Navigation Links
New studies question vascular multiple sclerosis hypothesis and treatment

Two important new studies challenge the controversial hypothesis that venous congestionchronic cerebrospinal venous insufficiency (CCSVI)contributes to the development of multiple sclerosis (MS). This theory has resulted in many MS patients receiving experimental endovascular angioplasty, a treatment for MS unproven by clinical trials. The studies refuting the CCSVI theory with the first negative medical evidence on the subject, are available today in Annals of Neurology, a journal published by Wiley-Blackwell on behalf of the American Neurological Association.

For nearly 150 years it has been known that focal MS lesions tend to develop around cerebral veins that are thought to the portal by which inflammatory cells targeting myelin enter the brain. However, a 2009 study by Zamboni et al. offered an alternative theory suggesting that chronically impaired venous drainage (blood flow) from the central nervous systema term that he labeled Chronic Cerebrospinal Venous Insufficiency or CCSVIleads to MS development.1 Zamboni et al. also claimed that endovascular angioplasty was markedly effective in MS patients.2 Zamboni's work gained much attention in the press, especially their report that ultrasound diagnosis of CCSVI perfectly matched an MS diagnosis with 100% sensitivity and 100% specificity.

"These two papers should add a note of caution for MS patients and physicians who are contemplating interventions for possible venous abnormalities based on the findings of Zamboni. At this time, the theory must be considered unconfirmed and unproven. Such interventions carry risk, and several people have already been harmed by the inappropriate application of venous angioplasty and stenting for MS," says Stephen L. Hauser, M.D., the Robert A. Fishman Distinguished Professor and Chair of the Department of Neurology at the University of California, San Francisco, and editor-in-chief of the Annals of Neurology. A previously published review of the evidence in the Annals by Khan et al. noted that treatment procedures, based upon these findings, have included placing stents in the jugular veins of MS patients which led to serious injury in some cases.

In the current issue of the Annals, Florian Doepp, M.D., and colleagues in Germany performed an extended extra- and trans-cranial color-coded sonography study on 56 MS patients (36 female; 20 male) and 20 control subjects (12 female; 8 male). The analysis included extra-cranial venous blood volume flow (BVF), internal jugular vein (IJV) flow analysis during Valsalva maneuver (VM), as well as tests included in the CCSVI criteria.

Results showed that blood flow direction was normal in all participants, excluding one subject with relapsing-remitting MS. Furthermore, the research team noted that blood volume flow (BVF) in both groups were equal in the supine body position. In summary, the researchers determined that none of the study participants fulfilled more than one criterion for CCSVI.

"Our results call into question the existence of CCSVI in a large proportion of patients with MS," said Dr. Doepp. "We did not find supporting evidence that cerebral venous congestion plays a significant role in the development of MS. Further studies are needed to clarify the difference between MS patients and healthy subjects in blood volume flow regulation," concluded Dr. Doepp.

A second study by researchers at Ume University in Sweden also concluded that CCSVI does not contribute to the development of MS. The Swedish research team led by Peter Sundstrm, M.D., Ph.D., tested the vital component of the CCSVI theorythe obstructed IJV flowin 21 MS patients and 20 healthy controls using magnetic resonance imaging with phase contrast (PC-MRI).

"Using PC-MRI, we were not able to reproduce the findings by Zamboni et al. which suggest CCSVI contributes to the development of MS," said Dr. Sundstrm. The researchers found no significant differences between the MS group and control group relating to total IJV blood flow. "Our study found no support for using endovascular procedures such as angioplasty or stenting to treat MS patients," Dr. Sundstrm affirmed.

MS is an inflammatory disease of the central nervous system in which lesions (plaques) form in the white matter of the brain and destroy the myelin sheath around nerve fibers. Initial symptoms of MStypically blurred or double vision, muscle weakness, sensory changes, or difficulty with balanceusually appear between the ages of 20 and 40. The course can be relapsing-remitting or relentlessly progressive, and if untreated results in permanent neurologic disability in most affected individuals. MS affects 2.5 million individuals worldwide, making it one of the most common neurological disorders and causes of disability in young adults.


Contact: Dawn Peters

Related medicine news :

1. Snake venom studies yield insights for development of therapies for heart disease and cancer
2. CIHR team grant to fund multidisciplinary breast cancer survivorship studies
3. FDA accepts historical controls for epilepsy monotherapy studies
4. Studies explore effects of war on former child soldiers
5. Pediatric clinical studies appear prone to bias, Hopkins review shows
6. Studies of womens attitudes to social egg freezing find reasons differ with age
7. Studies confirm presence, severity of pollution in national parks
8. Vitamin D Deficiency Linked to Diabetes, Metabolic Syndrome in Studies
9. 2 studies: Social factors, super users and urban emergency departments
10. MSU team studies connection between statins, tendon ruptures
11. Quincy Bioscience Launches; Research Studies More Accessible For Participants
Post Your Comments:
(Date:10/13/2017)... Worth, TX (PRWEB) , ... October 13, 2017 ... ... financial planning agency serving communities in the greater Dallas, Miami, and Raleigh regions, ... young boy fighting to overcome a rare and deadly chromosome abnormality. , After ...
(Date:10/13/2017)... ... ... While it’s often important to take certain medications during the night, finding ... identified a solution. , She developed a prototype for MOTION LIGHT-UP PILL BOX to ... the need to turn on a light when taking medication during the night, allowing ...
(Date:10/13/2017)... ... ... PurhealthRX , a leading Health and Nutrition Company, is announcing the ... spectrum CBD oil will revolutionize the rapidly growing CBD market by reducing the amount ... into liquid products, while reducing costs to end users. , The team of researchers ...
(Date:10/13/2017)... ... October 13, 2017 , ... Apple Rehab Shelton ... staged a mock evacuation of the facility as part of a disaster drill on ... Echo Hose EMS and Shelton City Emergency Manager, as well as the Connecticut ...
(Date:10/13/2017)... ... October 13, 2017 , ... Ellevate Network, the leading ... to advocate for action towards gender equality at their inaugural Summit in New York ... globe, and reached a social audience of over 3 million. To watch the Mobilize ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... , Oct. 2, 2017 Halo Labs announces the ... analysis system called the HORIZON at MIBio 2017 in ... subvisible and visible particulate matter in biopharmaceutical samples with unprecedented speed ... of the novel technique Backgrounded Membrane Imaging. ... The HORIZON subvisible particle analysis system ...
(Date:9/27/2017)... Israel and NEW YORK , Sept. 27, ... with mobile health and big data solutions, today announced that its MyDario ... Please check your local TV listings for when The Dr. Oz Show ... ... season this month. ...
(Date:9/22/2017)... , Sept. 22, 2017 AVACEN Medical (AVACEN) ... is now successfully helping those with the widespread pain ... Fibromyalgia diagnosed Amanda in Essex, England ... washing my hair, experiencing no sleep at all, tremendous ... spasm… I cannot recommend [the AVACEN 100] enough, how ...
Breaking Medicine Technology: