ballooning of nonobstructed jugulars

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

Re: ballooning of nonobstructed jugulars

Postby Cece » Sun Dec 02, 2012 6:07 pm

http://www.sciencedirect.com/science/ar ... 7212000845
Autonomic dysfunction: A unifying multiple sclerosis theory, linking chronic cerebrospinal venous insufficiency, vitamin D3, and Epstein-Barr virus
Zohara Sternberg,
Department of Neurology, Baird MS center, Jacobs Neurological Institute, 100 High St. Buffalo, NY 14203, USA

Abstract
Multiple sclerosis (MS) is a disease with multiple etiologies. The most recent theory of the vascular etiology of MS, Chronic Cerebrospinal Venous Insufficiency (CCSVI), suggests that cerebral venous obstruction could lead to cerebral venous reflux, promoting local inflammatory processes.

This review article offers strong evidence that the route of the observed narrowing of cerebral veins arises from autonomic nervous system dysfunction, particularly cardiovascular autonomic dysfunction.

The dysfunction of this system has two major effects: 1) the reduction of mean arterial blood pressure, which has the potential to reduce the cerebral perfusion pressure and the transmural pressure, and 2) the failure of cerebral autoregulation to maintain constant cerebral blood flow in the face of fluctuations in cerebral perfusion pressure. Alterations in cerebral autoregulation could in turn raise the critical closure pressure, indicated to be the cerebral perfusion pressure at which the transmural pressure will be sub-sufficient to overcome the active tension imparted by the smooth muscle layer of the vessel. These two effects of autonomic nervous system dysfunction (reduction in arterial blood pressure and alterations in cerebral autoregulation), when combined with inflammation-induced high levels of nitric oxide in the brain, will lower transmural pressure sufficiently to the point where the threshold for critical closure pressure is reached, leading to venous closure.

In addition, cerebral vessels fail to overcome the closure as a result of low central venous pressure, which is also regulated by autonomic nervous system function. Furthermore, through their neuroregulatory effects, infectious agents such as the Epstein-Barr virus and vitamin D3 are able to alter the functions of the autonomic nervous system, influencing the rate of CCSVI occurrence.

The absence of CCSVI specificity for MS, observed in recent clinical studies, may stem from a high prevalence of autonomic nervous system dysfunction in control groups which were recruited to these studies. Future studies should investigate CCSVI in relation to cardiovascular autonomic function.

From a neurologist (good to see this)
Unfortunately it's a theory that leaves out intraluminal abnormalities and outflow obstructions. Intraluminal abnormalities are being seen in people with MS both clinically and in Dr. Fox's autopsy study.
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Re: ballooning of nonobstructed jugulars

Postby Cece » Tue Dec 04, 2012 2:16 pm

http://www.plosone.org/article/info%3Ad ... 8CE46E9350
Reduced Cardiac Vagal Modulation Impacts on Cognitive Performance in Chronic Fatigue Syndrome

Background
Cognitive difficulties and autonomic dysfunction have been reported separately in patients with chronic fatigue syndrome (CFS). A role for heart rate variability (HRV) in cognitive flexibility has been demonstrated in healthy individuals, but this relationship has not as yet been examined in CFS. The objective of this study was to examine the relationship between HRV and cognitive performance in patients with CFS.

Methods
Participants were 30 patients with CFS and 40 healthy controls; the groups were matched for age, sex, education, body mass index, and hours of moderate exercise/week. Questionnaires were used to obtain relevant medical and demographic information, and assess current symptoms and functional impairment. Electrocardiograms, perceived fatigue/effort and performance data were recorded during cognitive tasks. Between–group differences in autonomic reactivity and associations with cognitive performance were analysed.

Results
Patients with CFS showed no deficits in performance accuracy, but were significantly slower than healthy controls. CFS was further characterized by low and unresponsive HRV; greater heart rate (HR) reactivity and prolonged HR-recovery after cognitive challenge. Fatigue levels, perceived effort and distress did not affect cognitive performance. HRV was consistently associated with performance indices and significantly predicted variance in cognitive outcomes.

Conclusions
These findings reveal for the first time an association between reduced cardiac vagal tone and cognitive impairment in CFS and confirm previous reports of diminished vagal activity.

This is the same HRV test that Dr. Arata is using.
Is Chronic fatigue syndrome a result of autonomic dysfunction or is autonomic dysfunction simply a symptom of Chronic fatigue syndrome? And how might it relate to chronic fatigue in MS.
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Re: ballooning of nonobstructed jugulars

Postby MrSuccess » Fri Dec 07, 2012 6:16 pm

..... let us review the path we have gone down ..... our HERO ... Dr.Zamboni presented to the world in 2008 ...... CCSVI. The concept was simple. He discovered that the venus system that allowed bloodflow from the brain-back -to-the-heart..... was compromised.

We were given medical imaging documentation to support his theory. I deem this evidence as TRUE. We easily can see the 'pinch points' .... and subsequent COLLATERAL routing of blood.

Next Advancement : Thanks to some incredibly skilled medical professionals .... we have medical imaging documentation showing us the ... INTERNAL .... problems affecting blood flow in the veins that carry blood from the head to the heart ... I deem this evidence as also being TRUE.

So .... we now can say ..... CCSVI can be an INTERNAL or EXTERNAL compromise put upon the veins draining blood from the brain - to-the-heart.

The JACOBS NEUROLOGICAL INSTITUTE ... has just put the CCSVI arrow directly into the bullseye . I have carefully read their findings in the previous post.

To quote Ringleader ...... this is HUGE .

Stay tuned . I'll explain their discovery in " plain speak" .... after I retrieve some information I have squirrled away somewhere :razz: .... saving it for this very day.

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Re: ballooning of nonobstructed jugulars

Postby 1eye » Sat Dec 08, 2012 4:23 pm

These observations (which conveniently ignore the azygus vein) sound like more "MS"-causes-CCSVI arguments but I rather think that CNS fluid also plays a role. If Dr. Arata wants to justify ballooning healthy vessels I think he'd better do his own randomized controlled clinical trials.

I think the brain and nervous system are exceedingly complex, but everywhere, especially there, good oxygenated healthy blood flow is of primary importance. How does the vagus affect the BBB, making it porous? The immune system? How does it even fit in with myelin destruction or the death of capillaries?

I think we have abundant evidence that these problems are vascular and primarily venous. There are still mysteries to be solved.

Blaming congenitally malformed veins and slowed perfusion on low arterial blood pressure is putting the cart before the horse. I have had high BP readings for quite some time now, and I'm glad I take BP meds because they are on the list of drugs which may be helping "MS".

The urge to say "we don't know" is strong but the evidence for what causes "MS" is getting stronger all the time, even when we don't have a real good handle on what "MS" is.
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Re: ballooning of nonobstructed jugulars

Postby Cece » Sat Dec 08, 2012 4:47 pm

http://europepmc.org/abstract/MED/18513359
Heart rate variability response to alcohol, placebo, and emotional picture cue challenges: effects of 0.1-Hz stimulation.

Abstract

Vaschillo EG, Bates ME, Vaschillo B, Lehrer P, Udo T, Mun EY, Ray S
Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854, USA. Evaschil@rci.rutgers.edu
Psychophysiology [2008, 45(5):847-858]

Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural
DOI: 10.1111/j.1469-8986.2008.00673.x


Heart rate variability (HRV) supports emotion regulation and is reduced by alcohol. Based on the resonance properties of the cardiovascular system, a new 0.1-Hz methodology was developed to present emotional stimuli and assess HRV reaction in participants (N=36) randomly assigned to an alcohol, placebo, or control condition. Blocked picture cues (negative, positive, neutral) were presented at a rate of 5 s on, 5 s off (i.e., 0.1-Hz frequency). SDNN, pNN50, and HF HRV were reduced by alcohol, compared to the placebo and control. The 0.1-Hz HRV index was diminished by alcohol and placebo, suggesting that autonomic regulation can be affected by cognitive expectancy. The 0.1-Hz HRV index and pNN50 detected changes in arousal during emotional compared to neutral cues, and the 0.1-Hz HRV index was most sensitive to negative valence. The 0.1-Hz HRV methodology may be useful for studying the intersection of cognition, emotion, and autonomic regulation.

According to this, HRV can be affected by placebo.
I agree that randomized controlled trials are needed.
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Re: ballooning of nonobstructed jugulars

Postby 1eye » Sat Dec 08, 2012 9:39 pm

Normally placebo controls (with good blinding) are there to prove that something will not work without the intervention under test. In this case it is not an absence of real stimulus that proves the non-placebo intervention is necessary, but a demonstration that the blinding works: the subject responds to placebo because the HRV is a cognitive phenomenon, and the placebo successfully fooled them. So it does not prove anything beyond the fact that the placebo works as well as the real thing. If the subjects had not responded to placebo, it would have proved alcohol is necessary to the HRV change. It isn't. Mistaken cognition (having the subject believe they have had alcohol) works just as well.

When I turned 18 it happened during the short time that the legal drinking age was 18 in Ontario. I had a blowout party featuring a lot of teenaged drinking. One of the bartenders had fun getting people bombed with a few bottles of vodka that were really full of water. Most people who drank that acted very drunk, but it was a wonderful thing because they neither crashed their cars nor suffered hangovers.

This study proves the same thing. Plus, it proves what my bartender friend proved: placebo works sometimes, in particular, for drinking and HRV. Also, the mind and emotional state have more control over the body than you might think. I question whether that extends to people who have enough brains to disbelieve the sham.
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Re: ballooning of nonobstructed jugulars

Postby MrSuccess » Thu Dec 13, 2012 6:18 pm

Professor Zohara Sternberg of the Jacobs Neurological Institute of Buffalo NY .... has given us something of great value in understanding CCSVI. Please read .... and if you have to .... reread her Abstract listed above . It's that important.

The Abstract is written in true doctor-speak .... so MrSuccess will attempt to explain it in plain talk. :lol:

Professor Sternberg is telling us that once a vein is collapsed - whereby the inner walls of the vein come in contact - they cannot disengage from each other . :idea: :idea: :idea:

I agree.

The reason why : SURFACE TENSION ...... MrSuccess would add to this ... .. a created VACUUM also.

CCSVI is the simple concept of a fluid [ BLOOD ] disrupted from returning back to a fluid pump [ your HEART ] . A circuit - heart to head ->>> head back to heart .... is not normal.

Now let me demonstrate the Power of Surface Tension AND the power of a VACUUM.

First: Surface Tension. The most easy example I can give you is the adhesive quality's of two EQUALLY smooth pieces of glass. Slightly moisten both pieces ..... now SLIDE them together .... so that they are exactly one on top of the other . Now try to PULL them apart.

Second : The Power of a VACUUM . Mr.Success offers the " Magdeburg Spheres ".

Professor Sternberg tells us something VERY IMPORTANT .... and that is this .... in the condition CCSVI ..... your heart - a simple diaphram pump - CANNOT create enough fluid FORCE to overcome the collapsed veins .

MrSuccess asks ..... Is CCSVI perhaps truly .....a HEART CONDITION ? :?: :idea:

Is the heart now creating a VACUUM in the vein returning blood from the brain to the heart ? :?: :idea:

DO NOT underestimate the power of surface tension or a vacuum . Dr. Sternberg clearly understands this.


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Re: ballooning of nonobstructed jugulars

Postby Anonymoose » Thu Dec 13, 2012 6:37 pm

Mr. S,

Ooo yes! Do think outside the box. Interesting concept!

I hope the focus shifts from avidly defending ccsvi, as it is currently defined, to exploring flow issues as a whole. It seems the angioplasties only address part of the flow issues. Find the rest of the story! The goal is to remedy MS not to give all to defend an incomplete treatment for MS symptoms.
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Re: ballooning of nonobstructed jugulars

Postby Cece » Thu Dec 13, 2012 7:17 pm

Is the goal to remedy MS or to defend CCSVI? I think the goal is for CCSVI to get the research and funding sooner rather than later. To get past the ridicule and the confusion over imaging and to get the science done. There is something worth defending here, and there have been attacks.

For us as patients, I think the goal is to share information especially considering the misinformation and hostility that is out there.

I think the possibilities that MrSuccess suggests might be a part of the physics equations of closed system hemodynamics. There's more I don't know than what I do know when it comes to those equations...
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Re: ballooning of nonobstructed jugulars

Postby Anonymoose » Thu Dec 13, 2012 7:54 pm

The best defense is a good offense. Expand and refine the scope and treatment of ccsvi/flow issues so the evidence is stronger and people are more appreciative of its implications and thus more willing to fund related research.

I think we all know that there is more to the flow issues than current ccsvi treatment addresses. It's frustrating that all of this brilliance isn't being applied towards getting at the rest of the equation and pushing movement forward rather than fighting for not good enough.

What has been accomplished thus far is a good start...but trying to sell an unfinished product isn't going to work very well....especially since the unfinished product carries some pretty significant risk.

I really do admire all you ccsvi gurus, your deep understanding, and passion. But you still frustrate me! Lol.

Best of luck with your mission!
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Re: ballooning of nonobstructed jugulars

Postby 1eye » Thu Dec 13, 2012 8:09 pm

I've heard through various grapevines that the jugulars have little to no blood in them when you are upright. I don't think the walls are strangers and I question that there is negative pressure involved. I also think it is normal for the sides to touch.

Ballooning may injure the walls, and the patient should stay prone until it heals, imo. I got away with just Plavix, but I think after-care is why I have probably clotted
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Re: ballooning of nonobstructed jugulars

Postby Anonymoose » Thu Dec 13, 2012 8:22 pm

That did confuse me when I was reading the zamboni papers. When upright, the jugulars are flat unless there is an obstruction or hypertension. In upright position most blood drains through the vvs not the jugulars. But zamboni's graph showed the ms jugs at nearly the same diameter (?? Term), whether sitting or supine. I don't think the jugulars even went completely flat in normal study participants....

Maybe vvs should be examined.
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Re: ballooning of nonobstructed jugulars

Postby MrSuccess » Fri Dec 14, 2012 1:10 am

CCSVI is all about - Fluid Flow -. It's that simple. In this case the fluid is blood.

In order for a fluid to flow .... there MUST be a pressure differential. Your heart creates this situation. As the heart pumps fluid OUT .... it draws in [ a vacuum] more fluid.

For many reasons ..... the veins bringing returned blood from your brain to your heart ... are restricted.

As Professor Sterberg points out .... once the veins walls experience surface tension ... the amount of force needed to separate ..... cannot be achieved .

Again I say ..... do not underestimate the power of surface tension and a VACUUM.

A simple Internet search of " Magdeburg Spheres " may not open veins ... but I do hope it opens eyes ..... and minds ........ :idea:


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Re: ballooning of nonobstructed jugulars

Postby munchkin » Fri Dec 14, 2012 10:12 am

Mrsuccess, I do think there is something to what you say. I have some major issues with my blood pressure, heart rate and rhythm, and circulation since my veins were severly damaged by the ccsvi procedure. This is not lesions as the first symtom was within one month of the damage occuring and I was still very active.
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Re: ballooning of nonobstructed jugulars

Postby 1eye » Fri Dec 14, 2012 5:06 pm

MrSuccess wrote:A simple Internet search of " Magdeburg Spheres " may not open veins ... but I do hope it opens eyes ..... and minds ........ :idea:
MrSuccess
Magdeburg Hemispheres demonstrate the power of atmospheric pressure. I do hope the atmosphere does not get into my veins.

The heart doesn't have the strength to generate enough vacuum to draw venous blood upwards from the feet. Calf muscles assist when we lift off on our toes. We have valves (part of CVI problems) which divide the task into discrete pieces the muscles can handle. I know this, because I too have had venous problems since the procedure. On my ankles. I don't blame the procedure, since I have seen older relatives (even my own departed mother) with swollen feet, and know what I am in for.

Certainly veins can collapse. Healthy jugulars do it all the time. What makes anyone think they can't be re-inflated? I think they are very dependent on gravity to return blood from the brain when we are upright, and that not much negative pressure is ever developed by the heart. Is any? I would think the heart would not last long if it had to do that as well. Any cardiac experts care to comment?
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