Neurologists unpack new Alzheimer’s surgery potential: 'This would be a true revolution in AD therapy'
Key Takeaways
Industry Buzz
“If this turns out to be reproducible across centers and with a higher number of patients, and if the approach has long-lasting effects, then this would be a true revolution in AD therapy (and maybe then I can retire).” — Jonathan Kipnis, PhD
“Precision techniques like robotic-guided surgery could redefine the safety and outcomes of surgical treatments for Alzheimer’s.” — Alex Dimitriu, MD
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China’s CSULS surgery has captured global attention for its novel approach to Alzheimer’s disease (AD).[] The procedure enhances the brain's glymphatic clearance system to remove amyloid-beta proteins, a hallmark of Alzheimer’s pathology. While pharmacological therapies dominate current treatments, CSULS is a new step toward surgical options for the disease.
Click here to learn more about the novel procedure: New Alzheimer’s surgery potential: 'My mother’s memory is stabilizing and improving'
In commenting on the trial, neuroscientist Jonathan Kipnis, PhD, said on X, “If this turns out to be reproducible across centers and with a higher number of patients, and if the approach has long-lasting effects, then this would be a true revolution in AD therapy.”
If this turns out to be reproducible across centers and with higher number of patients, and if the approach has long-lasting effects, then this would be a true revolution in AD therapy (and maybe then I can retire 😉) https://t.co/RCcBSJ1Dv7
— Jonathan Kipnis 💔🎗️ (@jonykipnis) November 25, 2024
Alex Dimitriu, MD, double board-certified in psychiatry and sleep Medicine and founder of Menlo Park Psychiatry & Sleep Medicine, tells MDLinx the procedure is a “mechanical solution” in combating AD.
Interest in surgical interventions for neurodegenerative disorders is growing in the United States. Let’s see what today’s top neuros have to say about current innovations.
How does it compare to current surgical interventions?
Deep-brain stimulation
Until recently, the only surgical approach for AD was DBS. By targeting structures such as the fornix and nucleus basalis of Meynert, DBS is said to modulate brain activity to potentially slow cognitive decline. However, Dr. Dimitriu says, “These might just be areas where toxins build up,” suggesting the need for a more targeted surgical approach to address the root cause.
Robotic-assisted surgeries, such as those performed at UT Health San Antonio, enhance the safety and accuracy of procedures like DBS.[] Dr. Dimitriu notes, “Precision techniques like robotic-guided surgery could redefine the safety and outcomes of surgical treatments for Alzheimer’s.”
When asked how DBS compares to conventional therapeutic options, Dr. Dimitriu tells MDLinx, “It’s still too early to tell if DBS will replace pharmacological treatments.”
Po-Chang Hsu, MD, agrees: “I don’t think DBS will replace pharmacological treatments entirely. Instead, DBS could complement drug therapies, especially for patients who don’t respond well to medications.”
Omental transposition
Another surgical innovation involves omental transposition, designed to increase cerebral blood flow (CBF) in aging brains.[] According to neurosurgeon Dr. Harry Sawyer Goldsmith from the University of California, who pioneered this method, decreased CBF plays a central role in AD progression. His findings suggest that placing the highly vascular omentum on the brain can enhance perfusion, potentially improving cognition in patients with viable intracerebral neurons.[]
While initial results showed improvement in one-third of patients, Dr. Goldsmith emphasized that the technique is most effective in early-stage AD patients who have only minimal neuronal loss.
Where AD procedures stand now
Dr. Dimitriu stresses there is no “single silver bullet” for AD. While surgeries remain experimental and their long-term efficacy is still under review, their development has sparked a discussion in the medical field.
Rapid recovery from Alzheimer's by enhancing lymphatic drainage.
— Analyze & Optimize (@Outdoctrination) November 23, 2024
The brain can accumulate toxic proteins Tau + β-Amyloid plaques, over time resulting in Alzheimer's.
The lymphatic system is there to drain out this "waste," but this process can become impaired and predisposes to… https://t.co/aDqxLjqwfg pic.twitter.com/gzUokgEpQL
Dr. Hsu summarizes the potential for recent advances in AD treatment: “A multi-pronged approach—including medications, lifestyle changes, and potentially therapies like gamma oscillation—will likely yield the best results.”