Effect of Long-Term Head and Neck Venous Outflow Obstruction on Cognitive Function: Evidence From Patients With Internal Jugular Vein Stenosis
Internal Jugular Vein Stenosis · Cognitive Impairment · Cerebral Venous Outflow Obstruction
De qué trata este estudio
El registro no identifica actualmente este estudio como reclutando. Consulta su estado antes de planificar una evaluación.
- Tipo de estudio
- Observacional
- Fase
- No aplica / no indicada
- Rango de edad
- 18 años - 65 años
- Sexo admitido
- Todos los sexos
- Voluntarios sanos
- Aceptados
- Participantes
- 72 Estimado
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Las explicaciones y la navegación están en español. Los textos proporcionados por el registro, incluidos títulos, resúmenes y criterios, se conservan en su idioma original. Puedes pedir orientación en español a WCR.
Acerca de la investigación
This study aims to determine the effect of long-term head and neck venous outflow obstruction-specifically internal jugular vein stenosis (IJVS) caused by atlas transverse process compression with a stenosis rate ≥50%-on cognitive function, and to observe the cognitive outcomes of atlas transverse process resection combined with release and perfusion technique in routine clinical care. The study uses a case-control design to compare cognitive function between patients with IJVS and matched healthy controls, and a prospective cohort design to follow surgical and non-surgical cohorts for 6 months. The Montreal Cognitive Assessment (MoCA) total score is the primary cognitive measure. The target population per the protocol summary is image-confirmed IJVS due to atlas transverse process compression (stenosis ≥50%), with mild-to-moderate cognitive impairment (MoCA \<26), aged 18-65 years.
Leer la descripción completa
Internal jugular vein stenosis is an important cause of head and neck venous outflow obstruction, and extrinsic stenosis caused by bony compression of the atlas transverse process is common in clinical practice. Atlas transverse process decompression is currently used mainly to relieve somatic symptoms such as pulsatile tinnitus, headache, and dizziness; however, high-quality evidence on its systematic effect on cognitive function is lacking. This study is conducted within routine clinical care and does not add any additional invasive sampling or traumatic examinations. During standard management-surgical decompression or conservative treatment-cognitive function and imaging-based venous outflow indicators are observed longitudinally.
In the case-control component, patients with IJVS (disease duration ≥6 months) are matched 1:1 to healthy controls by age, sex, and years of education; MoCA total scores and cognitive subdomain scores are compared. In the cohort component, patients are assigned to a surgical cohort or a non-surgical cohort according to clinical indications and patient preference, without randomization or inducement. Follow-up is conducted at 1, 3, and 6 months after surgery or enrollment. The planned total cohort sample size is 72 participants (36 surgical and 36 non-surgical, allowing for a 10% dropout rate). Healthy controls for the case-control analysis are matched 1:1 and are not counted within the 72 cohort participants.
¿Quién podría participar?
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Inclusion Criteria:
Cohort study (surgical cohort / non-surgical cohort):
Age 18-65 years, either sex. Confirmed by head and neck CT venography (CTV), MR venography (MRV), and jugular vein ultrasound as extrinsic IJVS caused by atlas transverse process compression, with a stenosis rate ≥50%.
Voluntary participation and signed written informed consent. Able to cooperate with MoCA cognitive assessment and related examinations at all scheduled time points.
No severe hepatic or renal insufficiency, coagulation disorders, or other severe underlying diseases.
Surgical cohort: no surgical contraindication and willingness to undergo atlas transverse process resection combined with release and perfusion technique. Non-surgical cohort: willingness to receive conservative treatment without surgery and no urgent surgical indication during follow-up.
Case-control study-case group:
Clinically confirmed IJVS with disease duration ≥6 months. CTV-confirmed IJVS caused by atlas transverse process compression. No history of previous cerebral infarction, intracranial hemorrhage, Alzheimer's disease, or other known causes of cognitive decline.
Complete baseline clinical and imaging data available.
Case-control study-healthy control group:
Age-, sex-, and education-matched individuals without IJVS, without head and neck venous outflow obstruction, and without severe organic disease or a history of cognitive impairment.
Exclusion Criteria
Cohort study:
Cognitive impairment caused by another definite etiology (e.g., Alzheimer's disease, cerebral infarction, cerebral hemorrhage, hypothyroidism).
Severe psychiatric disease preventing cooperation with cognitive assessment and study procedures.
Neck surgery, radiotherapy, or internal jugular vein intervention within the previous 3 months.
Pregnancy or breastfeeding. Malignant tumor, autoimmune disease, or other condition with an expected survival of less than 1 year.
Long-term use of sedative-hypnotics or cognitive-enhancing drugs that may affect MoCA assessment.
Refusal to participate in follow-up or inability to complete all scheduled assessments.
Case-control study:
Other imaging-detected venous abnormalities, such as venous sinus stenosis or jugular vein reflux, or the styloid process identified as the main compressive structure causing IJVS.
Severe heart failure or other major cardiac dysfunction. Severe hearing impairment or other conditions that may affect the validity or completion of cognitive assessment.
Intrathoracic or intracranial space-occupying lesions, cerebral vascular malformations, or other abnormalities on high-resolution chest CT, brain MRI, or CT that may constitute a major hemodynamic obstruction.
Población del estudio
Surgical cohort Procedure (routine clinical care, not a study intervention) Patients undergo atlas transverse process resection combined with release and perfusion technique according to clinical indications. The procedure aims to relieve bony compression of the internal jugular vein by the atlas transverse process. Postoperative follow-up is performed according to routine care. The study does not alter surgical indications or the operative procedure; it only observes changes in MoCA scores and imaging-based venous outflow indicators at 1, 3, and 6 months after surgery.
Healthy control group (case-control component) Observational comparator group Age-, sex-, and education-matched individuals without IJVS or head and neck venous outflow obstruction, matched 1:1 to the case group.
Entiende la evaluación inicialTratamiento, grupos y participación
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- Asignación
- No informado
- Enmascaramiento
- No informado
IJVS
Internal Jugular Vein Stenosis
HC
healthy controls
Qué evalúan los investigadores
Estas medidas indican qué se estudia. No prueban que un tratamiento funcione.
Medidas principales
Change in MoCA total score
Plazo: Baseline, 1 month, 3 months, and 6 months after surgery/follow-up
Change in the Montreal Cognitive Assessment total score from baseline to 6 months after surgery/follow-up. In the cohort component, between-group differences and repeated-measures trends are compared between the surgical and non-surgical cohorts. In the case-control component, baseline differences between cases and healthy controls are compared.
Medidas secundarias
IJV stenosis improvement rate
Plazo: Baseline, 1, 3, and 6 months after surgery/follow-up
Imaging-based quantitative assessment of improvement in IJVS severity by CTV/ultrasound.
Head and neck venous outflow patency
Plazo: Baseline, 1, 3, and 6 months
CTV/MRV assessment of venous sinus morphology, patency, and collateral circulation; ultrasound assessment of blood flow velocity and reflux.
Incidence of postoperative complications/adverse events
Plazo: Intraoperative period through 6-month follow-up
Bleeding, infection, hematoma, nerve stimulation, venous thrombosis, contrast agent reactions, etc.
Revisa las tablas completas y sus limitaciones en el registro oficial.
Abrir resultados oficiales ↗Centros de investigación (0)
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No hay centros indicados. Usa el contacto oficial del estudio.
Equipo y fechas
- Patrocinador principal
- Beijing Shijitan Hospital, Capital Medical University
- Inicio del estudio
- 10 nov 2026 Estimado
- Finalización primaria
- 30 jul 2028 Estimado
- Finalización del estudio
- 1 dic 2028 Estimado
- Primera publicación
- 10 nov 2026 Real
- Última actualización
- 10 nov 2026 Real
Contactos oficiales del estudio
Título oficial del estudio
Long-Term Head and Neck Venous Outflow Obstruction and Cognitive Function: Evidence From Patients With Internal Jugular Vein Stenosis-A Case-Control Study Combined With a Prospective Observational Cohort Study
Consulta a Wellness Clinical Research
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Fuente: API v2 de ClinicalTrials.gov. Patrocinadores e investigadores envían la información. La NLM no aprueba la seguridad ni la ciencia de todos los estudios registrados. Aviso del registro.
Consultado: 12 nov 2026 · Última actualización del registro: 10 nov 2026