes being limited to imaging cultured cells, tissue sections or anaesthetised animals. Image: Shutterstock

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China

A clinical trial in Chinese public hospitals is showing promise, but experts stress that further studies are needed


A clinical trial in Chinese public hospitals is showing promise, but experts stress that further studies are needed.
