パーキンソン病に対する深頸部リンパ管静脈バイパス術の症例報告

Parkinson's Disease (PD) is a progressive neurodegenerative disorder characterized by dopaminergic neuronal loss and α-synuclein aggregation. Current treatments do not halt disease progression. Recent research highlights impaired cerebral lymphatic drainage in PD, suggesting a potential therapeutic target.

We report a 56-year-old male with advanced PD who underwent deep cervical lymphovenous bypass (DCLB) surgery, a novel intervention designed to enhance lymphatic drainage by anastomosing the deep cervical lymphatic vessel to a vein. The patient had been diagnosed with PD in 2024 after experiencing progressive motor symptoms since 2019, with suboptimal response to conventional pharmacotherapy.

At three-month follow-up, significant improvements were observed: Movement Disorder Society-Unified Parkinson's Disease Rating Scale decreased by 30.4% (from 23 to 16), Non-Motor Symptoms Scale decreased by 71.4% (from 77 to 22), and Parkinson's Disease Questionnaire-39 decreased by 94.2% (from 52 to 3). Both motor symptoms (rigidity, bradykinesia) and non-motor symptoms (sleep disturbances, orthostatic dizziness) showed improvement.

DCLB was technically feasible and was followed by symptomatic improvements in this single patient. The underlying mechanism for this clinical response remains unclear and was not investigated with biomarkers in this report. While these preliminary findings are hypothesis-generating, causality cannot be inferred from an individual case. Further controlled studies incorporating neuroimaging and fluid biomarkers are needed to explore potential mechanisms.