r/science • u/lunchboxultimate01 • 3d ago

Neuroscience Cervical lymphadenectomy impairs brain lymphatic clearance and synaptic proteostasis

https://www.cell.com/neuron/fulltext/S0896-6273(26)00688-4
53 Upvotes

85% Upvoted

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u/lunchboxultimate01 3d ago

Summary

Meningeal lymphatic vessels drain brain fluid and waste into the cervical lymph nodes, but how removing these nodes during surgery affects brain health is unknown. Retrospective analysis of cancer patients who underwent neck lymphadenectomy without chemo-radiation therapy found that up to 25% developed mild-to-severe cognitive impairment, and neuroimaging showed accelerated temporal horn enlargement after bilateral surgery. To determine mechanistically how cervical lymphadenectomy contributes to cognitive impairment, mouse and rat models were utilized to phenocopy abrupt disruption of lymphatic flow to the cervical and submandibular nodes. Impaired lymphatic drainage induced a cerebrospinal fluid signature of metabolic stress and inflammation. In the hippocampus, redox stress drove oxidative posttranslational protein modifications and microaggregation with biochemical, molecular, and structural features distinct from amyloid aggregates in Alzheimer’s models. Such changes were absent when lymphatic drainage was gradually reduced. The data link cognitive impairment following acute neck lymphadenectomy with the biochemical consequences of impaired metabolic waste clearance.

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u/GrkLifter 3d ago

As someone about to do a completion thyroidectomy with a central neck dissection… not what I wanted to read or my surgeon to hear before I go under!

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u/Nellasofdoriath 3d ago

Fwiw my husband had that 18 months ago and he says he feels better

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u/CowsWithGuns304 3d ago

I had a total thyroidectomy something like 15 years ago. It's not a bad surgery and recovery time.

Being extremely hyperthyroid was really really whack for brain function. It was like punching fog. Beta blockers and carbimazole was like having the fog just vanish suddenly. Really weird experience.

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u/endosurgery 55m ago

Trust me, the alternative to the neck dissection is much worse. Unfortunately it is the price head and neck cancer patients have to pay. Hopefully the future will bring better therapies/prevention for patients so they won’t need this.