To me, by far, the most compelling study presented at the conference was Dr. Hubbard's. He demonstrated, using a functional MRI, that MS patients had significantly impaired cognitive function vs. healthy controls. Astoundingly, function was normalized after venous angioplasty. http://ccsvism.xoom.it/ISNVD/Abstract-Hubbard.pdf
I love his work too. It's objective measurement of immediate improvements post-procedure. It ties in the venoplasty of the jugular valves down by the base of the neck with the performance of the brain. It may be the biggest news coming out of ISNVD and that is saying something, because ISNVD was a feast.
One thing to note with Dr. Hubbard's work is that he did not show an improvement in task activation networks. The part of the brain focusing on the cognitive task was exactly the same pre- and post-venoplasty and this was 30%-70% less than what a healthy subject brought to bear on the task-activated part of the brain. It was the part of the brain that was NOT focusing on the task that went from being at the level of a MS patient pre-venoplasty to being at the level of a healthy subject post-procedure.
The finding of significant differences between normal controls and MS patients in BOLD response patterns associated with a cognitive task in both task-positive and task-negative cortical networks sheds light on neuronal mechanisms of cognitive impairment in MS patients. Most remarkably, the inhibition of the default network appears to be impaired in posterior parietal and anterior medial prefrontal cortex and this impairment is reversed and in fact normalized by venoplasty. Since BOLD response is a function of cerebral blood flow and volume, and also oxygen metabolism rate, the reduced BOLD responses in both task positive and task-negative networks may reflect not only altered neuronal function but also change in cortical venous blood volume in MS. Thus the recovery of the suppression in the default network by angioplastic treatment may reflect recovered neuronal and/ or vascular function. Moreover the increase in the venous undershoot component of the BOLD response in MS as compared to controls and its reduction after venoplasty provides evidence of impaired clearance and CNS venous insufficiency and holds out the promise that this method may provide an objective diagnostic test.
There's the full conclusion. The improvements were in the task-negative default network as well as the BOLD undershoot. It's amazing.
See what can be done when neurologists cooperate with IRs!