Deep cervical lymphovenous bypass for Parkinson’s disease: A hypothesis

• The onset and progression of Parkinson’s disease are closely linked to the accumulation of alpha-synuclein in the brain. • The brain’s lymphatic system is essential for the clearance of metabolic waste products, including alpha-synuclein. • A decrease in lymphatic system function is frequently observed in patients with Parkinson’s disease. • Animal studies have demonstrated that enhancing lymphatic drainage function contributes to the treatment of Parkinson’s disease. • The deep cervical lymphovenous bypass surgery has been proposed to enhance intracranial lymphatic drainage function, with the objective of treating Parkinson’s disease. As the population ages, the incidence of Parkinson’s disease has been progressively increasing, becoming a significant global public health concern. This disease is closely associated with the abnormal accumulation of α-synuclein, which adversely affects neuronal function and exacerbates symptoms. Recent studies have indicated that the lymphatic system plays a crucial role in clearing metabolic waste from the brain. However, patients with Parkinson’s disease often exhibit dysfunction of the brain’s lymphatic system, resulting in impaired clearance of α-synuclein. Therefore, reducing the accumulation of α-synuclein in the brain has emerged as a therapeutic target for Parkinson’s disease. In this context, a hypothesis is proposed regarding the use of deep cervical lymphovenous bypass surgery. This procedure aims to create a pathway for the drainage of cerebrospinal lymph by anastomosing the deep cervical lymphatic vessels with the cervical veins, thereby accelerating lymphatic drainage and improving the drainage function of the brain’s lymphatic system. If this hypothesis is validated, it could provide new solution into the treatment of Parkinson’s disease, potentially halting disease progression and possibly being applicable to other neurodegenerative disorders.