No evidence of CCSVI at MS onset

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

No evidence of CCSVI at MS onset

Postby MSUK » Tue Feb 01, 2011 3:02 am

Image

Abstract
Objective
An impaired cerebrospinal venous drainage, defined as chronic cerebrospinal venous insufficiency (CCSVI), has been recently hypothesized to be the possible cause of multiple sclerosis (MS). We investigated this hypothesis by studying the occurrence of CCSVI in clinically isolated syndromes (CISs) suggestive of MS..... Read More - http://www.msrc.co.uk/index.cfm/fuseact ... ageid/2944
MS-UK - http://www.ms-uk.org/
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Re: No evidence of CCSVI at MS onset

Postby frodo » Tue Feb 01, 2011 3:45 am

squiffy2 wrote:Image

Abstract
Objective
An impaired cerebrospinal venous drainage, defined as chronic cerebrospinal venous insufficiency (CCSVI), has been recently hypothesized to be the possible cause of multiple sclerosis (MS). We investigated this hypothesis by studying the occurrence of CCSVI in clinically isolated syndromes (CISs) suggestive of MS..... Read More - http://www.msrc.co.uk/index.cfm/fuseact ... ageid/2944


why this study does not need controls? the proper way to do it would be to check CCSVI at onset and in advanced MS, and to confirm that it does appear in advanced cases but not in onset.

It could be the case that the doctors that performed the study are unable to find CCSVI at all.
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Postby pairOdime » Tue Feb 01, 2011 5:30 am

Agreed, CCSVI abnormalities were there most likely. These vein derangements were probably of a more subtle nature than advanced CCSVI syndrome. Although, missing veins and hypoplasia should be rather obvious. As we know, congenital venous abnormalities would worsen over time. The greater the shear stress of the vessel lumen & hypoperfusion the greater the activation of endothelin 1 and disruption of NO (in combination with other feedback mechanisms) exacerbate the condition.
It's a paradigm shift
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Postby Cece » Tue Feb 01, 2011 7:19 am

Abstract
Objective
An impaired cerebrospinal venous drainage, defined as chronic cerebrospinal venous insufficiency (CCSVI), has been recently hypothesized to be the possible cause of multiple sclerosis (MS). We investigated this hypothesis by studying the occurrence of CCSVI in clinically isolated syndromes (CISs) suggestive of MS.

Methods
Fifty consecutive patients presenting with a CIS and evidence of dissemination in space of the inflammatory lesions (ie, possible MS [pMS]) underwent a detailed diagnostic workup, including extracranial and transcranial venous echo-color Doppler sonography (ECDS-TCDS). Those with CCSVI underwent selective venography. Fifty healthy subjects (HCs) age-matched and gender-matched with pMS patients (HC1); 60 patients with transient global amnesia (TGA); and 60 healthy subjects age-matched and gender-matched with TGA patients (HC2) constituted the control groups and underwent ECDS-TCDS.

Results
Mean age of pMS patients was 33.0 ± 8.5 years (range, 14–50); 35 (70%) were female (female:male ratio, 2.3). TCDS was normal in all pMS patients. One or more abnormal ECDS findings were observed in 26 of 50 (52.0%) pMS patients, in 35 of 110 (31·8%) HCs (HC1+HC2), and in 41 of 60 (68.3%) TGA patients. Eight (16%) pMS patients fulfilled the diagnosis of CCSVI. Selective phlebography performed in 7 of these patients (1 denied consent) did not show venous anomalies.

Interpretation
Our findings do not support a cause-effect relationship between CCSVI and pMS. Further studies are warranted to clarify whether CCSVI is associated with later disease stages and characterizes the progressive forms of MS.

Source: Ann Neurol 2011;69:90–99.(01/02/11)

I don't know, while these are not presented as positive findings, it was still the case that eight CIS patients were diagnosed with CCSVI through the ECDS and that none of the controls were. Phlebography did not show venous anomalies, that is surprising. There is debate among the researchers as to what is considered abnormal or not when it comes to these veins. My guess is that this was a study done by someone unfamiliar with CCSVI.

In the TGA patients, they're looking for jugular vein valves that are insufficient so as to allow blood to flow back toward the brain from the heart; they found this in 68%. If they were looking for the same in CCSVI patients, they wouldn't find it, our jugular valves might be considered super-sufficient, in that they block the flow in both directions (backwards or forwards).
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Postby 1eye » Tue Feb 01, 2011 12:03 pm

Hey, wait a minute. How can they even test for CCSVI if it doesn't exist?

How do all these peer-reviewed publications get away with that? They must be in the clutches of those devious Ultrasound equipment and stent manufacturers. Good thing they have people like us to keep the flames of truth burning.

BTW these so-called 'Zamboni' criteria... They are equally applicable and statistically numerically scientifically unassailable in the most remote possible connection with the same kind of mathematically incontestable kind of MS lesion spatial dissemination, right? I mean, the MacDonald criteria are infallible, as they have been around for centuries, and are an actuarial certainty, right? At least as good as Fannie May's credit rating, right?
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Let's Be Objective

Postby MarkW » Thu Feb 03, 2011 7:42 am

So what - in CIS it is not possible to detect CCSVI with a Doppler scan. At the risk of being pilloried:
- no one has proven that CCSVI is the cause of MS. Its a theory or hypothesis without significant supporting data. Get over these facts please. Look for problems with valves in veins, using catheter venography, in CIS if you are are a researcher.

Much more interesting in a neuro led study which reports that people with Relapsing Remitting MS (RRMS) for more than 10 years are highly likely (12 of 13 subjects or 92%) to have Extracranial Venous Stenosis or Stenoses (EVS). for details study:
Yamout B, Herlopian A, Issa Z, Habib RH, Fawaz A, Salame J, Wadih A, Awdeh H, Muallem N, Raad R, Al-Kutoubi A.
American University of Beirut Medical Center, Beirut, Lebanon.
Extracranial venous stenosis is an unlikely cause of multiple sclerosis.

Message: If you have RRMS for 10 years you are highly likely to have treatable (extra cranial) stenoses. So why not get them diagnosed and treated, asap ???

The etiology (root causes) of MS is unknown after 150 years of research, please do not expect a answer soon.

MarkW
Mark Walker - Oxfordshire, England. Registered Pharmacist (UK). 11 years of study around MS.
Mark's CCSVI Report 7-Mar-11:
http://www.telegraph.co.uk/health/8359854/MS-experts-in-Britain-have-to-open-their-minds.html
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Re: Let's Be Objective

Postby silverbirch » Thu Feb 03, 2011 9:42 am

MarkW wrote:Extracranial venous stenosis is an unlikely cause of multiple sclerosis.

Message: If you have RRMS for 10 years you are highly likely to have treatable (extra cranial) stenoses. So why not get them diagnosed and treated, asap ???

The etiology (root causes) of MS is unknown after 150 years of research, please do not expect a answer soon.

MarkW


MarkW can you explain inter crainial - I apoligise if Im going off thread
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Postby sumsum » Thu Feb 03, 2011 11:07 am

Well, I am not sure what these researchers defined as CCSVI and according to which criteria they were investigating. What I know is that I am CIS and according to blood flow measurement, my left jugular only has 1/10th of the capacity of my right one.

Certainly, this is a quite disbalanced result...
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Re: Let's Be Objective

Postby EJC » Thu Feb 03, 2011 12:17 pm

silverbirch wrote:MarkW can you explain inter crainial - I apoligise if Im going off thread


Yup, I'd like a laymans explanation of that one too.
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Re: Let's Be Objective

Postby concerned » Thu Feb 03, 2011 2:40 pm

MarkW wrote:

Message: If you have RRMS for 10 years you are highly likely to have treatable (extra cranial) stenoses. So why not get them diagnosed and treated, asap ???

MarkW




Because it might not help MS symptoms at all.


I'm not sure why people are asking for a definition of intercranial, le mot juste would be intracranial. intracranial means within the cranium ---- extracranial means outside the cranium.

Intercranial would mean between, among, or within a group of craniums.
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Cranium

Postby MarkW » Thu Feb 03, 2011 3:10 pm

The cranium is the skull; Extra is outside; Inter is inside.

Sumsum - if I had CIS and stenosis I would have my veins treated. Its your personal choice and there are no results with CIS so far.

MarkW wrote:
Message: If you have RRMS for 10 years you are highly likely to have treatable (extra cranial) stenoses. So why not get them diagnosed and treated, asap ???

Concerned comments: Because it might not help MS symptoms at all.

MarkW replies: But it might help MS symptoms and the majority of patients and clinicians who report observations, report improvements. I do not see any logical reason for waiting if you have RRMS for more than 10 years. MS is progressive and the procedure is a lesser risk.

Goodnight all,

MarkW
Mark Walker - Oxfordshire, England. Registered Pharmacist (UK). 11 years of study around MS.
Mark's CCSVI Report 7-Mar-11:
http://www.telegraph.co.uk/health/8359854/MS-experts-in-Britain-have-to-open-their-minds.html
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Re: Cranium

Postby concerned » Thu Feb 03, 2011 3:30 pm

MarkW wrote:The cranium is the skull; Extra is outside; Inter is inside.

Sumsum - if I had CIS and stenosis I would have my veins treated. Its your personal choice and there are no results with CIS so far.

MarkW wrote:
Message: If you have RRMS for 10 years you are highly likely to have treatable (extra cranial) stenoses. So why not get them diagnosed and treated, asap ???

Concerned comments: Because it might not help MS symptoms at all.

MarkW replies: But it might help MS symptoms and the majority of patients and clinicians who report observations, report improvements. I do not see any logical reason for waiting if you have RRMS for more than 10 years. MS is progressive and the procedure is a lesser risk.

Goodnight all,

MarkW


Intra is inside. Inter is between. Like internet (WWW) vs. intranet (LAN).


I don't see a majority reporting improvements, maybe 50/50 at best, but that's just a guess. Also, not many of these improvements seem to last very long.
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Postby CaptBoo » Thu Feb 03, 2011 3:47 pm

Interesting. Concerned is saying that venous angplasty for CCSVI is now showing in his estimation a 50/50 shot at improving MS-type symptoms, if only temporarily. Re-stenosis disproves placebo.
<div>There be no dragons   ...Reese Palley</div>
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Postby 1eye » Thu Feb 03, 2011 4:14 pm

Placebo, in this case, is voodoo, probably from one of Dr. Freedman's nightmares.

I think we're far past worrying about that.

As Dr. Hewett of Pacific Interventionalists says, "ALL VEINS WILL RESTENOSE. It's not a matter of "if" -- it is a matter of "when." At least to thousands of (former?) 'MS' patients, placebo is not worth firing a synapse over.
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Re: Cranium

Postby 1eye » Thu Feb 03, 2011 4:40 pm

concerned wrote:Intra is inside. Inter is between. Like internet (WWW) vs. intranet (LAN).


I'm not sure of the literal translations of the Latin prefixes, but an internet is a network of probably heterogenous networks. An intranet is anybody's guess. LAN stands for Local Area Network, from the fact that one of the first LAN media, the Ethernet, is distance-limited, and usually homogenous. A WAN (Wide etc. etc.) is Wide, and may even include what we have come to call "The" Internet.

The WWW is the World Wide Web, having nothing to do with networks, but what you do with them. You are using it now, and it is implemented using a hypertext language.

Maybe, like intermural games, an intranet is "between", but in this case it's your ears.
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