Dr. Zivadinov Featured at Masters of MS Website

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Dr. Zivadinov Featured at Masters of MS Website

Postby questor » Mon Jun 07, 2010 2:39 pm

An MS_social_worker/friend pointed me to this site for general MS information from a neurologist's perspective:

Masters of MS Website

Dr. Zivadinov is featured this month with focus on CCSVI. Nothing surprising in what he says, but I liked his careful and concise statement to the neurological/MS_patient community :

"My view at this point is that CCSVI is associated with MS; however it is yet to be determined whether CCSVI is among the risk factors that, along with others, increase a person’s susceptibility to developing this disease. The fact that CCSVI prevalence is about 38% in patients with a first clinical attack of MS and almost 90% in those with secondary progressive MS and a disease history of 20 years suggests to me that venous insufficiency has a high likelihood of affecting people with MS over time."

--Tracy
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Postby eric593 » Mon Jun 07, 2010 2:59 pm

Thanks.

How have you been doing since your procedure?
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Postby questor » Mon Jun 07, 2010 4:14 pm

From the About page at the Masters of MS site:

More information has been published about multiple sclerosis (MS) in the past decade than in the entire history of medical literature. Clinical practices even a few years out of date may not be in the best interest of our MS patients. But it’s nearly impossible to keep up with all the advances, much less apply them in a disease that varies greatly among patients.

That’s why we created MastersofMS.com. This website is a forum for specialists with the latest expertise on MS to share their knowledge with you, the MS clinician. It’s simple: register for the site, enter your question, and our experts will address it directly. Or browse the archived topics on the site.


Given that the expected audience of this site is the MS clinican, I think Dr. Zivadinov's comments are especially meaningful.

eric593, I've been updating a topic at this site with my progress (it varies day to day):

http://www.thisisms.com/ftopicp-112319.html#112319

--Tracy
CCSVI Procedure 9/16/2009 at Stanford
Stent in left and right IJVs
SPMS
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Jugular Venous Reflux and Age

Postby Shayk » Mon Jun 07, 2010 7:34 pm

Tracy

Thanks for posting this. I find Buffalo's results of CCSVI in people with SPMS pretty interesting.
CCSVI prevalence ..........almost 90% in those with secondary progressive MS and a disease history of 20 years

I've come across some info on another condition, "Leukoaraiosis", "a major cause of vascular and dementia in the elderly" where it's been suggested that jugular venous reflux may be relevant.

Pathogenesis of leukoaraiosis: role of jugular venous reflux
Chronic cerebral hypoperfusion associated with vasogenic edema, microbleeding or/and endothelial dysfunction found in LA favors venous ischemia, in stead of arterial ischemia, as its pathogenesis.

The involved regions in LA, periventricular and subcortical regions, are the drainage territory of deep cerebral venous system and the watershed region between the superficial and deep cerebral venous system respectively....

cerebral venous hypertension caused by downstream venous outflow impairment might play a major role in the pathogenesis of LA.

Internal jugular vein is the main venous outflow pathway for cerebral venous drainage.

The frequency of jugular venous reflux (JVR) is increased with aging.

Hypertension, which has a decreased venous distensibility, might further exacerbate the sustained or long-term repetitive retrograde-transmitted cerebral venous pressure and venous outflow insufficiency caused by JVR.

Clinically, JVR caused by a dural AV fistula does lead to cerebral hypoperfusion, white matter abnormalities, vasogenic edema and cognitive impairment in several published reports.

JVR is suggested to play a key role in the pathogenesis of LA through a sustained or long-term repetitive retrograde-transmitted cerebral venous pressure and venous outflow insufficiency, which might lead to chronic cerebral venous hypertensions, abnormal cerebral venules structural changes, decreased cerebral blood flow, endothelial dysfunction, and vasogenic edema in cerebral white matters.

Clearly, the highlight as it pertains to the Buffalo findings re: 90% CCSVI in people with SPMS, is that it would appear that jugular venous reflux gets worse with age, so the Buffalo results could be consistent with jugular venous reflux, at least viewed through this lens. There's also research indicating that disability levels in MS are related to age.

And, just to make it really interesting, here's Wikipedia's take on leukoaraiosis
Leukoaraiosis is a term for changes in the cerebral white matter that can be detected with high frequency by CT and MRI in aged individuals.

It is a descriptive term for rarefaction of the white matter.

It is also commonly referred to as white matter hyperintensities (WMH) due to its bright white appearance on T2 MRI scans.

Underlying vascular mechanisms are suspected.

This white matter pathology is inconsistently associated with cognitive impairment, motor dysfunction, and gait disturbances. Slowed cognitive speed of processing and frontal executive abilities are also common.

Sounds kind of familiar to me.

Unrelated, but I just now saw this abstract and it may have already been posted, but interesting nonethless since there's lots of optic neuritis associated with MS.

Jugular venous reflux affects ocular venous system in transient monocular blindness

Take care all and thanks again Tracy. Hope more improvements consistently come your way.

Sharon
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Postby Cece » Mon Jun 07, 2010 7:41 pm

Wow, Sharon, interesting find.
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Postby cheerleader » Mon Jun 07, 2010 8:21 pm

Sharon---fabulous find. This is from Dr. Chung, who has been studying venous reflux/jugular valve insufficiency in TGA and other neurovascular situations. No wonder CCSVI gets worse with disease progression...aging doesn't help.

The Zivadinov interview is OK. He mentions two deaths (???) which continues to irritate me...but he's still researching the link, and that's the important thing.

Tracy--it was good to see your name pop up. Think of you often, and hope there are more better days than worse ones...and that there is still more healing ahead,
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dx dual jugular vein stenosis (CCSVI) 4/09
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Postby Guider » Mon Jun 07, 2010 8:40 pm

Why is it that we can't see the forest for the trees :?: :?: Amazing info.

Thanks for posting.




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