Rokkit wrote:Although getting excited about the 80% possibility is so tempting, it's just so hard to believe they wouldn't have mentioned that in the press release. Why on earth would they have included so many CIS? And why would they include CIS in the overall percentage? CIS is not MS. Just doesn't make sense.
costumenastional wrote:Another interprentation could be that in the early stages of MS the ccsvi is not easily detectable by the methods they are currently using, but as the veins stenosis is getting worse for whatever reason so does the MS.
Another useful aspect if ever answered.
not all CIS patients will covert to CDMS (22%, Cohen & Ruddick 2007), I think that the true CDMS CCSVI results are skewed significantly by lumping the 2 groups.
However, the question remains how to predict that a patient with CIS will develop CDMS? Several prospective studies addressed this issue using MRI as a surrogate marker in patients with CIS who already showed evidence of occult disease dissemination by the presence of asymptomatic white-matter lesions.[37-42] The majority of these patients will go on to develop CDMS.
In the Optic Neuritis Treatment Trial (ONTT) the number of brain lesions present in patients with monosymptomatic optic neuritis was a strong predictor of the likelihood for developing CDMS (Class I evidence).
A recently published 14-year prospective study on the use of MRI to predict the risk of developing MS in patients with CIS revealed that almost 90% of patients with abnormal baseline MRI developed CDMS during the follow-up period.
Interestingly, the conversion rates to definite MS did not depend on the number of lesions present on brain MRI at baseline.
Thus, multiple demyelinating lesions as seen on MRI at the time of CIS support the contention that the clinical presentation does not reflect the first pathological manifestation. Prospective MRI studies have shown:
•Lesional dissemination on brain MRI in a patient with CIS strongly predicts future conversion to CDMS (Class I).[4,34,35]
•Gadolinium-enhanced lesions at baseline strongly predicts future conversion to CDMS (Class I).
•The application of the new McDonald criteria more than doubles the rate of the diagnosis of MS within a year of presentation with a CIS (Class I).
•In patients with a classical syndrome of inflammatory demyelination and an abnormal baseline MRI, the possibility of an alternative diagnosis is negligible (Class I).[4,34,35
eve wrote:As I understand it people with CIS and certain lesions as seen on MRI have a 90% chance to develop MS. So what percentage of the CIS patients in this study have those lesions?
Direct-MS wrote:As a major risk factor which can be related to the disease pathogenesis, one would predict resoution of CCSVI would be of significant benefit.
Direct-MS wrote:If CCSVI was the primary cause of MS then we would expect close to 70% of the CIS patients to exhibit CCSVI. However if we go objectively with the Buffalo data and that only 60% of persons with MS have CCSVI then we would expect a result of 70 X .6 = 42% of those with CIS to exhibit CCSVI and that is approximately what was found.
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