ArticleJournal of Alzheimer's disease reports
Preoperative perivascular space burden predicts treatment response to deep cervical lymphovenous anastomosis in Alzheimer's disease: A pilot study.
Article in Journal of Alzheimer's disease reports. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Can supermicrosurgery treat Alzheimer's disease? - Current evidence and hope.Head & face medicine · 2026Review
- Deep cervical lymphovenous reconstruction in Alzheimer's disease: three target-defined interfaces with distinct mechanistic implications.Frontiers in aging neuroscience · 2026Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Deep cervical lymphovenous anastomosis (DLVA) shows promise for Alzheimer's disease (AD) treatment, but patient selection criteria remain undefined. Perivascular spaces (PVS) may predict glymphatic enhancement potential. Objective: To investigate whether preoperative magnetic resonance imaging (MRI) measures of PVS burden can predict treatment response to DLVA in AD patients and explore potential mechanisms through longitudinal glymphatic function assessment. Methods: Retrospective analysis of 10 AD patients undergoing DLVA. Preoperative T1-weighted MRI quantified PVS volumes using Frangi filtering. Treatment response was assessed at one month using Mini-Mental State Examination/Montreal Cognitive Assessment improvements ≥2 points. Results: Total PVS volume demonstrated perfect predictive accuracy for treatment response (AUC = 1.000) with an optimal cut-off of 5150 mm³ (sensitivity 100%, specificity 100%). White matter PVS volume also showed strong predictive performance (AUC = 0.875, cut-off 3630 mm³, sensitivity 75%, specificity 100%). The improved group had significantly higher preoperative PVS volumes (total PVS: p = 0.012, Cohen's d = 2.631; white matter PVS: p = 0.050, Cohen's d = 1.689). Preliminary longitudinal analysis revealed divergent Analysis Along the Perivascular Space (ALPS) index changes: the improved group showed mean increase (+0.0276), while the non-improved group demonstrated decrease (-0.0252). Conclusions: Preoperative PVS burden serves as a powerful predictor of DLVA response, with higher volumes indicating sufficient anatomical reserve for therapeutic benefit. These findings establish PVS volume as clinically actionable biomarkers for precision patient selection in glymphatic-targeted AD interventions.
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Registered trials
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