Dr. Zamboni's letter published in the Annals of Neurology

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

Dr. Zamboni's letter published in the Annals of Neurology

Postby cheerleader » Wed Nov 10, 2010 8:26 pm

Regarding the Doepp Study--
you have to purchase the journal to read the letter, but it's worth it.

link to journal

Dr. Zamboni states that the Doepp study actually proves CCSVI exists--
when comparing levels of jugular blood flow between normals and pwMS during positional changes from supine to upright--

One of the major regulators of cerebral venous outflow is posture, due to the gravitational gradient between the cerebral parenchymal veins and the base of the neck (␣30mmHg).2 The authors demonstrate a much larger change in blood flow volume in normal subjects compared to MS patients when the subjects go from a supine to an upright position. They find a change of 128ml/min and 56ml/min for the right and left sides, respectively, for MS patients. But they find a much larger change of 266ml/min and 105ml/min for their normal subjects. This result actually suggests the presence of chronic cerebrospinal venous insufficiency (CCSVI). Possible causes include intra-luminal septum, membrane, and immobile valve affecting the hydrostatic pressure gradient in the upright position. The presence of such blockages in the extracranial and extravertebral cerebral veins has been proven also by using catheter venography, the unquestionable gold standard in medicine.3,4


There's much, much more. It is a very illuminating letter-
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dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Postby PCakes » Wed Nov 10, 2010 8:44 pm

Very exciting that Dr Zamboni has offered to work with the German team!
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Postby David1949 » Wed Nov 10, 2010 8:49 pm

My guess is that one day Dr. Zamboni wins the Nobel prize.
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Postby CenterOfGravity » Wed Nov 10, 2010 10:31 pm

David1949 wrote:My guess is that one day Dr. Zamboni wins the Nobel prize.

That has been my feeling too. Takes time usually, 10-20 years is my guess. I actually have a casual friend who won one, seriously.

I loved reading his response, and I hope his offer is taken, if the researchers truly want to understand the whole thing.
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Postby CCSVIhusband » Thu Nov 11, 2010 5:52 am

My guess is it won't be though ... because I don't think they're genuinely interested in finding what Zamboni did. (sometimes publishing isn't about the "truth" it's about getting your name out there).
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Postby Rokkit » Thu Nov 11, 2010 6:32 am

So we've got Zamboni's offer and Ashton Embry's offer to fund a trip for Freedman et al to visit a CCSVI treatment center. Any takers? Yeah, I didn't think so.
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Postby cheerleader » Thu Nov 11, 2010 8:35 am

What is interesting is that prior to the era of the internet, a response letter in a journal could be easily disregarded. But this response letter is being given to many doctors today. It is being downloaded, copied and sent around the world.

Yesterday, Dr. Haacke spoke in Albany at a CCSVI conference regarding the importance of testing blood flow levels in pwMS and normals. He is now testing perfusion before and after angio. Lots of doctors saw him and Dr. Dake and Dr. Mehta speak about the reality of venous stenosis and reflux in pwMS. This is truly a grass roots movement. And the roots get stronger everyday.
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http://ccsviinms.blogspot.com
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Postby Esme » Thu Nov 11, 2010 10:47 am

CCSVI.nl published an editorial the 5th of August based on the available abstract of the Doepp research. We came to some of the same conclusions as Dr. Zamboni published just now. We asked him in Amsterdam where we had a meeting with him (just kidding, he was there for the Annual meeting of the ESCS to tell his collegues about CCSVI, we were there too and we had an interview, http://www.ccsvi.nl/Multimedia/Exclusive/, and a very pleasant long talk off camera with him) what his thoughts were on the subject. His eyes started to sparkle even more and he told us he was writing an article about this research! We did not include his comments and funny remarks about the upcoming article/letter in the video of the interview because we didn't want to spoil the 'surprise' for the German team.

Most of the 'negative' studies are not negative at all for CCSVI but are just presented as negative because the researchers want it to be negative for some non scientific reasons. Like this study by Doepp et al.
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Postby sbr487 » Thu Nov 11, 2010 10:58 am

Esme wrote:CCSVI.nl published an editorial the 5th of August based on the available abstract of the Doepp research. We came to some of the same conclusions as Dr. Zamboni published just now. We asked him in Amsterdam where we had a meeting with him (just kidding, he was there for the Annual meeting of the ESCS to tell his collegues about CCSVI, we were there too and we had an interview, http://www.ccsvi.nl/Multimedia/Exclusive/, and a very pleasant long talk off camera with him) what his thoughts were on the subject. His eyes started to sparkle even more and he told us he was writing an article about this research! We did not include his comments and funny remarks about the upcoming article/letter in the video of the interview because we didn't want to spoil the 'surprise' for the German team.

Most of the 'negative' studies are not negative at all for CCSVI but are just presented as negative because the researchers want it to be negative for some non scientific reasons. Like this study by Doepp et al.


Thank you!!!
A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die and a new generation grows up that is familiar with it
- Max Planck
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Postby scorpion » Thu Nov 11, 2010 11:31 am

I read Zamboni's response and it seems, in layman terms, he disagrees with how The Doepp study defined CCSVI. There looks like there were some positional variants that Doepp and his colleagues found insignificant but Zamboni believes are significant. Is this failry accurate? Whatever the case is Zamboni's promise to meet with Doepp's team to help them find "their mistake" is a great idea.

editorial from CCSVI.nl

"We did not include his(Zamboni) comments and funny remarks about the upcoming article/letter in the video of the interview because we didn't want to spoil the 'surprise' for the German team."

How cute. Please spare us the drama and give us some answers. Whenever I hope to read an article that gives me some indictation CCSVI is for real there is always some stupid comment in it such as "Most of the 'negative' studies are not negative at all for CCSVI but are just presented as negative because the researchers want it to be negative for some non scientific reasons. Like this study by Doepp et al". :roll:
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Postby Esme » Thu Nov 11, 2010 1:08 pm

scorpion wrote: How cute. Please spare us the drama and give us some answers. Whenever I hope to read an article that gives me some indictation CCSVI is for real there is always some stupid comment in it such as "Most of the 'negative' studies are not negative at all for CCSVI but are just presented as negative because the researchers want it to be negative for some non scientific reasons. Like this study by Doepp et al". :roll:


Nice manners, really. Very constructive indeed.

If you are not prepared to read and use your brain, that's your own choice.

The blood flow in the IJV's is 150% more in sitting/upright position in the patient group compared to the HC. Any idea how to explain that?
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Postby patientx » Thu Nov 11, 2010 1:32 pm

The blood flow in the IJV's is 150% more in sitting/upright position in the patient group compared to the HC. Any idea how to explain that?

Yes - due to MS, the autonomic regulation of blood flow could be affected. If anything, the higher blood flow rate should indicate better extracranial drainage.

How is higher IJV blood flow explained by CCSVI?
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Postby Jugular » Thu Nov 11, 2010 1:58 pm

patientx wrote:
The blood flow in the IJV's is 150% more in sitting/upright position in the patient group compared to the HC. Any idea how to explain that?

Yes - due to MS, the autonomic regulation of blood flow could be affected. If anything, the higher blood flow rate should indicate better extracranial drainage.

How is higher IJV blood flow explained by CCSVI?


The IJV are supposed to collapse when sitting upright and have little to no flow. It points to a blood flow anomoly.
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Postby Esme » Thu Nov 11, 2010 2:08 pm

patientx wrote:
The blood flow in the IJV's is 150% more in sitting/upright position in the patient group compared to the HC. Any idea how to explain that?

Yes - due to MS, the autonomic regulation of blood flow could be affected. If anything, the higher blood flow rate should indicate better extracranial drainage.

How is higher IJV blood flow explained by CCSVI?


Normally, the drainage in sitting/upright position is taken care of mostly by the AV/VV and less by the IJV's. In suspine position the IJV's form the main road for draining blood from the brain. This is demonstrated in the HC and the patients (480 and 499 ml per minute, average).

In sitting/upright position most of the drainage is done by the AV/VV in the HC: only 123 ml blood per minute flows through the IJV's.
In the patient group 318 ml blood per minute flows through the IJV's.

So because of problems in the AV/VV the blood cannot follow its favourite path in upright position through the AV/VV and is forced to choose the IJV's.

(see fig. 11 http://csvi-ms.net/files/multiple%20sclerosis-USG.pdf)
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Postby patientx » Thu Nov 11, 2010 3:29 pm

Jugular wrote:
patientx wrote:
The blood flow in the IJV's is 150% more in sitting/upright position in the patient group compared to the HC. Any idea how to explain that?

Yes - due to MS, the autonomic regulation of blood flow could be affected. If anything, the higher blood flow rate should indicate better extracranial drainage.

How is higher IJV blood flow explained by CCSVI?


The IJV are supposed to collapse when sitting upright and have little to no flow. It points to a blood flow anomoly.


I think the veins distend or collapse due to blood flowing through them, not the other way round. The fact that the blood flow in the IJVs in the upright position was higher for MS patients is an interesting finding that could mean something. I don't see how it indicates impeded flow, though.
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