Quote:
Proposed CCSVI criteria do not predict MS risk nor MS severity
Diego Centonze1,2,*,†, Roberto Floris3,†, Matteo Stefanini3, Silvia
Rossi1,2, Sebastiano Fabiano3, Maura Castelli1,2, Simone Marziali3, Alessio Spinelli3, Caterina Motta1,2, Francesco G. Garaci3, Giorgio Bernardi1,2, Giovanni Simonetti3DOI: 10.1002/ana.22436
Abstract
Objective:
It is still unclear if chronic cerebrospinal venous insufficiency (CCSVI) is associated with multiple sclerosis (MS), because substantial methodological differences have been claimed by Zamboni to account for the lack of results of other groups. Furthermore, it is still fully unexplored the potential role of venous malformations in influencing MS severity. This information is particularly relevant, because uncontrolled surgical procedures are increasingly offered to MS patients to treat their venous stenoses.
Methods:
In the present study, CCSVI was studied in 84 MS patients and in 56 healthy subjects by applying Zamboni method for CCSVI identification.
Results:
We found no significant differences (p=0.12) in CCSVI frequency between MS and control subjects. Furthermore, no differences were found between CCSVI-positive and CCSVI-negative patients in terms of relevant clinical variables such as disease duration, time between onset and first relapse, relapsing or progressive disease course, risk of secondary progression course. No statistically significant differences were also found between CCSVI-positive and CCSVI-negative MS subjects by analyzing direct measures of disability such as mean EDSS (p=0.07), mean progression index (p>0.1), and mean MS severity score (p>0.1). The percentage of subjects who reached EDSS 4.0 and 6.0 milestones was not different among CCSVI-negative and CCSVI-positive subjects, and no significant correlation was found between severity of disability and number of positive CCSVI criteria.
Interpretation:
Our results indicate that CCSVI has a role neither in MS risk nor in MS severity. Ann Neurol 2011.
The researchers were from Rome, Italy, at the Università Tor Vergata department of Neuroscience.
Here is the speed with which it was received, edited, and published. Is it abnormally fast?
Quote:
Publication History
Accepted manuscript online: 30 MAR 2011 08:07AM EST
Manuscript Accepted: 22 MAR 2011
Manuscript Revised: 14 MAR 2011
Manuscript Received: 7 DEC 2010
By Zamboni method, they must mean the doppler ultrasound. If as was suggested by Zamboni's earlier work and by some of the clinical findings, the azygos is more severely stenosed in patients with higher EDSS, the azygous really can't be measured by doppler ultrasound. That means doppler is not a good tool for determining if worse CCSVI is associated with worse MS since it is only looking at the jugulars.
I had about as blocked of jugulars as you can get (80% and 100% closed, a factoid relevant to nearly every discussion
) but very low EDSS; I would have worked against their hypothesis.
Of course they did not even get that far, since they could not find a greater percentage of CCSVI in MS patient as compared to normals. Ten out of fourteen of the papers presented at the Neurology conference last fall did find the association between CCSVI and MS, so this one is in the minority there, but papers will continue to come in.
Quote:
This information is particularly relevant, because uncontrolled surgical procedures are increasingly offered to MS patients to treat their venous stenoses.
I am so glad that the procedures are being offered. Remember last winter, when a person couldn't get treated for trying? Difficult times.
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