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RNA sequencing and proteomics analyzed gene\/protein changes, with results verified by western blotting and immunofluorescence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>CLE led to sleep and psychiatric disorders, linked to mitogen\u2010activated protein kinase\/extracellular signal\u2010regulated kinase (ERK) pathway activation. Activation of ERK may interfere with autophagy and is associated with phosphorylated tau accumulation. Peripheral blood analysis shows decreased brain waste in the peripheral blood post\u2010cLE, implicating impaired lymphatic drainage and brain waste build\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>These findings suggest a potential connection between cLE and AD\u2010like tauopathy, potentially influencing surgical decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Cervical lymphadenectomy (cLE) is the cornerstone of head and neck cancers, affecting millions of people each year. We provide the first evidence of mildly impaired cognitive functioning with significant anxiety\u2013depressive disorders in mice after long\u2010term cLE.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Long\u2010term cLE not only directly impairs brain wastes (amyloid beta, phosphorylated tau [p\u2010tau]) drainage, but also activates the Erk1\/2 signaling pathway leading to attenuation of autophagy.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>We found for the first time that long\u2010term cLE accelerated the deposition of p\u2010tau in young mice.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Patients after clinical cervical lymph node dissection showed reduced brain waste in peripheral blood consistent with mouse models. This study suggests the need for further evaluation of the neurologic effects of cervical lymph node dissection, a procedure that affects millions of people each year.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70136","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T01:19:10Z","timestamp":1743988750000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Tauopathy after long\u2010term cervical lymphadenectomy"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4933-6918","authenticated-orcid":false,"given":"Chenrui","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Tianjin Neurological Institute State Key Laboratory of Experimental Hematology Laboratory of Post\u2010Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin &amp; 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