Efficacy and Safety of Bilateral Cervical Lymphatic-Venous Anastomosis in the Treatment of Multiple System Atrophy

NCT ID: NCT07036939

Last Updated: 2025-06-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

46 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-07-01

Study Completion Date

2028-04-30

Brief Summary

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Multiple System Atrophy (MSA) is a rare and aggressive neurodegenerative disorder characterized by a combination of motor impairments, autonomic dysfunction, and cerebellar ataxia, with no currently available disease-modifying therapies. Emerging evidence suggests that impaired glymphatic clearance of pathological α-synuclein aggregates may contribute to disease progression. This clinical study investigates the potential of bilateral cervical lymphatic-venous anastomosis (LVA) - a microsurgical procedure connecting deep cervical lymphatics to veins - to enhance glymphatic drainage and slow disease progression in MSA patients.

This single-center prospective clinical study will enroll patients with clinically confirmed MSA to undergo bilateral cervical lymphatic-venous anastomosis (LVA). Through comprehensive pre- and postoperative evaluations including clinical scale assessments, blood biomarker testing, and neuroimaging examinations, the study aims to evaluate the short-term and long-term effects of bilateral LVA on patients' motor function, autonomic symptoms, and quality of life, as well as its potential to delay disease progression.

The study will further investigate whether the potential clinical improvements from LVA are mediated through enhanced intracranial lymphatic drainage function and subsequent clearance of pathological α-Syn protein in the brain. Safety assessments will include monitoring and recording both short-term and long-term postoperative complications. This research may provide a novel non-pharmacological intervention approach for MSA treatment.

Detailed Description

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Conditions

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Multiple System Atrophy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Immediate LVA group

Participants will undergo bilateral cervical lymphatic-venous anastomosis (LVA) surgery within 2 weeks after baseline assessments (including clinical scales, biomarker testing, and neuroimaging).

Group Type EXPERIMENTAL

Immediate LVA

Intervention Type PROCEDURE

Bilateral cervical lymphatic-venous anastomosis (LVA) performed within 2 weeks after baseline assessments.

Delayed LVA Group

Identical LVA procedure performed at 6 months (±2 weeks) post-baseline

Group Type ACTIVE_COMPARATOR

Delayed LVA

Intervention Type PROCEDURE

Identical LVA procedure performed at 6 months (±2 weeks) post-baseline

Interventions

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Immediate LVA

Bilateral cervical lymphatic-venous anastomosis (LVA) performed within 2 weeks after baseline assessments.

Intervention Type PROCEDURE

Delayed LVA

Identical LVA procedure performed at 6 months (±2 weeks) post-baseline

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Meets the 2022 Chinese Expert Consensus Diagnostic Criteria for Clinically Established Multiple System Atrophy (MSA).
* Unified MSA Rating Scale Part IV (UMSARS-IV) global disability score ≤3.
* Age: 40-70 years
* ASA (American Society of Anesthesiologists) Physical Status Classification ≤III, indicating acceptable anesthesia risk.
* Ability to complete neuropsychological assessments, physical examinations, brain MRI, and venous blood sampling.
* Willing to participate, provide biospecimens, and sign informed consent.

Exclusion Criteria

* Cognitive/Psychiatric Disorders: Congenital intellectual disability or severe neurological/psychiatric disorders affecting compliance.
* Severe Comorbidities: End-stage cardiac, hepatic, renal, or respiratory failure, or active malignancy with life expectancy \<1 year.
* Surgical Contraindications:
* Coagulopathy (uncontrolled bleeding risk)
* Allergy to surgical drugs/contrast agents
* Active neck infection (skin/deep tissue)
* Inability to adhere to study visits.
* Participation in other competing clinical trials.
Minimum Eligible Age

40 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ruijin Hospital

OTHER

Sponsor Role lead

Responsible Party

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Shengdi Chen

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Ruijin Hospital, Shanghai Jiao Tong University School of Medicine

Shanghai, Shanghai Municipality, China

Site Status

Countries

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China

Central Contacts

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Shengdi Chen, MD, PhD

Role: CONTACT

+86 13818018166

Chao Gao, MD, PhD

Role: CONTACT

+86 18217590273

Other Identifiers

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2025-264

Identifier Type: -

Identifier Source: org_study_id

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