Where would CCSVI fix inside the four patterns model?

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

Where would CCSVI fix inside the four patterns model?

Postby frodo » Sun Jun 02, 2013 12:24 pm

Maybe it is not very quoted today, but this was a breaking new not so long ago. Researchers from Mayo Clinic found four patterns of demyelination. Taken the summary from wikipedia:

Pattern I : The scar presents T-cells and macrophages around blood vessels, with preservation of oligodendrocytes, but no signs of complement system activation

Pattern II : The scar presents T-cells and macrophages around blood vessels, with preservation of oligodendrocytes, as before, but also signs of complement system activation can be found.

Pattern III : The scars are diffuse with inflammation, distal oligodendrogliopathy and microglial activation. There is also loss of myelin-associated glycoprotein (MAG). The scars do not surround the blood vessels, and in fact, a rim of preserved myelin appears around the vessels. There is evidence of partial remyelinization and oligodendrocyte apoptosis

Pattern IV : The scar presents sharp borders and oligodendrocyte degeneration, with a rim of normal appearing white matter. There is a lack of oligodendrocytes in the center of the scar. There is no complement activation or MAG loss.

It is reported that the two first patterns look like an autoimmune attack and the other two like cell apoptosis. Pattern IV is reported to be associated to PPMS. Therefore I suppose that being true the CCSVI theory and this model, a CCSVI lesion would be associated with Pattern III.

Does this makes sense? Any other thoughts?
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Re: Where would CCSVI fix inside the four patterns model?

Postby Cece » Mon Jun 10, 2013 3:12 pm

Not enough information to go on... I'm inclined to say that all four patterns are direct or indirect outcomes of CCSVI. If CCSVI leads to pressure in the venous sinuses, that can lead to blood-brain barrier breakdown and leukocyte infiltration, as well as impairment of nutrients across the blood-brain barrier. I still have to work through the recent paper from Dr. Beggs. I've read it but I haven't reread it, and it bears rereading. I also think Dr. Trapp has interesting ideas about exactly how apoptosis happens, at least in demyelinated axons becoming hypoxic, and would want to incorporate his ideas too into any understanding of how lesions form.
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Re: Where would CCSVI fix inside the four patterns model?

Postby 1eye » Mon Jun 10, 2013 3:57 pm

During your extracurricular reading, remember that paper Dr. Beggs referenced, which found 100% specificity for "MS", also by Dr. Beggs. He claims a criterion which does not require anything as nebulous as "separation in time and space", but is clinical and objective. Maybe it's time recommendations for "MS" diagnosis were rethunk.

Does age matter? "More study" may be wise.

Abstract is here.
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CCSVI procedure Albany Aug 2010
'MS' is over - if you want it
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Re: Where would CCSVI fix inside the four patterns model?

Postby frodo » Wed Jun 12, 2013 7:39 am

1eye wrote:During your extracurricular reading, remember that paper Dr. Beggs referenced, which found 100% specificity for "MS", also by Dr. Beggs. He claims a criterion which does not require anything as nebulous as "separation in time and space", but is clinical and objective. Maybe it's time recommendations for "MS" diagnosis were rethunk.


Still, reduced venous vasculature visibility (VVV) can be due to several causes. It can be true at the same time the 100% specificity and the four patterns model.
Last edited by frodo on Thu Jun 13, 2013 6:16 am, edited 1 time in total.
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Re: Where would CCSVI fix inside the four patterns model?

Postby Cece » Wed Jun 12, 2013 11:40 am

1eye wrote:During your extracurricular reading, remember that paper Dr. Beggs referenced, which found 100% specificity for "MS", also by Dr. Beggs. He claims a criterion which does not require anything as nebulous as "separation in time and space", but is clinical and objective. Maybe it's time recommendations for "MS" diagnosis were rethunk.

Needs replication, doesn't it? I agree that an objective test for MS would be ground-breaking. I was diagnosed and then undiagnosed and then rediagnosed over a handful of years, and that was an emotionally unpleasant process.
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