CCSVI, Hypoperfusion and MS

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

Severity of CCSVI Linked to Hypoperfusion in People with MS

Postby Shayk » Sun Feb 21, 2010 9:19 am

Bump, bump, bump......

Ok folks, the abstracts for the April AAN meeting are available for viewing. :) I've found a total of 3 directly linked to CCSVI, here's one that I think belongs in this thread--the n was 16 MS; 8 healthy controls.

P03.128 Hypoperfusion of Brain Parenchyma Is Strongly Associated with the Severity of Chronic Cerebrospinal Venous Insufficiency in Patients with Multiple Sclerosis
CONCLUSIONS/RELEVANCE: This study demonstrates that severity of CCSVI is directly associated with hypoperfusion of the brain parenchyma in MS. Supported by: Hillarescere Foundation and Buffalo Neuroimaging Analysis Center.

I couldn't find any info that the abstracts were under embargo until date/time of presentation so trust they're ok to post--I didn't see any further info on the preliminary Buffalo results.

If for some reason the links don't work, try going to AAN 2010, scroll down to "Search the 2010 Scientific Program", you'll be asked to agree to the terms of viewing before proceeding, the search box is at the top.

Ka ching--we're rocking on! :D Take care all

Sharon
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Postby ozarkcanoer » Sun Feb 21, 2010 10:14 am

Thanks, Saron !!

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Postby pegmegrund » Sun Feb 21, 2010 2:13 pm

Thank you for posting this!
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Postby cheerleader » Wed Mar 03, 2010 9:22 pm

Here is Dr. Simka's new paper on hypoperfusion-

link

Love this thread, Shayk :)
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Must read....

Postby Hope66 » Mon Mar 15, 2010 4:38 pm

Bumping this thread up for folks like me who were so taken by the drainage issue that I didn't pay much attention to hypoperfusion. It is truly fascinating and relevent and WOW.

Thanks Cheer, for kindly directing me back towards this thread. I very much appreciate it.

be well all,
Hope
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Postby cheerleader » Mon Mar 15, 2010 5:13 pm

Hi Hope...
glad you liked this thread! It's a personal fav. I believe this correction of slowed perfusion and slow MTT is why my husband had immediate relief from his crippling fatigue after his bilateral jugular stenting. It was instantaneous (he says he was on the table and felt a change as the stent was inserted) Almost a year later, the return of his energy and oomph is the most profound benefit of his treatment. His overactive bladder, sleep apnea and nighttime spasms are gone, too- thereby he has deeper and more restful sleep. (He also has not progressed or relapsed and is doing really well.) Can't wait for his one year MRI next month!
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Postby cheerleader » Tue May 11, 2010 9:20 am

Thought perhaps it was time to bump this oldie but goodie....
especially for all our new visitors.
enjoy!
cheer
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Postby robbie » Tue May 11, 2010 10:06 am

slowed perfusion and slow MTT

could there be any connection to CCSVI if your Mean Transit Time is faster not slower??? but your jugular is still narrowed?
Had ms for over 19 years now.
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Postby cheerleader » Tue May 11, 2010 12:45 pm

robbie wrote:
slowed perfusion and slow MTT

could there be any connection to CCSVI if your Mean Transit Time is faster not slower??? but your jugular is still narrowed?


hmmm...interesting question, Robbie. Usually stenosis is related to slower perfusion and slower MTT- I dunno. Will see if I can find any info. Nice to see your name over here!

Here's a terrific paper explaining MR perfusion technology and how radiologists measure perfusion time and why it's important. Here's the section that deals with arterial stenosis (not the same as venous, but a comparable mechanism)

MR perfusion imaging is useful not only in the assessment of stroke, but also in the assessment of stroke risk. Under normal circumstances, the brain has an autoregulatory mechanism for maintaining adequate cerebral oxygenation in the face of decreasing cerebral perfusion pressure, which allows normal blood flow despite fluctuations in systemic pressure. This mechanism may be impeded in patients with hemodynamically significant carotid artery stenosis who are at high risk for stroke. The ability to maintain an autoregulatory response to hemodynamic stress has been termed "cerebrovascular reserve capacity." Areas of the brain supplied by a markedly stenotic or occluded artery, in which vasodilatation has already occurred to maintain adequate flow, lack cerebrovascular reserve capacity. ....In addition to a poor response to a vasodilatory challenge, perfusion imaging may show other abnormalities in the cerebral hemisphere ipsilateral to a severe carotid stenosis or occlusion, such as delayed bolus arrival time and prolonged mean transit time [42, 43] (Fig. 6A,6B,6C,6D).

http://www.ajronline.org/cgi/content/full/175/1/207

Here's the abstract for the latest paper linking CCSVI/MS and hypoperfusion, presented at the AAN meeting in April:

Hypoperfusion of Brain Parenchyma Is Strongly Associated with the Severity of Chronic Cerebrospinal Venous Insufficiency in Patients with Multiple Sclerosis.

OBJECTIVE: To investigate the relationship between chronic cerebrospinal venous insufficiency (CCSVI) and cerebral perfusion in patients with multiple sclerosis (MS). BACKGROUND: CCSVI is a vascular condition described in MS patients, characterized by stenoses of the main extracranial veins with hampered cerebral venous outflow. We hypothesized that the impaired venous outflow contributes to hypoperfusion of brain parenchyma. DESIGN/METHODS: Sixteen consecutive relapsing-remitting MS patients (mean age 36.1yrs, mean disease duration 7.5yrs and median EDSS 2.5) and 8 age- and sex-matched normal controls (NC), were scanned on a GE 3T scanner using dynamic susceptibility contrast enhanced perfusion-weighted imaging (PWI). Cerebral blood flow (CBF), blood volume (CBV) and mean transit time (MTT) were measured in the gray matter (GM), white matter (WM), normal appearing (NA) GM, NAWM, thalamus, caudate, putamen, globus pallidus, hippocampus, amygdala, nucleus accumbens, red nucleus and substantia nigra. Diagnosis of CCSVI was established based on the venous hemodynamic (VH) Doppler criteria (Zamboni, JNNP, 2009) and the severity was based on fulfilled VH criteria (score 0-5) and VH insufficiency severity score (VHISS) (score 0-16). RESULTS: All 16 MS patients fulfilled the diagnosis of CCSVI (median VH=4, median VHISS=9) and none of the NC. There was a significant association between VH criteria and VHISS, and CBF, CBV and MTT in all examined regions of the brain parenchyma in MS patients. The most robust correlations were observed for lower CBF and higher VHISS in the GM, WM, NAGM and NAWM (r= -0.70 to -0.72, p<0.002), and in the thalamus, caudate, putamen, hippocampus, nucleus accumbens (r= -0.6 to -0.72, p<0.008). The correlation coefficients for CBV and MTT were in a range between r= -0.5 to -0.65. No relationship was observed for NC. CONCLUSIONS/RELEVANCE: This study demonstrates that severity of CCSVI is directly associated with hypoperfusion of the brain parenchyma in MS. Supported by: Hillarescere Foundation and Buffalo Neuroimaging Analysis Center.


link
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Postby Brightspot » Tue May 11, 2010 1:46 pm

Thanks folks, for bumping this important information into the path of those of us who had missed it.
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Postby ndwannabe » Tue May 11, 2010 3:07 pm

cheerleader wrote:Thought perhaps it was time to bump this oldie but goodie....
especially for all our new visitors.
enjoy!
cheer


Very timely, Cheer. Thank you.
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Postby cheerleader » Fri Nov 05, 2010 2:39 pm

Bump for new folks....
still my fav.
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slowed perfusion

Postby ThisIsMA » Sun Nov 07, 2010 1:06 am

Thank you for bumping this thread! I hadn't seen it yet. After learning about CCSVI last year I went back and looked at my MRI written comments, and found that I have "slowed perfusion" and "dawnson's fingers". It seemed like a clue that I might have CCSVI.

Its fanastic to learn that there has been an actual study linking slowed perfusion to CCSVI. Wow!!! There is hope that I might have something fixable!

Oh, and to read the part in this thread about a link between hypoperfusion and cognative issues, that gave me a chill. Cog fog and fatigue are my two biggest issues. Wow.
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Postby Cece » Sun Nov 07, 2010 8:50 am

Mine too, ThisisMA. One thing that I found especially convincing about CCSVI when I first heard it was how it clicked right into place with all the bits and pieces of info we already had about MS.
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Re: slowed perfusion

Postby cheerleader » Sun Nov 07, 2010 9:00 am

ThisIsMA wrote:Thank you for bumping this thread! I hadn't seen it yet. After learning about CCSVI last year I went back and looked at my MRI written comments, and found that I have "slowed perfusion" and "dawnson's fingers". It seemed like a clue that I might have CCSVI.
.


Cece and ThisIs--glad this thread has helped. The Haacke protocol will now be measuring perfusion pre and post angioplasty. I might humbly suggest that everyone interested in learning about CCSVI take some time, read the papers and absorb the information Sharon, Marie and I presented.
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