No association of abnormal cranial venous drainage with MS

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

No association of abnormal cranial venous drainage with MS

Postby MSUK » Mon Nov 01, 2010 2:31 am

Image

Abstract
Background Recent studies using colour-coded Doppler sonography showed that chronic impaired venous drainage from the central nervous system is almost exclusively found in multiple sclerosis (MS) patients. This study aimed to investigate the intracranial and extracranial venous anatomy and the intracerebral venous flow profile in patients with MS and healthy controls using magnetic resonance venography (MRV)....Read More - http://www.msrc.co.uk/index.cfm/fuseact ... ageid/2944
MS-UK - http://www.ms-uk.org/
User avatar
MSUK
Family Elder
 
Posts: 2087
Joined: Wed Oct 14, 2009 3:00 pm

Advertisement

Postby Jugular » Mon Nov 01, 2010 8:56 am

This is the full abstract and it appears to me to be a major kick in the teeth for CCSVI.

Abstract
Background Recent studies using colour-coded Doppler sonography showed that chronic impaired venous drainage from the central nervous system is almost exclusively found in multiple sclerosis (MS) patients. This study aimed to investigate the intracranial and extracranial venous anatomy and the intracerebral venous flow profile in patients with MS and healthy controls using magnetic resonance venography (MRV).

Methods Twenty patients with definite MS and 20 age- and gender-matched healthy controls were examined. MR imaging was performed on a whole-body 3T MR system including both 3D phase-contrast and dynamic 3D contrast-enhanced MRV as well as flow quantification of the internal cerebral veins and the straight sinus. Image analysis was performed by two experienced interventional neuroradiologists blinded to clinical data and structural brain imaging. The intracranial and extracranial neck veins were analysed for stenosis/occlusion and alternative venous drainage pattern.

Results A completely normal venous anatomy was observed in 10 MS patients and 12 controls. Anomalies of the venous system (venous stenosis/occlusions) were found in 10 MS patients and eight healthy controls. An anomalous venous system in combination with associated alternative venous drainage was observed in six MS patients and five healthy controls. Flow quantification showed no venous backflow in any MS patient or control.

Conclusions Findings suggestive of anomalies of the cranial venous outflow anatomy were frequently observed in both MS patients and healthy controls. Given the normal intracranial venous flow quantification results, it is likely that these findings reflect anatomical variants of venous drainage rather than clinically relevant venous outflow obstructions.

Mike P Wattjes1, Bob W van Oosten2, Wolter L de Graaf1, Alexandra Seewann2, Joseph C J Bot1, René van den Berg1,3, Bernard M J Uitdehaag2,4, Chris H Polman2, Frederik Barkhof1

1Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
2Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
3Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
4Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands

Source: Journal of Neurology, Neurosurgery & Psychiatry with Practical Neurology Copyright © 2010 by the BMJ Publishing Group Ltd.(01/11/10)
User avatar
Jugular
Family Elder
 
Posts: 375
Joined: Mon Dec 21, 2009 4:00 pm

Postby concerned » Mon Nov 01, 2010 9:09 am

So these researchers were using the Dr. Haake protocol, right?


http://www.thisisms.com/ftopict-9183.html


Is there something wrong with the Haake protocol then?
concerned
 

Postby scorpion » Mon Nov 01, 2010 9:23 am

Jugular wrote:This is the full abstract and it appears to me to be a major kick in the teeth for CCSVI.

Abstract
Background Recent studies using colour-coded Doppler sonography showed that chronic impaired venous drainage from the central nervous system is almost exclusively found in multiple sclerosis (MS) patients. This study aimed to investigate the intracranial and extracranial venous anatomy and the intracerebral venous flow profile in patients with MS and healthy controls using magnetic resonance venography (MRV).

Methods Twenty patients with definite MS and 20 age- and gender-matched healthy controls were examined. MR imaging was performed on a whole-body 3T MR system including both 3D phase-contrast and dynamic 3D contrast-enhanced MRV as well as flow quantification of the internal cerebral veins and the straight sinus. Image analysis was performed by two experienced interventional neuroradiologists blinded to clinical data and structural brain imaging. The intracranial and extracranial neck veins were analysed for stenosis/occlusion and alternative venous drainage pattern.

Results A completely normal venous anatomy was observed in 10 MS patients and 12 controls. Anomalies of the venous system (venous stenosis/occlusions) were found in 10 MS patients and eight healthy controls. An anomalous venous system in combination with associated alternative venous drainage was observed in six MS patients and five healthy controls. Flow quantification showed no venous backflow in any MS patient or control.

Conclusions Findings suggestive of anomalies of the cranial venous outflow anatomy were frequently observed in both MS patients and healthy controls. Given the normal intracranial venous flow quantification results, it is likely that these findings reflect anatomical variants of venous drainage rather than clinically relevant venous outflow obstructions.


I guess what the rearchers are saying is that what Zamboni was calling CCSVI MAY be nothing more than a veinuous system that is anatomically different but still works the way it is supposed too. I am not sure about a kick in the teeth but it is another independent study that seems to invalidate what we so far have learned about CCSVI. Hopefully the burden of proof will begin to fall on, as it should have from the beginning,Zamboni and his cohorts to PROVE that CCSVI exists instead of the other way around. It would certainly seem that with the severe neurological damage MS causes there should have been something that the radioologists saw on the doppler that would have indictated SOME kind of venuous involvement.
User avatar
scorpion
Family Elder
 
Posts: 1323
Joined: Wed Nov 05, 2008 4:00 pm

Postby Cece » Mon Nov 01, 2010 9:33 am

How does it fit with Dr. Zivadinov's research on MRV presented at ECTRIMS? That seemed to invalidate MRV studies (including his own prior research) and that it should be doppler studies, using Zamboni methods and not valsalva methods.
"However, the truth in science ultimately emerges, although sometimes it takes a very long time," Arthur Silverstein, Autoimmunity: A History of the Early Struggle for Recognition
Cece
Family Elder
 
Posts: 8989
Joined: Mon Jan 04, 2010 4:00 pm

Postby concerned » Mon Nov 01, 2010 9:47 am

Are you saying that Dr. Haake is, well, a hack?



Hasn't there been negative doppler studies that used the Zamboni method as well as valsalva and found no "CCSVI"?
concerned
 

Postby Leonard » Mon Nov 01, 2010 10:01 am

this is an old study by Dutch doctors, among them neurologists. they are part of the same circles as Freedman et al.
it was first reported in July, now gets renewed visibility because it was put on-line end of October.

Zamboni comments on the Dutch study start around 4:00.
in summary, MRI is not the right methodology
http://www.youtube.com/watch?v=RwfrSfQu ... r_embedded

http://www.youtube.com/watch?v=lilr-_A747A

I think that some people may have stronger veins (more Vit D during their childhood/ their mother metabolised more sun during pregnancy?), veins that are less susceptible to microbleedings. so, maybe, these people will also have stenoses but do not develop MS for that reason.

in any event, those with the weaker veins and MS benefit from liberation. that is the ultimate test! not whether other people happen to have stenoses and no MS.
Last edited by Leonard on Mon Nov 01, 2010 1:48 pm, edited 2 times in total.
User avatar
Leonard
Family Elder
 
Posts: 614
Joined: Fri Dec 18, 2009 4:00 pm
Location: Brussels, Capital of Europe

Postby Jugular » Mon Nov 01, 2010 10:04 am

I always thought that Doppler < MRV < Venogram, when it comes to detection tools.

According to this study, having a venous malformation and abnormal cranial drainage is not clinically relevant for MS because the same thing is as prevalent in the general population.
User avatar
Jugular
Family Elder
 
Posts: 375
Joined: Mon Dec 21, 2009 4:00 pm

Postby Jugular » Mon Nov 01, 2010 10:15 am

Leonard wrote:this is an old study by Dutch doctors, among them neurologists. they are part of the same circles as Freedman et al.
it was first reported in July, now gets renewed visibility because it was put on-line end of October.

Zamboni comments on the Dutch study start around 4:00.
in summary, MRI is not the right methodology
http://www.youtube.com/watch?v=RwfrSfQu ... r_embedded

http://www.youtube.com/watch?v=lilr-_A747A

I think that some people may have stronger veins (more Vit D during their childhood/ their mother metabolised more sun during pregnancy?), veins that are less susceptible to microbleedings. so, maybe, some people will also have stenoses but do not develop MS for that reason.

in any event, those with the weaker veins and MS benefit from liberation. that is the ultimate test! not whether other people happen to have stenoses and no MS.


I heard Zamboni to say that they've been using MRI's as a diagnostic tool for MS for the last 20 years and if this could be seen on an MRI it would have been discovered 20 years ago. The problem is that this is an MRV which images the veins and I doubt that had been used at all before. Furthermore, the researchers appeared to have used Haacke's protocol which measures blood flow.
User avatar
Jugular
Family Elder
 
Posts: 375
Joined: Mon Dec 21, 2009 4:00 pm

Postby scorpion » Mon Nov 01, 2010 10:29 am

Jugular wrote:I always thought that Doppler < MRV < Venogram, when it comes to detection tools.
According to this study, having a venous malformation and abnormal cranial drainage is not clinically relevant for MS because the same thing is as prevalent in the general population.


What makes things even more confusing to me was that Zamboni's initial findings, which really started the CCSVI mania, were found using doppler. Yet now everyone is trying to invalidate this study by saying that doppler is not an accurate means of identifying CCSVI???

Leonard said:

I think that some people may have stronger veins (more Vit D during their childhood/ their mother metabolised more sun during pregnancy?), veins that are less susceptible to microbleedings. so, maybe, some people will also have stenoses but do not develop MS for that reason.

Is this something that has been proven or is it a wild guess?

Leonard said:
in any event, those with the weaker veins and MS benefit from liberation. that is the ultimate test! not whether other people happen to have stenoses and no MS.


Once again can you please let me know where you discovered that "those with weaker veins and MS benefit from liberation" Although there are some blinded studies in the woodworks, no one can make an ABSOLUTE claim about anything at this point.
User avatar
scorpion
Family Elder
 
Posts: 1323
Joined: Wed Nov 05, 2008 4:00 pm

Postby CCSVIhusband » Mon Nov 01, 2010 10:46 am

scorpion wrote:
Jugular wrote:I always thought that Doppler < MRV < Venogram, when it comes to detection tools.
According to this study, having a venous malformation and abnormal cranial drainage is not clinically relevant for MS because the same thing is as prevalent in the general population.


What makes things even more confusing to me was that Zamboni's initial findings, which really started the CCSVI mania, were found using doppler. Yet now everyone is trying to invalidate this study by saying that doppler is not an accurate means of identifying CCSVI???

Leonard said:

I think that some people may have stronger veins (more Vit D during their childhood/ their mother metabolised more sun during pregnancy?), veins that are less susceptible to microbleedings. so, maybe, some people will also have stenoses but do not develop MS for that reason.

Is this something that has been proven or is it a wild guess?

Leonard said:
in any event, those with the weaker veins and MS benefit from liberation. that is the ultimate test! not whether other people happen to have stenoses and no MS.


Once again can you please let me know where you discovered that "those with weaker veins and MS benefit from liberation" Although there are some blinded studies in the woodworks, no one can make an ABSOLUTE claim about anything at this point.



No what made Zamboni's findings interesting was the fact that after people had angioplasty, their symptoms improved or abated significantly, some permanently. Who cares if it's diagnosed by Doppler, MRV, a dog sniffing you ... whatever. The results are important not the diagnostic. IF 100% of persons with MS have CCSVI (can someone show me where anyone hasn't YET? - and really I mean YET ... not someone who said they had Lyme Disease after they showed negative for CCSVI) ... then we can talk.


Until then ... I think this describes the situation of the persons that post on this thread (and any other thread knocking Zamboni's RESULTS ... now trying to play it as how do we diagnose it as more doctors are starting to see CCSVI does play a role in MS).

"When a true genius appears in the world, you may know him by this sign, that the dunces are all in confederacy against him." --- Jonathan Swift
User avatar
CCSVIhusband
Family Elder
 
Posts: 474
Joined: Sun Jun 27, 2010 3:00 pm
Location: Pittsburgh, PA USA

Postby concerned » Mon Nov 01, 2010 11:05 am

So wait, let me get this right, you're saying that in the context of this board, we [the skeptics] are true geniuses and all the people knocking us, such as yourself, are dunces, right?

Or was that just a veiled (or not so veiled) personal attack?

I can't tell.
concerned
 

Postby eve » Mon Nov 01, 2010 11:22 am

The dutch research has been discussed in this thread:

http://www.thisisms.com/ftopic-12297-da ... tch-0.html
dx 2002,RRMS,  suspected begin of MS 1978 (age 10)
User avatar
eve
Family Elder
 
Posts: 117
Joined: Tue Jan 05, 2010 4:00 pm
Location: Netherlands

Postby Cece » Mon Nov 01, 2010 11:32 am

Jugular wrote:I always thought that Doppler < MRV < Venogram, when it comes to detection tools.

According to this study, having a venous malformation and abnormal cranial drainage is not clinically relevant for MS because the same thing is as prevalent in the general population.

It's switched up: MRV<Doppler<Catheter venogram.

But the doppler needs to be done by someone with training, whereas the MRV is less sensitive to who is performing it.

Glad to hear this is not a new study. But studies will continue to come in on both sides as CCSVI is sorted out. Meanwhile when we go in to our IRs for dopplers, we do so with confidence that CCSVI will be found, because so many different IRs have found CCSVI is so many different MSers.
"However, the truth in science ultimately emerges, although sometimes it takes a very long time," Arthur Silverstein, Autoimmunity: A History of the Early Struggle for Recognition
Cece
Family Elder
 
Posts: 8989
Joined: Mon Jan 04, 2010 4:00 pm

Postby concerned » Mon Nov 01, 2010 11:40 am

eve wrote:The dutch research has been discussed in this thread:

http://www.thisisms.com/ftopic-12297-da ... tch-0.html


But it hadn't been published at that point I don't believe.
concerned
 

Next

Return to Chronic Cerebrospinal Venous Insufficiency (CCSVI)

 


  • Related topics
    Replies
    Views
    Last post

Who is online

Users browsing this forum: No registered users