I'm still in the mode of creating dots that may or may not ultimately connect. This time it seems to me there could be dots (yet to be connected of course) between CCSVI, fatigue, and disease progression.
First off, per the research in Italy, the "symptom" of CCSVI may be chronic fatigue (CF) and intervention seemed to reduce the perception of CF.
Is chronic fatigue the symptom of venous insufficiency associated with multiple sclerosis? A longitudinal pilot study
CONCLUSION: The reestablishment of cerebral venous return dramatically reduced CF perception in a group of MS patients with associated CCSVI, suggesting that CF is likely the symptom of CCSVI.
Now, for the "loose" dots, fatigue is being recognized more and more as a significant symptom and there is some information potentially linking fatigue with EDSS scores, disease progression and cortical atrophy.
Multiple sclerosis beyond EDSS: depression and fatigue
Fatigue is present in over three-quarters of patients with multiple sclerosis. It is considered the most debilitating symptom of the disease and is a major reason for work absenteeism
Now, for the interesting dots--fatigue has also been linked to EDSS scores, disability progression and atrophy.
Neuropsychiatric manifestations in multiple sclerosis: correlation of fatigue and depression with disease progression
When the patients were compared according to the presence of fatigue symptoms, patients with fatigue had significantly higher EDSS scores (p=0.03).
Physical dimension of fatigue correlated with disability change over time in patients with multiple sclerosis
After three years, with control for gender, age, and baseline disability status, a high baseline level of physical fatigue was associated with a worsening of disability status, whereas a low baseline level of physical fatigue was associated with the absence of worsening of the EDSS score.
Other dimensions of fatigue, depression and SF-36 were not associated with a worsening of disability. A patient's perceived fatigue may be not only a clinically and psychosocially meaningful outcome but also a predictor of objective outcomes such as changes in disability status at three years
Thus, based on that research, there seems to be a possibility that if interventions for CCSVI relieve fatigue, there is definitely the potential for stabilizing EDSS scores.
More research--a French adaptation of the tool used to measure fatigue.
Reconsidering fatigue at the onset of multiple sclerosis
We found a significant correlation between higher EMIF-SEP total scores and higher EDSS scores; likewise physical dimension of the EMIF-SEP were linked to disability
Other studies have failed to show any correlation between fatigue and disability. We suggest that this may be due to differences in sample size, or to the type of instrument used to quantify fatigue. As seen above, some tools do not allow for multi-dimensional assessment of fatigue. The EMIF-SEP scale is useful in that it allows for qualitative and quantitative assessment of fatigue.
Last, a link between atrophy and fatigue.
Relationship of cortical atrophy to fatigue in patients with multiple sclerosis
CONCLUSIONS: Cortical atrophy of the parietal lobe had the strongest relationship with fatigue.
We know atrophy is related to disability levels.
In all--diagnose and treat CCSVI, decrease fatigue and stabilize EDSS? It would be so sweet.
Take care all...just wanted to throw this out there while we wait for the clinical trials.