CCSVI: How RRMS becomes SPMS

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.
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vesta
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CCSVI: How RRMS becomes SPMS

Post by vesta »

The French Neurologist Jean-Martin Charcot, practicing at the Parisian la Pitié-Salpetrière hospital, first described Multiple Sclerosis (Sclérose en Plaques) in 1868. Among other things, he defined MS as a “rigidity disorder”. He thus set the tone in the Neurology profession of an unfortunate prejudice towards MS patients by claiming their “rigidity” symptoms were psychological in origin - signs of neurotic (usually female) hysteria. I now believe it is just this rigidity which is at the root of MS progression, but its origin is physiological, NOT psychological. Damaged nerves send “misfired” signals to the muscles which cramp and/or go into spasms. As the nervous system degenerates, the body becomes increasingly rigid, compressed as it is by muscles in spasm. And it is just this rigidity which triggers the process damaging to the central nervous system.

Let’s backtrack a bit.

As early as 1863 the Swiss pathologist George Edward Rindfleisch observed that MS lesions clustered around the brain’s draining veins. Disparate testimonies of this phenomena continued to surface thereafter, but it was only in 2008 that the Italian Professor Paolo Zamboni published a paper on the Internet offering an explanation. He described a condition he has named CCSVI in which venous blood “refluxes” into the Central Nervous System (CNS) owing to stenosed or damaged veins. These blood back jets injure the tissue which leads to inflammation of the myelin sheath and an immune system response. These early “attacks” describe relapse/remission MS (RRMS). Dr. Zamboni has thus discovered the origin of the “wound” which triggers the immune response.

Progressive MS presents the exception. My brief synopsis derived from MS UK’s site reads

“Primary Progressive MS (PPMS) concerns about 10 to 15% of MS cases. In contrast to RRMS (Relapse Remission) cases, the disease progresses continually without respite after striking an older population (age 40’ and 50’s). Unlike RRMS, there is little to no inflammation, there are fewer brain lesions, the lesions which do exist present fewer inflammatory cells, and more are found on the spinal cord than in the brain which leads to mobility problems. While PPMS cases exhibit less inflammation, there appears to be greater damage to the axons.”

PPMS patients are not included in MS drug research and treatment because both target the myelin damaging inflammation of RRMS. Now, if an entire subset of patients is excluded from research because they do not conform to the auto-immune theory of MS, maybe the theory itself is suspect.

Eventually RRMS may evolve into Secondary Progressive MS, meaning it resembles the primary form. I repeat. “there is little to no inflammation, there are fewer brain lesions, the lesions which do exist present fewer inflammatory cells, and more are found on the spinal cord than in the brain which leads to mobility problems. While PPMS cases exhibit less inflammation, there appears to be greater damage to the axons.”

What does this imply to me? It implies that the driving factor in progressive MS is no longer centered in obstructed venous blood flow but in a damaged spine and obstructed cerebro-spinal fluid circulation.

And here we can understand the MS positive feedback loop.

MS venous blood circulation is deficient for any number of reasons. A stress attack can trigger the blood “reflux” into the central nervous system (brain/spine) which inevitably damages the nerves. When the nerves are damaged, muscles cramp up, perhaps go into spasms. As the body freezes up, fluid circulation (blood/cerebrospinal fluid) slows setting the stage for the slightest stress event to trigger another “attack”. Thus each “attack” triggers muscle cramps and body rigidity which in turn sets the stage for more attacks. (I include ANY illness and/or toxicity as stress events. Also, poor blood circulation in the brain persists apart from occasional relapses so constant effort must be made to release body tension and blood/cerebrospinal fluid circulation.)

Eventually the body rigidity/muscle spasms deform and damage the spine by literally pulling the vertebrae out of alignment (among other things). (Consider the MS “hug”.) At this point it is no longer the blood reflux inflammation which “wound” the nerves but lesions and cerebrospinal fluid obstructions which impact the spine. We now have SPMS and increasing issues with mobility.

Obviously this implies that at the onset of RRMS one should make every effort to enhance blood/cerebrospinal fluid circulation through the brain/spinal cord in order to stop the blood “reflux” and the attendant muscle spasms/rigidity. I can see that had I known about CCSVI and followed the advice on this site 25 years ago, I wouldn’t need a cane today and needn’t worry now about the increasing rigidity in my spine.

I can also understand why “liberation therapy” (angioplasty) works best in the early RRMS phase when stenosed veins are the primary problem and treatment “liberates” the blood flow. One has thus prevented the wound. Once Progression sets in, there is little to no inflammation which implies that the veins are no longer the primary issue. In that case attention should focus on treating lesions on the spine or enhancing CSF flow. And since drug therapy focuses on the inflammation, none is proposed for Progressive MS."

Previously published on my site MSCure enigmas.net

At my request upright doc (Dr Flanagan) made the following comment on Dec 14, my comment of Dec 15 follows

QUOTE
It would take too long to comment on all of them but you make some interesting points.

I don't mean to toot my own horn but I started my researh in 1984 and published my first paper on the role of the vertebral veins in neurodegenerative diseases in 1987 long before Zamboni published his research. At the same time I described the role of the perivascular pathways and CSF as the lymph system of the brain and its importance to removal of wastes etc, decades before anything was mentioned about the glymphatic system. Considering Zamboni's theory versus mine, there are far more potential causes of venous insufficiency of the vertebral veins due to malformations, misalignments and deformation of the upper cervical spine than venous insufficiency due to malformation and blockage of the jugulars. Moreover, the vertebral veins are the primary drainage routes of the brain used during upright posture, not the jugulars and upright posture is used two-thirds of every day.

It was Schelling who introduced the term venous back jets not Zamboni. He attributed the violent back jets to trauma.

In addition to muscle spasms, muscle weakness can cause deformation of the spine. Most primary malformations, misalignments and deformation of the upper cervical spine, however, and spondylosis, scoliosis and stenosis in the lower spine in patients with MS are due to other causes not muscle spasms or weakness. Spasms and weaknesses cause secondary deformation.

It is wise to make every effort to enhance blood and cerebrospinal fluid circulation in all neurodegenerative diseases to provide nutrients and eliminate wastes, as well as inflammation.

Swimming and aqua therapy are terrific for many neurological disorders.[/quote]

Previously published on my site MS Cure Enigmas.net
http://www.mscureenigmas.net/ms-blog

My comment on Dec 15 This is ms
Thanks much for your response. Too bad I didn't know about your work in 1987, I could have avoided loss of function. You SHOULD toot your own horn (and I hope you will when I post this on Daily Kos next month - I'll let you know in advance should you wish to comment. My previous posts have brought out shills for the drug companies mostly.)
I'll give credit to Schelling for "back jet". Also especially to your work in structural issues. Somehow Zamboni's paper ignited general interest in blood/CSF circulation which DID change my life. I feel so much more confident that I can get some control over the disease process. There is an unfortunate tendency for allopaths to disdain Chiropractors (functional therapies). Your analyses provide a good explanation of why angioplasty can't work for many. I obviously don't know the technical details, but hope that other MSers can help themselves as I've been able to do with this bit of knowledge.
(role of fluid mechanics) I wrote another piece on MS Progression (Progressive MS and the Spine - Tims General discussion Dec 2, 2014) which I believe originates in spinal deformations. Anyway, thanks again. (I refer to your work often on my site, MS Cure Enigmas.net.)
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