AJNR Am J Neuroradiol. 2014 Mar 7. [Epub ahead of print]
A Sonographic Quantitative Cutoff Value of Cerebral Venous Outflow in Neurologic Diseases: A Blinded Study of 115 Subjects.
Monti L1, Menci E, Piu P, Leonini S, Arrigucci U, Bellini M, Zandonella A, Galluzzi P, Casasco A.
BACKGROUND AND PURPOSE:
The autonomic nervous system maintains constant cerebral venous blood outflow in changing positions. Alterations in cerebral autoregulation can be revealed by postural changes at quantitative color Doppler sonography. The aim of this study was to reach an optimal cutoff value of the difference between the cerebral venous blood outflow in the supine and seated positions that can discriminate healthy controls from patients with multiple sclerosis and those with other neurologic diseases and to evaluate its specificity, sensitivity, and diagnostic accuracy.
MATERIALS AND METHODS:
One hundred fifteen subjects (54 with MS, 31 healthy controls, 30 with other neurologic diseases) underwent a blinded quantitative color Doppler sonography evaluation of cerebral venous blood outflow in the supine and sitting positions. An optimal difference value between the supine and sitting positions of the cerebral venous blood outflow cutoff value was sought.
The difference value between supine and sitting positions of the cerebral venous blood outflow was ≤ 503.24 in 38/54 (70.37%) patients with MS, 9/31 (29.03%) healthy controls, and 13/30 (43.33%) subjects with other neurological diseases. A difference value between supine and sitting positions of the cerebral venous blood outflow at a 503.24 cutoff reached a sensitivity at 70.37%, a 70.96% specificity, a 80.85% positive predictive value, and a 57.89% negative predictive value; the quantitative color Doppler sonography parameters yielded significant differences. The difference value between supine and sitting positions of cerebral venous blood outflow ≤ 503.24 assessed the significant difference between MS versus other neurological diseases.
Alteration of cerebral venous blood outflow discriminated MS versus other neurologic diseases and MS versus healthy controls. The difference value between supine and sitting positions of cerebral venous blood outflow ≤ 503.24 was statistically associated with MS.
1 - this is not done by CCSVI researchers
2 - they attribute the difference in outflow as being due to autonomic impairment in the MS patients
3 - it is confirmation that you can distinguish between people with and without MS by measuring the blood flow
4 - let's say they are right that it is autonomic dysregulation that is causing blood flow abnormalities in the MS patients, then there might be a cumulative effect in those patients if there is also outflow obstructions in the veins
5 - there are reports of improvement in autonomic dysfunction after angioplasty treatment
6 - exciting times, exciting research. This research supports what we've been saying (and acting on) for five years now