Hydration status substantially affects chronic cerebrospinal venous insufficiency assessments
Claudiu I. Diaconu, BS,
Robert J. Fox, MD,
Alia Grattan, RVT,
Alexander Rae-Grant, MD,
Mei Lu, MD, PhD,
Heather L. Gornik, MD, MPH, RPVI and
Esther Soo H. Kim, MD, MPH, RPVI
We sought to determine the effect of hydration on the criteria for chronic cerebrospinal venous insufficiency (CCSVI), a proposed hypothesis for the etiology of multiple sclerosis (MS). Sixteen subjects (11 MS and 5 controls) were asked to fast overnight. The following morning, 2 CCSVI ultrasound examinations were performed: 1 in the mildly dehydrated state, and another 30–45 minutes after rehydrating with 1.5 L of Gatorade. Seven subjects fulfilled CCSVI criteria in the dehydrated state. Of these, 5 (71%) no longer fulfilled CCSVI criteria after rehydration. One additional subject met CCSVI criteria only after rehydration. Hydration status has a substantial effect on CCSVI criteria, suggesting that the sonographic findings of CCSVI may represent a physiologic rather than pathologic state.
© 2013 American Academy of Neurology
Latest study from Dr. Fox's group. To me, this suggests that hydration status is yet another failing of all the ultrasound studies that we have seen, since they failed to standardize this important variable. We do not know if the MS group or the normal group was better hydrated and it turns out this has significant effects of the result of any ultrasound study.
But more immediately and importantly, this suggest that staying hydrated is really, really important for us. Staying hydrated opens up the veins, at least a little, and we need that.
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